Figure 1.

Diagnostic algorithm for HER2 status evaluation in gastric and gastroesophageal adenocarcinomas. Immunohistochemistry (IHC) represents the initial testing method. IHC score 0 and 1+ are considered negative while score 3+ cases are considered positive and do not need further testing. Fluorescence in situ hybridization testing is required only for equivocal IHC score 2+ cases. On the basis of HER2 (red spots): CEP 17 (green spots) ratio (< 2 vs ≥ 2) patients are eligible or not to anti-HER2 therapy.