摘要
目的:检测乳腺癌HER2基因和Cerb B2表达状态,探讨HER2基因表达与年龄、雌激素受体(ER)、孕激素受体(PR)表达、Ki-67表达、肿瘤大小、淋巴结转移、肿瘤组织学分级、肿瘤临床分期之间的关系。同时比较显色原位杂交(CISH)方法与免疫组织化学染色(IHC)检测乳腺癌HER2基因及CerbB2表达的差异,讨论HER2基因检测在临床乳腺癌诊断治疗的意义。为临床选择有效的乳腺癌化疗药物治疗提供参考。方法:收集2008年1月到2011年澳门镜湖医院病理科乳腺癌标本100例,所有病例均为浸润性乳腺癌,术前未行辅助化疗、放疗或内分泌治疗,所有标本经手术切除、10%褔尔马林固定、石蜡包埋切片。采用显色原位杂交(CISH)方法和常规免疫组织化学染色(IHC)方法检测HER2基因扩增及CerbB2表达情况;记录病人年齢、ER、PR、淋巴结转移情况等资料、肿瘤组织学分级、肿瘤临床分期等资料;用统计学卡方(χ2)检测分析这些临床资料与HER2基因表达的关系;同时用统计学kappa检验对CISH与IHC检测结果一致性进行统计分析。结果:CISH检测结果显示,乳腺癌中HER2高度扩增为19%(19/100)、低度扩增12%(12/100)、无扩增69%(69/100)。Cerb B2免疫组织化学染色3+的占23%(23/100)、2+的占29%(29/100)、0～1+的占48%(48/100)。经统计学分析显示HER2基因表达在不同年龄组、有否淋巴结转移、肿瘤大小、不同临床分期无统计学意义,但在不同组织学分级、ER、PR、Ki-67表达之间均有统计学意义。与CISH结果相比,HER2免疫组织化学染色0～1+及3+的符合率呈高度相符(分别为100%、97%及100%),而2+符合率较低(24%)。结论:①31%浸润性乳腺癌有HER2基因扩增(包括高度和低度扩增),而Cerb B2阳性率为52%(包括3+和2+);②HER-2蛋白行IHC法检测结果为2+者,与CISH法检测为扩增结果的符合率较低(仅24%),故推荐进一步行CISH确认;③HER-2蛋白行IHC法检测结果为0～1+及3+者,�
Objective To study the relationship between HER2 oncogene amplification status detected by chromogenic in situ hybridization (CISH) and clinicopathology of breast carcinoma, and to compare the consistency with those obtained by immunohistochemistry (IHC). Methods 100 cases of breast cancer tissue were collected in Macao Kiang Wu Hospital from January 2008 to June 2011. All cases were confirmed as invasive carcinoma; none of them have neo-adjuvant chemotherapy, radiotherapy and endocrine therapy before surgery. The specimens of tumor tissue were fixed in 10% neutral formalin after surgery, paraffin-embedded routinely. HER2 gene amplification and Cerb B2 expression were respectively detected by chromogenic in situ hybridization (CISH) and immunohistochemistry (IHC). Patient’s clinical dates, including age, ER, PR, tumor size, number of lymph node metastasis, histological grade and clinical stage were collected and analyzed their relationship with HER2 amplification status using chi-square test. Meanwhile, the consistency between CISH and IHC results was analyzed statistically by using Kappa test. Results High level amplification of HER2 gene was detected by CISH in 19% (19/100 cases) breast carcinoma, low level amplification in 12% (12/100 cases) and no amplification in 69% (69/100 cases). IHC score 3 was 23% (23/100 cases), score 2 was 29% (29/100 cases), score 0 and score 1 were 48% (48/100 cases). CISH-IHC results showed a good concordance in the score 0, score 1 and score 3 groups, while a poor agreement in score 2 group was confirmed. HER2 gene amplification was relevant to histological grade (P<0.05), estrogen receptor (P<0.05) progesterone receptor (P<0.05) and Ki-67(P<0.05), but not relevant to age (P>0.05), tumor size (P>0.05), clinical stage (P >0.05) and number of lymph node metastasis (P>0.05). Conclusion 1. HER2 gene amplification including high and low levels was detected in 31% cases of invasive breast cancer, while Cerb B2 positive rate was 52%, including score 3 and 2. 2. There is quite differenc
出处
《心血管病防治知识（学术版）》
2012年第6期50-51,共2页
Prevention and Treatment of Cardiovascular Disease
关键词
乳腺癌
CISH
IHC
HER-2
Cerb
B2
Breast cancer
Chromogenic in situ hybridization (CISH)
Immunohistochemistry (IHC)
HER2
Cerb B2
