Qiu Zhejun, Sun Weidong, Zhou Chengzhong, Zhang Jiandong
Hepatogastroenterology. 2015 Jan-Feb;62(137):231-3.
BACKGROUND/AIMS: The efficacy of anti-HER2 therapy is mainly dependent on HER2 overexpression in the metastatic lesions. It is essential to decipher the heterogeneity of gene profiles between primary tumor and matched metastases in gastric cancer.
The frequency of HER2 expression in 100 gastric cancers of both primary tumors and corresponding multiple lymph node metastases were determined immunohistochemically. A modified HER2-scoring criteria by Hofmann et al recommended for gastric cancer were followed in our study, which considers basolateral, so-called "U-shape", HER2-expression as positive.
HER2 overexpression (2+, 3+) was seen in 33.0% of primary gastric cancers and 39.4% of the corresponding metastatic lymph nodes. For the first time, we compare HER2 expression heterogeneity among different lymph node metastases in the same patient, for the cases with 2 or more metastatic lymph nodes, HER2 expression discordance among the nodes was observed in 25.3% of the cases.
HER2 overexpression was seen in one-third of primary gastric cancers with lymph node metastases. As the receptor expression may lose or gain in the metastases at a probability of approximately 30%, assessment of the receptor status in metastatic lesions is encouraged.
背景/目的：抗HER2治疗的疗效主要取决于转移性病变中HER2的过表达。解读胃癌原发肿瘤与配对转移灶之间基因谱的异质性至关重要。
采用免疫组织化学方法测定100例胃癌原发肿瘤及相应多个淋巴结转移灶中HER2的表达频率。本研究遵循了Hofmann等人推荐的用于胃癌的改良HER2评分标准，该标准将基底外侧所谓的“U形”HER2表达视为阳性。
33.0%的原发性胃癌和39.4%的相应转移性淋巴结中可见HER2过表达（2+、3+）。我们首次比较了同一患者不同淋巴结转移灶之间的HER2表达异质性，对于有2个或更多转移性淋巴结的病例，25.3%的病例观察到各淋巴结之间HER2表达不一致。
三分之一伴有淋巴结转移的原发性胃癌中可见HER2过表达。由于转移灶中受体表达可能以约30%的概率丢失或获得，因此建议评估转移性病变中的受体状态。
