title: Differing deregulation of HER2 in primary gastric cancer and synchronous related metastatic lymph nodes.
abstract: BACKGROUND
  The aim of this study was to investigate how differences in expression of HER2 between primary gastric cancers (PGCs) and their corresponding metastatic lymph nodes (LMNs) might affect its potential as a prognostic indicator in treatments including anti-HER2 agents.
  
  
  METHODS
  The analysis was conducted in 102 patients who underwent surgical resection for primary gastric cancers (PGCs; adenocarcinoma, intestinal type) with synchronous LNMs. HER2 gene status and protein expression were investigated by immunohistochemistry (IHC) in all patients; fluorescence in situ hybridization (FISH) was performed in 22 patients. The correlation between HER2 gene status in PGCs and their LNMs was evaluated.
  
  
  RESULTS
  Positive HER2 expression as detected by IHC + FISH was observed in 27/102 PGC samples (26.5%) and 29/102 LNM samples (28.4%). HER2 amplification status in 102 paired PGC and LNM samples as evaluated by FISH + IHC was concordant in 92 patients (90.2%), 69 (67.6%) were unamplified and 23/102 (22.5%) were amplified at both sites, and discordant in 10 patients (9.8%), 4 (3.9%) were positive for PGC and negative for LNM, while 6 (5.9%) were positive for LNM and negative for PGC. The results of FISH + IHC showed very strong concordance in HER2 status between the PGC and LNM groups (k = 0.754).
  
  
  CONCLUSIONS
  The high concordance between HER2 results for PGCs and their LNMs indicates that assessment of HER2 status in the primary cancer alone is a reliable basis for deciding treatment with anti-HER2 agents in patients with LNMs from gastric adenocarcinoma.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9365749431029643.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Kochi
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujii
authors.forename: Shinobu
authors.initials: S
authors.lastname: Masuda
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kanamori
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mihara
authors.forename: Tomoya
authors.initials: T
authors.lastname: Funada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tamegai
authors.forename: Megumu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suda
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, 30-1OHyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan. takayama.tadatoshi@nihon-u.ac.jp.
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000235:genetics / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008198:Lymph Nodes / Q000737:chemistry* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D018579:Patient Selection; D011237:Predictive Value of Tests; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis* / Q000235:genetics; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000235:genetics / Q000473:pathology / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human