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Evaluation of HER2 by automated FISH and IHC in gastric carcinoma biopsies
Maria R Silva1, Ana Alarcão1, Teresa Ferreira1
1Anatomical Pathology Institute, Faculty of Medicine of the University of Coimbra, Coimbra - Portugal.
Purpose:
The use of trastuzumab (Herceptin) to target HER2 has been applied in breast carcinoma and gastric carcinoma (GC). Previous studies have tested trastuzumab's effectiveness by assessing HER2 expression or HER2 amplification by means of immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH). In this work we aimed to evaluate automated FISH and IHC technologies for HER2 detection in GC biopsies to be used in routine pathology practice.
Methods:
The study used an Oracle HER2 IHC System and an LSI HER2/CEP17 Dual Probe on an automated Bond system (Leica Microsystems). One hundred GC biopsies were evaluated including 44 intestinal type, 38 diffuse type and 18 indeterminate type according to Lauren's classification.
Results:
The overall concordance rate between the automated FISH and IHC methods was 94% (κ = 0.87), as 6 samples were scored as equivocal (4 in IHC and 2 in FISH). Moreover, HER2 positivity was significantly different between the 3 types of GC (p<0.05), being more frequent in intestinal-type GC (23%) than in the other 2 histological types (5% and 0%). Finally, the HER2/CEP17 FISH ratio was significantly different (p<0.01) between disomic and polysomic samples, being higher in polysomic samples (mean 1.633 ± 0.509) than in disomic samples (mean 1.231 ± 0.675).
Conclusions:
Automated HER2 testing of GC biopsies using the Leica Bond system was useful and efficient. This method allowed us to improve normal routine procedures, minimizing time and costs as well as handling and observation errors.
Insights
Automated HER2 testing using FISH and IHC on gastric cancer (GC) biopsies showed high concordance. This efficient method improves routine pathology, reducing errors and costs.
Area of Science:
- Oncology
- Pathology
- Molecular Diagnostics
Background:
- Trastuzumab targets HER2 in breast and gastric carcinomas.
- Previous HER2 detection relied on IHC or FISH.
- Evaluating automated technologies for HER2 detection in GC is crucial.
Purpose of the Study:
- To evaluate automated FISH and IHC technologies for HER2 detection in gastric cancer (GC) biopsies.
- To assess the utility of these automated methods in routine pathology practice.
Main Methods:
- Utilized an Oracle HER2 IHC System and LSI HER2/CEP17 Dual Probe on an automated Bond system (Leica Microsystems).
- Evaluated 100 GC biopsies classified by Lauren's criteria (intestinal, diffuse, indeterminate types).
Main Results:
- Achieved a 94% concordance rate between automated FISH and IHC (κ = 0.87).
- HER2 positivity was significantly higher in intestinal-type GC (23%) compared to other types (5%, 0%).
- HER2/CEP17 FISH ratio differed significantly between disomic and polysomic samples (p<0.01).
Conclusions:
- Automated HER2 testing on GC biopsies using the Leica Bond system is efficient and effective.
- This automated approach enhances routine procedures by minimizing time, cost, and errors.
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