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Soudamini AB, Nalwa A, Choudhary GR, Bharti JN, Rao M, Elhence PA, Pandey H, Goel AD. Human epidermal growth factor receptor 2/neu expression in urothelial carcinomas. Indian J Urol 2024; 40:44-48. [PMID: 38314071 PMCID: PMC10836454 DOI: 10.4103/iju.iju_287_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/06/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Urothelial carcinomas of the bladder are more common in males, making them the sixth-most common cancer in men and the tenth-most common cancer overall, worldwide. Current guidelines do not recommend routine testing for human epidermal growth factor receptor (HER2/neu) expression on the biopsy specimens of patients with urothelial carcinoma. This study was aimed at determining the expression pattern of HER2/neu and its usefulness in muscle-invasive and nonmuscle-invasive urothelial carcinoma. Methods HER2/neu expression was assessed in 89 specimens of urothelial cancer by immunohistochemistry (IHC), and equivocal cases were subjected to fluorescent in situ hybridization (FISH). Results On IHC for HER2/neu, 17.9% (7/39) of the muscle-invasive bladder cancers (MIBCs) showed a 3+ expression, whereas 22% (11/50) of the non-muscle invasive cancers were positive with a score of 3+. A significant correlation between HER2/neu status and muscle invasion could not be established in the current study (P = 0.74, Fisher's exact test). Three cases of muscle-invasive (7.7%) and 2 cases (4%) among nonmuscle invasive cancers showed equivocal expression. All the cases with equivocal (2+) expression on IHC were subjected to FISH and none showed gene amplification on hybridization and were considered as negative. Conclusion Overexpression of HER-2/neu was seen in 17.9% of MIBCs and 22% of non-MIBCs. There are no norms for routine testing of HER2/neu expression in the biopsy specimens of urothelial carcinoma. There is an unmet need to establish guidelines for HER2/neu scoring, similar to that for breast and gastric cancers, to determine the proportion of positive cases and help in identification of those who may benefit from targeted therapies.
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Affiliation(s)
| | - Aasma Nalwa
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Gautam Ram Choudhary
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jyotsna Naresh Bharti
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Meenakshi Rao
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Poonam Abhay Elhence
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Himanshu Pandey
- Department of Urology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Sanguedolce F, Zanelli M, Palicelli A, Bisagni A, Zizzo M, Ascani S, Pedicillo MC, Cormio A, Falagario UG, Carrieri G, Cormio L. HER2 Expression in Bladder Cancer: A Focused View on Its Diagnostic, Prognostic, and Predictive Role. Int J Mol Sci 2023; 24:ijms24043720. [PMID: 36835131 PMCID: PMC9962688 DOI: 10.3390/ijms24043720] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Bladder cancer (BC) is a heterogeneous disease from a molecular, morphological, and clinical standpoint. HER2 is a known oncogene involved in bladder carcinogenesis. Assessing HER2 overexpression as a result of its molecular changes in a routine pathology practice using immunohistochemistry might be a useful adjunct in several scenarios, namely (1) to correctly identify flat urothelial lesions and inverted urothelial lesions in the diagnostic setting; (2) to provide prognostic hints in both non-muscle invasive (NMI) and muscle invasive (MI) tumors, thus supplementing risk stratification tools, especially when evaluating higher-risk tumors such as those with variant morphology; (3) to improve antibody panels as a surrogate marker of BC molecular subtyping. Furthermore, the potential of HER2 as a therapeutic target has been only partly explored so far, in light of the ongoing development of novel target therapies.
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Affiliation(s)
- Francesca Sanguedolce
- Pathology Unit, Policlinico Riuniti, University of Foggia, 71122 Foggia, Italy
- Correspondence:
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy
| | | | - Angelo Cormio
- Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, 60126 Ancona, Italy
| | - Ugo Giovanni Falagario
- Department of Urology and Renal Transplantation, Policlinico Riuniti, University of Foggia, 71122 Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, Policlinico Riuniti, University of Foggia, 71122 Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, Policlinico Riuniti, University of Foggia, 71122 Foggia, Italy
- Department of Urology, Bonomo Teaching Hospital, 76123 Andria, Italy
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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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Chromogenic and Silver in Situ Hybridization for Identification of HER 2 Overexpression in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Appl Immunohistochem Mol Morphol 2019; 28:411-421. [DOI: 10.1097/pai.0000000000000773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ercoli G, Lopez G, Ciapponi C, Corti C, Despini L, Gambini D, Runza L, Blundo C, Sciarra A, Fusco N. Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers. J Vis Exp 2017. [PMID: 29286417 DOI: 10.3791/56686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Targeted therapies against the human epidermal growth factor receptor 2 (HER2) have radically changed the outcome of patients with HER2-positive breast cancers. However, a minority of cases displays a heterogeneous distribution of HER2-positive cells, which generates major clinical challenges. To date, no reliable and standardized protocols for the characterization and quantification of HER2 heterogeneous gene amplification in large cohorts have been proposed. Here, we present a high-throughput methodology to simultaneously assess the HER2 status across different topographic areas of multiple breast cancers. In particular, we illustrate the laboratory procedure to construct enhanced tissue microarrays (TMAs) incorporating a targeted mapping of the tumors. All TMA parameters have been specifically optimized for the silver in situ hybridization (SISH) of formalin-fixed paraffin-embedded (FFPE) breast tissues. Immunohistochemical analysis of the prognostic and predictive biomarkers (i.e., ER, PR, Ki67, and HER2) should be performed using automated procedures. A customized SISH protocol has been implemented to allow a high-quality molecular analysis across multiple tissues that underwent different fixation, processing, and storage procedures. In this study, we provide a proof-of-principle that specific DNA sequences could be localized simultaneously in distinct topographic areas of multiple and heterogeneously processed breast cancers using an efficient and cost-effective method.
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Affiliation(s)
- Giulia Ercoli
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; School of Medicine, University of Milan
| | - Camilla Ciapponi
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; School of Biology, University of Pavia
| | - Chiara Corti
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; School of Medicine, University of Milan
| | - Luca Despini
- Division of Breast Surgery, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
| | - Donatella Gambini
- Division of Medical Oncology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
| | - Letterio Runza
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Concetta Blundo
- Division of Breast Surgery, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
| | - Amedeo Sciarra
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Nicola Fusco
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Department of Biomedical, Surgical, and Dental Sciences, University of Milan;
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