RESUMEN
@#【Objective】To explore a simple positive contrast method for better quality control of HER2 immunohisto⁃ chemistry.【Methods】Breast cancer radical treatment specimens from Anhui Cancer Hospital from January 2015 to December 2018 were collected. Among these specimens，20 tumor samples with HER2 expression of 3+ were selected and prepared into tissue suspension. HER2 expression in cancer cells was confirmed by HE staining and immunohisto⁃ chemical staining respectively，and verified again after 1 month and 3 months. Wax blocks with HER2 expression of 0， 1+，2+ and 3+ in breast cancer and gastric cancer，were selected from archived database for HER2 staining comparison with the suspension as a contrast.【Results】The HER2 localization of cancer cells in 20 tissue suspension was clear，the staining intensity was 3+. The staining effect of tissue suspension was as same after 3 months，and could provide positive reference for HER2 staining of breast cancer and gastric cancer.【Conclusion】The HER2 positive contrast of tissue suspension could be used as immunohistochemical internal quality control，which is simple，reliable，practical，and easy to popularize.
RESUMEN
@#Introduction: Evaluation of HER2 status in breast cancer using immunohistochemistry (IHC) and in-situ-hybridisation (ISH) study is important to establish prognosis and to select patient for targeted therapy. Objective: The study aims to determine the concordance between HER2 protein IHC score and its gene status by dual-colour dual-hapten in-situ-hybridization (DDISH) study. Materials and Methods: Retrospective study was performed on 767 referred breast cancer cases over a period of five years. The HER2 IHC score (the initial and repeat test score) and the results of HER2 gene status by DDISH were retrieved from the histopathological reports. The agreement between initial IHC score with repeat test score was measured using Cohen Kappa. Chi square test analyzed the association between HER2 IHC score with its gene status by DDISH. Results: The concordance of HER2 IHC score between the initial and repeat test were 52.7% and 89.4% for IHC score 2+ and 3+ respectively. There was moderate agreement of HER2 IHC score between the initial and repeat test score (κ = 0.526, p<0.001). A significant association noted between HER2 IHC score with its gene status by DDISH (p<0.001). Only 56 out of 207 cases (27.1%) with 2+ IHC score showed HER2 gene amplification while the majority of cases with 3+ IHC score were gene-amplified (446 out of 451, 98.9%). Conclusion: ISH study should be done in all IHC-equivocal cases (2+) to select patient for targeted therapy. Gene amplification must also be confirmed in IHC-positive cases (3+) to prevent from giving non-effective treatment with possible adverse effects to patient with nonamplified HER2 gene.
Asunto(s)
Neoplasias de la MamaRESUMEN
Introducción: La amplificación del oncogen HER2 en adenocarcinoma gástrico fue descrita en 1986, predominantemente en los del tipo intestinal. La identificación de los carcinomas gástricos avanzados con alteraciones de HER 2 es esencial en la práctica clínica diaria, ya que estas neoplasias requieren un tratamiento específico de elección. Después de la publicación del ensayo ToGA sobre la expresión de HER2 en cáncer gástrico avanzado y de la unión gastroesofágica se hace necesario divulgar en nuestro medio la importancia de la determinación confiable de esta alteración. Material y métodos: En esta parte establecemos los requerimientos metodológicos que se requieren para que el estudio del HER2 sea confiable y permita establecer el uso de la terapia adecuada. Consta de una fase pre analítica y una fase analítica propiamente dicha, en tal sentido el papel de los gastroenterólogos y cirujanos en la toma de las muestras y el manejo de las piezas quirúrgicas es definitivamente crucial. Conclusiones: El objetivo de este consenso es dar conocer a gastroenterólogos, cirujanos, oncólogos médicos y patólogos la importancia del manejo de los especímenes de biopsias endoscópicas y quirúrgicas, de acuerdo a normas estrictas que permitan la realización de estudios confiables. Por otra parte, se plantea instruir sobre la forma adecuada de interpretación de los estudios de inmunohistoquímica, en biopsias endoscópicas, resecciones mucosales endoscópicas (mucosectomías) y especímenes quirúrgicos por parte de los patólogos.
Introduction: HER2 oncogene amplification in gastric adenocarcinoma was described in 1986, predominantly in the intestinal type. The identification of advanced gastric carcinomas with HER2 abnormalities is essential in daily clinical practice, as these neoplasms require specific treatment election Afterward publication Toga trial on HER2 expression in advanced gastric cancer and the Union gastroesophageal is necessary in our country the determination of this alteration. Methods: In this section we establish the methodological requirements for the study of HER2 and permits the use of appropriate therapy. The methods consists of a Pre analytical phase and an analytical phase itself, in this regard the role of gastroenterologists and surgeons in making samples and handling of surgical specimens is definitely crucial. Conclusions: The aim of this agreement is to teach gastroenterologists, surgeons, medical oncologists and pathologists the importance of handling specimens and surgical endoscopic biopsies, according to strict standards that allow reliable studies. Moreover, there is instruction on the proper interpretation of immunohistochemical studies on endoscopic biopsy, endoscopic mucosal resection and surgical specimens by pathologists.