title: Comparison of immunohistochemistry by automated cellular imaging system (ACIS) versus fluorescence in-situ hybridization in the evaluation of HER-2/neu expression in primary breast carcinoma.
abstract: OBJECTIVE
  Immunohistochemistry (IHC) and fluorescence in-situ hybridization (FISH) are both commonly used assays for evaluation of HER-2/neu status in breast cancer. However, there is still no consensus on which method is most predictive of patient response to Herceptin. Recently, the automated cellular imaging system (ACIS) has been shown to improve the accuracy and reproducibility in scoring IHC. Our aim was to compare the results of HER-2/neu expression and gene amplification in the same patients by IHC using the ACIS system and by FISH.
  
  
  RESULTS
  Two hundred and forty-seven breast cancer cases were studied. The concordance rate between IHC-ACIS (> or = 2.2) and FISH (> or = 2.0) was 94%. Fifteen patients were discordant; three had borderline FISH values and three had borderline IHC values. The other nine discordant cases consisted of five IHC-ACIS+, FISH- and six IHC-ACIS-, FISH+. HER-2/neu overexpression was more common in tumours that were high-grade, aneuploid, progesterone receptor and bcl-2 negative, with MIB-1 > 10%.
  
  
  CONCLUSIONS
  HER-2/neu assessment by the ACIS is reliable, rapid and inexpensive, and correlates highly with results obtained by FISH.
authors.affiliation: Department of Radiation Oncology, Division of Oncology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. otawfik@kumc.edu
authors.forename: O W
authors.initials: OW
authors.lastname: Tawfik
authors.forename: B F
authors.initials: BF
authors.lastname: Kimler
authors.forename: M
authors.initials: M
authors.lastname: Davis
authors.forename: J K
authors.initials: JK
authors.lastname: Donahue
authors.forename: D L
authors.initials: DL
authors.lastname: Persons
authors.forename: F
authors.initials: F
authors.lastname: Fan
authors.forename: S
authors.initials: S
authors.lastname: Hagemeister
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: C
authors.initials: C
authors.lastname: Connor
authors.forename: W
authors.initials: W
authors.lastname: Jewell
authors.forename: C J
authors.initials: CJ
authors.lastname: Fabian
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000235:genetics; D002288:Adenocarcinoma, Mucinous / Q000737:chemistry / Q000235:genetics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry* / Q000235:genetics; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000235:genetics; D018275:Carcinoma, Lobular / Q000737:chemistry / Q000235:genetics; D018276:Carcinoma, Medullary / Q000737:chemistry / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000235:genetics; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007150:Immunohistochemistry / Q000379:methods*; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis* / Q000096:biosynthesis / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases