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Ciesielski M, Szajewski M, Walczak J, Pęksa R, Lenckowski R, Supeł M, Zieliński J, Kruszewski WJ. Impact of chromosome 17 centromere copy number increase on patient survival and human epidermal growth factor receptor 2 expression in gastric adenocarcinoma. Oncol Lett 2020; 21:142. [PMID: 33552261 PMCID: PMC7798021 DOI: 10.3892/ol.2020.12403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022] Open
Abstract
The accurate evaluation of human epidermal growth factor receptor 2 (HER2) status is essential for the appropriate use of targeted therapies. An increased number of chromosome 17 centromere enumeration probe (CEP17) signals may underrate fluorescence in situ hybridization (FISH) outcomes, resulting in false-negative or a false-equivocal HER2 status assessment. The aim of the present study was to assess the frequency of CEP17 copy number increase (CNI), its effects on HER2 protein expression (and the subsequent effects on tumor cells), and the survival outcomes of patients with gastric cancer. Archival primary tumor samples from 244 patients that underwent gastric resection for adenocarcinoma were retrieved for both HER2 protein expression analysis (using immunochemistry) and HER2 gene amplification (using FISH). The associations between HER2 status, CEP17 CNI and multiple clinicopathological parameters (including survival outcome), were assessed. The relationship between CEP17 CNI and HER2 protein upregulation was also investigated. CEP17 CNI was detected in 17.2% of cases, and a strong association between CEP17 CNI and HER2 upregulation was revealed. The impact of CEP17 CNI on survival did not reach statistical significance. Consequently, CEP17 CNI was discovered to be strongly associated with HER2 upregulation in tumor cells, which may characterize a critical issue in HER2 testing. Therefore, the eligibility for HER2-targeted agents in CEP17 CNI-positive patients warrants further recognition.
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Affiliation(s)
- Maciej Ciesielski
- Department of Oncological Surgery, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland.,Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Pomeranian Voivodship 80-210, Poland
| | - Mariusz Szajewski
- Department of Oncological Surgery, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland.,Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Pomeranian Voivodship 80-210, Poland
| | - Jakub Walczak
- Department of Oncological Surgery, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland
| | - Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Pomeranian Voivodship 80-210, Poland
| | - Radosław Lenckowski
- Department of Pathomorphology, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland
| | - Małgorzata Supeł
- Department of Pathomorphology, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland
| | - Jacek Zieliński
- Department of Oncological Surgery, Medical University of Gdańsk, Gdańsk, Pomeranian Voivodship 80-210, Poland
| | - Wiesław Janusz Kruszewski
- Department of Oncological Surgery, Gdynia Centre of Oncology, Pomeranian Hospitals, Gdynia, Pomeranian Voivodship 81-519, Poland.,Division of Propedeutics of Oncology, Medical University of Gdańsk, Gdańsk, Pomeranian Voivodship 80-210, Poland
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Reis APAM, Teixeira CMDS, Medeiros ARLD, Chaves KZC, Albuquerque CRD, Melo MR. Sociodemographic and Clinical-pathological Study of Molecular Subtitles of Breast Carcinoma in a Reference Unit of Maranhão. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:820-828. [PMID: 33348399 PMCID: PMC10309198 DOI: 10.1055/s-0040-1719147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To evaluate the distribution of the main sociodemographic and clinical-pathological characteristics in women with breast cancer according to the molecular profile by immunohistochemistry. METHODS A cross-sectional, retrospective, analytical and quantitative study was performed, with an analysis of 137 medical records from January 2015 to December 2018 of women attending the High Complexity in Oncology Unit of the city of Imperatriz, state of Maranhão, Brazil. The immunohistochemical profile of tumors based on the estrogen and progesterone receptor, Human Epidermal growth factor Receptor-type 2 (HER2) overexpression and Ki67 cell proliferation index was defined, from which six molecular subtypes were determined: luminal A, luminal B-HER2 negative, luminal B-HER2 positive, triple negative, overexpression of HER2 and inconclusive. RESULTS A total of 52.6% of the patients were postmenopausal, mean age 52.1 years old, brown (56.2%), had a schooling level < 9 years (40%), staging > IIB (52.6%) and 23.4% had metastasis. Invasive ductal carcinoma accounted for 84.7%, tumor size was 2 to 5 cm (48.9%), with lymph node involvement (56.2%), axillary lymphadenectomy in 67.2%, and mastectomy in 73.7% of the patients. The most frequent molecular subtype was the luminal B-HER2 negative (36.5%), and the luminal A subtype showed characteristics of better prognosis when compared with the others. CONCLUSION It was concluded that in the association of molecular subtypes with sociodemographic and clinical-pathological characteristics, there were no statistically significant results obtained, except for complementary therapy, referring to hormone therapy, and there was a high index of metastasis at diagnosis, which was a worrying factor and indicative of failures in the screening and early diagnosis of this population.
