荧光原位杂交与免疫组织化学检测胃癌组织中HER-2基因及蛋白表达一致性

摘要

Purpose To investigate the consistency of HER-2 expression in gastric carcinoma by fluorescence in situ hybridization ( FISH ) and immunohistochemistry ( IHC ). Methods The expression of C-erbB-2 protein and HER-2 gene amplification in 50 cases of gastric cancer were detected by IHC and FISH, respectively, and the concordance between them was analyzed by SPSS 19. 0. Results The expression of C-erbB-2 protein was negative, weak, moderately and strongly positive in 26, 11, 9 and 4 cases, respectively, by IHC. 11 cases were HER-2 gene positive in FISH, among which 2, 5 and 4 cases were weak, moderately and strongly positive in IHC respectively. All of 4 cases with strongly positive C-erbB-2 expression by IHC were positive in FISH. However, HER-2 gene amplification existed in 5 cases among 9 cases with moderately positive C-erbB-2 expression by IHC. Conclusions The concordance rate in our investigation between IHC and FISH of HER-2 is 95. 1% , with a high degree of consistency ( Kappa coefficient 0. 773 , P ＜ 0. 001 ). In addition, the results of IHC and FISH have a higher coincidence rate in the cases with strongly positive or negative ( negative or weak positive ) expression of C-erbB-2. It can be an indication to decide whether herceptin can be used in clinical therapy or not. But in the cases with moderately positive expression of C-erbB-2, the results of FISH are diversified, indicating these cases need further detection by FISH.%目的 探讨荧光原位杂交(fluorescence in situ hybridization,FISH)与免疫组织化学(immunohistochemistry,IHC)检测胃癌组织中HER-2基因扩增及与C-erbB-2蛋白表达结果的一致性.方法 采用FISH和IHC法分别检测50例胃癌组织中HER-2基因扩增和C-erbB-2蛋白表达,并采用SPSS 19.0进行统计学分析.结果 50例胃癌标本进行IHC检测结果11例为(﹢),9例为(++),4例为(+++),26例为(-);50例胃癌标本进行FISH检测结果11例为(+),39例为(-);其中,FISH检测阳性标本中IHC检测有2例(﹢),5例(++),4例(+++).IHC检测C-erbB-2蛋白为(+++)的病例FISH检测均为(+),而IHC检测C-erbB-2蛋白(++)的9位患者中有4例经FISH检测证实HER-2呈(-),5例呈(+).结论 IHC与FISH检测HER-2状态结果的符合率为95.1%(39/41),具有高度一致性(Kappa系数=0.773,P<0.001).当IHC检测C-erbB-2蛋白表达为(-)或(+++)时IHC和FISH检测结果有较高符合率,可作为临床是否应用Herceptin治疗的依据,而C-erbB-2蛋白表达为(++)的病例则必须进一步行HER-2基因扩增检测.