الفهرس | Only 14 pages are availabe for public view |
Abstract CRC is the third most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide. Globally, over 1.3 million new cases (9.7) were diagnosed and approximately 690,000 deaths (8.5 %) in 2014. In Egypt, CRC is the 7th commonest cancer in Egypt representing 3.4% of male cancers and 3% of female cancers. CRC presents with different symptoms depending on the region of origin in the colon and the stage at presentation. Initial symptoms of CRC may include microcytic anemia due to occult blood loss, fatigue, unintentional significant weight loss, abdominal colic, change in bowel habits. Surgery is the primary and curative treatment for CRC, and the role of postoperative chemotherapy to improve disease-free and overall survival for high-risk colorectal patients is well-established, but is still not able to prevent recurrence in all patients. So there are multiple ongoing researches for alternative compounds to be used as adjuvant therapy. One of these targets is HER2/neu, which is primarily associated with breast cancer. So, the aim of this study is to evaluate of HER2/ neu expression in patients with colorectal cancer and Its Relation to other clinicopathological variables and Prognostic Factors. Overexpression of the HER2/neu gene is an independent predictor of a shorter overall survival and time to relapse in patients with breast cancer. Several studies are done to evaluate HER2/neu in CRC which resulted in a large debate because expression rates varied between zero and 84%. Various therapeutic approaches are being tested in HER2/neu positive CRC patients (trastuzumab plus lapatinib),(trastuzumab plus pertuzumab), achieving clinical benefit in 70% of patients and an overall response rate of 30%. HER2/neu evaluation is done according to scoring of breast and gastric carcinoma. No other studies evaluate HER2/neu by the two methods. HER2/neu expression according to scoring of breast cancer was detected in 19 cases (31.6%) of patients with CRC. HER2/neu expression according to scoring of gastric carcinoma was detected in 12 patients (22.6%) of patients with CRC. There is no statistically difference between two methods as regard relation between HER2/neu and different clinicopathological features. HER2/neu overexpression is associated with higher TNM stages and positive nodal status. There is no statistically difference in OS and PFS. But, HER2/neu-positive CRCs showed a tendency to poorer survival. Although statistically in significant, Right-sided colon cancer tends to be poorer prognosis than Left-sided colon cancer. |