人表皮生长因子受体 2 在微乳头状和其他变异型尿路上皮癌中的过表达。

Human Epidermal Growth Factor Receptor 2 Overexpression in Micropapillary and Other Variants of Urothelial Carcinoma.

机构信息

Department of Pathology, Istanbul Education and Research Hospital, Ministry of Health, Istanbul, Turkey.

Department of Pathology, Medical Faculty, Dokuz Eylül University, lzmir, Turkey.

出版信息

Eur Urol Focus. 2018 Apr;4(3):399-404. doi: 10.1016/j.euf.2016.06.007. Epub 2016 Jun 21.

DOI:10.1016/j.euf.2016.06.007

PMID:28753766

Abstract

BACKGROUND

Human epidermal growth factor receptor 2 (HER2) protein overexpression or gene amplification has been shown in urothelial bladder cancer. This could be helpful when using targeted anti-HER2 therapy on these tumors.

OBJECTIVE

To evaluate HER2 immunohistochemical expression in conventional urothelial carcinoma (UC), in situ UC, and UC variants primarily in micropapillary urothelial carcinoma (MPUC).

DESIGN, SETTING, AND PARTICIPANTS: The study evaluated 60 MPUC cases; 25 invasive, 20 low-grade noninvasive, and 10 high-grade noninvasive UC cases; 8 in situ UC cases; and 69 UC variant cases. The immunohistochemistry staining was scored according to recommendations of the American Society of Clinical Oncology/College of American Pathologists 2013 HER2 test guideline established for breast cancer and only 3+ staining was considered HER2 overexpression.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

HER2 overexpression was determined by 3+ staining.

RESULTS AND LIMITATIONS

34 of 60 MPUC cases (56%) showed HER2 overexpression (3+ staining). We observed 3+ staining HER2 overexpression in nine of 25 conventional invasive UC cases (36%), four of eight in situ UC cases (50%), and three of six lipid cell variant cases (50%). 3+ staining HER2 overexpression was not seen in eight glandular, six small cell, and five sarcomatoid variant cases. HER2 overexpression was negative in the 20 low-grade noninvasive UC cases but positive in two of the 10 high-grade noninvasive UC cases (20%). We observed HER2 overexpression most commonly in MPUC cases. We also found HER2 overexpression in conventional invasive and in situ UC cases.

CONCLUSIONS

Pure in situ UC and conventional invasive UC, especially MPUC, could be candidate tumors for treatment with anti-HER2 antibody (trastuzumab therapy).

PATIENT SUMMARY

Targeted therapy has a limited place in treatment of bladder cancer. In this study, human epidermal growth factor receptor 2 (HER2) overexpression in bladder carcinomas was evaluated in a large number of cases. Anti-HER2 therapy could be used in bladder cancers, as in breast and gastric cancers.

摘要

背景

人表皮生长因子受体 2（HER2）蛋白过表达或基因扩增已在膀胱癌中被发现。这对于这些肿瘤使用靶向抗 HER2 治疗可能会有帮助。

目的

评估常规尿路上皮癌（UC）、原位 UC 和 UC 变体（主要为微乳头状尿路上皮癌[MPUC]）中 HER2 的免疫组化表达。

设计、地点和参与者：该研究评估了 60 例 MPUC 病例；25 例浸润性、20 例低级别非浸润性和 10 例高级别非浸润性 UC 病例；8 例原位 UC 病例；和 69 例 UC 变体病例。免疫组织化学染色根据美国临床肿瘤学会/美国病理学家学院 2013 年乳腺癌 HER2 检测指南的建议进行评分，仅 3+染色被认为是 HER2 过表达。

测量结果和统计分析

通过 3+染色确定 HER2 过表达。

结果和局限性

60 例 MPUC 病例中有 34 例（56%）显示 HER2 过表达（3+染色）。我们观察到 25 例常规浸润性 UC 病例中有 9 例（36%）、8 例原位 UC 病例中有 4 例（50%）和 6 例脂质细胞变体病例中有 3 例（50%）存在 3+染色 HER2 过表达。8 例腺性、6 例小细胞和 5 例肉瘤样变体病例未见 3+染色 HER2 过表达。20 例低级别非浸润性 UC 病例 HER2 过表达阴性，但 10 例高级别非浸润性 UC 病例中有 2 例阳性（20%）。我们观察到 HER2 过表达最常见于 MPUC 病例。我们还发现常规浸润性和原位 UC 病例中存在 HER2 过表达。