Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL 32610-0275, USA.
Arch Pathol Lab Med. 2012 Jun;136(6):610-7. doi: 10.5858/arpa.2011-0371-OA.
Human epidermal growth factor receptor 2 (HER2/neu) is overexpressed in a proportion of gastroesophageal (GE) adenocarcinomas, and trastuzumab treatment results in significant improvement in overall survival in patients with HER2/neu-overexpressing GE tumors. Grading of HER2/neu expression in GE tumors and its clinical application is different from that of breast cancer. HER2/neu immunohistochemistry (IHC) image analysis (IA), widely used in breast cancer, has not been studied in GE tumors.
To evaluate the correlation between manual HER2/neu IHC scoring and HER2/neu IHC image analysis in GE adenocarcinomas with characterization of associated clinicopathologic features.
Tumor grade, growth pattern, and stage were evaluated in 116 cases of primary GE adenocarcinoma biopsy and resection specimens. Using anti-HER2/neu antibody and the proposed HER2/neu scoring system for gastric cancer, HER2/neu IHC expression was recorded after manual scoring and automated IA interpretation.
HER2/neu overexpression (IHC 3+) was detected in 19% (10 of 54) of gastric tumors, and overall correlation between manual HER2/neu IHC interpretation and IA interpretation was 78% (42 of 54). HER2/neu overexpression (IHC 3+) was detected in 26% (16 of 62) of GE junction tumors, and the overall correlation between manual HER2/neu IHC interpretation and IA interpretation was 84% (52 of 62).
The HER2/neu IHC scoring system for GE adenocarcinomas differs from that of breast carcinoma. Automated IA, validated for scoring of HER2/neu IHC in breast cancer, has a low correlation between HER2/neu IHC 2+ and IHC 3+ cases scored by conventional light microscopy and cannot be reliably used in the interpretation of HER2/neu IHC expression in GE adenocarcinomas.
人类表皮生长因子受体 2（HER2/neu）在一部分胃食管（GE）腺癌中过表达，曲妥珠单抗治疗可显著改善 HER2/neu 过表达的 GE 肿瘤患者的总生存期。GE 肿瘤中 HER2/neu 表达的分级及其临床应用与乳腺癌不同。HER2/neu 免疫组化（IHC）图像分析（IA）在乳腺癌中广泛应用，但尚未在 GE 肿瘤中进行研究。
评估 GE 腺癌中 HER2/neu IHC 手动评分与 HER2/neu IHC 图像分析之间的相关性，并对相关临床病理特征进行描述。
对 116 例原发性 GE 腺癌活检和切除标本进行肿瘤分级、生长模式和分期评估。使用抗 HER2/neu 抗体和胃癌 HER2/neu 评分系统，对 HER2/neu IHC 表达进行记录，分别采用手动评分和自动 IA 解读。
胃肿瘤中检测到 HER2/neu 过表达（IHC 3+）占 19%（54 例中的 10 例），手动 HER2/neu IHC 解读与 IA 解读的总相关性为 78%（54 例中的 42 例）。GE 连接部肿瘤中检测到 HER2/neu 过表达（IHC 3+）占 26%（62 例中的 16 例），手动 HER2/neu IHC 解读与 IA 解读的总相关性为 84%（62 例中的 52 例）。
GE 腺癌的 HER2/neu IHC 评分系统与乳腺癌不同。经验证可用于乳腺癌 HER2/neu IHC 评分的自动化 IA，与传统光学显微镜下 HER2/neu IHC 2+和 IHC 3+病例的评分相关性较低，不能可靠地用于 GE 腺癌中 HER2/neu IHC 表达的解读。
