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- Title
Human epidermal growth factor receptor 2 testing in gastric carcinoma: issues related to heterogeneity in biopsies and resections.
- Authors
Lee, Stephen; de Boer, Willem Bastiaan; Fermoyle, Soraya; Platten, Michael; Kumarasinghe, Marian Priyanthi
- Abstract
Lee S, de Boer W B, Fermoyle S, Platten M & Kumarasinghe M P (2011) Histopathology 59, 832-840 Human epidermal growth factor receptor 2 testing in gastric carcinoma: issues related to heterogeneity in biopsies and resections Aims: To assess human epidermal growth factor receptor 2 (HER2) status and heterogeneity using immunohistochemistry (IHC) and silver in-situ hybridization (SISH) in gastric carcinoma and dysplasia, and to correlate HER2 status between biopsy and resection specimens of gastric carcinoma. Methods and results: Immunohistochemistry for HER2 was performed in 178 cases of gastric carcinoma, and SISH in cases showing at least 1+ reaction. HER2 positivity [European Medicines Agency (EMA) guidelines] was identified in 20.2% of carcinomas and 12.9% of high-grade dysplasia, and HER2 heterogeneity noted in 50% and 33% of these cases, respectively. IHC negative/positive reactivity and SISH results were concordant in 96.2%. SISH amplification was seen in 35.3% of IHC 2+ and in a case with previously unrecognized staining pattern. Concordance of IHC HER2 status on biopsies and gastrectomies was seen in 74.1%. False negative IHC results on either the biopsy or gastrectomy were seen in 19.4% of HER2 amplified cases. Conclusions: Human epidermal growth factor receptor 2 status in gastric carcinoma is comparable to previous studies with good concordance between IHC and SISH; all IHC 2+ and unusual patterns should be assessed with ISH studies; heterogeneity of tumour HER2 overexpression/amplification is common with possible implications for HER2 testing; and HER2 overexpression appears sufficiently specific to be considered a potential diagnostic biomarker of dysplasia.
- Subjects
HER2 protein; GASTROINTESTINAL cancer; GASTRECTOMY; STOMACH biopsy; IMMUNOHISTOCHEMISTRY; DIAGNOSTIC use of in-situ hybridization; REACTIVITY (Chemistry); DYSPLASIA; GENETICS
- Publication
Histopathology, 2011, Vol 59, Issue 5, p832
- ISSN
0309-0167
- Publication type
Article
- DOI
10.1111/j.1365-2559.2011.04017.x