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Use of immunohistochemistry and silver in situ hybridization (Sish) in evaluation of human epidermal growth factor receptor2 (HER2/neu) status in Iraqi patients with breast cancer

Breast cancer is the commonest cause of cancer related death in women worldwide. Amplification or over-expression of the ERBB2 (HER/neu) gene occurs in approximately 15-30% of breast cancer cases and it is strongly associated with an increased disease recurrence and a poor prognosis. Determination of HER2/neu status is crucial in the treatment plan as that positive cases will respond to trastuzumab therapy. It has been used to test for HER2/neu by immunohistochemistry as a first step and then to study only the equivocal positive cases (score 2+) by in situ hybridization technique. The aim of our study is to compare between immunohistochemistry and silver in situ hybridization (SISH) in assessment of human epidermal growth factor (HER2/neu) receptors status among breast cancer patients. A cross-sectional study was conducted at The Medical City in Baghdad, from October 2016 to April 2017, where formalin fixed, paraffin embedded tumor tissue from 52 female patients (aged 33 to 71 years) with the diagnosis of breast cancer have been included in this study for the evaluation of human epidermal growth factor (HER2/neu) protein overexpression and gene amplification by immunohistochemistry and silver in situ hybridization (SISH) method respectively. Base line data about patients were obtained from their hospital records. The distribution of human epidermal growth factor (HER2/neu) protein overexpression by immunohistochemistry showed that the (+2) score/equivocally positive were seen in 24 cases, which comprise the largest number of cases in this study (46.15%). Ten cases (19.23%) for each of scores 0/negative and +1/negative were present, while (+3) score/positive was the smallest group with only 8 cases (15.38% of cases). All results of SISH were negative in the category of (0 score/negative). In the contrary, all the 8 cases in (+3 score/positive) category were showing positive SISH results. Category (+1 score/negative) HER2 showed two cases (20%) with a positive SISH result, while that of (+2 score/equivocal positive) showed 8 positive cases (about 33.33%). For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridization (ISH) are the recommended techniques, with high concordance between the two techniques, however; performance of silver in situ hybridization in assessment of HER2/neu gene status in all cases of invasive breast carcinoma is recommended as significant number of negative cases by immunohistochemistry showed positive amplification by in situ hybridization and can be treated with anti-HER2 targeted treatments.

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Publication Date
Sun Jul 07 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Chromogenic in Situ Hybridization Technique versus Immunohistochemistry in Assessment of HER2/neu Status in 448 Iraqi Patients with Invasive Breast Carcinoma

BACKGROUND: The rapidly growing knowledge regarding factors controlling tumour growth, with the new modalities of therapy acting on the biological activity of the tumours draw the attention of most cancer researches nowadays and represent a major focus for clinical oncology practice. For the detection of HER2/neu protein overexpression and gene amplification, immunohistochemistry (IHC) and in-situ hybridisation (ISH) is the recommended techniques, respectively, with high concordance between the two techniques. The current United Kingdom recommendations for HER2/neu testing are either for a two-tier system using IHC with reflex ISH testing in equivocal positive cases, or a one-tier ISH strategy. AIM: To compare the results of HER2/neu gene s

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Publication Date
Thu Dec 01 2016
Journal Name
Karbala Journal Of Medicine
Assessment Of Her-2/Neu Gene Amplification Status by Chromogenic in Situ Hybridization in Breast Cancer Patients with Equivocal 2+ Her-2/Neu Immunostaining and Its Relation to The Clinic Pathological Parameters

background: human epidermal growth factor receptor-2 (her2/neu) is related to growth factor receptors with alkaline kinase activity and it is regarded as important prognostic and therapeutic factor that can depended on in breast cancer therapy. HER2/neu expression by immunohistochemistry (IHC) is submitted to a great in terob server inconsistency. Subsequently additional confirmatory tests for assessment of gene alterations and amplification status are needed for patients with early or metastatic breast cancer. In situ hybridization techniques and specifically Chromogenic in situ hybridization (CISH) was arise as a practical, cost-effective, and alternative to fluorescent in situ hybridization in testing for gene alterationAims of the study

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Publication Date
Fri Dec 07 2018
Journal Name
Asian Journal Of Pharmaceutical And Clinical Research
IMMUNOHISTOCHEMICAL EXPRESSION OF THE PROMISING THERAPEUTIC TARGET (HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR 2/NEU) IN IRAQI PATIENTS WITH MEDULLOBLASTOMA

Objectives: With the advent of ongoing novel modalities toward the treatment of human epidermal growth factor receptor 2 (HER2)/NEU - positive malignancies, the serious side effects of chemoradiotherapy have been minimized. Hence, this study was conducted to identify the patterns of immunohistochemical expression of the promising therapeutic target (HER2/NEU) among Iraqi patients with medulloblastoma in an attempt to provide basic histological information’s that would help in future clinical researches.Materials and Methods: In this retrospective study, 42 formalin - fixed paraffin - embedded tissue blocks represent cases of surgically removed medulloblastomas were retrieved from the archived materials in a specialized surgical ho

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Publication Date
Mon Apr 01 2019
Journal Name
Biochemical And Cellular Archives
Association Of Human Cytomegalovirus With Her2 Protooncogene Overexpression In Iraqi Breast Cancer Patients

Human cytomegalovirus (HCMV) has a worldwide distribution and common infections. The presence of HCMV genome and antigens has been detected in many kinds of human cancers. The proto-oncogene Her2/neu is overexpressed in 25% to 30% of human breast cancers and frequently associated with tumor aggressiveness and worse prognosis. Examination was applied to detect different HCMV antigens and to demonstrate their correlation with Her2/neu overexpression in breast cancer. The present study includes samples from 70 women of 60 breast cancer patients and 10 normal breast tissues. Formalin-fixed paraffin embedded tissue blocks were obtained from each woman according to ethical approval. Human cytomegalovirus early antigen expression was detected in 5

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Publication Date
Wed Apr 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Detection of Human Papilloma Virus type 6 and type 11 in women with Breast Cancer by in situ hybridization technique.

