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A study of HER2 gene amplification and protein expression in gastric cancer
Benedict Yan1, Ee Xuan Yau, Siti Shyba Bte Omar
1Department of Pathology, National University Health System and National University of Singapore, Singapore, Republic of Singapore.
Background:
Gastric cancer is a leading cause of cancer-related mortality, and current treatment outcomes for advanced disease remain poor. HER2 has been identified as a potential candidate for targeted therapy in gastric cancers displaying HER2 gene amplification and protein overexpression.
Aims:
To study the prevalence rate of HER2 gene amplification/overexpression in a local population, and determine the concordance rate between the various modalities.
Methods:
128 gastric cancer samples were analysed by fluorescence (FISH) and chromogenic (CISH) in situ hybridisation and immunohistochemistry (IHC). The relation between HER2 status and various clinicopathological parameters was also analysed.
Results:
11.7% (15/128) and 9.4% (12/128) of gastric cancers displayed HER2 gene amplification and protein overexpression (score 3+), respectively, with a perfect correlation between the FISH and CISH analyses. There was also a significant inverse correlation between overall survival and HER2 protein overexpression in intestinal-type gastric carcinomas (p<0.05).
Conclusion:
Results, besides corroborating existing reports that discrepancies exist between HER2 ISH and IHC assays, also suggest the need to rigorously evaluate CISH as an independent reference standard for assessment of HER2 amplification in gastric cancers.
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