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Japanese Journal of Clinical Oncology Advance Access originally published online on May 31, 2005
Japanese Journal of Clinical Oncology 2005 35(6):324-331; doi:10.1093/jjco/hyi089
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© 2005 Foundation for Promotion of Cancer Research

Usefulness and Limitation of Multiple Endoscopic Biopsy Sampling for Epidermal Growth Factor Receptor and c-erbB-2 Testing in Patients with Gastric Adenocarcinoma

Mikihiko Kimura1, Hitoshi Tsuda1, Daisaku Morita1, Eiji Shinto1, Takao Tanimoto1, Takashi Ichikura2, Hidetaka Mochizuki2 and Osamu Matsubara1

Departments of 1 Pathology II and 2 Surgery I, National Defense Medical Tokorozawa, Saitama, Japan

For reprints and all correspondence: Hitoshi Tsuda, Department of Pathology II, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. E-mail: htsuda{at}ndmc.ac.jp

Received February 15, 2005; accepted April 25, 2005

Background: Our objective was to examine the utility of endoscopic biopsy specimens in judging the status of epidermal growth factor receptor (EGFR) and c-erbB-2 genes and proteins in the entire tumor.

Methods: Endoscopic biopsy specimens and specimens of whole representative cut surfaces of corresponding surgically resected tumors were obtained from 14 patients with gastric carcinoma, and immunohistochemistry and fluorescence in situ hybridization were then performed to determine the protein expression and gene amplification profiles, respectively, of EGFR and c-erbB-2 in these biopsy and surgical specimens.

Results: Among the eight endoscopic biopsy specimens obtained from three gastric carcinomas in which EGFR protein overexpression and gene amplification were judged to be positive in the corresponding surgically resected tissue specimens, EGFR overexpression was detected in three specimens (38%), but EGFR amplification was not detected (0%). Among the 19 endoscopic biopsy specimens obtained from five gastric carcinomas in which c-erbB-2 protein overexpression and gene amplification were judged to be positive in the corresponding surgically resected tissue specimens, c-erbB-2 overexpression and amplification (c-erbB-2/CEP17 ratio) were detected in 14 (74%) and 16 (84%) specimens, respectively. All three cases with EGFR overexpression and all five cases with c-erbB-2 overexpression showed intratumor heterogeneity with regard to their EGFR and c-erbB-2 status, respectively.

Conclusions: The c-erbB-2 status could be adequately assessed not only by examining surgically resected materials, but also by examining multiple endoscopic biopsy specimens. On the other hand, to assess the EGFR status accurately, the use of surgically resected samples appeared to be more reliable than the use of multiple endoscopic biopsy samples.

Key Words: epidermal growth factor receptor • c-erbB-2 (HER2) • endoscopic biopsy specimen • fluorescence in situ hybridization • intratumor heterogeneity


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