Her2-Diagnostik beim magenkarzinom: Was ist anders im vergleich zum mammakarzinom?

Translated title of the contribution: Her2 testing in gastric cancer: What is different in comparison to breast cancer?

J. Rüschoff, I. Nagelmeier, G. Baretton, M. Dietel, H. Höfler, H. U. Schildhaus, R. Büttner, W. Schlake, O. Stoss, H. H. Kreipe

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Based on data from a large multicenter phase III trial (ToGA study) trastuzumab has very recently been approved by the EMEA for metastatic gastric cancer and adenocarcinoma of the gastro-esophageal junction. Only patients with tumors which over express Her2 as defined by IHC2+ and a confirmatory FISH+ result, or IHC 3+, determined by an accurate and validated assay are eligible for trastuzumab therapy. However, testing of Her2 status by immunohistochemistry (IHC) differs from breast cancer in core aspects: 1. IHC2+/3+ is scored even though membranous staining is incomplete if membrane staining is clearly detectable even at low magnification (2.5x/5x, 3+) or medium magnification (10x/20x, 2+). 2. Additionally, membrane staining at the appropriate intensity found in at least 10% of tumor cells is restricted to resection specimens. Evaluation of Her2 in situ hybridization (ISH) is similar to breast cancer with ratio values of≥2.0 indicating Her2 gene amplification. Taking these modifications into account and defining the HER2 positive subgroup as IHC 3+ and IHC2+/FISH+, approximately 16% of gastric cancers are considered Her2 positive, affecting mainly tumor regions with intestinal (gland forming) type carcinoma. In contrast to breast cancer, up to one-third of gastric cancers show a heterogeneous Her2 status both at IHC and ISH levels which favors bright field ISH over FISH.

Translated title of the contributionHer2 testing in gastric cancer: What is different in comparison to breast cancer?
Original languageGerman
Pages (from-to)208-217
Number of pages10
JournalPathologe
Volume31
Issue number3
DOIs
StatePublished - May 2010
Externally publishedYes

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