Yau T K, Sze H, Soong Inda S, Hioe F, Khoo U S, Lee Anne W M
Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Hong Kong Med J. 2008 Apr;14(2):130-5.
To evaluate the prevalence of human epidermal growth factor receptor 2 (HER2) gene overexpression in breast cancer patients encountered in Hong Kong and the concordance of HER2 findings from primary immunohistochemistry assays and confirmatory in-situ hybridisation assays.
Retrospective study.
Department of Clinical Oncology in a public hospital in Hong Kong.
All patient referrals between July 2006 and June 2007 with newly diagnosed invasive breast cancer (for prevalence evaluation), and all patients treated at our unit with confirmatory in-situ hybridisation tests performed within the study period (for concordance evaluation).
There were 272 consecutive breast cancer patients eligible for prevalence evaluation. The distribution for immunohistochemistry staining in 249 cases for scores 0, 1+, 2+, and 3+ were 99 (40%), 40 (16%), 58 (23%), and 52 (21%) respectively. In the remaining 23 patients, four and 19 breast cancers were unscored and reported by immunohistochemistry to be HER2-positive and -negative, respectively. The overall HER2 overexpression rate (3+ or reported as positive) was 21%. HER2 overexpression was associated with grade 3 histology (P<0.001) and negative hormonal receptor status (P<0.001). However, it was not associated with age (P=0.525), T-classification (P=0.740), N-classification (P=0.691), nor group stages (P=0.433). Of the 37 patients with confirmatory in-situ hybridisation tests performed, 10 (71%) of 14 with immunohistochemistry staining of 3+ and 1 (4%) of 23 with immunohistochemistry staining of 2+ were found to have HER2 gene amplification.
More than 25% of HER2 overexpression identified by immunohistochemistry assays in this Hong Kong cohort could not be verified by confirmatory in-situ hybridisation assays. Compliance with the latest guidelines for HER2 testing should improve the future accuracy and concordance.
评估香港地区乳腺癌患者中人表皮生长因子受体2（HER2）基因过表达的患病率，以及原发性免疫组织化学检测结果与确证性原位杂交检测结果的一致性。
回顾性研究。
香港一家公立医院的临床肿瘤学系。
2006年7月至2007年6月间所有新诊断为浸润性乳腺癌的患者转诊病例（用于患病率评估），以及在研究期间接受我们科室确证性原位杂交检测的所有患者（用于一致性评估）。
共有272例连续的乳腺癌患者符合患病率评估条件。249例病例免疫组织化学染色评分为0、1+、2+和3+的分布分别为99例（40%）、40例（16%）、58例（23%）和52例（21%）。在其余23例患者中，4例和19例乳腺癌未评分，免疫组织化学报告分别为HER2阳性和阴性。HER2总体过表达率（3+或报告为阳性）为21%。HER2过表达与组织学3级（P<0.001）和激素受体阴性状态（P<0.001）相关。然而，它与年龄（P=0.525）、T分期（P=0.740）、N分期（P=0.691）或分组分期（P=0.433）无关。在进行确证性原位杂交检测的
