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Different HER2 IHC detection methods are consistent in High, but heterogeneous changes have potentially affected diagnosis and treatment strategies.
Human 2 (HER2) is an important prognosis and therapeutic target in breast cancer.HER2 -positive breast cancer patients usually have a good response against HER2 treatment (such as Twozumab).However, the diversity of HER2 detection methods and the inconsistency of standards may lead to heterogeneity, which affects clinical decisions.Immunohistochemical (IHC) is a common method for detecting HER2 expression, but the differences between different antibodies and detection platforms may cause changes in HER2 scores, which will affect the diagnosis and treatment strategy.
In addition, the heterogeneity of breast cancer, that is, HER2 expression levels in different areas are inconsistent, and they will also produce test results and treatment effects.Influence.Understanding the consistency between different IHC detection methods and its impact on heterogeneity models are of great significance to improve the diagnosis accuracy and therapeutic effect of breast cancer.At the annual meeting of the American and Canadian Society (USCAP) this year, a study at the Fourth Hospital of Hebei Medical University attracted attention. The study aims to compare the four commonly used HER2 IHC detection methods (4B5, SP2, CB11 and EP3) based on four commonly used Her2 IHC testing methods (4B5, SP2, CB11 and EP3)Her2 expression level differences to evaluate the consistency of these methods in detecting HER2 heterogeneity.
Research Design
A total of 202 invasive breast cancer Fermarin -waisted ballad(FFPE) Her2 IHC testing was performed, and three pathologists evaluated the HER2 score and heterogeneous mode of the four detection methods.HER2 level interpretation standards follow the latest US Clinical Oncology Society/ASCO/CAP Guide.Studies define heterogeneity as different dyeing intensity (such as strong, medium, weak, weak, and almost invisible) and incomplete HER2 cell membrane staining in & gt; 50%of tumor cells.The heterogeneity model is divided into agglomeration, mixed type and decentralized type.The detection data are processed and analyzed based on the Re-MAP of the multi-mode of research and education.
Research Results
Among 202 cases of infiltrated breast cancer, the IHC results under the 4B5 detection method areThe number of cases of 0, 1+, 2+, and 3+ was 74 (36.6%), 52 cases (25.7%), 36 cases (17.8%), and 40 cases (19.8%), respectively.If the KAPPA values (accuracy) and ICC values (consistency) of SP3, CB11 and EP3 are 0.90, 0.90 and 0.89, respectively.For HER2 IHC 3+, 2+, and 1+, CB11 has the highest accuracy, while SP3 is the most sensitive.After dyeing with different detection methods, the heterogeneity mode also changed.In addition, after the test results are uniformly classified into HER2 positive, HER2 low expression, and HER2 0, it is found that there is a high consistency between different detection methods.
Table 1 Compared with 4B5, the reliability and consistency parameters of different immunohistochemical analysis
Figure 1 Different detection methods Her2 dyeing results and heterogeneity mode (A. SP3 and 4B5 stain results comparison, B. CB11 and 4B5 stain results comparison, C. EP3Compared with 4B5 dyeing results, changes in D. SP3 and 4B5 heterogeneity models, changes in E. CB11 and 4B5 heterogeneity models, changes in F. EP3 and 4B5 heterogeneity models, G. CB11 and EP3 heterogeneityChanges in patterns)
Figure 2 HER2 clinical classification results of different detection methods
Conclusion
In short, research has found that the four HER2 immunohistochemical chemical dyeing detection methods are highly consistent.This shows that the consistency of different detection methods on HER2 scores is high, and it can provide a reliable basis for clinical decisions.However, changes in HER2 scores caused by different detection methods can also cause changes in heterogeneity, which may affect the diagnosis and treatment of breast cancer.Therefore, in actual clinical applications, the characteristics of different detection methods need to be comprehensively considered to optimize the diagnosis and treatment strategy of breast cancer.
Future research should continue to explore the consistency and heterogeneous changes of different HER2 testing methods in clinical applications, especially for research on new antibodies and detection platforms.In addition, the impact of HER2 heterogeneous confrontation with HER2 treatment effect should be further studied to further improve the effect of individualized therapeutic treatment of patients with breast cancer.Through the research of multi -center and large samples, you can better understand the consistency and heterogeneous changes of HER2 detection methods, and provide a more reliable basis for clinical practice.
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