ARUP's Laboratory Test Directory

HER-2/neu (PATHWAY®) (4B5) Tissue Assay, Paraffin : 2002218

Mnemonic: 4B5 IP

Methodology: Immunohistochemistry
Performed: Mon-Fri
Reported: 1-5 days
Specimen Required: Collect: Tumor tissue.

Storage/Transport Temperature: Paraffin-embedded, formalin-fixed tissue block, or 5 unstained, positively charged slides at 20-25°C. (Min: 4 slides) Protect paraffin block from excessive heat. Ship in cooled container during summer months. Include surgical pathology report.

Unacceptable Conditions: No tumor in tissue. Frozen specimens and specimens fixed/processed in alternative fixatives (alcohol, Prefer®).

Stability (collection to initiation of testing): Ambient: Indefinitely; Refrigerated: Acceptable; Frozen: Unacceptable
Reference Interval:
Criteria for intensity of cell membrane staining with PATHWAY® HER-2/neu:
 
Grade Interpretations Microscopic Finding
0 Negative No staining is observed in invasive tumor cells.
1+ Negative Weak, incomplete membrane staining in any proportion of invasive tumor cells, or weak, complete membrane staining in less than 10% of cells.
2+ Equivocal Complete membrane staining that is nonuniform or weak but with obvious circumferential distribution in at least 10% of cells, or intense complete membrane staining in less than 30% of tumor cells.
3+ Positive Uniform intense membrane staining of
more than 30% of invasive tumor cells.
3+ reactions with HercepTest® are considered a positive result and indicative of a possible response to Herceptin therapy. 0 and 1+ reactions are considered negative and suggest a lack of response to Herceptin therapy. It is recommended that a 2+ result be confirmed by FISH testing, and FISH results should be considered definitive.

Interpretive Data: The results of the Ventana PATHWAY® anti-HER2/neu (4B5) rabbit monoclonal assay are interpreted in a semi-quantitative manner.  Assay is performed on paraffin-embedded, formalin-fixed tissue. Antibody clone is 4B5 and uses a biotinylated detection system.

ARUP Laboratories uses the ASCO/CAP criteria for interpretation of HER2 protein expression. Positive cases are those with uniform intense membrane staining of more than 30% of invasive tumor cell (Score 3+). Negative cases are defined as no staining (Score 0) or weak, incomplete membrane staining in any proportion of invasive tumor cells, or weak, complete membrane staining in less than 10% of cells (Score 1). Equivocal cases are those with complete membrane staining that is nonuniform or weak but with obvious circumferential distribution in at least 10% of cells, or intense complete membrane staining in 30% or less of tumor cells (Score 2). 

For more information refer to the ASCO/CAP guidelines found at http://www.jco.org.
CPT Code(s): 88360
 
 

 

 

 
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