摘要
目的 探讨HER-2蛋白表达和基因扩增与乳腺癌淋巴结转移和雌激素受体(ER)、孕激素受体(PR)的关系.方法 采用免疫组化SP法和荧光原位杂交法检测64例乳腺癌新鲜标本中的HER-2蛋白表达和基因扩增情况,并结合ER、PR及淋巴结转移情况对比分析.结果 64例中HER-2蛋白表达强阳性15例,阳性7例,弱阳性3例,阴性39例,其中基因过表达(免疫组化检测强阳性或阳性)率为37.5%;基因扩增20例.无扩增44例.扩增率31.3%.免疫组化与荧光原位杂交检测符合率为90.9%(P〈0.05).ER、PR表达情况与HER-2蛋白表达和基因扩增呈负相关(r=-0.36、-0.35,P〈0.05),ER和PR均阴性者HER-2蛋白表达率(60.0%)及基因扩增率(55.0%)明显高于ER和(或)PR阳性者(分别为22.7%、20.5%).差异均有统计学意义(×2=8.47、7.64,均P〈0.05).淋巴结转移情况与HER-2蛋白表达及基因扩增无关(r=0.16、0.22,P〉0.05).结论 HER-2蛋白表达和基因扩增提示乳腺癌预后不良,HER-2及ER、PR在乳腺癌的治疗中有着重要作用,免疫组化可作为检测HER-2基因状态的首选方法 ,但对于HER-2++者需进一步行荧光原位杂交检测.HER-2蛋白表达和基因扩增与淋巴结转移无关.
Objective To study the amplification and expression of HER-2 gene and proteinum in breast cancer and to investigate the relationship between HER-2 and proteinum and ER,PR and lymph node metastasis. Methods Apply fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) method to detect the amplification and expression of HER-2 gene and proteinum and the expression of ER,PR and lymph node metastasis in 64 case of breast cancer. Results HER-2 overexpression was 22, with (+++) 15 cases and (++) 7 cases. There are 20 cases to find HER-2 gene amplification,the positive rate was 31.35% ,the coincidence of HER-2 overexpression and HER-2 gene amplification was 90.9% (P〈0.05),The expression of HER-2 had negative correlation with the expression ER,PR (r=-0.36,-0.35, P〈0.05), HER-2 gene and proteinum positive expression was significant higher in PR and ER negative group than in PR and (or) ER positive group (IHC 60.0% vs 22.7%, P〈0.05, FISH 55.0% vs 20.5%,X^2=8.47,7.64, P〈0.05). HER-2 gene amplification had no statistical significance with lymph node metastasis (P〉0.05). Conclusion The amplification and overexpression of HER-2 gene and proteinum foreshow breast cancer was insensitive for some treatment plan and unfavourable prognosis. ER,PR and HER-2 might play a important role on the occurrence and development in breast cancer.
出处
《浙江医学》
CAS
2010年第2期166-168,172,共4页
Zhejiang Medical Journal