Digital Image Analysis Of Her2 Immunostained Gastric And Gastroesophageal Junction Adenocarcinomas
Manual assessment of HER2 protein expression in gastric and gastroesophageal junction (GGEJ) adenocarcinomas is prone to inter-observer variability and hampered by tumor heterogeneity and different scoring criteria. Cases are frequently referred to FISH.
This study aimed to evaluate the accuracy of digital image analysis (DIA) for the assessment of HER2 protein expression.
110 GGEJ adenocarcinomas were included in TMAs with 3 tissue cores per case. Two immunoassays, PATHWAYÂ® and HercepTestâ„¢, and FISH were performed. The HER2 CONNECTâ„¢ DIA software as designed for breast carcinoma was applied. Connectivity, calculated by the software, was converted to standard IHC scores applying predetermined cut-off values for breast carcinoma as well as novel cut-off values.
Applying HER2 CONNECTâ„¢ with established connectivity cut-off values designed for breast carcinoma resulted in 72.7% sensitivity and 100% specificity for the identification of HER2 positive cases. By application of new cut-off values, the sensitivity was increased to 100%, while the specificity remained 100%. With the new cut-off values, a 36-50% reduction of IHC equivocal cases requiring additional FISH analysis was observed. Conclusion: HER2 CONNECTâ„¢ with adjusted cut-off values seems to be an effective tool for the assessment of HER2 protein expression in GGEJ adenocarcinomas, allowing for a decreased need for FISH analyses.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
4. In case of virtual slide publication the authors agree to copy the article in a structural modified version to the journal's VS archive.