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HER2 heterogeneity in gastric/gastroesophageal cancers: From benchside to practice

World Journal of Gastroenterology 2016年第26期22卷 5879-5887页

作者： federica grillo Matteo Fassan Francesca Sarocchi Roberto Fiocca Luca Mastracci Department of Surgical and Diagnostic Sciences Pathology Unit University of Genoa 16132 Genoa Italy Institute for Research and Cure of Cancer (IRCCS) S. Martino-IST University Hospital 16132 Genoa Italy Department of Medicine (DIMED) Surgical Pathology Unit University of Padua 35121 Padua Italy

HER2 is overexpressed in approximately 10%-20% of gastric and gastroesophageal junction carcinomas. In these types of cancer, accurate assessment of HER2 status is mandatory, for selecting patients who may benefit from targeted therapies with anti-HER2 drugs such as Trastuzumab. This manuscript focuses on HER2 in gastric carcinogenesis, on optimal evaluation of HER2 and on the possible causes which may contribute to inaccurate HER2 evaluation. Similarly to breast cancer HER2 evaluation, standardization of HER2 testing in gastric cancer is necessary in diagnostic practice. The three principle aspects which require consideration are:(1) the choice of sample with regards to cancer morphology- intestinal vs diffuse areas;(2) the choice of scoring criteria- use of HER2 scoring criteria specific for gastric cancer; and(3) the choice of HER2 evaluation methods- use of an algorithm in which both immunohistochemistry and in situ hybridization play a role. Problematic issues include:(1) pre-analytic variables with particular emphasis on fixation;(2) recommended methodology for HER2 assessment(immunohistochemistry vs in situ hybridization);(3) HER2 heterogeneity both within the primary tumor and between primary tumor and metastases;(4) reliability of biopsies in HER 2 evaluation; and(5) quantity of sample(FFPE blocks from surgical specimens or endoscopic biopsies) necessary for an adequate assessment.

关键词： Gastric cancer HER2 Heterogeneity Immunohistochemistry FISH

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Narrow-band imaging with magnifying endoscopy is accurate for detecting gastric intestinal metaplasia

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World Journal of Gastroenterology 2013年第17期19卷 2668-2675页

作者： Edoardo Savarino Marina Corbo Pietro Dulbecco Lorenzo Gemignani Elisa Giambruno Luca Mastracci federica grillo Vincenzo Savarino Gastroenterology Unit Department of Surgical Oncological and Gastroenterological Sciences University of Padua Gastroenterology Unit Department of Internal Medicine University of Genoa Department of Anatomic Pathology University of Genoa

AIM:To investigate the predictive value of narrowband imaging with magnifying endoscopy (NBI-ME) for identifying gastric intestinal metaplasia (GIM) in unselected patients. METHODS:We prospectively evaluated consecutive patients undergoing upper endoscopy for various indications, such as epigastric discomfort/pain, anaemia, gastro-oesophageal reflux disease, suspicion of peptic ulcer disease, or chronic liver diseases. Patients underwent NBI-ME, which was performed by three blinded, experienced endoscopists. In addition, five biopsies (2 antrum, 1 angulus, and 2 corpus) were taken and examined by two pathologists unaware of the endoscopic findings to determine the presence or absence of GIM. The correlation between light blue crest (LBC) appearance and histology was measured. Moreover, we quantified the degree of LBC appearance as less than 20% (+), 20%-80% (++) and more than 80% (+++) of an image field, and the semiquantitative evaluation of LBC appearance was correlated with IM percentage from the histological findings. RESULTS:We enrolled 100 (58 F/42 M) patients who were mainly referred for gastro-esophageal reflux disease/dyspepsia (46%), cancer screening/anaemia (34%), chronic liver disease (9%), and suspected celiac disease (6%); the remaining patients were referred for other indications. The prevalence of Helicobacter pylori (H. pylori ) infection detected from the biopsies was 31%, while 67% of the patients used proton pump inhibitors. LBCs were found in the antrum of 33 patients (33%); 20 of the cases were classified as LBC+, 9 as LBC++, and 4 as LBC+++. LBCs were found in the gastric body of 6 patients (6%), with 5 of them also having LBCs in the antrum. The correlation between the appearance of LBCs and histological GIM was good, with a sensitivity of 80% (95%CI:67-92), a specificity of 96% (95%CI:93-99), a positive predictive value of 84% (95%CI:73-96), a negative predictive value of 95% (95%CI:92-98), and an accuracy of 93% (95%CI:90-97). The NBI-ME ex

关键词： Narrow-band imaging Magnification Gastric intestinal metaplasia Light blue crest Gastric cancer Endoscopy Precancerous conditions Gastric biopsy

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Histopathological landscape of rare oesophageal neoplasms

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World Journal of Gastroenterology 2020年第27期26卷 3865-3888页

作者： Gianluca Businello Carlo Alberto Dal Pozzo Marta Sbaraglia Luca Mastracci Massimo Milione Luca Saragoni federica grillo Paola Parente Andrea Remo Elena Bellan Rocco Cappellesso Gianmaria Pennelli Mauro Michelotto Matteo Fassan Department of Medicine(DIMED) Surgical Pathology and Cytopathology UnitUniversity of PaduaPadua 35121Italy Department of Surgical and Diagnostic Sciences(DISC) Pathology UnitUniversity of GenovaGenova 16123Italy Department of Pathology and Laboratory Medicine First Pathology DivisionFondazione IRCCS-Istituto Nazionale dei TumoriMilan 20133Italy Pathology Unit Morgagni-Pierantoni HospitalForlì47121Italy Pathology Unit Fondazione IRCCS Casa Sollievo della SofferenzaSan Giovanni Rotondo 71013Italy Department of Pathology Ospedale Mater Salutis di LegnagoLegnago 37045Italy

The landscape of neoplastic pathology of the oesophagus is dominated by malignancies of epithelial origin,in particular by oesophageal adenocarcinoma and oesophageal squamous cell ***,several other histopathological variants can be distinguished,some associated with peculiar histopathological profiles and prognostic behaviours and frequently underrecognized in clinical *** aim of this review is to provide a comprehensive characterization of the main morphological and clinical features of these rare variants of oesophageal neoplastic lesions.

关键词： Gastrointestinal tumours Oesophageal tumours Histopathology Rare tumours Mesenchymal tumours

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