Abstract
BackgroundHuman epidermal growth factor receptor-2 (HER2) overexpression and gene amplification are currently established by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), respectively. This study investigates whether high-density single nucleotide polymorphism (SNP) arrays can provide additional diagnostic power to assess HER2 gene status.MethodsDNA from 65 breast tumor samples previously diagnosed by HER2 IHC and FISH analysis were blinded and examined for HER2 copy number variation employing SNP array analysis.ResultsSNP array analysis identified 24 (37%) samples with selective amplification or imbalance of the HER2 region in the q-arm of chromosome 17. In contrast, only 15 (23%) tumors were found to have HER2 amplification by IHC and FISH analysis. In total, there was a discrepancy in 19 (29%) samples between SNP array and IHC/FISH analysis. In 12 of these cases, the discrepancy towards FISH could be attributed to concomitant amplification or deletion of the centromeric region, which harbors the FISH reference probe sequence. In 3 tumors, repeated IHC/FISH analysis revealed that the original IHC/FISH analysis had failed to indicate the correct HER2 expression level. Finally, the SNP array analysis revealed that more than two thirds of the samples exhibited polyploidy that was unrecognized by conventional FISH.ConclusionsCollectively, the data show that determination of HER2 copy number variations by SNP array-based genomic segmentation analysis is an effective supplement to IHC/FISH HER2 analysis that, by providing additional diagnostic sensitivity and accuracy, may elect more women for targeted treatment with HER2 inhibitors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1035-1) contains supplementary material, which is available to authorized users.
Highlights
Human epidermal growth factor receptor-2 (HER2) overexpression and gene amplification are currently established by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), respectively
Pathological characteristics of the breast tumor samples Sixty-five primary breast tumor samples were selected for the study, comprising 12 tumors scored as IHC 0, 15 as IHC 1+, 32 as IHC 2+, and 6 as IHC 3+ (Table 1, HER2 IHC)
The HER2/CEP17 ratios of all the IHC 2+ tumor samples were examined by FISH analysis (Table 1, HER2 FISH)
Summary
Human epidermal growth factor receptor-2 (HER2) overexpression and gene amplification are currently established by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), respectively. Breast cancer development and progression rely on several molecular pathways including estrogen receptor and human epidermal growth factor receptor-2 (HER2) receptor signaling, which represent important prognostic indicators and provide the molecular basis for targeted treatment by antibodies or small molecule inhibitors. Antibodies or small molecule inhibitors such as Trastuzumab and Lapatinib efficiently inhibit the HER2 receptor and have been shown to improve overall survival and reduce risk of relapse [7,8,9,10,11]. Accurate testing of HER2 amplification is of major importance for clinical decision-making in breast cancer patients
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