Xu Yan, Yang Wentao, Yang Fei, Lu Yongming, Cai Xu, Zhou Xiaoyan
Department of Pathology, Cancer Hospital, Fudan University and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Department of Pathology, Cancer Hospital, Fudan University and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China. E-mail:
Zhonghua Bing Li Xue Za Zhi. 2014 Apr;43(4):226-30.
To compare dual-color in-situ hybridization (DISH) with fluorescence in situ hybridization(FISH) in evaluating the human HER2 gene status in invasive breast cancer.
HER2 gene status in 110 cases of breast invasive ductal carcinomas with a 2+ score on immunohistochemistry (IHC) was investigated by FISH and DISH. The 2007 and 2013 ASCO (American Society of Clinical Oncology)/CAP (College of American Pathologists) HER2 guideline were used respectively to evaluate the agreement between these two techniques.
(1) Using the 2007 ASCO/CAP guideline, the overall concordance between FISH and DISH was 97.3% (107/110). Fifty of 51 samples with amplification by FISH were also detected by DISH and the remaining one sample was equivocal.Eight of 10 equivocal samples by FISH were equivocal by DISH and the remaining two samples were negative. Forty-nine samples with no amplification by FISH were all negative by DISH. The concordance was 98.0%, 8/10 and 100.0% respectively for the FISH positive, equivocal and negative groups. (2) Using the 2013 ASCO/CAP guideline, the overall concordance between FISH and DISH was 90.0% (99/110). Fifty-three of 55 samples with amplification by FISH were also detected by DISH and the remaining two were equivocal and negative respectively. Two of 12 equivocal samples by FISH were equivocal by DISH and the remaining ten samples were negative in 7 cases and equivocal in 3 cases. Forty-three samples with no amplification by FISH were all negative by DISH. The concordance was 96.4%, 3/12 and 100.0% respectively for the FISH positive, equivocal and negative groups. Pearson correlation analysis indicated that the HER2 status detected by FISH and DISH were significantly correlated with each other (R=0.584, P<0.01).
There is a high concordance between DISH and FISH for assessing the HER2 gene status in invasive breast cancer. DISH is a new option for assessing HER2 gene status of breast cancer in clinical practice. The clinical significance of the discordance between DISH and FISH in equivocal cases warrants further study.
比较双色原位杂交（DISH）与荧光原位杂交（FISH）评估浸润性乳腺癌中人类HER2基因状态的效果。
采用FISH和DISH检测110例免疫组化（IHC）评分为2+的乳腺浸润性导管癌患者的HER2基因状态。分别依据2007年和2013年美国临床肿瘤学会（ASCO）/美国病理学家学会（CAP）的HER2指南评估这两种技术之间的一致性。
（1）依据2007年ASCO/CAP指南，FISH与DISH的总体一致性为97.3%（107/110）。FISH检测出的51例扩增样本中，50例也被DISH检测到，剩余1例结果不明确。FISH检测出的10例结果不明确样本中，8例DISH检测结果也不明确，其余2例为阴性。FISH检测无扩增的49例样本，DISH检测均为阴性。FISH阳性、结果不明确和阴性组的一致性分别为98.0%、8/10和100.0%。（2）依据2013年ASCO/CAP指南，FISH与DISH的总体一致性为90.0%（99/110）。FISH检测出的55例扩增样本中，53例也被DISH检测到，其余2例分别为结果不明确和阴性。FISH检测出的12例结果不明确样本中，2例DISH检测结果也不明确，其余10例样本中7例为阴性，3例结果不明确。FISH检测无扩增的43例样本，DISH检测均为阴性。FISH阳性、结果不明确和阴性组的一致性分别为96.4%、3/12和100.0%。Pearson相关分析表明，FISH和DISH检测的HER2状态彼此显著相关（R=0.584，P<0.01）。
DISH与FISH在评估浸润性乳腺癌HER2基因状态方面具有高度一致性。DISH是临床实践中评估乳腺癌HER2基因状态的一种新选择。DISH与FISH在结果不明确病例中不一致的临床意义值得进一步研究。
