HER2/neu expression in Antral Metaplasia of Gall Bladder: An Original Study of 100 cases

A BSTRACT Introduction: Pathologic changes in gall bladder wall due to bile stasis can lead to metaplasia and dysplasia ultimately leading to adenocarcinoma of gall bladder as a part of multistep continuum. As clinical findings and radiological findings of Gall bladder neoplasms remain elusive, histopathological evaluation of mucosal changes in preneoplastic lesions of gall bladder such as antral metaplasia can establish a better understanding of its pathogenesis and improve patient outcome. HER2/neu is an epidermal growth factor receptor over expressed by aggressive breast cancers. It has clinical importance because of its prognostic value and treatment with a monoclonal antibody that targets the HER2 surface receptor often results in tumor regression. It is part of the targeted therapy used in treatment of many malignancies.Although HER2/neu expression has been studied in gall bladder neoplasms, so far studies on its expression in preneoplastic lesions is limited. Aim: To study the morphological findings and immunohistochemical expression of HER2/neu in histopathologically diagnosed cases of antral metaplasia of the gallbladder. Materials and Methods: Our study was a cross-sectional study comprising 100 cases of cholecystectomy specimens received for histopathological examination over a period of 1 year. Results: Out of the study population, 30 cases of antral metaplasia were recorded, of which 23 (76.7%) were female and 7 (23.3%) were male. The age ranged from 24 to 66 years. The mean age was 46.23 ± 12.35 years . One-third of the gallbladder neoplasms (33.34%) showed an adjacent mucosa with features of antral metaplasia. Weak positivity (1+) of HER2/neu was noted in 26.27% of cases of antral metaplasia. Conclusion: Gallbladder epithelium exhibiting antral metaplasia was not associated with HER2/neu expression.