HER2 expression in upper tract urothelial carcinoma and the relationship with clinicopathological characteristics-an analysis of 155 patients in Southwest China

World J Urol. 2024 Sep 13;42(1):521. doi: 10.1007/s00345-024-05222-8.

Abstract

Objective: We aimed to evaluate the expression of HER2 in patients with upper tract urothelial carcinoma (UTUC) in Southwest China by using a relatively large cohort, and to determine the relationship between HER2 expression and clinicopathological characters.

Materials and methods: We retrospectively enrolled the clinical data of 155 UTUC patients who have undergone radical nephroureterectomy (RNU) from March 2019 to September 2022. HER2 expression was assessed using immunohistochemistry and scored according to the HercepTest (Scores of 0 or 1 + were considered as negative and 2 + or 3 + as positive). Tumor molecular phenotype was classified by the panel of CK20, CK5/6, and CD44.

Results: HER2 was overexpressed in 55 (35.5%) patients. It was associated with pathologic characteristics such as grade (p = 0.017), tumor molecular phenotype (p < 0.001) and Ki-67 expression (p = 0.017). On univariate and multivariable logistic regression analysis, HER2 overexpression remained associated with higher grade (HR, 10.6; 95% CI 1.0-112.6; p = 0.050) and luminal molecular phenotype (HR, 8.0; 95% CI 1,6-38.4; p = 0.010). During disease progression after nephroureterectomy, the phenotype of the tumor might change and a switch phenomenon in phenotype after recurrence in the bladder was reported.

Conclusion: According to our study, in Southwest China, one-third of UTUC patients overexpressed HER2. Tumors with high grade or luminal phenotype tended to be HER2 positive. HER2 may represent a promising target for therapy in UTUC.

Keywords: Clinicopathological characteristics; HER2; Upper urinary tract urothelial carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell* / genetics
  • Carcinoma, Transitional Cell* / metabolism
  • Carcinoma, Transitional Cell* / pathology
  • Carcinoma, Transitional Cell* / surgery
  • China / epidemiology
  • Female
  • Humans
  • Kidney Neoplasms / genetics
  • Kidney Neoplasms / metabolism
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery
  • Male
  • Middle Aged
  • Receptor, ErbB-2* / genetics
  • Receptor, ErbB-2* / metabolism
  • Retrospective Studies
  • Ureteral Neoplasms* / genetics
  • Ureteral Neoplasms* / metabolism
  • Ureteral Neoplasms* / pathology
  • Ureteral Neoplasms* / surgery

Substances

  • ERBB2 protein, human
  • Receptor, ErbB-2