Yao J G, Wang C H, Liu Y
Department of Pathology, the Second Affiliated Hospital of Jiaxing University of Zhejiang Province, Jiaxing 314000, China.
Zhonghua Bing Li Xue Za Zhi. 2017 Apr 8;46(4):245-248. doi: 10.3760/cma.j.issn.0529-5807.2017.04.006.
To study the clinical significance of HER2 overexpression and/or amplification in gallbladder adenocarcinoma. HER2 staining was performed on 123 cases of gallbladder adenocarcinoma specimens by IHC using scoring criteria for gastric cancer. FISH test was performed on the IHC score 2+ and 3+ cases and the results were correlated with clinicopathological findings. In total of 123 cases of gallbladder adenocarcinomas, HER2 amplification detection rate was 22.0%(27/123). Among 27 cases with HER2 gene amplification, 5 cases were IHC 2+ (5/12) and 22 cases were IHC 3+ (91.7%, 22/24), and the concordance rates between IHC and FISH were 41.7%and 91.7% respectively. The heterogeneity of HER2 expression was observed in 3 cases with complete strong cell membrane staining but the number of stained cells of<10%.Among them, 1 case showed HER2 gene amplification. The difference of HER2 gene amplification in well, moderately and lowly differentiated tumors has statistical significance(χ=24.4, <0.01), and its detection rate was related to the degree of tumor differentiation (=0.45). About 20% gallbladder adenocarcinomas have HER2 positivity, providing the targeted therapy implicationfor these patients.IHC HER2 scoring system for gastric carcinoma is suitable for gallbladder carcinoma. However, the cases with complete strong membrane staining but in <10% tumor cells should be included in the 2+ score IHC group.
研究HER2过表达和/或扩增在胆囊腺癌中的临床意义。采用胃癌评分标准，对123例胆囊腺癌标本进行免疫组化HER2染色。对免疫组化评分2+和3+的病例进行荧光原位杂交（FISH）检测，并将结果与临床病理特征进行相关性分析。123例胆囊腺癌中，HER2扩增检出率为22.0%（27/123）。在27例HER2基因扩增病例中，免疫组化2+的有5例（5/12），免疫组化3+的有22例（91.7%，22/24），免疫组化与FISH的符合率分别为41.7%和91.7%。3例出现HER2表达异质性，细胞膜呈完全强染色，但染色细胞数<10%，其中1例显示HER2基因扩增。高、中、低分化肿瘤中HER2基因扩增差异有统计学意义（χ=24.4，<0.01），其检出率与肿瘤分化程度相关（=0.45）。约20%的胆囊腺癌存在HER2阳性，为这些患者提供了靶向治疗依据。胃癌免疫组化HER2评分系统适用于胆囊癌。然而，细胞膜呈完全强染色但肿瘤细胞数<10%的病例应纳入免疫组化2+评分组。
