Evaluation of Expression of Human Epidermal Growth Factor Receptor 2 (HER2) in Gastric and Gastroesophageal Junction Adenocarcinoma Using IHC and Dual-ISH

Anticancer Res. 2018 Jan;38(1):367-372. doi: 10.21873/anticanres.12231.

Abstract

Background/aim: Trastuzumab® is used for human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic gastric/gastroesophageal junction (GEJ) adenocarcinoma. Our aim was to compare HER2 expression by immunohistochemistry (IHC) and dual in situ hybridization (DISH) in early-stage vs. late-stage gastric and GEJ tumors.

Materials and methods: Fifty early-stage and 50 late-stage gastric tumors and a similar number of early-stage and late-stage GEJ tumors were studied. HER2 was analyzed by IHC and dual-ISH using tissue microarray.

Results: Of 200 selected cases, 168 had satisfactory results. Among the 110 cases with both tests successfully performed, there were only five cases with discrepancy between assays (4.5%). Seven equivocal (2+) cases by IHC were all found to be amplified by dual-ISH. When compared with IHC, dual-ISH identified 12 additional HER2-positive cases (10.9%).

Conclusion: The 12.5% overall overexpression/amplification in gastric and GEJ adenocarcinomas is in concordance with previous reports. No correlation was found between tumor stage and HER2 overexpression/amplification. Determination of HER2 in limited tissue samples benefits from combinational IHC and ISH testing.

Keywords: DISH; HER2; esophageal cancer; gastric cancer.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biomarkers, Tumor / metabolism*
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / pathology*
  • Esophagogastric Junction / pathology*
  • Female
  • Humans
  • Immunohistochemistry / methods
  • In Situ Hybridization, Fluorescence / methods
  • Male
  • Middle Aged
  • Receptor, ErbB-2 / biosynthesis*
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology*
  • Trastuzumab / therapeutic use

Substances

  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab

Supplementary concepts

  • Adenocarcinoma Of Esophagus