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Affiliation(s)
| | | | | | | | - Camila Rosa de Albuquerque
- Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brazil
| | - Mateus Rufino Melo
- Centro de Ciências Sociais, Saúde e Tecnologia, Universidade Federal do Maranhão, Imperatriz, MA, Brazil
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Pasricha S, Asthana S, Labani S, Kailash U, Srivastav A, Gupta G, Mehta A, Kamboj M. Impact of 2013 ASCO/CAP guidelines on various HER2 reporting categories in breast cancer by fluorescentin-situhybridization and Immunohistochemistry: A meta-analysis with systematic review. ACTA ACUST UNITED AC 2020. [DOI: 10.25259/ijmio_17_2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective:The ASCO/CAP guidelines for reporting HER2 in breast cancer, first released in 2007, aimed to standardize the reporting protocol, and were updated in 2013 and 2018, to ensure right treatment. Several studies have analyzed the changes attributed to 2013 updated guidelines, and majority of them found increase in positive and equivocal cases. However, the precise implication of these updated guidelines is still contentious, in spite of the latest update (2018 guidelines) addressing some of the issues. We conducted systematic review and meta- analysis to see the impact of 2013 guidelines on various HER2 reporting categories by both FISH and IHC.Materials and Methods:After extensively searching the pertinent literature, 16 studies were included for the systematic review. We divided our approach in three strategies: (1) Studies in which breast cancer cases were scored for HER2 by FISH or IHC as a primary test concurrently by both 2007 and 2013 guidelines, (2) Studies in which HER2 results were equivocal by IHC and were followed by reflex-FISH test by both 2007 and 2013 guidelines, and (3) Studies in which trends of HER2 reporting were compared in the two periods before and after implementation of updated 2013 guidelines. All the paired data in these respective categories was pooled and analyzed statistically to see the overall impact of the updated guidelines.Results:In the first category, by pooled analysis of primary FISH testing there has been a significant increase in the equivocal cases (P< 0.001) and positive cases (P= 0.037). We also found 8.3% and 0.8% of all the negative cases from 2007 guidelines shifted to equivocal and positive categories, respectively. Similarly by primary IHC testing there has been a significant increase in both equivocal cases (P< 0.001) and positive cases (P= 0.02). In the second category of reflex-FISH testing there was a substantial increase in the equivocal cases (P< 0.0001); however there is insignificant decrease (10% to 9.7%;P= 0.66) in the amplified cases. In the third approach for evaluating the trend, with the implementation of 2013 guidelines, there was increase in the equivocal category (P= 0.025) and positive category (P= 0.0088) by IHC. By FISH test also there was significant increase in the equivocal category (P< 0.001) while the increase in the positive category was non-significant (P= 0.159).Conclusions:The updated 2013 guidelines has significantly increased the positive and equivocal cases using primary FISH or IHC test and with further reflex testing, thereby increasing the double equivocal cases and increasing the cost and delaying the decision for definite management. However, whether the additional patients becoming eligible for HDT will derive treatment benefit needs to be answered by further large clinical trials.
