MEME MALİGN NEOPLAZMLARINDA TRU-CUT VE EKSİZYONEL BİYOPSİ MATERYALLERİNİN C-erbB2 EKSPRESYONLARININ FARKLI İKİ MERKEZDE DEĞERLENDİRİLEREK KARŞILAŞTIRILMASI; 50 OLGUNUN RETROSPEKTİF ANALİZİ

Yıl 2021, Cilt: 24 Sayı: 1, 101 - 107, 21.03.2021

Ferda Keskin Çimen , Rabia Demirtaş

https://doi.org/10.17049/ataunihem.866072

Öz

Amaç: Kadınlarda en sık görülen kanser tipi meme karsinomudur. Laboratuvar yöntemlerinde görülen gelişmelere paralel erken tanı olanaklarındaki gelişmelerle prognozda iyileşme söz konusudur. Prognozun ve tedaviye cevabın belirlenmesinde önemli faktörlerden birisi de Kromozom 17’nin uzun kolunda yer alan Human Epidermal Büyüme Faktör Reseptör 2 (HER2, c-erbB2) genidir. Meme karsinomunda, HER-2 gen değerlendirilmesinde, birçok tıbbi patoloji laboratuvarında en sık kullanılan yöntemlerden biri immünohistokimyasal (İHK) işlemlerdir. İHK yöntemde, invaziv karsinom hücrelerinin boyanma yüzdesi ve boyanma niteliğine (zayıf-orta-kuvvetli/inkomplet-komplet membranöz) göre skorlanma yapılır. Çalışmamızda, her iki merkeze ait İHK değerlendirme skorlarını kıyaslayarak olası farklılıkları ve nedenlerini ortaya koymayı amaçladık.
Yöntem: Çalışmamıza Tıbbi Patoloji laboratuvarımızda son 5 yılda meme karsinomu tanısı almış, İHK çalışmaları yapılmış, çeşitli nedenler ile Erzurum Atatürk Üniversitesi Tıbbi Patoloji Laboratuvarında yeniden İHK çalışmaları tekrar edilmiş, hem tru-cut biyopsi hem de eksizyonel biyopsileri her iki merkezde değerlendirilmiş 50 hasta dahil edildi. 50 olguya ait Patoloji raporları retrospektif olarak analiz edildi.
Bulgular: Her iki merkezde yapılan değerlendirme kıyaslandığında tru-cut biyopsi materyallerinin 30’u (%60’ı), eksizyonel biyopsi materyallerinin ise 31’i (%62’si) aynı skora sahipti.
Sonuç: Değerlendirme sonuçlarında iki merkez arasında benzerlikler olmasına rağmen, azımsanamayacak kadar farklılıklar da tespit edilmiştir.

Anahtar Kelimeler

Meme kanseri, Epidermal büyüme faktörü, Reseptör, İmmünhistokimya

COMPARISON OF C-erbB2 EXPRESSIONS OF TRU-CUT AND EXCISIONAL BIOPSY MATERIALS IN BREAST MALIGNANT NEOPLASMS IN TWO DIFFERENT CENTERS; RETROSPECTIVE ANALYSIS OF 50 CASES

Öz

Aim: The most common type of cancer in women is breast carcinoma. There is an improvement in prognosis with the developments in early diagnosis possibilities parallel to the developments seen in laboratory methods. One of the important factors in determining the prognosis and response to treatment is the Human Epidermal Growth Factor Receptor 2 (HER2, c-erbB2) gene located on the long arm of Chromosome 17. One of the most frequently used methods in the evaluation of HER-2 gene in breast carcinoma in many medical pathology laboratories is immunohistochemical (IHC) methods. In the IHC method, scoring is made according to the staining percentage of invasive carcinoma cells and the quality of staining (weak-medium-strong / incomplete-complete membranous). In this study, we aimed to reveal the possible differences and their reasons by comparing the IHC evaluation scores of both centers.
Methods: Fifty patients who were diagnosed with breast carcinoma in the last 5 years in our Medical Pathology laboratory, IHC studies were conducted, IHC studies were repeated in Erzurum Atatürk University Medical Pathology Laboratory for various reasons, and both tru-cut biopsy and excisional biopsies were evaluated in both centers. Pathology reports of 50 cases were analyzed retrospectively.
Results: When the evaluations made in both centers were compared, 30 (60%) of tru-cut biopsy materials and 31 (62%) of excisional biopsy materials had the same score.
Conclusion: Although there are similarities between the two centers in the evaluation results, substantial differences were also detected.

