Concordance between HER2 IHC/FISH status and HER2 mRNA levels. (A) The percent concordances of HER2-low and HER2 0 were 74.9% and 41.3%, respectively, and Cohen’s kappa was 0.126, p < 0.001; (B) The percent concordances of HER2 2+/FISH− and HER2 0/1+ were 77.6% and 40.3%, respectively, and Cohen’s kappa was 0.169, p < 0.001. a HER2 mRNA expression level was classified as low level or high level by the ΔCT cut-off value from the ROC curve; the ΔCT cut-off between HER2 0 and HER2-low was 3.10 (low level, ΔCT ≥ 3.10; high level, ΔCT < 3.10); the ΔCT cut-off between HER2 0/1+ and HER2 2+/FISH− was 2.98 (low level, ΔCT ≥ 2.98; high level, ΔCT < 2.98). b Concordance was calculated using IHC/FISH as standard test. Abbreviations: HER2, human epidermal growth factor receptor 2; IHC, immunohistochemistry; FISH, fluorescence in situ hybridization; mRNA, message ribonucleic acid; CT, cycle threshold.