Gülten Gülsün, Yilmaz Bayram, Demirkan Neşe Çalli
Department of Pathology, Şanlıurfa Training and Research Hospital, 63250 Şanlıurfa, Turkey.
Department of Pathology, Hitit University Erol Olçok Training and Research Hospital, 19040 Çorum, Turkey.
Oncol Lett. 2020 Aug;20(2):1897-1905. doi: 10.3892/ol.2020.11731. Epub 2020 Jun 11.
Detecting the amplification and expression of human epidermal growth factor receptor (HER2) is important for planning trastuzumab treatment for patients with gastric carcinoma. The present study aimed to analyse HER2 amplification and expression in primary gastric adenocarcinoma tumours and metastatic lymph nodes using microarray methods, and to assess the potential contribution of these methods to treatment planning. In total, 60 patients with lymph node metastasis were included in the present study. Microarray blocks were obtained from the tissue blocks of primary tumours and metastatic lymph nodes. HER2 expression and amplification were investigated using immunohistochemical and silver hybridisation (SISH) methods, respectively. Following immunohistochemical evaluation of HER2 in primary tumours, the sensitivity and specificity of the microarray method relative to the single block method were 69 and 100%, respectively. For HER2 detection in microarray block sections from primary tumours, the sensitivity and specificity of the SISH method relative to immunohistochemistry were 56 and 100%, respectively. When using SISH in microarray blocked sections, there was a high degree of concordance (98% concordance rate) between HER2 amplification in the primary tumour and the metastatic lymph node. Furthermore, the sensitivity and specificity of metastatic lymph node results relative to those of the primary tumour were 100 and 98%, respectively. Overall, the single block method was more reliable compared with the microarray method for planning treatment. When microarray blocking was used, a large number of samples must be tested to ensure reliable results. The immunohistochemical method is recommended as the first step as SISH alone increases the risk of false-negative results. Assessing HER2 amplification for treatment planning would be beneficial for primary tumours, as well as metastatic lymph nodes.
检测人表皮生长因子受体（HER2）的扩增和表达对于为胃癌患者制定曲妥珠单抗治疗方案具有重要意义。本研究旨在使用微阵列方法分析原发性胃腺癌肿瘤和转移性淋巴结中HER2的扩增和表达，并评估这些方法对治疗方案制定的潜在贡献。本研究共纳入60例有淋巴结转移的患者。微阵列块取自原发性肿瘤和转移性淋巴结的组织块。分别使用免疫组织化学和银原位杂交（SISH）方法研究HER2的表达和扩增。在对原发性肿瘤中的HER2进行免疫组织化学评估后，微阵列方法相对于单块方法的敏感性和特异性分别为69%和100%。对于原发性肿瘤微阵列块切片中的HER2检测，SISH方法相对于免疫组织化学的敏感性和特异性分别为56%和100%。在微阵列块切片中使用SISH时，原发性肿瘤和转移性淋巴结中HER2扩增之间存在高度一致性（一致率为98%）。此外，转移性淋巴结结果相对于原发性肿瘤结果的敏感性和特异性分别为100%和98%。总体而言，在制定治疗方案时，单块方法比微阵列方法更可靠。使用微阵列包埋时，必须检测大量样本以确保结果可靠。由于单独使用SISH会增加假阴性结果的风险，因此建议将免疫组织化学方法作为第一步。评估HER2扩增以制定治疗方案对原发性肿瘤以及转移性淋巴结均有益。