Background: Breast cancer is one of the common malignancies among women worldwide. Human papillomavirus (HPV) infections have been linked to many human cancers in addition to cervical cancer and one of them is breast cancer.
Objective: To investigate the presence of human papilloma virus type 6 and type 11in breast cancer tissue specimens by in situ hybridization technique.
Patients and Methods: Thirty four formalin-fixed, paraffin embedded tissue blocks from breast cancer patients were obtained from the archives of the pathology laboratory of Al-Yarmouk Teaching Hospital from January 2011 to July 2012. In addition formalin-fixed, paraffin embedded blocks tissue for twenty fibroadenoma of breast were collected and used as control g

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Breast Cancer Subtypes among Iraqi Patients: Identified By Their ER, PR and HER2 Status

Background: Breast cancer ranks the first among the Iraqi population since three decades and is currently forming a major public health problem being the second cause of death women. Novel management of breast cancer depends upon precise evaluation of their molecular subtypes; identified by Hormone (Estrogen and Progesterone) receptors and HER2 contents of the primary tumor.
Objective: To assess the rates of the different molecular breast cancer subtypes in the examined tissue specimens belonging to females diagnosed with breast cancer in Iraq; correlating the findings with those reported in the literature at the regional and global levels.
Patients and Methods: This retrospective study documented the findings of tissue biopsy exam

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Publication Date
Sun Jan 01 2017
Journal Name
Indian Journal Of Pathology And Microbiology
Assessment of topoisomerase II-alpha gene status by dual color chromogenic in situ hybridization in a set of Iraqi patients with invasive breast carcinoma

Abstract Background: The human epidermal growth factor receptor 2(HER2) proto-oncogene is overexpressed or amplified in approximately 15%-25% of invasive breast cancers. Approximately 35% of HER2-amplified breast cancers have coamplification of the topoisomerase II-alpha (TOP2A) gene encoding an enzyme that is a major target of anthracyclines. Hence, the determination of genetic alteration (amplification or deletion) of both genes is considered as an important predictive factor that determines the response of breast cancer patients to treatment. The aims of this study are to determinate TOP2A status gene amplification in a set of Iraqi patients with breast cancer that have had an equivocal (2+) and positive HER2/neu by immunohistochemistry

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Ultrasound findings in prediction of breast cancer histological grade and HER2 status

Background: Breast cancer is the most frequent cancerous tumor and major cause of death from cancer between women all over the world.
Objectives: is to assess if ultrasound features of breast cancer can predict its histopathological grade and HER2 status of breast cancer for patients had their diagnosis in Oncology Teaching Hospital in Medical city complex from September 2014 to November 2015
Patients and Methods: This is retrospective study of 102 patients whom histopathologically proved breast cancer had reviewed their ultrasound findings and correlate them with histopathological grade and HER2 status.
Results: well circumscribed lesions, poorly defined and spiculated lesions are more likely to be of intermediate to high grade

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Clinical And Diagnostic Research
Immunohistochemical Expression of HER2/neu Receptors in Iraqi Patients with Endometrioid Carcinoma

Introduction: With the advent of era of targeted cancer therapy, the serious side effects of chemoradiotherapy have been minimised. Considering the success story of anti-HER2/neu drugs in breast cancer oncology, the present study was conducted. The study evaluates the immunohistochemical expression of HER2/neu in endometrioid cancer among Iraqi patients. Aim: To assess the immunohistochemical expression of HER2/neu in endometrioid carcinoma of uterus and to find the relationship of this expression with FIGO stage and grade and with patient age. Materials and Methods: In this cross sectional study, formalin-fixed, paraffin-embedded tissue blocks of 62 hysterectomy specimens that were diagnosed as endometrioid carcinoma in the teaching labora

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Publication Date
Thu Jan 14 2016
Journal Name
International Journal For Sciences And Technology
Evaluation of her/2-neu gene status using FISH/CISH techniques in Iraqi breast carcinoma patients

The present study aimed to examine the concordance between FISH/CISH techniques for assessment of amplification of her2neu gene in Iraqi breast carcinoma patients. Seventy four (74) Iraqi breast cancer patients were involved at the study from the Histopathology Department at the Central Public Health Laboratory in Bagdad, Iraq. Amplification of HER2neu was detected in (33.8%) by fluorescence in situ hybridization and (13.51%) showed high amplification by chromogenic in situ hybridization and (32.43%) showed low amplification. The results of chromogenic in situ hybridization were significantly correlated with the results of two-color fluorescence in situ hybridization with the same tumors. In addition, the study involved the correlation betw

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