显色原位杂交与免疫组织化学法检测子宫颈癌中HER-2/neu

1987年slamon等首次报道HER-2蛋白过表达与乳腺癌及卵巢癌患者的生存期缩短及近期复发有关.抗HER-2人源化抗体在乳腺癌基因治疗中已广泛应用,显色原位杂交(CISH)在乳腺癌HER-2基因检测方面较为成熟,但在子宫颈病变的研究中报道较少.我们分别采用CISH与免疫组织化学(IHC)检测子宫颈鳞痛组织中HER-2基因扩增和蛋白表达状况,探讨CISH在检测子宫颈癌HER-2基凶扩增中的作用.     

显色原位杂交检测乳腺癌HER2基因扩增的应用价值

目的评估显色原位杂交（CISH）技术在检测乳腺癌标本中HER2基因扩增的应用价值。方法分别采用免疫组织化学（IHC）EnVision和CISH两种方法,检测165例乳腺癌中HER2蛋白表达及HER2基因扩增的情况。结果（1）IHC检测HER2蛋白表达阴性者107例,表达阳性1＋者24例,CISH均未检测到HER2基因扩增;（2）IHC检测HER2表达3＋者22例,CISH检测中21例呈现HER2基因的高倍扩增,仅1例呈低倍扩增,HER2基因高倍扩增及其蛋白表达之间的符合率为95．5％;（3）IHC检测HER2表达2＋者12例,CISH检测有3例HER2基因呈高倍扩增,6例呈低倍扩增,3例无扩增。结论CISH在检测HER2基因扩增与IHC检测的结果具有较高的一致性和敏感性,可以作为一种检测乳腺癌HER2基因状况的方法。     

显色原位杂交和免疫组织化学检测乳腺癌HER2/neu基因状况和蛋白表达的对照性研究

目的探讨显色原位杂交（CISH）在检测乳腺癌中HER2／neu基因扩增上的作用。方法挑选乳腺浸润性导管癌患者组织石蜡蜡块（回顾性255例,前瞻性271例）,进行免疫组织化学（IHC）、CISH检测。15例回顾性标本送往德国HERA检测中心进行FISH检测。结果（1）回顾性病例中IHC阳性3＋者CISH基因扩增率为91．6％（120／131）,IHC2＋者CISH基因扩增率为56．5％（39／69）,IHC与CISH检测结果符合率为81．2％（207／255）,两者明显相关（P〈0．01）。（2）前瞻性病例中IHC蛋白过表达率31．7％．CISH基因扩增率27．3％。IHC3＋者CISH基因扩增率为91．4％（53／58）,IHC2＋者CISH基因扩增率为46．4％（13／28）,IHC与CISH检测结果符合率为89．7％（243／271）,两者明显相关（P〈0．01）。（3）经德国检测中心荧光原位杂交（FISH）检测的15例中14例和CISH结果完全一致,1例检测失败,而CISH为无扩增。（4）CISH检测基因扩增与雌激素受体（ER）、孕激素受体（PR）表达明显负相关（P值均〈0．01）。结论CISH检测HER2基因扩增结果与IHC检测蛋白过表达及FISH结果高度一致,CISH是检测HER2基因扩增的一项新技术。     

HER2银染色原位杂交结果与前处理条件的相关性

HER2基因扩增和／或HER2蛋白过表达是判断乳腺癌患者预后的重要风险评估因子,同时也是判断曲妥珠单抗靶向治疗是否适用的重要依据。评价HER2状态的方法有免疫组织化学染色法（ IHC）、荧光原位杂交（ FISH）、显色原位杂交（CISH）及银染原位杂交（SISH）。 SISH法在亮视野下观察切片,切片可长期保存,观察结果与FISH结果的符合率高达90％～99％［1-5］。2013年美国临床肿瘤学会／美国病理医师学院（ASCO／CAP）乳腺癌HER2检测指南及中国乳腺癌HER2检测指南（2014版）相应增加了亮视野原位杂交的检测及判读指南等内容［6-7］,使得HER2 SISH检测技术逐步走向规范化、标准化。为了更顺利的开展HER2 SISH的检测,提高检测的成功率,我们分析不同前处理条件对HER2 SISH染色结果的影响。     

