Monoplex LightCycler Polymerase Chain Reaction Quantitation of the HER2 Gene for Quality Assurance of HER2/neu Testing by Immunohistochemistry and Fluorescence In Situ Hybridization

被引:3
作者
Layfield, Lester J. [1 ]
Willmore-Payne, Carlynn [2 ]
Isom, Gary [2 ]
Holden, Joseph A. [1 ]
机构
[1] Univ Utah, Sch Med, Dept Pathol, Salt Lake City, UT USA
[2] ARUP Inst, Salt Lake City, UT USA
关键词
HER2; FISH; immunohistochemistry; quality assurance;
D O I
10.1097/PAI.0b013e318171923a
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
Background: Assessment of HER2 by immunohistochemistry (IHC) or fluorescence in Situ hybridization (FISH) is a standard practice for breast carcinomas. Testing is associated with a 20% disagreement between laboratories. The College of American Pathologists (CAP) guidelines for HER2 testing include validation of HER2 test methods by achieving 95% concordance with another validated method. Our laboratory requires IHC 3+ FISH nonamplified specimens to undergo retesting by polymerase chain reaction (PCR). A random sample of IHC 2+ cases are routinely tested by PCR. We found this practice useful for resolving discrepancies in HER2 testing. Methods: At clinician request, seventy-nine 3+ and one hundred forty-eight 2+ cases were tested by FISH. In 22 cases, IHC was 3+ but FISH was nonamplified. These 22 cases underwent HER2 LightCycler monoplex polymerase chain reaction (M PCR) testing. Seventeen 2+ nonamplified cases were tested by MPCR. Results: Twenty-one 3+, FISH nonamplified cases were found to be MPCR nonamplified. One IHC 3+, FISH nonamplified case was MPCR amplified. Seventeen 2+. FISH nonamplified cases were MPCR nonamplified. In all but one case, FISH and MPCR were concordant. Discussion: American Society of Clinical Oncology/CAP guidelines propose validation of testing procedures by showing 95% concordance with a validated test for positive and negative assays. Specific actions are not recommended to resolve discordances between tests. Our laboratory uses 3 different modalities for HER2 testing. We have found that our 2 methods for testing gene amplification status show a higher degree of concordance between themselves than either did with IHC. Review of the 3+ IHC nonamplified cases showed them to have a dark, granular circumferential staining pattern.
引用
收藏
页码:562 / 567
页数:6
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