Department of Pathology, The Ohio State University Wexner Medical Center, Columbus.
Am J Clin Pathol. 2019 Jun 5;152(1):17-26. doi: 10.1093/ajcp/aqz012.
The 2018 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) human epidermal growth factor receptor 2 (HER2) guideline focused update revises the HER2 scoring criteria. We evaluated the impact on HER2 rates in breast carcinoma diagnosed at our center.
In a retrospective series of breast core biopsies with invasive carcinoma diagnosed between 2014 and 2017 (n = 1,350), HER2 status was classified according to 2013 and 2018 ASCO/CAP guidelines and changes in HER2 status identified.
The 2018 guidelines reclassified the HER2 status of 6% of patients. Most changed from HER2 equivocal status (equivocal by immunohistochemistry and fluorescence in situ hybridization under the 2013 guidelines) to HER2-negative status (2018 guidelines). The HER2-positive rate decreased by 0.4%.
The 2018 guidelines decrease the rate of HER2 equivocal and positive breast cancer and reduce repeat HER2 testing on excision specimens. Approximately 0.4% of patients will become newly ineligible for anti-HER2 therapy.
2018 年美国临床肿瘤学会/美国病理学家协会（ASCO/CAP）人表皮生长因子受体 2（HER2）指南重点更新修订了 HER2 评分标准。我们评估了其对本中心诊断的乳腺癌中 HER2 率的影响。
在一项回顾性系列研究中，纳入了 2014 年至 2017 年间诊断的 1350 例浸润性乳腺癌的核心活检，根据 2013 年和 2018 年 ASCO/CAP 指南对 HER2 状态进行分类，并确定了 HER2 状态的变化。
2018 年指南重新分类了 6%的患者。大多数患者从 2013 年指南下免疫组织化学和荧光原位杂交 HER2 不确定状态（equivocal）转变为 HER2 阴性状态（2018 年指南）。HER2 阳性率下降了 0.4%。
2018 年指南降低了 HER2 不确定和阳性乳腺癌的发生率，并减少了切除标本上重复的 HER2 检测。约 0.4%的患者将新不符合抗 HER2 治疗的条件。
