ปัจจัยที่มีผลต่อการเสื่อมสภาพของสไลด์แก้วอิมมูโนฮีสโตเคมี HER2 ในผู้ป่วยมะเร็งเต้านม

Suchanan Rattanasalee

Authors

Suchanan Rattanasalee Anatomical Pathology Department, Nakornping Hospital

Keywords:

slide age, circumferential membranous staining, staining intensity, HER2

Abstract

Background: HER2 status is a key determinant of targeted therapy in breast cancer. Archived immunohistochemical slides are frequently re-evaluated in referred patients; however, slide degradation may lead to misinterpretation and adversely affect treatment planning.

Objectives: To investigate the factors and storage duration influencing the degradation of HER2 immunohistochemical glass slides archived for 1 to 5 years in patients with breast cancer.

Methods: This retrospective analytical study evaluated 154 HER2-positive (3+) immunohistochemical glass slides archived at Nakornping Hospital between June 2020 and December 2025. All slides were independently re-evaluated in circumferential membranous staining completeness and intensity by three pathologists, and associated factors were analyzed using logistic regression.

Results: Of the 154 glass slides, 105 (68.18%) retained their original 3+ staining quality. Within this preserved group, 37 slides (35.24%) had been archived for less than 1 year, and 94 (89.52%) were obtained from core needle biopsy specimens. When circumferential membranous staining completeness and intensity were assessed, slides archived for more than 1 year showed a continuous decline in preservation, with a crude OR of 0.70 (95% CI: 0.58–0.85, p < 0.001). Notably, slides archived for > 4–5 years exhibited a highly significant reduction in preservation quality, with a crude OR of 0.09 (95% CI: 0.03–0.33, p < 0.001). Conversely, tissue specimen size had no significant effect on quality preservation when controlling for the duration of storage.

Conclusion: Glass slides archived for more than 4 years show a significant decline in the reliability of HER2 assessment. Repeating immunohistochemistry on the corresponding paraffin block is therefore recommended rather than re-reading the archived slide.

References

World Health Organization. Breast cancer [Internet]. Geneva: World Health Organization; c2026 [updated 2026 Apr 16; cited 2026 May 24]. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer

International Agency for Research on Cancer. Cancer Today: Pie chart - Prevalence [Internet]. Lyon: World Health Organization; 2024 [updated 2024 Feb 8; cited 2026 May 24]. Available from: https://gco.iarc.who.int/today/en/dataviz/pie-prevalence?mode=cancer&types=2&sexes=2&populations=764_920&key=total&group_populations=1&sort_by=value1&prev_time=3

International Agency for Research on Cancer. South-Eastern Asia: cancer fact sheet [Internet]. Lyon: World Health Organization; c2024 [updated 2024 Feb 8; cited 2026 May 24]. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/920-south-eastern-asia-fact-sheet.pdf

Likhitmaskul T. Current status and risk factors of breast cancer [Internet]. Chonburi: Bangkok Hospital Pattaya; c2026 [updated 2026 Mar 11; cited 2026 May 24]. Available from: https://www.bangkokhospital.com/th/pattaya/content/breast-cancer-overview-bph [In Thai]

Shirman Y, Lubovsky S, Shai A. HER2-Low Breast Cancer: Current Landscape and Future Prospects. Breast Cancer (Dove Med Press). 2023;15:605-16. doi: 10.2147/BCTT.S366122.

Erickson AW, Ghodrati F, Habbous S, Jerzak KJ, Sahgal A, Ahluwalia MS, et al. HER2-targeted therapy prolongs survival in patients with HER2-positive breast cancer and intracranial metastatic disease: a systematic review and meta-analysis. Neurooncol Adv. 2020;2(1):vdaa136. doi: 10.1093/noajnl/vdaa136.

Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235(4785):177-82. doi: 10.1126/science.3798106.

Roche Diagnostics. HER2: Expressing potential beyond breast cancer [Internet]. Basel: F. Hoffmann-La Roche Ltd; c2022 [updated 2022 May 25; cited 2026 Feb 12]. Available from: https://diagnostics.roche.com/global/en/diagnostics-insights/her2-expressing-potential-beyond-breast-cancer.html

Che Y, Ren F, Zhang X, Cui L, Wu H, Zhao Z. Immunohistochemical HER2 Recognition and Analysis of Breast Cancer Based on Deep Learning. Diagnostics (Basel). 2023;13(2):263. doi: 10.3390/diagnostics13020263.

Begum NF, Ramalingam K, Ramani P. Storage, Retention, and Use of Leftover Pathology Specimens: The Underestimated Treasures. Cureus. 2024;16(1):e53025. doi: 10.7759/cureus.53025.

Grushko TA, Filiaci VL, Montag AG, Apushkin M, Gomez MJ, Monovich L, et al. Effects of Slide Storage on Detection of Molecular Markers by IHC and FISH in Endometrial Cancer Tissues From a Clinical Trial: An NRG Oncology/GOG Pilot Study. Appl Immunohistochem Mol Morphol. 2022;30(1):27-35. doi: 10.1097/PAI.0000000000000949.

Royal College of Pathologists of Thailand. Guidelines for initial design of anatomical pathology laboratories and examination rooms [Internet]. Bangkok: Royal College of Pathologists of Thailand; c2020 [cited 2026 Feb 12]. Available from: https://www.rcthaipathologist.org/album/pdf/5611e2a988cd480edb70e3bea17ec2c0.pdf [In Thai]

Mirlacher M, Kasper M, Storz M, Knecht Y, Dürmüller U, Simon R, et al. Influence of slide aging on results of translational research studies using immunohistochemistry. Mod Pathol. 2004;17(11):1414-20. doi: 10.1038/modpathol.3800208.

Nuovo AJ, Garofalo M, Mikhail A, Nicol AF, Vianna-Andrade C, Nuovo GJ. The effect of aging of formalin-fixed paraffin-embedded tissues on the in situ hybridization and immunohistochemistry signals in cervical lesions. Diagn Mol Pathol. 2013;22(3):164-73. doi: 10.1097/PDM.0b013e3182823701.

Schmid T, Hidde J, Grünier S, Jungnickel R, Dariz P, Riedel J, et al. Ageing Effects in Mounting Media of Microscope Slide Samples from Natural History Collections: A Case Study with Canada Balsam and PermountTM. Polymers (Basel). 2021;13(13):2112. doi: 10.3390/polym13132112.

Xie R, Chung JY, Ylaya K, Williams RL, Guerrero N, Nakatsuka N, et al. Factors influencing the degradation of archival formalin-fixed paraffin-embedded tissue sections. J Histochem Cytochem. 2011;59(4):356-65. doi: 10.1369/0022155411398488.

Ministry of Public Health, Office of the Permanent Secretary, Legal Division. Guidelines for medical record destruction [Internet]. Nonthaburi: Ministry of Public Health; c2025 [cited 2026 May 24]. Available from: https://legal.moph.go.th/index.php?option=com_remository&Itemid=814&func=pdfviewer&id=2104 [In Thai]

Li Q, Zhang R, Yan H, Zhao P, Wu L, Wang H, et al. Prognostic significance of HER3 in patients with malignant solid tumors. Oncotarget. 2017;8(40):67140-51. doi: 10.18632/oncotarget.18007.

Breast Cancer Research Foundation. Breast cancer statistics and resources [Internet]. New York: Breast Cancer Research Foundation; c2024 [cited 2026 Feb 12]. Available from: https://www.bcrf.org/breast-cancer-statistics-and-resources/