乳腺癌Her-2基因检测方法对比研究

研究表明，Her-2作为肿瘤发生的癌基因，在20％-30％的侵袭性乳腺癌中过度表达，与乳腺癌的侵袭转移及预后密切相关。近年来一种特异性的单克隆抗体药物Her—ceptin已运用于临床，并且用于筛选该类疾病，目前公认的方法有两种：即免疫组化（IHC）法和荧光原位杂交（FISH）法，但其结果之间一致性较差。我们采用美国Zymed公司生产的Her-2显色原位杂交（CISH）检测试剂，以探讨CISH法检测Her-2基因状态的临床应用价值。[第一段]     

一项关于HER2基因检测的多中心研究

HER2基因状态对于乳腺癌患者治疗方案选择、预后评估十分重要.目前常用方法有免疫组织化学(IHC)、荧光原位杂交(FISH)和显色原位杂交(CISH).IHC在大多数病理实验室均能开展,但是所得结果对组织固定情况及其他因素较敏感,统计分析表明基层实验室用IHC方法所得出的HER2蛋白表达结果约20%被正规的中心实验室证明是错误的.     

新旧两版指南对浸润性乳腺癌HER-2基因扩增的判读影响

目的探讨2014版与2019版《乳腺癌HER-2检测指南》对浸润性乳腺癌HER-2基因扩增的判读影响。方法收集698例浸润性乳腺癌石蜡标本,采用免疫组化(immunohistochemistry, IHC)法和荧光原位杂交(fluorescence in situ hybridization, FISH)法对HER-2蛋白表达和基因扩增进行检测,并用2014和2019版指南分别对检测结果进行判读。结果根据2014版指南FISH判读法检测HER-2基因扩增的阳性检出率为40.7%(284/698),阴性检出率为52.1%(364/698),不确定为7.2%(50/698)。根据2019版指南FISH判读法检测HER-2基因扩增的阳性检出率为40.0%(279/698),阴性检出率为60.0%(419/698)。两版指南中IHC与FISH法检测HER-2蛋白表达与基因扩增的总一致率分别为54.7%、55.7%;两版检测结果具有一致性(Kappa=0.277,P0.001;Kappa=0.251,P0.001),且均呈正相关(r=0.608,P0.001;r=0.641,P0.001)。结论 2019版指南取消FISH法检测HER-2基因扩增的不确定结果,使其阴性率有所增加,更加明确了HER-2基因状态,为临床靶向治疗提供参考。     

结直肠癌组织中EGFR及HER-2的表达及临床意义

目的：探讨结直肠癌组织中表皮生长因子受体（ epiderma1 growth factor receptor,EGFR）和人类表皮生长因子受体-2（ hu-man epiderma1 receptor-2,HER-2）蛋白的表达,并分析二者与临床病理特征的关系。方法采用免疫组化PV-9000两步法检测78例结直肠癌组织中EGFR和HER-2的表达,分析二者表达与结直肠癌临床病理特征的关系;应用银染原位杂交（ si1ver in situ hybridization,SISH）法检测结直肠癌组织中HER-2基因扩增情况。结果 EGFR在结直肠癌组织中的阳性率为69.23%（54/78）,EGFR表达与结直肠癌浸润深度、淋巴结转移呈正相关,与患者性别、年龄、肿瘤大小、细胞分化程度、Dukes分期无关;HER-2在结直肠癌组织中的阳性率为25.64%（20/78）,HER-2表达与结直肠癌浸润深度、淋巴结转移呈正相关,与患者性别、年龄、肿瘤大小、细胞分化程度、Dukes分期无关。EGFR与HER-2蛋白表达呈正相关。20例HER-2蛋白阳性者中,10例HER-2基因扩增;其中15例HER-2蛋白（~）中有10例HER-2基因扩增,占高表达组的66.67%;5例HER-2蛋白（+）者无HER-2基因扩增。结论 EGFR和HER-2蛋白在结直肠癌中均呈高表达,EGFR和HER-2的表达与结直肠癌侵袭、转移密切相关,二者可能存在协同作用。HER-2蛋白（~）与HER-2基因扩增密切相关,故该类患者可考虑先行免疫组化初步筛选,再行SISH法检测确认,从而为结直肠癌分子的靶向治疗提供有价值的信息。     

