PMID- 23197004
OWN - NLM
STAT- MEDLINE
DCOM- 20140331
LR  - 20161020
IS  - 1533-4058 (Electronic)
IS  - 1533-4058 (Linking)
VI  - 21
IP  - 5
DP  - 2013 Oct
TI  - Image cytometric HER2 in gastric carcinoma: is a new algorithm needed?
PG  - 414-9
LID - 10.1097/PAI.0b013e31827955c8 [doi]
AB  - BACKGROUND: Algorithms for quantitation of HER2 immunohistochemistry were 
      developed for breast carcinoma, where the membranous stain must be entirely 
      around the cell membrane. For gastric carcinoma, although assessment of intensity 
      of immunostain (0 to 3) is similar, the site and percentage of stain differs by 
      lacking the requirement of entire cell membrane positivity (complete, 
      basolateral, or lateral membranous reactivity is sufficient for a positive 
      result). We quantitated HER2 in gastric cancer specimens visually and by image 
      cytometry, comparing results, and where available, with fluorescence in situ 
      hybridization (FISH). The goal was to assess whether lack of concordance among 
      results, might suggest a requirement for changing the image cytometric algorithm. 
      DESIGN: All gastric carcinoma biopsies, resections, and cell blocks studied for 
      HER2 expression/amplification in the past 2 years were included. Immunostain 
      intensity, percentage, and score 0 to 3+ (0, 1+ negative, 2+ equivocal, 3+ 
      positive), were evaluated visually, and by image cytometry with the ACIS score 0 
      to 3 (0, 1 negative, 2 equivocal, 3 positive). FISH (<1.8 negative, 1.8 to 2.2 
      equivocal, >2.2 amplified) was performed on all specimens with scores 2 and 3 by 
      image cytometry. Results were compared. RESULTS: Sixty-eight specimens were 
      studied, including 43 (63.2%) biopsies, 17 (25%) resections, and 8 (11.8%) cell 
      blocks. Forty-seven (69.1%) were primary gastric, esophageal, or gastroesophageal 
      junction adenocarcinoma; 19 (27.9%) were metastatic; 3 (4.4%) were well, 14 
      (20.6%) moderately (17, 25% tubular), and 51 (75%) poorly differentiated (poorly 
      cohesive). Fourteen (20.6%) of cases were HER2 IHC positive with no significant 
      difference in frequency based on type of specimen, site of carcinoma, or 
      differentiation. Of the 14 visually HER2 IHC positive, 13 were positive by image 
      cytometry (93% concordance), all 13 were amplified by HER2 FISH (100% 
      concordance). Of the 3 cases equivocal both visually and by image cytometry, only 
      1 was FISH amplified. Fifty-one were negative by IHC visually and 52 by image 
      cytometry (98% concordance). None of the 5 HER2 IHC negative were amplified by 
      FISH. CONCLUSIONS: Despite different recommendations for interpretation of HER2 
      in gastric versus breast cancer, equivocal and positive/amplified results 
      visually, and by image cytometry, and where FISH was performed, are similar. This 
      concordance is noted for biopsy, resection, and cell block specimens, for primary 
      versus metastatic, and for moderately versus poorly differentiated carcinoma; 
      HER2 positivity/amplification is most frequent with poor differentiation, but not 
      significantly so. There seems to be no need for the HER2 image cytometric 
      algorithm used for breast cancer, to be changed when used for assessment of 
      gastric cancers.
FAU - Ormenisan, Claudia
AU  - Ormenisan C
AD  - Department of Pathology, Emory University Hospital, Atlanta, GA.
FAU - Wang, Jason
AU  - Wang J
FAU - Lawson, Diane
AU  - Lawson D
FAU - Cohen, Cynthia
AU  - Cohen C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Appl Immunohistochem Mol Morphol
JT  - Applied immunohistochemistry & molecular morphology : AIMM
JID - 100888796
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Algorithms
MH  - Breast Neoplasms/*diagnosis/pathology
MH  - Carcinoma/*diagnosis/pathology
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Image Cytometry/*methods/standards
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Neoplasm Metastasis
MH  - Neoplasm Staging
MH  - Practice Guidelines as Topic
MH  - Receptor, ErbB-2/*metabolism
MH  - Reproducibility of Results
MH  - Stomach Neoplasms/*diagnosis/pathology
EDAT- 2012/12/01 06:00
MHDA- 2014/04/01 06:00
CRDT- 2012/12/01 06:00
PHST- 2012/12/01 06:00 [entrez]
PHST- 2012/12/01 06:00 [pubmed]
PHST- 2014/04/01 06:00 [medline]
AID - 10.1097/PAI.0b013e31827955c8 [doi]
PST - ppublish
SO  - Appl Immunohistochem Mol Morphol. 2013 Oct;21(5):414-9. doi: 
      10.1097/PAI.0b013e31827955c8.