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Ann Thorac Surg 1998;66:1163-1164
© 1998 The Society of Thoracic Surgeons

Original articles: general thoracic

Invited commentary

David H. Harpole, Jr, MDa

a Division of Thoracic Surgery, Duke University Medical Center, Box 3617, Durham, NC 27710, USA

e-mail: harpo001{at}mc.duke.edu


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This article by Dr Hsieh and associates details the immunohistochemical evidence of overexpression of the HER-2/neu protein in 42 patients with stage I adenocarcinoma lung cancer. They describe a novel technique for quantifying the amount of HER-2/neu expression seen on microscope slides. Their scoring scale appears to be less subjective than the usual 0 to 2+ scoring system. It has often been complained that the review of immunoperoxidase staining is subjective, and this scoring scale should improve and standardize results across laboratories.

Data from our laboratories and others [1–3] have reinforced the results described in this article for evaluating the expression of HER-2/neu and early-stage non–small cell lung cancer. In the Comment section, Hsieh and associates reviewed the other methods of evaluating tumor protein expression such as tissue enzyme-linked immunosorbent assays and the measurement of the cleaved extracellular domain of the HER-2 protein in patient serum. As these techniques become more widely available and reproducible, they also may be helpful to the clinician.

There is no question that growth regulating factors such as the tyrosine kinase receptors (HER-2/neu, EGFR) are important not only in carcinogenesis but in tumor growth. The development of specific blocking agents of these receptors should block tumor growth and will undoubtedly be useful in the future.


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  1. Harpole DH Jr, Herndon JE II, Wolfe WG, Iglehart JD, Marks JR. A prognostic model of recurrence and death in stage I non–small cell lung cancer utilizing presentation, histopathology and oncoprotein expression. Cancer Res 1995;55:51–45.
  2. Harpole D.H., Jr, Marks J.R., Richards W.G., Herndon J.E., II, Sugarbaker D.J. Localized adenocarcinoma of the lung: oncogene expression of erbB-2 and p53 in 150 patients. Clin Cancer Res 1995;1:659-664.[Abstract]
  3. Harpole D.H., Jr, Richards W.G., Herndon J.E., II, Sugarbaker D.J. Angiogenesis and molecular biologic substaging in patients with stage I non–small cell lung cancer. Ann Thorac Surg 1996;61:1470-1476.[Abstract/Free Full Text]




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