Anahtar Kelimeler

Breast cancer, Epidermal growth factor, Receptor, Immunhistochemistry

Kaynakça

• 1. Rosai J: Breast. In: Ackerman’s Surgical Pathology. 8.th ed. New York: Mosby; 1992.p. 1623-6.
• 2. Mc Pherson K, Steel CM, Dixon JM. ABC of breast diseases. Breast cancer epidemiology, risk factors, andgenetics. British Medical Journal, 2000;321(7261): 624-8.
• 3. Popescu NC, King CR, Kraus MH. Localization of thehuman erbB-2gene on normal and rearranged chromosomes 17 tobands q12-21.32.Genomics 1989;4(3):362-6.
• 4. Bargmann CI, Hung MC, Weinberg RA: The neu oncogene encodes an epidermal growth factor receptor-related protein. Nature 1986; 319(6050):226-30.
• 5. Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE, LevinWJ, Stuart SG, Udove J, Ullrich A. Studies of the HER-2/neu proto oncogene in human breast and ovarian cancer. Science, 1989;244(4905):707-12.
• 6. Pauletti G, Godolphin W, Press MF, Slamon DJ. Detection and quantitation of HER-2/neu gene amplification in human breast cancer archival material using fluorescence in situ hybridization. Oncogene, 1996;13(1):63-72.
• 7. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science, 1987;235(4775):177-82.
• 8. Geyer CE, Forster J, Lindquist D, Chan S, Romieu CG, PienkowskiT, Jagiello-Gruszfeld A, Crown J, Chan A, Kaufman B, Skarlos D, CamponeM, Davidson N, Berger M, Oliva C, Rubin SD, Stein S, Cameron D.Lapatinib plus capecitabine for HER2-positive advanced breast cancer. New England Journal of Medicine, 2006;355 (26):2733-43.
• 9. Özdamar ŞO, Barut F, Gün BD, Bahadır, Numanoğlu, Sacide ÇOLAK, Gökçe. Zonguldak Karaelmas Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı Histokimya ve İmmünohistokimya Laboratuvar Deneyimi. Ondokuz Mayıs Üniversitesi Tıp Dergisi, 2006;23(3):79–85.
• 10. Tubbs RR, Pettay JD, Roche PC, Stoler MH, Jenkins RB, Grogan TM. Discrepancies in clinical laboratory testing of eligibility for trastuzumab therapy: apparent immunohistochemical false-positives do not get the message. Journal of Clinical Oncology, 2001;19(10):2714-21.
• 11. Onody P, Bertrand F, Muzeau F, Bièche I, Lidereau R. Fluorescence in situ hybridization and immunohistochemical assay sfor HER-2/neu status determination: application to node-negative breast cancer. Archives of Pathology & Laboratory Medicine, 2001;125(6):746-50.
• 12. Jacobs TW, Gown AM, Yaziji H, Barnes MJ, Schnitt SJ. HER-2/neu protein expression in breast cancer evaluated by immunohistochemistry. A study of interlaboratory agreement. American Journal of Clinical Pathology, 2000;113(2):251-8.
• 13. Couturier J, Vincent-Salomon A, Nicolas A, Beuzeboc P, MouretE, Zafrani B, et al. Strong correlation between results of fluorescent in situ hybridization and immunohistochemistry for the assessment of the ERBB2 (HER-2/neu) gene status in breast carcinoma. Modern Pathology, 2000;13(11):1238-43.
• 14. Ridolfi RL, Jamehdor MR, Arber JM. HER-2/neu testing in breast carcinoma: a combined immunohistochemical and fluorescence in situ hybridization approach. Modern Pathology, 2000;13(8):866-73.
• 15. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, CoteRJ, et al. American Society of Clinical Oncology/College of American Pathologists Guide line recommendations for human epidermal growth factor receptor 2 testing in breas tcancer. Archives of Pathology & Laboratory Medicine, 2007;131(1):18.
• 16. Pala EE, Bayol Ü, Özgüzer A, Küçük Ü, Akdeniz ÇY, Sezer Ö. Meme Kanserinde Her2 Durumunu Belirlemedeki Sorunlar. Journal Breast Health, 2015;11:10-6.
• 17. Tsuda H, Kurosumi M, Umemura S, Yamamoto S, Kobayashi T, OsamuraRY. HER2 testing on core needle biopsy specimens from primary breast cancers:interobserver reproducibility and concordance with surgically resected specimens. BioMed Central Cancer, 2010;10:534.
• 18. Apple SK, Lowe AC, Rao PN, Shintaku IP, Moatamed NA: Comparison of fluorescent in situ hybridization HER2/neuresults on core needle biopsy and excisional biopsy in primary breast cancer. Modern Pathology, 2009;22(9):1151-9.
• 19. Solomides CC, Zimmerman R, Bibbo M. Semiquantitative assessment of c-erbB-2 (HER-2) status of cytology specimens and tissue sections from breas tcarcinoma. Analytical and Quantitative Cytology and Histology, 1999;21(2):121-5.
• 20. Desmedt C, Zoppoli G, Gundem G, Pruneri G, Larsimont D, Fornili M, et al. Genomic characterization of primary invasive lobular breast cancer. Journal of Clinical Oncology, 2016; 34(16):1872–81.
• 21. Kurozumi S, Alsaleem M, Monteiro CJ, Bhardwaj K, Joosten SEP, Fujii T, Shirabe K, Green AR, Ellis IO, Rakha EA, Mongan NP, Heery DM, Zwart W, Oesterreich S, Johnston SJ. Targetable ERBB2 mutation status is an independent marker of adverse prognosis in estrogen receptor positive, ERBB2 non-amplified primary lobular breast carcinoma: a retrospective in silico analysis of public datasets. Breast Cancer Research, 2020;22(1):85.