HER-2/neu expression in Premalignant and Malignant epithelial lesions of Uterine Cervix-A cross sectional study

Cervical cancer is a serious global public health issue that affects women. Worldwide cervical cancer was responsible for more than 340000 fatalities in 2020. It ranks second among those under 50 years old and the fourth most common cause of cancer related death in women overall.[1] 16 percent of all cervical cancer cases and 15.2 percent of all cervical cancer death worldwide occur in India, respectively. In India 122,844 women diagnosed with cervical cancer each year and 67,477 of these women dies as a result of the illness.Cervical cancer incidence peaks between the ages of 55 and 59 years. The high prevalence of cervical cancer in poor countries like India is mostly attributed to a lack of awareness campaign and official screening programmes as a result of which the majority of women present with cervical cancer in advanced stages. Cervical cancer is responsible for 90 percent of deaths in low and middleincome nations.[2] The primary etiological agent of cervical carcinogenesis is the human papilloma virus. It results in DNA damage, aberrant centrosomes, epigenetic alterations and DNA methylation.[2] Squamous morphology makes up about 70 percent of cervical carcinomas. Invasive carcinoma develops from premalignant cervical lesions over time. Therefore most lesions can be detected early on by screening programmes, before they progress to malignancy. Numerous tissue indicator has been investigated in cervical cancer, opening the door to targeted therapy and treatment for later stages of the condition. Oncogenes are the focus of extensive research into how different malignancies originate.The development of effective anti-cancer medicines depends critically on the discovery of novel markers with prognostic or predictive value. One of the growth receptor families that has been explored the most is the HER family.The c-erbB-2 proto-oncogene, also known by the name HER-2/neu,(HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR-2) is a gene on chromosome 17q21 that encode for growth factor receptor like molecule with tyrosine kinase activity. [3-4] Its structure is similar to that of the epidermal growth factor receptor and has 1255 aminoacids. Its expression is thought to be linked to poor prognosis, aggressive biological behaviour and propensity for metastasis in a number of human malignancies.[5] It has been noted that the majority of patients with IB to IIIB stage cancers do not respond to standard chemo-radiation based therapy. Molecular targeted medicines are currently seen as the next natural step in enhancing cervical cancer patient’s prognosis.[5] HER-2/neu expression in cervix lesion can help in the innovative therapeutic approaches and can be used as a guide to targeted therapies in case of carcinoma cervix. The expression of HER-2/neu in carcinoma cervix and their relationship with disease stage, grade and response to treatment is not well established in the current literature and very few studies have been conducted in this aspect. This study is undertakento determine the expression of HER-2/neu in pre malignant and malignant lesions of uterine cervix.