Department of Surgery II, Tokyo Women's Medical University, Tokyo, Japan.
Jpn J Clin Oncol. 2010 Jul;40(7):613-9. doi: 10.1093/jjco/hyq019. Epub 2010 Mar 4.
Breast cancer is a heterogeneous disease. The aim of this prospective study, in which fluorescence in situ hybridization was used to determine human epidermal growth factor receptor 2 status in primary breast cancers and in the lymph node metastases, was to verify the stability of human epidermal growth factor receptor 2 status in the following steps of neoplastic progression of breast cancer, which is fundamental for an appropriate therapeutic approach.
From patients with primary breast cancer, for whom, after January 2003, surgery was performed and involved metastatic lymph nodes were found, we randomly selected four groups of 15 patients, whose human epidermal growth factor receptor 2 score by immunohistochemistry was either 0, 1+, 2+ or 3+, respectively, totaling to 60. For each of those patients, their primary tumors and all of the metastatic lymph nodes were examined. Primary tumors and metastatic lymph nodes in each patient were examined by fluorescence in situ hybridization.
Of 18 patients with fluorescence in situ hybridization-positive primary tumors, 15 (83.3%) were fluorescence in situ hybridization-positive and 2 (11.1%) were fluorescence in situ hybridization-negative in all of their metastatic lymph nodes, and 1 (5.5%) patient had mixed (fluorescence in situ hybridization-positive or -negative) metastatic lymph nodes. Of 42 patients with fluorescence in situ hybridization-negative primary tumors, 40 (95%) were fluorescence in situ hybridization-negative and 2 (5%) fluorescence in situ hybridization-positive in all of their metastatic lymph nodes.
This study revealed that fluorescence in situ hybridization resulted in a high concordance of 83.3% between the human epidermal growth factor receptor 2 manifestation (fluorescence in situ hybridization-positive status) in primary tumors and that in metastatic lymph nodes, demonstrating that it is appropriate to determine whether and how to apply treatment by trastuzumab based on the results of evaluation of human epidermal growth factor receptor 2 expression.
乳腺癌是一种异质性疾病。本前瞻性研究的目的是，使用荧光原位杂交来确定原发性乳腺癌和淋巴结转移灶中的人表皮生长因子受体 2 状态，以验证乳腺癌肿瘤进展的以下步骤中人表皮生长因子受体 2 状态的稳定性，这对于适当的治疗方法至关重要。
从 2003 年 1 月后接受手术且存在转移性淋巴结的原发性乳腺癌患者中，我们随机选择了 4 组，每组 15 例，其免疫组织化学检测的人表皮生长因子受体 2 评分分别为 0、1+、2+或 3+，共 60 例。对每组患者的原发性肿瘤和所有转移性淋巴结进行了随机选择。对每例患者的原发性肿瘤和转移性淋巴结进行了荧光原位杂交检测。
在 18 例荧光原位杂交阳性的原发性肿瘤患者中，有 15 例（83.3%）所有转移性淋巴结的荧光原位杂交均为阳性，2 例（11.1%）为阴性，1 例（5.5%）患者的转移性淋巴结为混合性（荧光原位杂交阳性或阴性）。在 42 例荧光原位杂交阴性的原发性肿瘤患者中，有 40 例（95%）所有转移性淋巴结的荧光原位杂交均为阴性，2 例（5%）为阳性。
本研究表明，荧光原位杂交在原发性肿瘤和转移性淋巴结中人表皮生长因子受体 2 表现（荧光原位杂交阳性状态）之间具有 83.3%的高度一致性，表明基于人表皮生长因子受体 2 表达评估来确定是否以及如何应用曲妥珠单抗治疗是合适的。
