Interpretation and clinical significance of different HER-2 classification standards in metastatic colorectal cancer
10.12354/j.issn.1000-8179.2024.20241496
- VernacularTitle:转移性结直肠癌中HER-2不同分类标准的判读及临床意义
- Author:
Wang YANG
1
;
Song YANYAN
;
Guo YUHONG
;
Liu YANXUE
;
Wei TING
;
Sun YAN
Author Information
1. 天津医科大学肿瘤医院病理科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,天津市消化系统肿瘤重点实验室(天津市 300060)
- Publication Type:Journal Article
- Keywords:
HER-2 low expression;
metastatic colorectal cancer(mCRC);
Hofmann criteria;
HERACLES criteria
- From:
Chinese Journal of Clinical Oncology
2024;51(24):1255-1260
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Given the rising popularity of antibody-drug conjugate(ADC),this study was performed to assess the expression of hu-man epidermal growth factor receptor 2(HER-2)in metastatic colorectal cancer(mCRC)based on the Hofmann and HERACLES standards and to investigate its clinical significance.Methods:We evaluated 105 metastatic lesions and corresponding primary tumor tissues from 70 patients diagnosed with mCRC at Tianjin Medical University Cancer Institute&Hospital from January 2011 to December 2013.We assigned each patient to one of the three HER-2 expression classifications(HER-2 absent,HER-2 low,and HER-2 positive)separately using Hofmann and HERACLES criteria.We compared the consistency of the two evaluation criteria and the results between matched metastatic lesions and primary tumors.We also analyzed the correlation between HER-2 expression and clinicopathological factors in the patients.Results:HER-2 positivity rates based on Hofmann and HERACLES criteria were 3.8%(4/105)for metastatic lesions of mCRC and 7.1%(5/70)and 5.7%(4/70)for primary tumors,respectively.The detection rates of low HER-2 expression in both primary and metastatic lesions were higher with the Hofmann criteria(28.6%vs.25.7%)than with the HERACLES criteria(20.0%vs.11.4%).The consistency of HER-2 expression assess-ment between the two criteria was good(kappa coefficient:0.828).An inconsistency was observed in HER-2 expression between primary tu-mors and metastatic lesions(inconsistency rate,28.6%).Conclusions:The incidences of HER-2 positivity and low HER-2 expression were in-consistent between metastatic and primary lesions in mCRC,suggesting that clinical testing for both should be conducted simultaneously to improve the detection rates.The Hofmann criteria showed a higher detection rate for low HER-2 expression than that by the HERACLES cri-teria.Given the lack of a unified interpretation standard for HER-2 expression in CRC,the relationship between the clinical efficacy of ADC and HER-2 expression under different interpretation standards needs to be further evaluated in large-sample,multicenter studies.
