综合基因组测序在检测人表皮生长因子受体2阳性结直肠癌中的应用
Utility of comprehensive genomic sequencing for detecting HER2-positive colorectal cancer.
作者信息
Shimada Yoshifumi, Yagi Ryoma, Kameyama Hitoshi, Nagahashi Masayuki, Ichikawa Hiroshi, Tajima Yosuke, Okamura Takuma, Nakano Mae, Nakano Masato, Sato Yo, Matsuzawa Takeaki, Sakata Jun, Kobayashi Takashi, Nogami Hitoshi, Maruyama Satoshi, Takii Yasumasa, Kawasaki Takashi, Homma Kei-Ichi, Izutsu Hiroshi, Kodama Keisuke, Ring Jennifer E, Protopopov Alexei, Lyle Stephen, Okuda Shujiro, Akazawa Kohei, Wakai Toshifumi
机构信息
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
出版信息
Hum Pathol. 2017 Aug;66:1-9. doi: 10.1016/j.humpath.2017.02.004. Epub 2017 Feb 22.
HER2-targeted therapy is considered effective for KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (CRC). In general, HER2 status is determined by the use of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Comprehensive genomic sequencing (CGS) enables the detection of gene mutations and copy number alterations including KRAS mutation and HER2 amplification; however, little is known about the utility of CGS for detecting HER2-positive CRC. To assess its utility, we retrospectively investigated 201 patients with stage I-IV CRC. The HER2 status of the primary site was assessed using IHC and FISH, and HER2 amplification of the primary site was also assessed using CGS, and the findings of these approaches were compared in each patient. CGS successfully detected alterations in 415 genes including KRAS codon 12/13 mutation and HER2 amplification. Fifty-nine (29%) patients had a KRAS codon 12/13 mutation. Ten (5%) patients were diagnosed as HER2 positive because of HER2 IHC 3+, and the same 10 (5%) patients had HER2 amplification evaluated using CGS. The results of HER2 status and HER2 amplification were completely identical in all 201 patients (P < .001). Nine of the 10 HER2-positive patients were KRAS 12/13 wild-type and were considered possible candidates for HER2-targeted therapy. CGS has the same utility as IHC and FISH for detecting HER2-positive patients who are candidates for HER2-targeted therapy, and facilitates precision medicine and tailor-made treatment.
HER2靶向治疗被认为对KRAS密码子12/13野生型、HER2阳性的转移性结直肠癌(CRC)有效。一般来说,HER2状态通过免疫组织化学(IHC)和荧光原位杂交(FISH)来确定。综合基因组测序(CGS)能够检测基因突变和拷贝数改变,包括KRAS突变和HER2扩增;然而,关于CGS在检测HER2阳性CRC中的效用知之甚少。为了评估其效用,我们回顾性研究了201例I-IV期CRC患者。使用IHC和FISH评估原发部位的HER2状态,同时也使用CGS评估原发部位的HER2扩增,并在每位患者中比较这些方法的结果。CGS成功检测到415个基因的改变,包括KRAS密码子12/13突变和HER2扩增。59例(29%)患者存在KRAS密码子12/13突变。10例(5%)患者因HER2 IHC 3+被诊断为HER2阳性,同样这10例(5%)患者经CGS评估存在HER2扩增。在所有201例患者中,HER2状态和HER2扩增的结果完全一致(P <.001)。10例HER2阳性患者中有9例为KRAS 12/13野生型,被认为可能是HER2靶向治疗的候选者。CGS在检测HER2靶向治疗候选的HER2阳性患者方面与IHC和FISH具有相同的效用,并有助于精准医学和量身定制的治疗。