Predictive value of tumor budding and HER2/neu overexpression in gastric carcinoma: Preliminary findings from a tertiary care center

Gastric adenocarcinoma poses a significant global health challenge, highlighting the need for advanced prognostic markers to improve patient management. Tumor budding, defined by small clusters of dedifferentiated tumor cells at the invasive front, is increasingly recognized as a histopathological marker of aggressive tumor behaviour and poor clinical outcomes across several cancers. Similarly, HER2 Neu, a receptor tyrosine kinase involved in key signalling pathways, is crucial for gastric cancer progression and response to targeted therapies. This study aims to elucidate the prognostic value of tumor budding and HER2 Neu expression through comprehensive clinicopathological analysis. The cohort comprised 29 males (56%) and 23 females (44%), aged 32-77 years (mean 52 years). Weakness was the most common symptom (84.6%), while hematemesis was the least common (11.5%). The distal stomach was the most frequent tumor site (42%), followed by the body (33%). Tumor types included wall thickening (42.3%), ulceroproliferative (23.1%), solid (19.2%), and ulcerative (15.4%). Among the 52 cases, 26 were HER2 Neu positive and 26 were HER2 Neu negative. Most tumors were stage T3 (53.8%). A significant correlation between budding score and tumor stage (P = 0.008) was identified. Additionally, a statistically significant correlation was found between lymph node status and tumor budding score (P = 0.002). HER2 Neu status significantly correlated with tumor grade (P < 0.001). Six-month survival was inversely correlated with tumor budding score, though not significantly (P = 0.142), and HER2 Neu status did not significantly impact six-month survival (P = 0.375).