Question re "numbers"

[Soccermom]

Hi folks,
quick question...

What testing method gives a Her2 result in the double digits? The only ones that I am ware of are FISH and IHC neither of which,to my knowledge, ranges to the double digits. In Barbs talk w Dr Pegram he spoke of ranges in the doiuble digits, so I am confused?
"

Thanks for any clarification,
Marcia

"
There are 2 types of tests available to determine HER2 status: Fluorescence In Situ Hybridization (FISH) and ImmunoHistoChemistry (IHC).

• A FISH test checks to see whether or not the cancer cells have a normal number of HER2 genes. Using a special microscope the pathologist looks at cancer cells to see how many HER2 genes there are compared with some other normal genes
  • If there are 2 or more HER2 genes for each normal gene in the cells (that is, if the ratio is =2.0) the tumor is HER2+
• An IHC test measures how much HER2 protein there is on the surface of the cancer cells. The test is scored on a scale of 0 to 3+
  • A patient who has a tumor with a score of 3+ is considered to have HER2+ breast cancer
  • The National Comprehensive Cancer Network guidelines recommend that a tumor with a score of 2+ should be retested with the FISH test to determine whether the tumor is HER2+

[PinkGirl]

Hi Soc
The way I read it, Dr. Pegram was talking about
the FISH test when he listed the double digit
numbers. I didn't think they went that high.

[Hazel Joyce]

When I read Dr. Pegram's response, I took it to mean the number of copies of the HER-2/neu gene on each cell. My pathology report says that I had an average of 20 copies per cell. My ratio was 10.5 (FISH).

[Karen W]

If I remember correctly, mine is 6.3.

Karen

[PinkGirl]

That makes more sense Hazel.

[lilyecuadorian]

on liver : mine is her2 neu:CEP17 ratio 63/148 = 4.2
on my breast: CEP17 ratio+385/100= 3.8

[Soccermom]

OK, maybe I just need an interpretation of my original path..
"Sixty tumor nuclei were counted and showed an average of 10+ copies of LSI Her-2 gene per nucleus and an average of 2.6 copies of CEP17 per nucleus.

The tumor cells demonstrate amplification of the her-1/neu gene copy levels (Her-2neu: CEP17 signal ratio 3.85) "

I dont see any high numbers thats why Dr Pegrams reference to double digits had me baffled?

Thanks to anyone who might care to explain!
Hugs,marcia

[PinkGirl]

Hi Soc

This is how I understand the FISH test

They always check 60 tumour cell nuclei.
The Her2 gene # is compared to the CEP 17 #

Your Her2 was 10
Your CEP 17 was 2.6

10 divided by 2.6 is 3.85

The double digit numbers are like your "10". It could
have been 20, 30, 40 etc.

[Joanne S]

I'm learning something new.
CEP17 = chromosome 17 centromere
centromere is a region in the middle of the chromosome involved in cell division and the control of gene expression.

Results of the HER-2/CEP17 FISH assay should always be used in conjunction with other information available from the clinical evaluation of the patient and other prognostic factors, such as tumor size, histologic grade, nodal status, patient's age, hormone receptor status, and other known risk factors.
</FIELD-TEXT>

Perhaps this may help.
http://metasystems.de/downloads/a04_loerch.pdf
http://www.nature.com/modpathol/jour.../3880505a.html

[tousled1]

The HER2 Serum test will give you double digits. A normal reading would be 15 and below.

[Soccermom]

WOW!!! Thank you one and all for the wealth of information (Joanne YOU ROCK!)
Never been a "10" before !! This is a good thing I take it!
Thanks again,Marcia