Correlation of Lauren’s histological type and expression of E-cadherin and HER-2/neu in gastric adenocarcinoma

Khushboo Dewan, Renu Madan, Prasanta Sengupta


Background: To evaluate whether a proven association between clinicopathological features and expression of molecular markers could provide a clue towards the relevance of these markers in gastric adenocarcinoma (GAC).

Aims: The present study aimed to find any relation between immunohistochemical expression of E-cadherin and HER-2/neu proteins, and Lauren’s histological type and stages of GAC.

Materials and Methods: 100 cases of primary GAC diagnosed on biopsy or gastrectomy were included in the study. Immunohistochemical expression of E-cadherin and HER-2/neu was studied with respect to site, Lauren’s histological type, and stages of GAC.

Results: A total of 11 cases showed a loss of E-cadherin expression and 17 cases overexpressed HER-2/neu. Loss of E-cadherin was seen in 26% of Lauren’s diffuse type, but only in 5.7% of intestinal GAC (P=0.014). While 35% of the GAC present at greater curvature showed HER-2/neu overexpression, whereas 16% at antro-pyloric region and none at lesser curvature showed HER-2/neu overexpression (P=0.04). All of the 17 HER-2/neu overexpressing GAC were Lauren’s intestinal type (P=0.012).

Conclusion: Loss of E-cadherin and HER-2/neu overexpression are associated with Lauren’s diffuse and intestinal type respectively. Anti-HER-2/neu monoclonal antibody therapy would be helpful in approximately one-fifth of gastric adenocarcinoma patients.


Dewan K, Madan R, Sengupta P. IJPLM 2016;2(1):OA2. (Republished: 21 December 2016)


E-cadherin, Gastric adenocarcinoma, HER-2/neu, Lauren’s classification


1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global Cancer Statistics. CA Cancer J Clin 2011;61:69–90.

2. Lauren P. The histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965; 64: 31-49

3. Liu X, Chu K. E-cadherin and Gastric Cancer: Cause, Consequence, and Applications. BioMed Research International 2014, Article ID 637308, 9 pages. 2014/637308.

4. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO Classification of Tumours of the Digestive system 4th edition. IARC. Lyon 2010. Pg 48-63.

5. Ruschoff J, Hanna W, Bilous M, Hofmann M, Osamura RY, Penault-Llorca F, et al. HER2 testing in gastric cancer: a practical approach. Mod Pathol 2012; 25: 637–50.

6. Bang Y-J, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010 Aug 28;376(9742):687–97.

7. Berx G, Becker KF, Hofler H, van Roy F. Mutations of the human E-cadherin (CDH1) GENE. Hum Mutat 1998; 12:226-37.

8. Shimoyama Y, Hirohasht S. Expression of E- and P-Cadherin in gastric Carcinomas. Cancer Res. 1991;51:2185-92.

9. Xing XB, Tang YB, Yuan G, Wang YF, Wang JH, Yang Y, et al. The prognostic value of E-cadherin in gastric cancer: A meta-analysis Int J Cancer 2013:132, 2589–96.

10. Bukholm IK, Nesland JM, Boressen Dale AL. Re-expression of E-Cadherin, α-catenin and β- catenin, but not of γ- catenin, in metastatic tissue from breast cancer patients. J Pathol 2000;190:15-19.

11. Raziee HR, Kermani T, Ghaffarzadegan, Shageri T, Ghavamnasiri R. HER-2/neu expression in resectable gastric cancer and its relationship with histopathologic subtype, grade and stage. Iranian Journal of Basic Medical Sciences. 2007;10:139-45.

12. Lordick F, Bang YJ, Kang YK et al. HER2-positive advanced gastric cancer: similar HER2-positivity levels to breast cancer. Eur J Cancer 2007; 5(4): 271.

13. Lakshmi V, Valluru VR, Madhavi J, Valluru N. Role of Her 2 Neu in Gastric Carcinoma-3 Year Study in a Medical College Hospital Indian Journal of Applied Research 2014;4:47-50.

14. Rajagopal I, Niveditha SR, Sahadev R, Nagappa PK, Rajendra SG. HER 2 Expression in Gastric and Gastro-esophageal Junction (GEJ) Adenocarcinomas. Journal of Clinical and Diagnostic Research 2015; 9: 6-10.

15. Yonemura Y, Ninomiya I, Yamaguchi A, Fushida S, Kimura H, Ohoyama S, et al. Evaluation of immunoreactivity for erbB-2 protein as a marker of poor short term prognosis in gastric cancer. Cancer Res. 1991 Feb 1;51(3):1034–8.

16. Tanner M, Hollmén M, Junttila TT, Kapanen AI, Tommola S, Soini Y, et al. Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIalpha gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol. 2005 Feb;16(2):273–8.