110例乳腺癌患者HER-2基因扩增状况及其与临床病理特征的关系

摘要

目的 在蛋白及基因水平检测乳腺癌中HER-2的表达,比较免疫组化(IHC)及荧光原位杂交(FISH)法检测结果,探讨其与乳腺癌患者的临床病理特征关系.方法 应用免疫组化及荧光原位杂交法测定HER-2蛋白表达及基因扩增,并分析其与乳腺癌患者临床病理特征的相关性.结果 与FISH的一致性在IHC检测HER-2(+++)和HER-2(+/-)组较好,Kappa值＝0.444,两者一致率为72.2%,而在HER-2(++)组一致性较差.110例乳腺癌患者中,FISH检测有77例(70.0%)HER-2基因扩增.IHC法HER-2(+++)4例中全部有HER-2基因扩增;HER-2(++)92例中有68例(73.9%)HER-2基因扩增;HER-2(+/-)14例中有5例(35.7%)HER-2基因扩增.94例浸润性导管癌中66例(70.2%)有HER-2 基因扩增,7例浸润性小叶癌中有4例(57.1%)HER-2 基因扩增,9例其他肿瘤类型中有4例(44.4%)HER-2基因扩增.不同病理类型及浸润性导管癌的组织学分级间HER-2基因扩增阳性率差异无统计学意义(P > 0.05).HER-2基因扩增与ER、PR阴性状态有相关性(P < 0.05),与患者是否绝经无相关性(P > 0.05).结论 在HER-2(+++)和HER-2(+/-)中常可以用IHC代替FISH检测HER-2基因扩增状况,而对于HER-2(++)则应常规进行FISH检测.HER-2基因扩增状况与绝经、病理类型及浸润性导管癌组织学分级无相关性,与ER、PR表达呈负相关.HER-2基因可作为判断乳腺癌预后及拟订治疗方案的良好指标.%Objective To detect the HER-2 gene and protein expression in breast cancer, compare the results between immunohistochemistry (IHC) detection and Fluorescence In-Situ Hybridization (FISH) detection, and explore its correlation with clinicopathologic features of breast cancer patients. Methods HER-2 protein and amplification of HER-2 gene were assayed by use of IHC and FISH method respectively, and then the correlation between HER-2 expression of breast cancer and the clinicopathologic features of breast cancer patients was researched. Results The coincidence of FISH assaying results to IHC assaying results in HER-2 (+++) and HER-2 (+/-) groups were quite well, arriving at 72.2% and having a Kappa value 0.444, but the corresponding result in HER-2 (++) was relatively poor. There were total 77 HER-2 gene amplification cases out of 110 FISH assay cases of breast cancer. According to IHC assaying results, following results can be drawn: all the 4 HER-2 (+++) cases assayed had HER-2 gene amplification, 68 out of 92 cases HER-2 (++) had HER-2 gene amplification, and 5 out of 14 cases HER-2 (+/-) had HER-2 gene amplification. According to cancer types, following results can be drawn: 66 out of 94 cases with invasive ductal carcinoma had HER-2 gene amplification, 4 out of 7 cases with invasive lobular carcinoma had HER-2 gene amplification, and 4 out of 9 cases with other type of cancers had HER-2 gene amplification. The difference of positive rate of HER-2 gene amplification between different pathological types and histologic grade of invasive ductal carcinoma were not statistically significant (P > 0.05). HER-2 gene amplification had correlation to ER and PR negative state (P < 0.05), but had no relationship with whether patient was in menopause (P > 0.05). Conclusion IHC may take place of FISH in detecting HER-2 status in HER-2 (+++) and HER-2 (+/-) groups, but FISH should be used routinely in the HER-2 (++) detection. The presence of HER-2 amplification has no correlation to menopause, cancer type and histologic grade of invasive ductal carcinoma, but has negatively correlation to ER and PR expression. HER-2 gene can be an excellent indicator to judge breast cancer prognosis and protocol therapeutic schedule.