Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Via Gramsci 14, Parma 43126, Italy.
Br J Cancer. 2011 Apr 26;104(9):1372-6. doi: 10.1038/bjc.2011.121. Epub 2011 Apr 12.
Trastuzumab has recently shown efficacy in the treatment of HER2-positive advanced gastric adenocarcinoma. Although antibody-based therapies target the metastatic disease, HER2 status is usually evaluated in the primary tumour because metastatic sites are rarely biopsied. The aim of this study was to compare HER2 status in primary and paired metastatic sites of gastric adenocarcinoma.
The HER2 status was assessed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in 72 secondary lesions of gastric adenocarcinoma and in the corresponding primary tumours.
Concordance of FISH results, evaluable in 68 primary and matched metastatic sites, was 98.5%. Concordance of IHC results, available in 39 of the 72 paired cases, was 94.9%. Only one case showed discordance between primary tumour and metastasis, being negative by both IHC and FISH in the primary and showing HER2 overexpression and amplification in the corresponding pancreatic lymph node metastasis.
The high concordance observed between HER2 results obtained by both IHC and FISH on primary tumours and corresponding metastases suggests that in gastric cancer HER2 status is maintained in most cases unchanged during the metastatic process.
曲妥珠单抗最近在治疗 HER2 阳性晚期胃腺癌方面显示出疗效。虽然抗体类药物针对转移性疾病，但由于很少对转移部位进行活检，因此通常在原发性肿瘤中评估 HER2 状态。本研究的目的是比较胃腺癌的原发性和配对转移性部位的 HER2 状态。
通过荧光原位杂交（FISH）和免疫组织化学（IHC）评估 72 例胃腺癌的继发性病变和相应的原发性肿瘤中的 HER2 状态。
可评估的 68 例原发性和配对转移性部位中，FISH 结果的一致性为 98.5%。39 对配对病例中，IHC 结果的一致性为 94.9%。仅 1 例原发性肿瘤和转移灶之间存在不一致性，原发性肿瘤的 IHC 和 FISH 均为阴性，而相应的胰腺淋巴结转移灶显示 HER2 过表达和扩增。
原发性肿瘤和相应转移灶中通过 IHC 和 FISH 获得的 HER2 结果之间观察到的高度一致性表明，在大多数情况下，胃腺癌的 HER2 状态在转移过程中保持不变。
