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Monosomy of chromosome 17 in breast cancer during interpretation of HER2 gene amplification
Authors:Matteo Brunelli  Alessia Nottegar  Giuseppe Bogina  Anna Caliò   Luca Cima  Albino Eccher  Caterina Vicentini  Lisa Marcolini  Aldo Scarpa  Serena Pedron  Eleonora Brunello  Sakari Knuutila  Anna Sapino  Caterina Marchiò   Emilio Bria  Annamaria Molino  Luisa Carbognin  Giampaolo Tortora  Bharat Jasani  Keith Miller  Ibrahim Merdol  Lucia Zanatta  Licia Laurino  Tiina Wirtanen  Giuseppe Zamboni  Marcella Marconi  Marco Chilosi  Erminia Manfrin  Guido Martignoni  Franco Bonetti
Abstract:
Monosomy of chromosome 17 may affect the assessment of HER2 amplification. Notably, the prevalence ranges from 1% up to 49% due to lack of consensus in recognition. We sought to investigate the impact of monosomy of chromosome 17 to interpretation of HER2 gene status. 201 breast carcinoma were reviewed for HER2 gene amplification and chromosome 17 status. FISH analysis was performed by using double probes (LSI/CEP). Absolute gene copy number was also scored per each probe. HER2 FISH test was repeated on serial tissue sections, ranging in thickness from 3 to 20 µm. Ratio was scored and subsequently corrected by monosomy after gold control test using the aCGH method to overcome false interpretation due to artefactual nuclear truncation. HER2 immunotests was performed on all cases. 26/201 cases were amplified (13%). Single signals per CEP17 were revealed in 7/201 (3.5%) cases. Five out of 7 cases appeared monosomic with aCGH (overall, 5/201, 2.5%) and evidenced single signals in >60% of nuclei after second-look on FISH when matching both techniques. Among 5, one case showed amplification with a pattern 7/1 (HER2/CEP17>2) of copies (3+ at immunotest); three cases revealed single signals per both probes (LSI/CEP=1) and one case revealed a 3:1 ratio; all last 4 cases showed 0/1+ immunoscore. We concluded that: 1) monosomy of chromosome 17 may be observed in 2.5% of breast carcinoma; 2) monosomy of chromosome 17 due to biological reasons rather than nuclear truncation was observed when using the cut-off of 60% of nuclei harboring single signals; 3) the skewing of the ratio due to single centromeric 17 probe may lead to false positive evaluation; 4) breast carcinomas showing a 3:1 ratio (HER2/CEP17) usually show negative 0/1+ immunoscore and <6 gene copy number at FISH.
Keywords:Breast carcinoma   monosomy   chromosome 17   HER 2 amplification   FISH analysis   double probes   aCGH method   single signals   ratio (HER2/CEP 17)   false positive
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