乳腺癌Her-2基因检测方法对比

研究表明,Her-2作为肿瘤发生的癌基因,在20%~30%的侵袭性乳腺癌中过度表达,与乳腺癌的侵袭转移及预后密切相关[1]。近年来一种特异性的单克隆抗体药物Her-ceptin已运用于临床,并且用于筛选该类疾病,目前公认的方法有两种:即免疫组化(IHC)法和荧光原位杂交(FISH)法,但其结果之间一致性较差[2,3]。我们采用美国Zymed公司生产的Her-2显色原位杂交(CISH)检测试剂,以探讨CISH法检测Her-2基因状态的临床应用价值。1材料与方法1.1材料选择2005年6月~2006年6月经IHC法检测的乳腺癌石蜡标本69例,其中c-erbB-2蛋白()15例、()32例、(+)6例、(…     

显色原位杂交技术在乳腺癌HER-2/neu原癌基因检测上的应用及意义

对于检测常规甲醛固定的乳腺癌石蜡组织切片中HER-2／neu原癌基因的核苷酸序列技术方法而言,荧光原位杂交法（FISH）一直是公认比较敏感和经典的检测方法。而显色原位杂交法（chromogenic in situ hybridization,CISH）作为一种核酸原位分子杂交技术方法,也可用于常规甲醛固定的乳腺癌石蜡组织切片中的HER-2／neu原癌基因的检测。     

Her-2/neu expression in salivary duct carcinoma: an immunohistochemical and chromogenic in situ hybridization study.

Salivary duct carcinoma (SDC) shares significant morphologic and immunophenotypic overlap with ductal carcinoma of the breast, including HER-2/neu expression. Previous studies have detected HER-2/neu at the protein level in SDCs; however, no study, to date, has assayed whether this expression is related to gene amplification detected by chromogenic in situ hybridization (CISH). Formalin-fixed, paraffin-embedded tissue sections from 12 previously diagnosed SDCs were evaluated by immunohistochemistry (IHC) and CISH for HER-2/neu status. Result concordance was seen in all 12 cases. A total of 4 SDCs were positive by IHC; all 4 cases showed amplification with CISH. The remaining 8 cases were negative by IHC and showed no gene amplification with CISH. SDCs in this study show HER-2/neu overexpression on both the protein and gene levels in approximately 30% of cases. These findings suggest a role may exist for Herceptin (trastuzumab) based therapy in some SDC patients.     

Comparison between immunohistochemistry and chromogenic in situ hybridization in assessing HER-2 status in breast cancer

Human epidermal growth factor receptor-2 (HER-2) is usually determined as a potential target for breast cancer therapy. The purpose of the present study was to compare chromogenic in situ hybridization (CISH) with immunohistochemistry (IHC) in determination of HER-2 status, in metastatic breast cancer patients screened for the clinical study of chemotherapy +/- herceptin. It was possible to assess both CISH and IHC in 56 cases, using CISH Detection Kit (Zymed) and HercepTest (DakoCytomation), respectively. HER-2 was amplified by CISH in 32 cases (57%) while 33 (59%) were HER-2-positive by IHC. A concordance between HER-2 status determined by CISH and IHC was noted in 43 of 56 cases (77%; P = 0.00008). Gene amplification was observed in 6/16 cases (37.5%) in IHC-negative subgroup (1+), while no amplification was observed in 5/10 cases (50%) in the IHC-positive subgroup (2+). These results suggest that there was a greater heterogeneity on the genetic level and that simple IHC classification was not sufficient. It is suggested that CISH could be considered as a useful additional method to IHC in determining HER-2 status in breast cancer patients, with a recommendation for testing not only the 2+ but also the 1+ subgroup of patients.     

