Objective  This study aimed to validate the accuracy and validity of Her-2 assessment used for endoscopic biopsies and lymph node metastases by comparing these samples with the surgical materials obtained from the same patients.This study also aimed to analyze the relationship between primary tumor and clinicopathological characteristics of gastric cancer.

  Methods  Her-2 status was evaluated according to Gastric cancer Her-2 testing guidelines in 107 cases of gastric cancers with coupled endoscopic biopsies and surgical materials and in 76 cases of the corresponding lymph node metastases.

  Results  were then compared and analyzed.

  Results  The complete concordance of the Her-2 status of endoscopic biopsies and surgical samples (n=107) was noted in 86.9% of the cases.This result is consistent between the two different samples (Z=6.381 3, P < 0.000 1).Primary gastric cancer and the corresponding lymph node metastases also displayed uniformity (Z=3.027 4, P=0.002 5).The positive rate of Her-2 was significantly associated with Lauren type, tumor histological grade, depth of invasion, lymph node metastasis, and TNM stage.

  Conclusion  A high concordance was observed between primary tumor and biopsy specimen (endoscopic biopsies and lymph node metastases), in which Her-2 status exhibited a high predictive value.Her-2 status is correlated with invasion and cancer metastasis.Hence, the most appropriate criteria for Her-2 status assessment in lymph nodes should be considered to improve the Her-2 diagnosis system of gastric cancer.