Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
J Breast Cancer. 2011 Dec;14(4):276-82. doi: 10.4048/jbc.2011.14.4.276. Epub 2011 Dec 27.
Valid determination of HER2 status is a prerequisite to establish an adequate treatment strategy for breast cancer patients, regardless of the disease stage. The goal of this study was to examine the feasibility of the newly developed silver-enhanced in situ hybridization (SISH) technique as an alternative to fluorescence in situ hybridization (FISH) for HER2 assay in primary invasive breast cancer.
FISH and SISH for HER2 amplification were performed using tissue microarray. Both methods were used in 257 consecutive primary breast cancers.
HER2 amplification was observed in 62 (23.1%) of a total of 257 breast cancers based on SISH. Of the 257 breast cancers measured using both methods, the results of the two methods were consistent in 248 (concordance, 96.5%; kappa=0.903). When we compared HER2 amplification in the primary tumor with the metastatic lymph nodes of the same patients, HER2 amplification was observed in nine cases (14.0%) out of 64 cases in which HER2 was not amplified in the primary tumors. In contrast, HER2 status was completely preserved in metastatic lymph nodes showing HER2 amplification in the primary tumor.
These results indicate that SISH can be a feasible alternative to FISH in the clinical setting. In node-positive breast cancer, confirmation of the HER2 status of the metastatic lymph nodes appears to be mandatory, regardless of the HER2 status of the primary tumors.
HER2 状态的准确测定是制定乳腺癌患者治疗策略的前提，无论疾病分期如何。本研究旨在评估新型银增强原位杂交（SISH）技术替代荧光原位杂交（FISH）检测原发性浸润性乳腺癌 HER2 扩增的可行性。
使用组织微阵列对 FISH 和 SISH 进行 HER2 扩增检测。两种方法均应用于 257 例连续原发性乳腺癌。
基于 SISH，共 257 例乳腺癌中有 62 例（23.1%）HER2 扩增。对 257 例同时用两种方法检测的乳腺癌进行比较，两种方法的结果一致（一致性，96.5%；kappa=0.903）。对同一患者的原发肿瘤和转移淋巴结的 HER2 扩增进行比较，在 64 例原发肿瘤中 HER2 未扩增的病例中，有 9 例（14.0%）淋巴结发生 HER2 扩增。相反，在原发肿瘤中 HER2 扩增的淋巴结中，HER2 状态完全保留。
这些结果表明，SISH 可作为临床 FISH 的一种可行替代方法。在淋巴结阳性的乳腺癌中，无论原发肿瘤的 HER2 状态如何，对转移淋巴结的 HER2 状态进行确认似乎是必要的。
