title: Clinical significance of assessing Her2/neu expression in gastric cancer with dual tumor tissue paraffin blocks.
abstract: One paraffin block is routinely used for human epidermal growth factor receptor 2 (Her2/neu) immunohistochemistry (IHC) assessment. Here, we investigated if picking 2 paraffin blocks for Her2/neu evaluation on 1 slide is an economical, efficient, and practical method, which may reduce false negativity of Her2/neu IHC assessment due to intratumoral heterogeneity. A total of 251 gastric cancer (GC) patients were divided into a cohort using 1 tumor tissue paraffin block (single-block group, n = 132) and a cohort using dual tumor tissue paraffin blocks (dual-block group, n = 119) when evaluating Her2/neu expression status by IHC. In dual-block group, we combined the results from 2 different paraffin blocks and used the higher one as the final score. The number of IHC 1+, 2+, and 3+ specimens in the single-block group was 31 (23.5%), 40 (30.3%), and 19 (14.4%), respectively. The combined final IHC score in the dual-block group of 1+, 2+, and 3+ was 26 (21.8%), 34 (28.6%), and 23 (19.3%), respectively. Inconsistent Her2/neu expression between blocks was found in 36 (30.3%) cases in the dual-block group. The pooled data in the single-block group and the dual-block group indicated that, when using dual blocks, the Her2/neu-positive (3+) rate of GC was higher compared to that in the single-block group. Our results implied that using dual paraffin blocks to assess Her2/neu expression of GC may help identify more patients with Her2/neu-positive GC who could benefit from targeted therapy, by reducing false-negative rate of Her2 status assessment. This is an efficient, economical, and practical method for Her2/neu evaluation of GC.
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Xiaowen
authors: X
authors: Ge
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Haixing
authors: H
authors: Wang
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Haiying
authors: H
authors: Zeng
authors: Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Xuejuan
authors: X
authors: Jin
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Akesu
authors: A
authors: Sujie
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Chen
authors: C
authors: Xu
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Yalan
authors: Y
authors: Liu
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Jie
authors: J
authors: Huang
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Yuan
authors: Y
authors: Ji
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Yunshan
authors: Y
authors: Tan
authors: Department of Oncology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Tianshu
authors: T
authors: Liu
authors: Department of Pathology, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China. Electronic address: hou.yingyong@zs-hospital.sh.cn.
authors: Yingyong
authors: Y
authors: Hou
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China. Electronic address: qin.jing@zs-hospital.sh.cn.
authors: Jing
authors: J
authors: Qin
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Yihong
authors: Y
authors: Sun
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Fenglin Rd #180, Shanghai, 200032, PR China.
authors: Xinyu
authors: X
authors: Qin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D005784:Gene Amplification / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010232:Paraffin; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D014021:Tissue Preservation
chemical_list: D014408:Biomarkers, Tumor; D010232:Paraffin; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Dual paraffin blocks; Gastric cancer; Her2/neu; Immunohistochemistry; Trastuzumab