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Rosty, Christophe; Vincent-Salomon, Anne; Sastre-Garau, Xavier

International Journal of Gynecological Pathology: October 2004 - Volume 23 - Issue 4 - p 411-412
doi: 10.1097/01.pgp.0000139670.49581.b3
Letters to the Editor

To the Editor:

We thank Dr. Fadare and Dr. Zheng for their interest in our study, which reported a low occurrence of HER-2/neu overexpression/amplification in cervical carcinoma (1). Taken together, both studies found an overall HER-2/neu expression in 4/243 (1.6%) of primary cervical carcinomas, as determined by immunohistochemistry. The small subset of cervical carcinoma with HER-2/neu immunostaining represents 4/53 (7.5%) of adenocarcinomas. These tumors seem not to be associated with HPV infection and thus may define a specific entity with a distinctive biology that requires further investigation. Interestingly, the two immunohistochemical methods gave similar positive results, with the HerCept test (DakoCytomation) showing no indeterminate 2+ immunoreactivity. Because our cases with diffuse HER-2/neu immunostaining were not associated with HER-2/neu gene amplification, it would have been interesting to perform FISH analysis on these other two cases. Our study also found two tumors with a focal strong HER-2/neu immunostaining in <5% of neoplastic cells. Such results may be missed by using tissue microarray that analyze only a small part of the tumor tissue. Belone et al. (2) reported a shift from negative to positive HER-2/neu expression at the time of tumor relapse for two patients. This finding would suggest that a fraction of the primary tumor may have HER-2/neu overexpression that is selected during the metastatic process. Our cases with focal immunostaining may support this hypothesis. If confirmed in a large series of cases with relapse and metastasis, it would indicate that only advanced stage cervical carcinoma need be tested for HER-2/neu overexpression. However, this hypothesis is in disagreement with results we obtained in breast carcinoma (3), showing that HER-2/neu status is stable during the metastatic process.

Christophe Rosty

Anne Vincent-Salomon

Xavier Sastre-Garau





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1. Rosty C, Couturier J, Vincent-Salomon A, et al. Overexpression/amplification of HER-2/neu is uncommon in invasive carcinoma of the uterine cervix. Int J Gynecol Pathol 2004;23:13–7.
2. Bellone S, Palmieri M, Gokden M, et al. Selection of HER-2/neu-positive tumor cells in early stage cervical cancer: Implications for Herceptin-mediated therapy. Gynecol Oncol 2003;91:231–40.
3. Vincent-Salomon A, Jouve M, Genin P, et al. HER2 status in patients with breast carcinoma is not modified selectively by preoperative chemotherapy and is stable during the metastatic process. Cancer 2002;94:2169–73.
©2004International Society of Gynecological Pathologists