Immunohistochemical determination of HER2 expression in breast cancer from core biopsy specimens: a reliable predictor of HEr2 status of the whole tumor
Immunohistochemical determination of HER2 expression in breast cancer from core biopsy specimens: a reliable predictor of HEr2 status of the whole tumor
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DOI：
10.1023/a:1012281221647
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发表时间：
2001-01-01
影响因子：
3.8
通讯作者：
Marth, C
中科院分区：
文献类型：
--
作者：
Mueller-Holzner, E;Fink, V;Marth, C
乳腺癌中 HER2 过度表达与预后不良、对内分泌治疗耐药以及对蒽环类药物和紫杉醇化疗敏感有关。此外，曲妥珠单抗 (Herceptin(R)) 对 HER2 过表达肿瘤患者显示出治疗益处。因此，了解治疗前 HER2 状态可以优化选择接受治疗的患者。除了明确的组织学诊断外，肿瘤的核心活检还提供了术前评估 HER2 状态的机会。在 64 名浸润性乳腺癌患者中，使用 DAKO HercepTest(TM) 对核心活检切片和随后切除的整个肿瘤进行了免疫组织化学研究。 15 个肿瘤 (23%) 显示 HER2 过度表达，44 个肿瘤 (69%) 核心活检和整个肿瘤切片均为阴性。两个核心活检呈阴性，而相应的最终样本呈 2+ 阳性。 3例在核心活检中观察到弱过表达，但整个肿瘤呈阴性。核心活检和整个肿瘤切片获得的结果的总体一致性为 92% kappa = 0.8）。核心活检中 HER2 结果阴性与评分 3+ 的肿瘤标本无关，也不存在活检中之前评分为 3+ 的整个肿瘤标本呈阴性的情况。如果要求最高程度的过表达 (3+)，仅使用核心活检结果就可以正确选择我们研究患者中的 100%。因此，我们得出结论，核心活检的免疫组织化学研究为术前有效评估 HER2 过度表达提供了机会。
HER2 overexpression in breast cancer is associated with a poor prognosis, resistance to endocrine therapy and chemosensitivity to anthracyclines and paclitaxel. Moreover, trastuzumab (Herceptin(R)) shows therapeutic benefit in patients with HER2 overexpressing tumors. Therefore, knowledge of the pretherapeutical HER2 status allows an optimal selection of patients for treatment. In addition to a definitive histological diagnosis, core biopsies of tumors offer the opportunity to evaluate the HER2 status preoperatively. In 64 patients with invasive breast cancer, sections of core biopsies and of the subsequently removed whole tumor were investigated immuno-histochemically with the DAKO HercepTest(TM). Fifteen tumors (23%) revealed HER2 overexpression, and 44 tumors (69%) were negative in both, the core biopsy and the whole tumor sections. Two core biopsies were negative whereas the corresponding final specimen was 2+ positive. In 3 cases weak overexpression was observed in the core biopsy, but the whole tumor was negative. The overall concordance of the results achieved at core biopsy and whole tumor sections was 92% kappa = 0.8). A negative HER2 result on core biopsy was never associated with a score 3+ tumor specimen nor was there a case of negative whole tumor specimen with a preceding 3+ score in the biopsy. If one demands the highest degree of overexpression (3+), 100% of our study patients would have been selected correctly using the results on core biopsy alone. We thus conclude, that the immunohistochemical investigation of core biopsies offers the opportunity for a valid preoperative estimation of HER2 overexpression.