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Affiliation(s)
- Sunil Pasricha
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India,
| | - Smita Asthana
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India,
| | - Satyanarayana Labani
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India,
| | - Uma Kailash
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India,
| | - Abhinav Srivastav
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India,
| | - Gurudutt Gupta
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India,
| | - Anurag Mehta
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India,
| | - Meenakshi Kamboj
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India,
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Yang L, Chen M, Pu T, Wu S, Wei B, Yang J, Bu H, Zhang Z. The differences of clinicopathologic characteristics among subgroups of reclassified HER2 fluorescence in situ hybridization (FISH) according to the ASCO/CAP 2018 breast cancer HER2 testing guidelines. J Clin Pathol 2019; 73:283-290. [DOI: 10.1136/jclinpath-2019-206222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 12/25/2022]
Abstract
AimsThe aim of this study is to analyse differences in clinicopathologic features among reclassified human epidermal growth factor receptor-2 (HER2) fluorescence in situ hybridization (FISH) results in breast cancers according to 2018 guidelines.MethodsAccording to different ratios of HER2 copy numbers to chromosome 17 centromere numbers (HER2/CEP17) and average HER2 copy numbers, 3795 invasive breast cancers were classified into six groups. Clinicopathologic features were collected and compared among different FISH groups.ResultsThere were no statistically significant differences about HER2 positive rate between 2013 and 2018 guidelines (p=0.518). After re-evaluating these cases according to 2018 guidelines, the cases that converted to a HER2 positive status had clinicopathologic features similar to samples in group 1 (ratio ≥2.0, HER2 ≥4.0). Compared with group 5 (ratio <2.0, HER2 <4.0), the cases in groups 1 had higher histological grade, more frequent occurrence of negative oestrogen receptor and progesterone receptor status and a higher Ki67 index. The samples in group 4 (ratio <2.0, 4.0≤HER2<6.0) showed a higher histological grade and higher Ki67 index than did the samples in group 5 but had a lower histological grade and lower Ki67 index than did the samples in group 1a (ratio ≥2.0, HER2 ≥6.0).ConclusionDifferent categories of HER2 FISH test results have significant differences in clinicopathologic features. With no equivocal cases in 2018 HER2 guidelines, the clear division of HER2 status is helpful for making treatment recommendations about HER2 targeted therapy.
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Schneider F, Jin Y, Van Smaalen K, Gulbahce EH, Factor RE, Li X. The FDA-Approved Breast Cancer HER2 Evaluation Kit (HercepTest; Dako) May Miss Some HER2-Positive Breast Cancers. Am J Clin Pathol 2019; 151:504-510. [PMID: 30668632 DOI: 10.1093/ajcp/aqy171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Accurate evaluation of human epidermal growth factor receptor 2 (HER2) in breast cancer is critical. METHODS HER2 fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) tests were performed on 52 cases using a US Food and Drug Administration (FDA)-approved kit (HercepTest, FDA kit) and a laboratory-developed test (LDT) with the HercepTest antibody and a Leica Bond automated stainer. RESULTS By FISH, 22 were HER2 positive, 29 were negative, and one was equivocal. Of the 22 HER2 FISH-positive cases, five were negative by the FDA kit and none by LDT. The five discrepant cases were retested using the same FDA kit in another Clinical Laboratory Improvement Amendments-certified laboratory, and all five cases were still negative. None of the 29 HER2 FISH-negative cases were positive by the FDA kit or LDT. The overall IHC-FISH concordance rate was 90.4% for the FDA kit and 100% for the LDT. CONCLUSIONS The FDA kit may miss some HER2-positive cases. The LDT has a higher sensitivity and a higher concordance rate with FISH results.
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Affiliation(s)
- Frank Schneider
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Yulan Jin
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | - Kevin Van Smaalen
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
| | | | | | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA
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Impact of the updated 2018 ASCO/CAP guidelines on HER2 FISH testing in invasive breast cancer: a retrospective study of HER2 fish results of 2233 cases. Breast Cancer Res Treat 2019; 175:51-57. [DOI: 10.1007/s10549-019-05148-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/22/2019] [Indexed: 12/18/2022]
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Sorscher S. Reclassifying HER2-equivocal disease. Breast Cancer Res Treat 2018; 167:823. [DOI: 10.1007/s10549-017-4545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/16/2017] [Indexed: 11/27/2022]
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