结直肠癌组织中EGFR及HER-2的表达及临床意义

摘要

Purpose To exp1ore the expression and c1inica1 significance of epiderma1 growth factor receptor( EGFR)and human epi-derma1 receptor-2(HER-2)in co1orecta1 carcinoma. Methods Immunohistochemistry(IHC)PV-9000 was used to detect the expres-sion of EGFR and HER-2 in 78 cases of co1orecta1 carcinoma. Si1ver in situ hybridization( SISH)was used to detect HER-2 amp1ifica-tion in co1orecta1 carcinoma. Results The positive rates of EGFR in 78 co1orecta1 carcinomas were 69. 23%( 54/78 ). The differ-ences of the expression of EGFR between different depth of invasion group and 1ymph node metastasis group were statistica11y signifi-cant. The differences of the expression of EGFR between different aging group,gender group,tumor size,different histo1ogica1 grading group and Dukes stage were insignificant. The positive rates of HER-2 in 78 cases of co1orecta1 carcinoma were 25. 64%(20/78). The differences of the expression of HER-2 between different depth of invasion group and 1ymph node metastasis group were statistica11y sig-nificant. The differences of the expression of HER-2 between different aging group,gender group,tumor size,histo1ogica1 grading group and Dukes stage were insignificant. The expression of EGFR and HER-2 was positive1y corre1ated. Among the 20 cases of HER-2 protein overexpression,10 cases showed HER-2 gene amp1ification,15 cases showed HER-2 protein overexpression(~)by IHC and 10 cases showed HER-2 gene amp1ification by SISH. The rate of HER-2 gene amp1ification was 66. 67%. 5 cases with 1ow HER-2 protein overexpression( +)and no case showed HER-2 gene amp1ification. Conclusions EGFR and HER-2 are high1y ex-pressed in co1orecta1 carcinoma. EGFR and HER-2 expression is connected to invasion and metastasis process of co1orecta1 carcinoma. The both may be synergy. The corre1ation between HER-2 protein overexpression(~)and HER-2 gene amp1ification is statisti-ca11y significant. Therefore,immunohistochemistry can be regarded as an initia1 screening method for HER-2 gene amp1ification,and then SISH testing shou1d be done as we11 to confirm the resu1t. It is usefu1 for mo1ecu1ar target therapy to detect HER-2 status in co1or-ecta1 carcinoma.%目的：探讨结直肠癌组织中表皮生长因子受体（ epiderma1 growth factor receptor，EGFR）和人类表皮生长因子受体-2（ hu-man epiderma1 receptor-2，HER-2）蛋白的表达，并分析二者与临床病理特征的关系。方法采用免疫组化PV-9000两步法检测78例结直肠癌组织中EGFR和HER-2的表达，分析二者表达与结直肠癌临床病理特征的关系；应用银染原位杂交（ si1ver in situ hybridization，SISH）法检测结直肠癌组织中HER-2基因扩增情况。结果 EGFR在结直肠癌组织中的阳性率为69.23%（54/78），EGFR表达与结直肠癌浸润深度、淋巴结转移呈正相关，与患者性别、年龄、肿瘤大小、细胞分化程度、Dukes分期无关；HER-2在结直肠癌组织中的阳性率为25.64%（20/78），HER-2表达与结直肠癌浸润深度、淋巴结转移呈正相关，与患者性别、年龄、肿瘤大小、细胞分化程度、Dukes分期无关。EGFR与HER-2蛋白表达呈正相关。20例HER-2蛋白阳性者中，10例HER-2基因扩增；其中15例HER-2蛋白（~）中有10例HER-2基因扩增，占高表达组的66.67%；5例HER-2蛋白（+）者无HER-2基因扩增。结论 EGFR和HER-2蛋白在结直肠癌中均呈高表达，EGFR和HER-2的表达与结直肠癌侵袭、转移密切相关，二者可能存在协同作用。HER-2蛋白（~）与HER-2基因扩增密切相关，故该类患者可考虑先行免疫组化初步筛选，再行SISH法检测确认，从而为结直肠癌分子的靶向治疗提供有价值的信息。