Tumor containing fragment number influences immunohistochemistry positive rate of HER2 in biopsy specimens of gastric ca
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RESEARCH
Open Access
Tumor containing fragment number influences immunohistochemistry positive rate of HER2 in biopsy specimens of gastric cancer Chen Xu1,2†, Yalan Liu1,2†, Xiaowen Ge1,2, Dongxian Jiang1,2, Ying Zhang1,2, Yuan Ji1,2, Jun Hou1,2, Jie Huang1,2, Jieakesu Su1,2, Haiying Zeng1,2, Jing Qin3* and Yingyong Hou1,2*
Abstract Background: HER2 assessment in biopsy specimens of gastric cancer (GC) is challenging because of the intratumoral heterogeneity. False negative results may be get because of limited biopsy material. The aim of this study is to explore how tumor-containing fragment number and biopsy specimen number affect HER2 immunohistochemistry (IHC) positive rate. Methods: Eight hundred and ninety biopsy specimens and 459 paired resected specimens were collected. IHC staining of HER2 was performed. HER2 IHC positive (scored 3+) rate was compared based on tumor-containing fragment number, biopsy specimen number, average size and tumor tissue proportion of tumor-containing fragments. The positive predictability of biopsy specimens to resected specimens was analyzed based on tumor fragment number. Results: HER2 IHC positive rates were 2.0, 3.5, 7.0, 13.2, 17.1, and 15.9% when tumor fragment numbers were 1, 2, 3, 4, 5 and 6 respectively. The rate rose with the increase of tumor fragment number (P = 0.004). ROC curve analysis showed that biopsy specimens exhibited positive predictability when tumor fragment number reached 3, but showed better performance when the number was ≥4 (P < 0.05). After fragment number reached 4, no statistic differences were reached in either HER2 IHC positive rate or positive predictability with further increase of the number (P > 0.05). HER2 IHC positive rate was not associated with biopsy number (P = 0.127), average size of tumor fragments (P = 0.397), and tumor tissue proportion of tumor fragments (P = 0.825) directly. Conclusions: The number of tumor-containing fragments influences HER2 IHC positive (scored 3+) rate. Greater than or equal to 4 (≥4) tumor fragments give better results in the positive rate as well as positive predictability. We recommend the number of tumor containing fragments be described in the HER2 IHC pathology reports for clinical reference in endoscopic biopsy specimens of GC. Keywords: Gastric cancer, HER2, Biopsy, Immunohistochemistry
* Correspondence: [email protected]; [email protected] † Equal contributors 3 Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 20032, China 1 Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 20032, China Full list of author information is available at the end of the article © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons li
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