乳腺癌组织中HER2的表达及其与临床病理特征的关系

摘要

Objective To investigate the expression of HER2 in breast carcinomas by perform-ing immunohistochemistry(IHC)and fluorescent in situ hybridization(FISH),and to analyze the relationship between HER2 expression and clinicopathological characteristics.Methods The ex-pression of HER2 gene was detected by FISH and the expression of HER2,ER,PR,Ki67 and P53 protein was measured by IHC in 463 breast cancer samples collected from 2010 to 2015.The con-sistency between HER2 gene and protein expression and the relationship between HER2 expres-sion and clinicopathological characteristics were analyzed.Results HER2 gene amplification rate and protein expression rate were 35.64%(165/463)and 26.35%(122/463),respectively.Further-more,HER2 gene amplification rates were 91.50%,10.00%,8.27% and 7.14% in IHC HER2+++,++,+ and-samples,respectively.The gene amplification and protein expression of HER2 were positively correlated with pathological grade(r=0.140,r=0.310;P<0.01),tumor size(r=0.103,P<0.05;r=0.499,P<0.01),lymph node metastasis(r=0.175,r=0.220;P<0.01)and Ki67 expression(r=0.220,r=0.331;P<0.01),but negatively correlated with ER(r=-0.406, r=-0.382;P<0.01)and PR expression(r=-0.610,r=-0.635;P=0.01).Conclusion The IHC and FISH have a good consistency and correlation for detecting HER2 expression.However, there is a low consistency between HER2 protein expression and gene amplification in HER2 ++cases,suggesting that the HER2 should be further detected by FISH.The expression of HER2 is associated with Ki67,ER,PR,lymph node metastasis,tumor size and pathological grade.%目的 对比研究 IHC检测乳腺癌组织中 HER2蛋白表达与 FISH 检测 HER2基因扩增的一致性,探讨HER-2基因表达与患者临床病理特征的相关性.方法 收集2010-2015年乳腺癌根治术后癌组织标本463例,应用 FISH检测标本中 HER2基因表达、IHC检测 HER2、ER、PR、Ki67、P53的蛋白表达,分析 HER2基因与蛋白表达的一致性和相关性及其与患者临床病理特征的关系.结果 463例乳腺癌标本中 HER2基因扩增率为35.64%(165/463),HER2蛋白表达阳性率为26.35%(122/463);HER2蛋白表达+++、++、+和-的标本中 HER2基因扩增率分别为91.50%、10.00%、8.27%、7.14%;HER2基因扩增及蛋白表达与病理学分级(r=0.140、r=0.310,均P<0.01)、肿块大小(r=0.103、P<0.05,r=0.499,P<0.01)、有无淋巴结转移(r=0.175、r=0.220,均P<0.01)及Ki67 表达(r=0.220、r=0.331,均P<0.01)呈正相关,与 ER(r=-0.406、r=-0.382,均P<0.01)、PR表达(r=-0.610、r=-0.635,均P<0.01)呈负相关.结论 FISH 和 IHC两种方法检测 HER2表达具有较好的一致性及相关性,但 HER2蛋白表达++组与 HER2基因扩增间的一致性较低,提示 HER2蛋白表达++者须进一步进行 FISH检测;HER2表达与Ki67、ER、PR、淋巴结转移、肿块大小及病理学分级之间存在相关性.