PDF(Pubmed)
Abstract：
BACKGROUND: HER2-targeted therapies have recently emerged as an option in the management of metastatic colorectal cancer (mCRC) overexpressing HER2. However, data regarding HER2 status in primary CRC and its corresponding liver metastases are limited, potentially influencing clinical decisions. Therefore, the aim of this study was to compare the HER2 status in primary CRC and paired liver metastases.
METHODS: Patients with mCRC who were operated from their primary colorectal cancer and their corresponding synchronous or metachronous liver metastases, in the digestive surgery department of Besançon University Hospital, between April 1999 and October 2021, were included. Tissue microarrays were constructed from matched primary CRC and liver metastastic tissue samples. HER2 status was assessed by immunohistochemistry and in situ hybridization according to Valtorta\'s criteria.
RESULTS: A series of 108 paired primary CRC and liver metastases, including a series of multiple liver metastases originating from the same patients (n = 24), were assessed. Among the primary CRC, 89 (82.4%), 17 (15.8%) and 2 (1.8%) cases were scored 0, 1 + and 2 + respectively. In liver metastases, 99 (91.7%), 7 (6.5%) and 2 (1.8%) were scored 0, 1 + and 2, respectively. Overall, there was a 19% discrepancy rate in HER2 status between primary CRC and metastases, which increased to 21% in cases with multiple synchronous or metachronous liver metastases in a given patient. No significant difference was found between metachronous and synchronous metastases regarding the HER2 status (p = 0.237).
CONCLUSIONS: Our study highlights the temporal and spatial heterogeneity of HER2 status between primary CRC and corresponding liver metastases. These findings raise the question of a sequential evaluation of the HER2 status during disease progression, to provide the most suitable treatment strategy.
METHODS: Patients with mCRC who were operated from their primary colorectal cancer and their corresponding synchronous or metachronous liver metastases, in the digestive surgery department of Besançon University Hospital, between April 1999 and October 2021, were included. Tissue microarrays were constructed from matched primary CRC and liver metastastic tissue samples. HER2 status was assessed by immunohistochemistry and in situ hybridization according to Valtorta\'s criteria.
RESULTS: A series of 108 paired primary CRC and liver metastases, including a series of multiple liver metastases originating from the same patients (n = 24), were assessed. Among the primary CRC, 89 (82.4%), 17 (15.8%) and 2 (1.8%) cases were scored 0, 1 + and 2 + respectively. In liver metastases, 99 (91.7%), 7 (6.5%) and 2 (1.8%) were scored 0, 1 + and 2, respectively. Overall, there was a 19% discrepancy rate in HER2 status between primary CRC and metastases, which increased to 21% in cases with multiple synchronous or metachronous liver metastases in a given patient. No significant difference was found between metachronous and synchronous metastases regarding the HER2 status (p = 0.237).
CONCLUSIONS: Our study highlights the temporal and spatial heterogeneity of HER2 status between primary CRC and corresponding liver metastases. These findings raise the question of a sequential evaluation of the HER2 status during disease progression, to provide the most suitable treatment strategy.
摘要：
背景：HER2靶向治疗最近已成为治疗过表达HER2的转移性结直肠癌（mCRC）的一种选择。然而,有关原发性CRC及其相应肝转移的HER2状态的数据有限，潜在影响临床决策。因此,本研究的目的是比较原发性CRC和配对肝转移的HER2状态.
方法：接受原发性大肠癌及其相应的同步或异发肝转移手术的mCRC患者，在贝桑松大学医院消化外科，1999年4月至2021年10月，包括在内。从匹配的原发性CRC和肝转移组织样品构建组织微阵列。根据Valtorta标准通过免疫组织化学和原位杂交评估HER2状态。
结果：一系列108成对的原发性CRC和肝转移，包括一系列源自同一患者的多发性肝转移（n=24），被评估。在主要的CRC中，89（82.4%），17例（15.8%）和2例（1.8%）分别为0、1+和2+。在肝转移中，99（91.7%），7分(6.5%)和2分(1.8%)分别为0、1+和2分。总的来说,原发性CRC和转移之间的HER2状态差异率为19%，在给定患者中，在具有多个同步或异发肝转移的情况下，该比例增加到21％。在HER2状态方面，异时转移和同步转移之间没有发现显着差异（p=0.237）。
结论：我们的研究强调了原发性CRC和相应肝转移之间HER2状态的时间和空间异质性。这些发现提出了在疾病进展期间对HER2状态进行顺序评估的问题。提供最合适的治疗策略。
方法：接受原发性大肠癌及其相应的同步或异发肝转移手术的mCRC患者，在贝桑松大学医院消化外科，1999年4月至2021年10月，包括在内。从匹配的原发性CRC和肝转移组织样品构建组织微阵列。根据Valtorta标准通过免疫组织化学和原位杂交评估HER2状态。
结果：一系列108成对的原发性CRC和肝转移，包括一系列源自同一患者的多发性肝转移（n=24），被评估。在主要的CRC中，89（82.4%），17例（15.8%）和2例（1.8%）分别为0、1+和2+。在肝转移中，99（91.7%），7分(6.5%)和2分(1.8%)分别为0、1+和2分。总的来说,原发性CRC和转移之间的HER2状态差异率为19%，在给定患者中，在具有多个同步或异发肝转移的情况下，该比例增加到21％。在HER2状态方面，异时转移和同步转移之间没有发现显着差异（p=0.237）。
结论：我们的研究强调了原发性CRC和相应肝转移之间HER2状态的时间和空间异质性。这些发现提出了在疾病进展期间对HER2状态进行顺序评估的问题。提供最合适的治疗策略。
