乳腺癌患者的HER2放大状态的变化,在免疫组织化学指导的情况下混合化后发生变化
Cameron Beech1,2, Diane M Wilcock1, Kristina H Moore1
1Institute for Experimental Pathology, ARUP Laboratories.
Applied immunohistochemistry & molecular morphology : AIMM
|January 27, 2025
概括
2018年ASCO/CAP关于乳腺癌中HER2检测的指导方针引入了一种新的IHC导向的ISH重新计数,用于模糊的结果. 这种重新计数在某些情况下显著改变了HER2放大状态,影响了治疗决策.
科学领域:
- 在瘤学瘤学.
- 分子诊断学 分子诊断
- 病理学 病理学 病理学
背景情况:
- 2018年ASCO/CAP指导方针引入了免疫组织化学 (IHC) 导向的在位杂交 (ISH) 对乳腺癌中模两可的HER2结果的重新计算.
- 这一补充旨在解决模两可的情况,但在诊断工作流程中引入了复杂性.
研究的目的:
- 为了评估2+IHC导向的ISH重新计数对模糊病例的HER2检测结果的影响.
- 分析在指南实施后HER2放大状态和相关指标的变化.
主要方法:
- 自2018年指南以来测试的模两可的ISH病例 (2,3和4组) 的回顾性审查.
- 在2+IHC导向ISH重新计数后,对HER2组数和放大状态的变化进行分析.
- 在IHC引导的再计数之前和之后,HER2/CEP17比率和每个细胞的HER2信号数的比较.
主要成果:
- 在IHC指导的ISH重计后,HER2组数和放大状态经常发生变化.
- 这些变化是由HER2/CEP17比率和每个细胞平均HER2信号数量的显著变化所驱动的.
- 最终被归类为HER2增强的模糊样本显示了更高的初始ISH计数,更接近放大值.
结论:
- 由IHC指导的ISH重新计数显著影响乳腺癌患者的一个子集的HER2测试结果.
- 这种重新评估可能会导致基于修订的HER2放大状态的治疗选择的转变.
- 这项研究强调了解决模两可的HER2 ISH结果的临床意义.
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