Comparison of chromogenic in situ hybridisation with fluorescence in situ hybridisation and immunohistochemistry for the assessment of her-2/neu oncogene in archival material of breast carcinoma

The successful treatment of breast cancer is dependent upon a number of complex factors. Her-2/neu gene amplification is known to be one of the most common genetic alterations associated with breast cancer and its accurate determination has become necessary for the selection of patients for trastuzumab therapy.The aim of this study was to prove the consistency of chromogenic in situ hybridisation (CISH) technique after analyzing the overexpression of the Her-2/neu proto-oncogene in 100 invasive breast carcinomas and by comparing CISH results with immunohistochemistry (IHC) and fluorescence in situ hybridisation (FISH). Moreover, it was done to evaluate the possible correlation of estrogen (ERs) and progesterone receptors (PRs), the proliferation marker Ki67 and the tumour suppressor gene p53 with HER-2/neu status of these breast carcinomas.Of the 100 breast carcinomas that were analysed, 22 cases showed HER-2/neu amplification, 66 cases showed no amplification, whereas 12 cases were non-interpretable in both assays (FISH and CISH). Consequently, the overall concordance between FISH and CISH was 100%. Additionally, it was observed that when HER-2/neu gene was overexpressed, there was an association with negative PRs and ERs status, negative p53 protein expression and high Ki67 labelling index.It is concluded that patients with tumours scoring 2+ with the CBE356 antibody (borderline immunohistochemistry-tested cases) would also benefit from CISH as it is shown to be highly accurate, practical and can be easily integrated into routine testing in any histopathology laboratory. Finally, CISH represents an important addition to the HER2 testing algorithm.     

HER-2/neu oncogene amplification by chromogenic in situ hybridization in 130 breast cancers using tissue microarray and clinical follow-up studies

Determining of HER-2/neu oncogene amplification has become clinically important for managing breast cancer. Fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) are currently regarded as the standard methods. Chromogenic in situ hybridization (CISH) was investigated as a new modification with an accurate, sensitive technique. From 1998 to 2002, using CISH and IHC, the amplification and protein expression of the HER-2/neu oncogene were examined using paraffin sections in 130 breast carcinomas and to determine the prognostic role of HER-2/neu for outcome after a follow-up of 24- 64 months. Amplifications by CISH and overexpression by IHC were observed in 28 (22%) and 27 cases (20.8%), respectively. Of the 104 patients, 20 patients (19.2%) with amplification had a shorter disease-free interval (34.9 months vs. 38.0 months in controls) (p=0.372). 15 patients (14.4%) had a disease recurrence, but there is no significant difference between 3 patients amplifying the oncogene and 12 patients without oncogene (20.6 months vs. 19.6 months) (p=0.862). 6 patients (5.8%) of these died. CISH is a useful alternative, particularly for confirming the IHC results. There is no relationship between the early recurrence and the HER-2/neu positive group, but lymph node status was statistically significant.     

Comparison of liquid based cytology and histology for the evaluation of HER-2 status using immunostaining and CISH in breast carcinoma

BACKGROUND: HER-2 amplification is an important prognostic biomarker and treatment determinant in breast carcinoma. AIMS: To correlate immunocytochemical (ICC) expression of HER-2 and gene amplification determined by chromogenic in situ hybridisation (CISH) using liquid based cytology (LBC) with immunohistochemistry (IHC) and CISH using histological samples of the same breast carcinomas. METHODS: Frozen sections and cytobrushings of 103 breast carcinomas were analysed. Four techniques were performed on each tumour: two on LBC samples (ICC, and CISH, both graded as positive, indeterminate, or negative) and two on histological samples (IHC and CISH). Two cell lines (MCF-7, negative; BT 474, positive) were used as controls for cytological analysis. A complementary fluorescence in situ hybridisation technique was carried out in histological samples with low amplification (4-10 dots/nucleus). RESULTS: Interobserver agreement for the four techniques calculated by the kappa coefficient indicated a substantial agreement. Nine cases failed in cytology because of poor cellularity. Among 94 cases, 19 were amplified; 73, 12, and 9 tumours were scored 0 or 1+, 2+, and 3+, respectively by IHC and 75, 13, and 6, respectively, by ICC. CISH found no amplification in 72 tumours. Correlations between the IHC and CISH results in the histological and cytological samples were always significant. CONCLUSIONS: Her-2 status could be determined in LBC samples and correlated well with reference histological methods using in situ hybridisation. ICC was less reliable because of the presence of the cytoplasmic membrane. However, these results should be confirmed by a large multicentre study.     

