HER-2/neu gene amplification by FISH predicts poor survival in Barrett's esophagus-associated adenocarcinoma

The HER-2/neu oncogene is localized to chromosome 17q and shares significan t homology with the epidermal growth factor receptor. HER-2/neu protein ove rexpression has been associated with poor prognosis in a variety of tumors, but its significance in Barrett's esophagus-associated adenocarcinoma (BEA d) is unknown. Therefore, the aim of this study was to evaluate the prevale nce and prognostic value of HER-2/neu gene amplification by fluorescence in situ hybridization (FISH) in 63 cases of BEAd. Routinely processed tissue sections from resection specimens of 63 patients with BEAd (M/F ratio, 10:1 ; mean age, 63 years) were assayed for HER-2/neu gene amplification by FISH using the Ventana unique sequence probe (Ventana Medical Systems, Inc, Tus con, AZ). FISH results were correlated with the pathological features of th e tumors and with patient survival. Clinical follow-up data were available for 54 patients (mean follow-up, 31 months [range, 1 to 152 months]). The H ER-2/neu gene was amplified in 12 of 63 (19%) cases. The presence of HER-2/ neu gene amplification showed a trend toward a correlation with depth of tu mor invasion (P=.07), lymph node metastasis (P =.13), and pathological stag e (P =.14), but did not correlate with any of the other pathological featur es, such as degree of differentiation or tumor size. On both univariate and multivariate analysis, HER-2/neu gene amplification was associated with sh ortened survival (P =.03). HER-2/neu oncogene amplification, as determined by FISH, correlates with shortened patient survival and independently predi cts poor outcome in patients with BEAd. HUM PATHOL 31:35-39. Copyright (C) 2000 by W.B. Saunders Company.