Intratumoral HER2 heterogeneity is a well-described gastric cancer feature and may explain many false-negative results related to this oncogene. An 81-year-old man was diagnosed at our hospital with stage IV gastric cancer with multiple lymph node metastases. Immunohistochemistry (IHC) analysis indicated that the primary tumor was HER2-negative. After a chemotherapy course, we submitted a pretreatment biopsy specimen for comprehensive cancer genome profiling (CGP) to determine the last-line therapy. This revealed HER2 amplification. The specimen was reevaluated using fluorescence in situ hybridization and IHC with deeper-cut specimens, which confirmed that the tumor was indeed HER2-positive. Therefore, the patient was treated with chemotherapy plus trastuzumab, which elicited tumor shrinkage and conferred long-term survival. Our current data underscore the CGP importance, which can provide more accurate tumor profilings and inform subsequent treatment decisions.
"},{"@language":"ja","@value":"症例は81歳男性，cStage IVのHER2陰性（0）胃癌として化学療法を行った．最終治療前のがん遺伝子パネル検査で，HER2遺伝子の増幅が認められた．生検検体の薄切を追加し再検討したところ，HER2（2＋）の領域があり，FISH法で陽性であった．その後Trastuzumabを導入し，長期間生存中である．HER2の偽陰性が，がん遺伝子パネルで判明した貴重な症例と考えられた．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410293710918867969","@type":"Researcher","foaf:name":[{"@language":"en","@value":"WADA Hironori"},{"@language":"ja","@value":"和田 浩典"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867972","@type":"Researcher","foaf:name":[{"@language":"en","@value":"FUJINO Yasuteru"},{"@language":"ja","@value":"藤野 泰輝"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"},{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867843","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KAGEMOTO Kaizo"},{"@language":"ja","@value":"影本 開三"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867842","@type":"Researcher","foaf:name":[{"@language":"en","@value":"KIDA Yoshifumi"},{"@language":"ja","@value":"喜田 慶史"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867844","@type":"Researcher","foaf:name":[{"@language":"en","@value":"OKADA Yasuyuki"},{"@language":"ja","@value":"岡田 泰行"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867840","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MITSUI Yasuhiro"},{"@language":"ja","@value":"三井 康裕"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867841","@type":"Researcher","foaf:name":[{"@language":"en","@value":"OKAMOTO Koichi"},{"@language":"ja","@value":"岡本 耕一"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867970","@type":"Researcher","foaf:name":[{"@language":"en","@value":"BANDO Yoshimi"},{"@language":"ja","@value":"坂東 良美"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"徳島大学病院病理部"},{"@language":"en","@value":"Division of Pathology, Tokushima University Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867968","@type":"Researcher","foaf:name":[{"@language":"en","@value":"MIYAMOTO Hiroshi"},{"@language":"ja","@value":"宮本 弘志"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867973","@type":"Researcher","foaf:name":[{"@language":"en","@value":"SATO Yasushi"},{"@language":"ja","@value":"佐藤 康史"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]},{"@id":"https://cir.nii.ac.jp/crid/1410293710918867971","@type":"Researcher","foaf:name":[{"@language":"en","@value":"TAKAYAMA Tetsuji"},{"@language":"ja","@value":"高山 哲治"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Science"},{"@language":"ja","@value":"徳島大学大学院医歯薬学研究部消化器内科学分野"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"04466586"},{"@type":"EISSN","@value":"13497693"}],"prism:publicationName":[{"@language":"en","@value":"Nippon Shokakibyo Gakkai Zasshi"},{"@language":"ja","@value":"日本消化器病学会雑誌"},{"@language":"en","@value":"Nippon Shokakibyo Gakkai zasshi"},{"@language":"ja","@value":"日消誌"},{"@language":"en","@value":"Nippon Shokakibyo Gakkai Zasshi"},{"@language":"ja","@value":"日本消化器病学会雑誌"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society of Gastroenterology"},{"@language":"ja","@value":"一般財団法人 日本消化器病学会"}],"prism:publicationDate":"2022-10-10","prism:volume":"119","prism:number":"10","prism:startingPage":"937","prism:endingPage":"945"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2023004968"}],"availableAt":"2022-10-10","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E3%81%8C%E3%82%93%E9%81%BA%E4%BC%9D%E5%AD%90%E3%83%91%E3%83%8D%E3%83%AB%E6%A4%9C%E6%9F%BB","dc:title":"がん遺伝子パネル検査"},{"@id":"https://cir.nii.ac.jp/all?q=Trastuzumab","dc:title":"Trastuzumab"},{"@id":"https://cir.nii.ac.jp/all?q=HER2%E9%99%BD%E6%80%A7%E8%83%83%E7%99%8C","dc:title":"HER2陽性胃癌"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2009915739"},{"@type":"PUBMED","@value":"36216544"}]}