Which breast carcinomas need HER‐2/neu gene study after immunohistochemical analysis? Results of combined use of antibodies against different c‐erbB2 protein domains

AIMS: Evaluation of HER2 gene amplification in breast cancers is a compelling, routine procedure. The aim of this work was to evaluate which breast carcinomas would really benefit from HER-2/neu gene analysis. METHODS AND RESULTS: We studied 130 invasive breast carcinomas by immunohistochemistry (IHC) using CB11 and TAB250 MAbs directed against different domains of the c-erbB2 molecule. From this series, we selected 106 cases (32 G1, 36 G2, and 38 G3) in which HER-2/neu gene analysis, using chromogenic in-situ hybridization (CISH), was successful. IHC results were scored using the FDA approved system with three score values: 0/1+ (negative), 2+, 3+ (positive). In addition, we developed a double scoring system with six score values (0/1+ 2+ negative, 3+, 4+, 5+, 6+ positive) obtained by summating the individual scoring values obtained with each MAb. All double scoring negative cases were non-amplified (100% sensitivity), whereas all cases scored 6+ were amplified. Double scoring values and CISH results were then correlated with grade and histological type. G1 ductal carcinomas and carcinomas of lobular and of special histological type did not show HER-2/neu amplification even in the presence of protein over-expression. CONCLUSIONS: The combined results of IHC analysis (double scoring values) obtained using MAbs directed against different c-erbB2 domains correctly indicates the HER-2/neu gene status in 57.5% of cases. In addition, simple morphological features such as low grade and special histological type are good predictors of the non-amplification of the HER-2/neu gene in breast carcinoma.     

Expression and amplification of Her2, EGFR and cyclin D1 in breast cancer: immunohistochemistry and chromogenic in situ hybridization

Determination of Her2, epidermal growth factor receptor (EGFR) and cyclin D1 status is now of major clinical importance due to the development of molecule-targeting drugs in anticancer therapy. Immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH) are the most simple and convenient methods for evaluating gene alterations and their protein consequences. The purpose of the present study was to investigate the status of Her2, EGFR and cyclin D1 on both IHC and CISH in 95 primary breast carcinomas. There was substantial consistency between the IHC and CISH results of Her2 and EGFR, showing fair agreement between protein overexpression and gene amplification. However, cyclin D amplification was not related to protein overexpression. Moreover, there was no correlation between Her2, EGFR and cyclin D1. Her2 protein overexpression and amplification were positively associated with histological grade, nuclear grade and inversely correlated with the expression of estrogen receptor (ER) and progesterone receptor (PR). In ER-negative and postmenopausal patients, EGFR gene amplification was strongly associated with worse recurrence-free survival (P = 0.0087, P = 0.0149, respectively). Overall, the present findings suggest that EGFR gene amplification is important in predicting prognosis and this should be evaluated in breast carcinoma in addition to Her2 status in routine pathological practice.     

Chromogenic in situ hybridization for the detection of HER-2/neu gene amplification in breast cancer with an emphasis on tumors with borderline and low-level amplification: does it measure up to fluorescence in situ hybridization?

We compared chromogenic in situ hybridization (CISH) with fluorescence in situ hybridization (FISH) for assessing HER-2/neu gene amplification using tissue microarrays (TMAs) made from formalin-fixed, paraffin-embedded tissue blocks from 113 cases of invasive breast carcinoma. TMAs were created using 0.6-mm tissue cores with 4 sampled cores per tumor. For both assays, a HER-2/chromosome 17 signal ratio of 2.0 or more was considered positive for gene amplification. The average ratio of cores from the same tumor was used for determination of gene amplification status of that particular tumor Of 113 cases, 102 were tested successfully by both assays. The results were concordant in 100.0% of cases (63 amplified; 39 nonamplified). All 22 cases of borderline (ratio, 2.0-2.5) or low-level (ratio, 2.6-3.9) amplification by FISH also showed HER-2 gene amplification by CISH. CISH is as sensitive as FISH in detecting borderline and low-level HER-2 amplification. Reliable recognition of the invasive carcinoma area by light microscopy and preservation of the test slides are added advantages of CISH. CISH performs as well as FISH in the analysis of HER-2 gene amplification in breast cancer and might have advantages in certain situations.