Amplification of the TOP2A gene does not predict high levels of topoisomerase II alpha protein in human breast tumor samples

Genes Chromosomes Cancer. 2004 Apr;39(4):288-97. doi: 10.1002/gcc.20008.


Recent clinical trials have suggested that patients whose breast tumors overexpress HER2 may derive particular benefit from anthracycline-containing chemotherapy compared to that without anthracycline. It has been proposed that the HER2 gene amplification reported in these tumors might mask an underlying TOP2A gene amplification that occurs frequently and concurrently with HER2 amplification. Topoisomerase II alpha, encoded by TOP2A, is a direct molecular target of anthracycline drug action and is potentially useful as a predictive marker of response to anthracycline therapy for breast cancer. In this study, we examined whether TOP2A gene amplification is an appropriate marker for identifying breast tumors expressing high levels of topoisomerase II alpha. We determined topoisomerase II alpha protein expression by immunohistochemistry in 81 human breast tumors in relation to HER2 and TOP2A gene copy numbers analyzed by fluorescence in situ hybridization, histologic grade, cell proliferation fraction measured by MIB-1 expression, and HER2 protein expression determined by immunohistochemistry. The results showed no correlation between TOP2A gene copy number and topoisomerase II alpha protein expression levels in breast tumors, in contrast to the analogous situation for HER2 gene amplification and HER2 immunohistochemistry. Our results suggest that TOP2A gene amplification in breast tumors does not predict high expression of topoisomerase II alpha protein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Neoplasm
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Chromosomes, Human, Pair 17 / genetics
  • DNA Topoisomerases, Type II / genetics*
  • DNA Topoisomerases, Type II / immunology
  • DNA-Binding Proteins
  • Data Interpretation, Statistical
  • Formaldehyde / metabolism
  • Gene Amplification / genetics*
  • Gene Dosage
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Immunohistochemistry / methods
  • Immunohistochemistry / statistics & numerical data
  • In Situ Hybridization, Fluorescence / methods
  • Ki-67 Antigen / immunology
  • Paraffin Embedding / methods
  • Ploidies
  • Poly-ADP-Ribose Binding Proteins
  • Predictive Value of Tests
  • Receptor, ErbB-2 / biosynthesis
  • Receptor, ErbB-2 / immunology
  • Tissue Fixation / methods


  • Antigens, Neoplasm
  • DNA-Binding Proteins
  • Ki-67 Antigen
  • Poly-ADP-Ribose Binding Proteins
  • Formaldehyde
  • Receptor, ErbB-2
  • DNA Topoisomerases, Type II
  • TOP2A protein, human