摘要
目的：探讨人表皮生长因子受体2（HER-2）在直肠癌手术切除标本与活检标本表达的一致性及其临床意义。方法收集2009年9月至2012年3月间在北京大学肿瘤医院接受直肠癌根治术治疗且资料完整的544例患者的临床资料和手术标本。采用免疫组织化学方法分别检测手术切除标本与术前活检标本的HER-2表达情况，对于可疑阳性者进一步采用荧光原位杂交（FISH）检测；分析手术切除标本与活检标本中HER-2表达的一致性以及接受新辅助放疗或放化疗患者手术切除标本与活检标本HER-2状态的一致性；同时分析HER-2表达与肿瘤临床病理学特征的关系。结果免疫组化结果显示，直肠癌手术标本中HER-2阳性率为3．7％（20／544），术前活检标本为2．1％（5／235）。两种标本中HER-2表达的一致性为99．6％（234／235），一致性检验Kappa值为0．907（P＜0．01）。对于接受新辅助放疗或放化疗患者，其术前活检标本与手术标本HER-2状态的一致性为98．6％（73／74）。 HER-2过表达或基因扩增与患者的性别分布、年龄、肿瘤分化程度、淋巴结转移状态、远处转移状态以及TNM分期均无关（均P＞0．05）。结论 HER-2在直肠癌中的阳性表达率较低，且与肿瘤的临床病理学特征无关。直肠癌活检标本HER-2表达状态可以预测手术切除标本中HER-2的状态，且该预测不受新辅助放化疗的影响。
Objective To investigate the consistence of human epidermal growth factor receptor 2 （HER-2） expression in resection samples and biopsy samples from rectal cancer and its clinical implication. Methods Clinical data and tissue samples of 544 rectal cancer patients who received surgical resection at Peking University Cancer Hospital from September 2009 to March 2012 were collected and analyzed retrospectively. Immunohistochemical method was used to test HER-2 expression in both surgical resection samples and preoperative biopsy samples. Suspect positive samples with HER-2 （＋＋） were further examined by FISH. Consistence of HER-2 expression between resection samples and biopsy samples, and between resection samples from those patients undergoing neoadjuvant radiotherapy or radiochemotherapy and biopsy samples was analyzed. Association between HER-2 expression and clinicopathological characteristics was examined as well. Results Among 544 surgical resection samples, positive HER-2 samples of 20 cases （3.7%） were identified either by immunohistochemistry （HER-2,＆nbsp;＋＋＋） or by FISH amplification. Among 235 paired biopsy samples, positive HER-2 samples of 5 cases （2.1%） were identified. Consistence of HER-2 expression between these two samples was 99.6%（234/235）. The kappa value of consistence test was 0.907 （P〈0.01）. Consistence between resection samples from patients receiving neoadjuvant therapy and biopsy samples was 98.6%（73/74）. There was no association of HER-2 over-expression or amplification with gender, age, tumor differentiation grade, lymph-node metastasis, distant metastasis, TNM stage and overall survival. Conclusions Positive rate of HER-2 expression is quite low in rectal cancer and has no relation to clinicopathological characteristics and prognosis. HER-2 status in biopsy samples of rectal cancer is highly consistent with paired surgical resection samples, which is not affected by neoadjuvant radiochemotherapy.
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2015年第6期597-601,共5页
Chinese Journal of Gastrointestinal Surgery
基金
国家自然科学基金（81101878）；北京市卫生系统高层次卫生技术人才队伍建设专项经费
