RESUMEN
PURPOSE: Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are used to determine human epidermal growth factor receptor-2 (HER-2) status and patient eligibility for trastuzumab therapy. Using FISH and IHC, we analyzed the relationship between pathologic complete response to trastuzumab-based neoadjuvant therapy and level of HER-2 amplification in locally advanced breast cancer. EXPERIMENTAL DESIGN: Breast biopsies from 93 HER-2-positive patients treated with trastuzumab-based neoadjuvant therapy were centrally collected and analyzed retrospectively for HER-2 amplification using FISH and HER-2 overexpression using IHC. Tumors were classified by FISH as no, low, or high amplification. Biopsies were reassessed centrally by IHC and graded 0, 1+, 2+, or 3+. RESULTS: HER-2 status of tumor samples as assessed by FISH and IHC correlated: 16 no amplification (11 IHC 1+ and 5 IHC 2+), 27 low amplification (26 IHC 3+ and 1 IHC 2+), and 50 high amplification (all IHC 3+). Trastuzumab-based neoadjuvant therapy achieved pathologic complete response in 35 of 93 (37.6%) tumors. Pathologic complete response rate in low- and high-amplification tumors was significantly higher than in no-amplification tumors (44% versus 6%; P < 0.004). Pathologic complete response rate in high-amplification tumors was significantly higher compared with low-amplification tumors (56% versus 22%; P < 0.005). In the subgroup of low- plus high-amplification tumors, no correlation was found between pathologic complete response rate and IHC score, treatment regimen, T or N stage, tumor grade, or hormonal receptors. CONCLUSIONS: This is the first study to show positive correlation between level of HER-2 amplification assessed by FISH and rate of pathologic complete response to trastuzumab-based neoadjuvant treatment.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Regulación Neoplásica de la Expresión Génica , Terapia Neoadyuvante/métodos , Neoplasias/tratamiento farmacológico , Neoplasias/genética , Receptor ErbB-2/biosíntesis , Adulto , Anciano , Anticuerpos Monoclonales Humanizados , Biopsia , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Femenino , Humanos , Inmunohistoquímica/métodos , Hibridación Fluorescente in Situ , Persona de Mediana Edad , Receptor ErbB-2/genética , Estudios Retrospectivos , Trastuzumab , Resultado del TratamientoRESUMEN
Vaginal tumours are rare, and Brenner tumour is one of the most infrequent vaginal lesions. Brenner tumour is a transitional tumour that typically arises in the ovaries. Some cases have been reported in the broad ligament, uterus and paratesticular structures. Only five cases have been reported in the vagina. We report a sixth case and discuss the histogenesis of this tumour, as well as the differential diagnosis with the mixed tumour of the vagina.
Asunto(s)
Tumor de Brenner/patología , Neoplasias Vaginales/patología , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Ováricas/patologíaRESUMEN
Plexiform schwannoma is a form of schwannoma which usually involves cutaneous tissues. It cannot be easily differentiated from malignant tumors, especially deep or cellular lesions. We report a deep plexiform schwannoma which we place among the various benign or malignant nerve sheath tumors, which may or may not develop within the context of genetic disease. Finally, the differential diagnoses are discussed. Recognition of the lesion is necessary for appropriate treatment.