Kimura Mikihiko, Tsuda Hitoshi, Morita Daisaku, Shinto Eiji, Tanimoto Takao, Ichikura Takashi, Mochizuki Hidetaka, Matsubara Osamu
Department of Pathology II, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Jpn J Clin Oncol. 2005 Jun;35(6):324-31. doi: 10.1093/jjco/hyi089. Epub 2005 May 31.
Our objective was to examine the utility of endoscopic biopsy specimens in judging the status of epidermal growth factor receptor (EGFR) and c-erbB-2 genes and proteins in the entire tumor.
Endoscopic biopsy specimens and specimens of whole representative cut surfaces of corresponding surgically resected tumors were obtained from 14 patients with gastric carcinoma, and immunohistochemistry and fluorescence in situ hybridization were then performed to determine the protein expression and gene amplification profiles, respectively, of EGFR and c-erbB-2 in these biopsy and surgical specimens.
Among the eight endoscopic biopsy specimens obtained from three gastric carcinomas in which EGFR protein overexpression and gene amplification were judged to be positive in the corresponding surgically resected tissue specimens, EGFR overexpression was detected in three specimens (38%), but EGFR amplification was not detected (0%). Among the 19 endoscopic biopsy specimens obtained from five gastric carcinomas in which c-erbB-2 protein overexpression and gene amplification were judged to be positive in the corresponding surgically resected tissue specimens, c-erbB-2 overexpression and amplification (c-erbB-2/CEP17 ratio) were detected in 14 (74%) and 16 (84%) specimens, respectively. All three cases with EGFR overexpression and all five cases with c-erbB-2 overexpression showed intratumor heterogeneity with regard to their EGFR and c-erbB-2 status, respectively.
The c-erbB-2 status could be adequately assessed not only by examining surgically resected materials, but also by examining multiple endoscopic biopsy specimens. On the other hand, to assess the EGFR status accurately, the use of surgically resected samples appeared to be more reliable than the use of multiple endoscopic biopsy samples.
我们的目的是研究内镜活检标本在判断整个肿瘤中表皮生长因子受体（EGFR）和c-erbB-2基因及蛋白状态方面的实用性。
从14例胃癌患者中获取内镜活检标本以及相应手术切除肿瘤的完整代表性切面标本，然后进行免疫组织化学和荧光原位杂交，分别测定这些活检和手术标本中EGFR和c-erbB-2的蛋白表达和基因扩增情况。
在从3例胃癌获取的8份内镜活检标本中，相应手术切除组织标本中EGFR蛋白过表达和基因扩增被判定为阳性，其中3份标本（38%）检测到EGFR过表达，但未检测到EGFR扩增（0%）。在从5例胃癌获取的19份内镜活检标本中，相应手术切除组织标本中c-erbB-2蛋白过表达和基因扩增被判定为阳性，分别有14份（74%）和16份（84%）标本检测到c-erbB-2过表达和扩增（c-erbB-2/CEP17比值）。所有3例EGFR过表达病例和所有5例c-erbB-2过表达病例在其EGFR和c-erbB-2状态方面分别显示出肿瘤内异质性。
不仅通过检查手术切除材料，而且通过检查多个内镜活检标本，均可充分评估c-erbB-2状态。另一方面，为准确评估EGFR状态，使用手术切除样本似乎比使用多个内镜活检样本更可靠。
