粘液性卵巢癌中的 HER2 低表达和过表达:ASCO/CAP 和 ToGA 免疫组化评分分析。

IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY International Journal of Gynecological Pathology Pub Date : 2024-05-01 Epub Date: 2024-03-04 DOI:10.1097/PGP.0000000000000972
Rachel Han, Ainhoa Madariaga, Eduardo Gonzalez-Ochoa, Adam C Smith, Lisa Wang, Stephanie Lheureux, Marjan Rouzbahman
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引用次数: 0

摘要

粘液性卵巢癌是一种不常见的恶性肿瘤,其特点是对化疗耐药,转移后生存率低。HER2 扩增是一种常见的晚期癌变,但粘液性卵巢癌中 HER2 低表达的发生率尚不清楚。此外,确定这些肿瘤过表达的最佳方法尚未确定。我们试图评估 ASCO/CAP 和 ToGA 试验的 HER2 IHC 评分方法与 FISH、p53 和错配修复蛋白状态的相关性,并确定粘液性卵巢癌中 HER2 低表达的发生率。研究共纳入了 23 名患者的 29 个肿瘤。对 HER2、p53、MLH1、PMS2、MSH2 和 MSH6 进行了免疫组化。根据 ASCO/CAP 和 ToGA 试验标准进行评分。根据 ASCO/CAP 标准进行 HER2 FISH 检测和评分。确定HER2低的比例,定义为1+或2+染色且FISH阴性。根据 ASCO/CAP 标准,26% 的患者染色结果为 3+,35% 的患者染色结果为 2+。使用 ToGA,30% 显示 3+,57% 显示 2+ 染色。通过 FISH 检测,26% 的患者 HER2 扩增呈阳性。两种系统都能捕捉到所有 FISH 阳性病例;使用 ASCO/CAP 可减少等位和假阳性病例。在HER2阴性病例中,88%为HER2低表达。在 55% 的病例中检测到 p53 表达异常;未在任何病例中发现错配修复缺陷。ASCO/CAP指南在确定粘液性卵巢癌的HER2过表达方面既准确又节省资源。HER2低表达在这些肿瘤中很常见;应进一步研究确定HER2靶向疗法(包括抗体药物共轭物)的作用。
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HER2-low and Overexpression in Mucinous Ovarian Cancer: Analysis of ASCO/CAP and ToGA Immunohistochemical Scoring.

Mucinous ovarian carcinoma is an uncommon malignancy characterized by resistance to chemotherapy and poor survival in the metastatic setting. HER2 amplification is a frequent late event in carcinogenesis, yet the incidence of HER2-low in mucinous ovarian carcinoma is unknown. Further, the optimal method for determining overexpression in these tumors is not established. We sought to assess the ASCO/CAP and ToGA trial scoring methods for HER2 IHC with correlation to FISH, p53, and mismatch repair protein status and to determine the incidence of HER2-low in mucinous ovarian carcinoma. A total of 29 tumors from 23 patients were included. Immunohistochemistry for HER2, p53, MLH1, PMS2, MSH2, and MSH6 was performed. Scoring was performed according to the ASCO/CAP and ToGA trial criteria. HER2 FISH was performed and scored according to the ASCO/CAP criteria. The proportion of HER2-low, defined as 1+ or 2+ staining with negative FISH, was determined. Using ASCO/CAP, 26% demonstrated 3+ while 35% demonstrated 2+ staining. Using ToGA, 30% demonstrated 3+ while 57% demonstrated 2+ staining. By FISH, 26% were positive for HER2 amplification. Both systems captured all FISH-positive cases; the use of ASCO/CAP resulted in fewer equivocal and false-positive cases. Among HER2-negative cases, 88% were HER2-low. Aberrant p53 expression was detected in 55% of cases; mismatch repair deficiency was not identified in any cases. ASCO/CAP guidelines are accurate and resource-effective in determining HER2 overexpression in mucinous ovarian carcinoma. HER2-low is common in these tumors; further studies to determine the role of HER2-targeted therapy including antibody-drug conjugates are indicated.

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来源期刊
CiteScore
3.90
自引率
12.50%
发文量
154
审稿时长
6-12 weeks
期刊介绍: International Journal of Gynecological Pathology is the official journal of the International Society of Gynecological Pathologists (ISGyP), and provides complete and timely coverage of advances in the understanding and management of gynecological disease. Emphasis is placed on investigations in the field of anatomic pathology. Articles devoted to experimental or animal pathology clearly relevant to an understanding of human disease are published, as are pathological and clinicopathological studies and individual case reports that offer new insights.
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