Xue Jinbing, Ma Houshi, Zhang Xiaoliang, Wang Shun, Wang Jinxian, Li Zeqin, Wu Xi, Yang Tianhang, Zhang Changsong, Luo Gangyin
Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China.
Suzhou ZhongKe Medical Device Industry Development Co., Ltd, Suzhou, 215163, China.
Appl Biochem Biotechnol. 2025 Apr 30. doi: 10.1007/s12010-025-05233-0.
Targeted therapy is essential for the 15-30% invasive breast cancer patients with human epidermal growth factor receptor 2 (HER2) over-expression. However, current HER2 diagnosing methods rely on complex manual works and highly subjective interpretations. To more accurately and objectively assess the HER2 amplification status of formalin fixed paraffin embedded (FFPE) samples, a droplet digital PCR (ddPCR) assay based on multi-reference genes was developed. We established a four-fluorescence ddPCR assay using breast cancer cell lines (T-47D and SK-BR-3) and validated it on 101 clinical breast cancer FFPE samples. Compared to clinicopathological results, the ddPCR assay based on two out of three reference genes demonstrated superior sensitivity (82.6%), specificity (98.7%), and consistency (95.0%) in determining HER2 status over assays using single or three reference genes. Whole genome sequencing of the abnormal cases further confirmed that the ddPCR assay outperformed clinical immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and quantitative PCR (qPCR) in accuracy. Our findings demonstrate that the multi-reference gene ddPCR assay significantly improves the accuracy of HER2 status detection and reduces errors associated with chromosome 17 abnormalities. This method holds promise as a complementary or alternative approach to conventional IHC and FISH testing in tissue biopsies and is also feasible for liquid biopsies.
靶向治疗对于15%至30%的人表皮生长因子受体2(HER2)过表达的浸润性乳腺癌患者至关重要。然而,目前的HER2诊断方法依赖于复杂的手工操作和高度主观的解读。为了更准确、客观地评估福尔马林固定石蜡包埋(FFPE)样本的HER2扩增状态,开发了一种基于多参考基因的液滴数字PCR(ddPCR)检测方法。我们使用乳腺癌细胞系(T-47D和SK-BR-3)建立了一种四荧光ddPCR检测方法,并在101例临床乳腺癌FFPE样本上进行了验证。与临床病理结果相比,基于三个参考基因中的两个的ddPCR检测方法在确定HER2状态方面,相较于使用单个或三个参考基因的检测方法,表现出更高的灵敏度(82.6%)、特异性(98.7%)和一致性(95.0%)。对异常病例的全基因组测序进一步证实,ddPCR检测方法在准确性方面优于临床免疫组织化学(IHC)、荧光原位杂交(FISH)和定量PCR(qPCR)。我们的研究结果表明,多参考基因ddPCR检测方法显著提高了HER2状态检测的准确性,并减少了与17号染色体异常相关的误差。这种方法有望作为组织活检中传统IHC和FISH检测的补充或替代方法,并且对于液体活检也是可行的。