Abstract
Our goal is to verify HER2 status variability between primary tumor and metastatic site. Our second intention is to identify the most reliable criteria for pathological HER2 status assessment in gastric cancer node metastases since, at present, there is not a validated standard. 3 independent pathologists evaluated HER2 immunohistochemical and gene status (for IHC 2+ cases) in 34 gastric carcinoma metastatic lymph nodes and in their corresponding primary tumors. For primary gastric cancers, we followed the current HER2 assessment guidelines and for nodal metastases, we applied two immunohistochemical scoring systems with different cut-offs. The immunohistochemical inter-pathologists mean agreement was 71.4 % (κ = 0.45); a final score for each case was defined after collegial revision. By applying the two immunohistochemical criteria, we found 2 discordant cases, which can imply different pathological management. Moreover, a significantly different HER2 status between lymph node metastasis and primary tumor was obtained in 4 cases (concordance ratio 87.5 %). None of the patients would have undergone a different therapeutic pathway despite the scoring method applied. On the other hand we also detected a subset of patients who could have their therapeutic management changed, according to the differences between HER2 status in lymph nodes metastases and primary tumor.
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Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, Lordick F, Ohtsu A, Omuro Y, Satoh T, Aprile G, Kulikov E, Hill J, Lehle M, Rüschoff J, Kang YK (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase III, open-label, randomised controlled trial. Lancet 376:687–97
Hoffmann M, Stoss O, Shi D, Buttner R, van de Vijver M, Kim W, Ochiai A, Rüschoff J, Henkel T (2008) Assessment of a HER2 scoring system for gastric cancer: results from a validation study. Histopathology 52:797–805
Rüschoff J, Dietel M, Baretton G, Arbogast S, Walch A, Monges G, Chenard MP, Penault-Llorca F, Nagelmeier I, Schlake W, Höfler H, Kreipe HH (2010) HER2 diagnostics in gastric cancer: guideline validation and development of standardized immunohistochemical testing. Virchows Arch 457:299–307
Wolff AC, Hammond EH M, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, van de Vijver M, Wheeler TM, Hayes DF (2007) American Society of Clinical Oncology/College of American Pathologists Guideline recommendations for Human Epidermal Growth Factor Receptor 2 testing in breast cancer. Arch Pathol Lab Med 131:18–43
Albarello L, Pecciarini L, Doglioni C (2011) HER2 Testing in gastric cancer. Adv Anat Pathol 18:53–59
Bozzetti C, Negri FV, Lagrasta CA, Crafa P, Bassano C, Tamagnini I, Gardini G, Nizzoli R, Leonardi F, Gasparro D, Camisa R, Cavalli S, Silini EM, Ardizzoni A (2011) Comparison of HER2 status in primary and paired metastatic sites of gastric carcinoma. Br J Cancer 104:1372–1376
Nassar A, Cohen C, Agersborg SS, Zhou W, Lynch KA, Albitar M, Barker EA, Vanderbilt BL, Thompson J, Heyman ER, Lange H, Olson A, Siddiqui MT (2001) Trainable Immunohistochemical HER/neu Image Analysis. A multisite performance study using 260 breast tissue specimen. Arch Pathol Lab Med 135:896–902
Marx AH, Tharun L, Muth J, Dancau AM, Simon R, Yekebas E, Kaifi JT, Mirlacher M, Brümmendorf TH, Bokemeyer C, Izbicki JR, Sauter G (2009) HER-2 amplification is highly homogeneous in gastric cancer. Hum Pathol 40:769–777
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In our study HER2 positivity was found in 8 out of 34 patients. One of these underwent surgery after edition of ToGA trial, so he was able to receive the biological drug in addiction to conventional chemotherapy regimen, on oncologists’ recommendation. The other 7 patients were operated before August 2010, so they did not receive eligibility indication for Trastuzumab. After our study, the diagnosis of HER2 positivity in primary tumor or in metastatic site was communicated to oncologists in order to take in consideration the option of a further specific treatment.
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Pagni, F., Zannella, S., Ronchi, S. et al. HER2 Status of Gastric Carcinoma and Corresponding Lymph Node Metastasis. Pathol. Oncol. Res. 19, 103–109 (2013). https://doi.org/10.1007/s12253-012-9564-2
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DOI: https://doi.org/10.1007/s12253-012-9564-2