Department of Pathology, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Gastroenterological Surgery, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey.
Indian J Pathol Microbiol. 2022 Apr-Jun;65(2):321-327. doi: 10.4103/IJPM.IJPM_535_20.
HER2-targeted therapy has been shown to benefit HER2-positive gastric cancer. It is very important to determine the HER2 expression level correctly to select the appropriate test and sampling method.
In this study, we investigated the frequency of overexpression of HER2 and intratumoral heterogeneity of HER2-positive cases, comparison of HER2 used immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) performance in biopsy and resection specimens, the correlation of HER2 status between biopsy and resection specimens, and its relationship with clinicopathological findings.
Formalin-fixed, paraffin-embedded specimens of a total of 40 surgically resected and biopsy specimens of gastric cancer were analyzed. HER2 status was examined using both IHC and FISH techniques, and the findings and their association with different clinicopathological parameters were evaluated.
The concordance rate between the results of IHC and FISH in biopsy and resection specimens was 96.6% and 86.6%, respectively. In paired 20 cases, the overall concordance rate of HER2-IHC and HER2-FISH status between biopsy and resection specimens was 90% and 100%, respectively. HER2-IHC analysis revealed that 5/40 cases were IHC 2+ and only 1 of 5 IHC 2+ cases demonstrated HER2-FISH amplification.
Our results showed that HER2-IHC was well concordant with FISH in cases with a score of 0/1+ or 3+ and demonstrates strong concordance between biopsy and resection specimens. FISH should be performed when the IHC result is equivocal. In our study, no statistically significant correlation was observed between HER2 positivity and clinicopathological parameters. Overall, both biopsy and resection specimens are appropriate for HER2 testing.
曲妥珠单抗靶向治疗已被证明对 HER2 阳性胃癌有效。正确确定 HER2 表达水平对于选择合适的检测和采样方法非常重要。
本研究旨在调查 HER2 过表达的频率和 HER2 阳性病例的肿瘤内异质性，比较活检和切除标本中免疫组织化学（IHC）和荧光原位杂交（FISH）检测 HER2 的性能，分析活检和切除标本中 HER2 状态的相关性及其与临床病理特征的关系。
分析了总共 40 例手术切除和胃癌活检的福尔马林固定、石蜡包埋标本。使用 IHC 和 FISH 技术检测 HER2 状态，并评估其与不同临床病理参数的关系。
活检和切除标本中 IHC 和 FISH 结果的一致性率分别为 96.6%和 86.6%。在 20 对配对标本中，活检和切除标本中 HER2-IHC 和 HER2-FISH 状态的总体一致性率分别为 90%和 100%。HER2-IHC 分析显示，40 例中有 5 例为 IHC 2+，而 5 例 IHC 2+中仅有 1 例显示 HER2-FISH 扩增。
我们的结果表明，HER2-IHC 与 0/1+或 3+评分的 FISH 结果具有良好的一致性，并显示出活检和切除标本之间具有很强的一致性。当 IHC 结果不确定时，应进行 FISH 检测。在我们的研究中，HER2 阳性与临床病理参数之间未观察到统计学显著相关性。总体而言，活检和切除标本均适合进行 HER2 检测。
