Giuliani Silvia, Ciniselli Chiara Maura, Leonardi Elena, Polla Enzo, Decarli Nicola, Luchini Claudio, Cantaloni Chiara, Gasperetti Fabio, Cazzolli Daniela, Berlanda Gabriella, Bernardi Daniela, Pellegrini Marco, Triolo Renza, Ferro Antonella, Verderio Paolo, Barbareschi Mattia
Unit of Surgical Pathology, Santa Chiara Hospital, Largo Medaglie Oro 9, 38122, Trento, Italy.
Unit of Medical Statistics, Biometry and Bioinformatics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Virchows Arch. 2016 Jul;469(1):45-50. doi: 10.1007/s00428-016-1940-y. Epub 2016 Apr 21.
Human epithelial growth factor receptor 2 (HER2) overexpression and/or amplification is of predictive and prognostic value in infiltrating breast carcinoma (IBC). We evaluated the proportion of HER2-positive cases (score 3 overexpression/score 2 plus fluorescence in situ hybridization (FISH) amplification) in a consecutive series of 2163 patients. According to immunohistochemical analysis of HER2 expression, using Herceptest and FDA criteria, 839 cases had score 0, 476 score 1+, 699 score 2+, and 149 score 3+. Of the 699 scoring 2+ cases, 160 (22.88 %) showed Her2 gene amplification by FISH analysis, making a total of 309 (14.28 %) HER2-positive cases. Grade 1 ductal and special type IBC were never HER2 positive, while only three infiltrating lobular carcinomas but a relevant percentage of small IBC were HER2 positive. Of HER2-positive cases, 52.1 % was pT1 and of these, 38.5 % was pT1b or smaller. Logistic regression analysis revealed that estrogen receptor (ER), progesterone receptor (PgR), grade, and pT were significantly associated with HER2 positivity and that HER2 3+ cases were more frequently of higher grade and pT than HER2 2+/Her2 amplified cases. In addition, HER2 3+ cases were more frequently in ER and PgR negative than HER2 2+/Her2 amplified cases. We conclude that the proportion of HER2 positive cases is lower than that reported in older literature and that pathological characteristics differ between HER2 3+ and HER2 2+/Her2 amplified cases.
人表皮生长因子受体2（HER2）过表达和/或扩增在浸润性乳腺癌（IBC）中具有预测和预后价值。我们评估了连续2163例患者中HER2阳性病例（评分3过表达/评分2加荧光原位杂交（FISH）扩增）的比例。根据使用Herceptest和FDA标准对HER2表达进行的免疫组织化学分析，839例评分为0分，476例评分为1+分，699例评分为2+分，149例评分为3+分。在699例评分为2+的病例中，160例（22.88%）通过FISH分析显示Her2基因扩增，使HER2阳性病例总数达到309例（14.28%）。1级导管癌和特殊类型IBC从未HER2阳性，而只有3例浸润性小叶癌，但相当比例的小IBC为HER2阳性。HER2阳性病例中，52.1%为pT1，其中38.5%为pT1b或更小。逻辑回归分析显示，雌激素受体（ER）、孕激素受体（PgR）、分级和pT与HER2阳性显著相关，且HER2 3+病例比HER2 2+/Her2扩增病例更常为高分级和pT。此外，HER2 3+病例比HER2 2+/Her2扩增病例更常为ER和PgR阴性。我们得出结论，HER2阳性病例的比例低于旧文献报道，且HER2 3+和HER2 2+/Her2扩增病例的病理特征不同。
