Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	126420
DOI	10.4251/wjgo.126420
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Gastric cancer with zero or low human epidermal growth factor receptor 2 expression: Clinicopathological features and prognosis
Manuscript Source	Unsolicited Manuscript
All Author List	Wei Du, Min Zhang, Jia-Xin Zhang, Xue Jiang, Quan Zhang and Zhong-Xin Shi
Funding Agency and Grant Number	Funding Agency Grant Number The Plan of Jilin Province for the Improvement of Health Science and Technology Capabilities No. 2025WS-KA022
Corresponding Author	Zhong-Xin Shi, Chief Physician, Department of Pathology, The Affiliated Hospital of Beihua University, No. 12 Jiefang Middle Road, Chuanying District, Jilin City 132013, Jilin Province, China. szx9640@163.com
Key Words	Human epidermal growth factor receptor 2-low expression; Human epidermal growth factor receptor 2-zero expression; Gastric cancer; Prognosis; Retrospective cohort study
Core Tip	Analysis of 202 surgically treated gastric cancer patients compared 94 human epidermal growth factor receptor 2 (HER2)-zero (immunohistochemistry 0) cases with 108 HER2-low (immunohistochemistry 1+ or 2+/in situ hybridization-negative) counterparts. Apart from a higher moderate-differentiation rate in the HER2-low group, the two cohorts were well-balanced across all other clinicopathological variables. The Kaplan-Meier curves for overall survival nearly overlapped (log-rank P = 0.995), with disease-free survival showing a similar null difference (log-rank P = 0.882). On multivariate Cox regression, HER2-low status yielded a hazard ratio of 1.03 (P ＝ 0.957), an essentially neutral estimate. Given only 17 death events, modest survival differences cannot be ruled out, yet within this cohort’s limits, HER2-low and HER2-zero tumours emerged as prognostically indistinguishable after gastrectomy. In practice, this means for post-gastrectomy patients, HER2 expression in the 0-to-low range should not shape prognostic expectations. Whether to consider HER2-directed agents should hinge on therapeutic eligibility rather than on presumed baseline risk.
Citation	Du W, Zhang M, Zhang JX, Jiang X, Zhang Q, Shi ZX. Gastric cancer with zero or low human epidermal growth factor receptor 2 expression: Clinicopathological features and prognosis. World J Gastrointest Oncol 2026; In press DOI: https://doi.org/10.4251/wjgo.126420
PDF	126420-in-press.pdf

Received	2026-08-05 11:23
Peer-Review Started	2026-08-05 11:23
First Decision by Editorial Office Director
Return for Revision	2026-08-31 03:18
Revised	2026-09-03 08:50
Publication Fee Transferred	2026-09-14 01:43
Second Decision by Editor	2026-10-22 03:01
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-22 09:14
Articles in Press	2026-10-22 09:14
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5204 (online)
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