胃原发性癌与同步相关转移性淋巴结中 HER2 的不同失调。
Differing deregulation of HER2 in primary gastric cancer and synchronous related metastatic lymph nodes.
机构信息
Department of Digestive Surgery, Nihon University School of Medicine, 30-1OHyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
出版信息
Diagn Pathol. 2013 Nov 21;8:191. doi: 10.1186/1746-1596-8-191.
BACKGROUND
The aim of this study was to investigate how differences in expression of HER2 between primary gastric cancers (PGCs) and their corresponding metastatic lymph nodes (LMNs) might affect its potential as a prognostic indicator in treatments including anti-HER2 agents.
METHODS
The analysis was conducted in 102 patients who underwent surgical resection for primary gastric cancers (PGCs; adenocarcinoma, intestinal type) with synchronous LNMs. HER2 gene status and protein expression were investigated by immunohistochemistry (IHC) in all patients; fluorescence in situ hybridization (FISH) was performed in 22 patients. The correlation between HER2 gene status in PGCs and their LNMs was evaluated.
RESULTS
Positive HER2 expression as detected by IHC + FISH was observed in 27/102 PGC samples (26.5%) and 29/102 LNM samples (28.4%). HER2 amplification status in 102 paired PGC and LNM samples as evaluated by FISH + IHC was concordant in 92 patients (90.2%), 69 (67.6%) were unamplified and 23/102 (22.5%) were amplified at both sites, and discordant in 10 patients (9.8%), 4 (3.9%) were positive for PGC and negative for LNM, while 6 (5.9%) were positive for LNM and negative for PGC. The results of FISH + IHC showed very strong concordance in HER2 status between the PGC and LNM groups (k = 0.754).
CONCLUSION
The high concordance between HER2 results for PGCs and their LNMs indicates that assessment of HER2 status in the primary cancer alone is a reliable basis for deciding treatment with anti-HER2 agents in patients with LNMs from gastric adenocarcinoma.
VIRTUAL SLIDES
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9365749431029643.
背景
本研究旨在探讨胃原发性肿瘤（PGC）与相应转移性淋巴结（LMN）之间 HER2 表达差异如何影响其作为抗 HER2 治疗中预后指标的潜力。
方法
对 102 例接受胃原发性癌（腺癌，肠型）手术切除且伴同步 LMN 的患者进行了分析。对所有患者进行免疫组织化学（IHC）检测 HER2 基因状态和蛋白表达；22 例患者进行了荧光原位杂交（FISH）检测。评估了 PGC 与 LMN 之间 HER2 基因状态的相关性。
结果
在 102 例 PGC 样本中（26.5%）和 102 例 LNM 样本中（28.4%），通过 IHC+FISH 检测到阳性 HER2 表达。通过 FISH+IHC 评估 102 对 PGC 和 LNM 样本的 HER2 扩增状态，92 例（90.2%）患者结果一致，69 例（67.6%）为未扩增，23 例（22.5%）在两个部位均扩增，10 例（9.8%）患者结果不一致，4 例（3.9%）PGC 阳性而 LNM 阴性，6 例（5.9%）为 LNM 阳性而 PGC 阴性。FISH+IHC 结果显示，PGC 与 LNM 组 HER2 状态具有很强的一致性（k=0.754）。
结论
PGC 和 LNM 之间 HER2 结果的高度一致性表明，单独评估原发性肿瘤的 HER2 状态是决定 LNMs 来自胃腺癌患者接受抗 HER2 治疗的可靠基础。
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