HER-2 overexpression and gene amplification of advanced breast cancers determined by fluorescence in situ hybridization in fine needle aspiration specimens.

Zhihui Zhang; Linlin Zhao; Huiqin Guo; Lei Guo; Yun Ling; Xin XU; Huan Zhao; Qinjing Pan

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HER-2 overexpression and gene amplification of advanced breast cancers determined by fluorescence in situ hybridization in fine needle aspiration specimens.

Author: Zhihui ZHANG ¹ ; Linlin ZHAO ¹ ; Huiqin GUO ¹ ; Lei GUO ¹ ; Yun LING ¹ ; Xin XU ¹ ; Huan ZHAO ¹ ; Qinjing PAN ²
Author Information

1. Department of Cytopathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
2. Department of Cytopathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. Email: pqjing@hotmail.com.
Publication Type:Journal Article
MeSH: Adult; Aged; Biopsy, Fine-Needle; Breast Neoplasms; genetics; metabolism; pathology; Carcinoma, Ductal, Breast; genetics; metabolism; pathology; Female; Gene Amplification; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Lymphatic Metastasis; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Paraffin Embedding; Receptor, ErbB-2; genetics; metabolism; Sensitivity and Specificity
From: Chinese Journal of Oncology 2014;36(3):183-187
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo explore the feasibility of testing HER-2 expression and gene amplification in fine needle aspiration specimens of advanced breast cancers, and to benefit the patients receiving targeted drug therapy.
METHODSLiquid-based cytology specimens by fine needle aspiration of 49 breast cancer cases were used in this study. The expression of HER-2 protein was detected by immunocytochemistry (ICC) and the gene amplification was assessed by fluorescence in situ hybridization (FISH). All the 49 cases had overexpression of HER-2 protein marked as ++ or +++ in immunohistochemistry (IHC), and had corresponding FISH results in formalin-fixed, paraffin-embedded (FFPE) tissue samples.
RESULTSFNA samples in all the 49 cases were tested by FISH, and showed a complete agreement with the FISH results in the histological specimens (kappa = 1.0). Of the 49 cases, 33 had HER-2 gene amplification in FFPE samples. So do that in FNA samples. Both had an amplification rate of 67.3%. Among the 33 cases with HER-2 gene amplification, 26 had an ICC score of +++ (78.8%). The conformity rate was 78.8%. Of the 33 cases, 29 had an IHC score of +++ (87.9%). Its conformity rate was 87.9%. The difference between the ICC and IHC results was statistically not significant (P = 0.322). Among the 16 cases with negative gene amplification by both ICC and IHC, 15 cases showed HER-2 protein expression as 0/+, and another one case was not counted because there was not enough cells. Of the 16 cases, 15 had an IHC score of ++ and one of +++ . To take the FISH results as gold standard, ICC results had a high sensitivity (87.9%) and specificity (100.0%).
CONCLUSIONSFISH in FNA samples can be used in the clinic to test HER-2 gene amplification and overexpression in breast cancers, with a high sensitivity and specificity in ICC. Our data support the use of FISH and ICC analysis to determine HER-2 status on FNA specimens in patients with advanced breast cancer and recurrence or metastatic tumors. When ICC score is +++ , it indicates that there is a HER-2 gene amplification by FISH.