摘要
人类表皮生长因子受体2(HER2)基因阳性是胃癌患者预后不良的标志之一,对于此类患者可以给予曲妥珠单抗等抗HER2靶向治疗,明确胃癌患者HER2状态对制定患者治疗方案以及评估预后有重要意义。对胃癌D2根治术后离体标本及时处理和固定是提高HER2检测阳性率前提,但是在临床工作中存在着外科医师对胃周淋巴结分拣导致离体标本无法及时固定的问题。除此之外,HER2活体组织检查(简称活检)标本取材选择、胃癌HER2表达异质性等也会影响胃癌HER2检测阳性率。为此,河北医科大学第四医院外三科成立专门的粗针多点穿刺活检团队,在胃癌标本离体后对癌灶进行快速、粗针多点、全层取材并单独固定,有效地解决了当前影响HER2检测阳性率的主要问题。团队核心工作内容包括构建和培训成熟团队、制定详细的操作流程、操作实施中的质量控制、持续的数据收集和反馈等。本中心胃癌术后离体标本多点穿刺取材HER2阳性率为16%,且穿刺取材实施方便、快速。本研究总结河北医科大学第四医院外三科对胃癌D2根治术后离体标本进行粗针多点穿刺活检的流程和经验,以提高胃癌标本HER2检测的阳性率,使更多胃癌患者从中获益。
Human epidermal growth factor receptor 2(HER2)positive is one of the signs of poor prognosis for patients with gastric cancer.For such patients,anti-HER2 targeted therapy such as trastuzumab can be given.It is of great significance to clarify the HER2 status of patients with gastric cancer in formulating patient treatment plans and assessing the prognosis.The timely processing and fixation of isolated specimens after radical gastric cancer D2 is a prerequisite for increasing the positive rate of HER2 status detection.However,in clinical work,there is a problem that surgeons can not fix the isolated specimens in time due to the sorting of peripheral gastric lymph nodes.In addition,the selection of biopsy specimens for HER2 detection and the heterogeneity of HER2 expression in gastric cancer will also affect the positive rate of HER2 detection in gastric cancer.To this end,the Third Department of Surgery of the Fourth Hospital of Hebei Medical University established a special thick needle multi-point biopsy team to perform rapid,thick needle multi-point,full-thickness sampling and separate fixation of the cancer foci after gastric cancer specimens were isolated,effectively avoiding the main problem that currently affects the positive rate of HER2 detection.The core work content of the team includes building and training a mature team,formulating detailed operation procedures,quality control during operation implementation,continuous data collection and feedback,etc.The positive rate of HER2 in multi-point puncture samples from gastric cancer surgery in our center was 16%,and the puncture samples were easy and fast to implement.This study summarizes the procedures and experience of the third department of Surgery of the Fourth Hospital of Hebei Medical University in performing thick needle multi-point biopsy on isolated specimens after radical gastric cancer D2 radical resection,in order to increase the positive rate of HER2 detection in gastric cancer specimens and benefit more gastric cancer patients.
作者
郑涛
郭洪海
丁平安
檀碧波
张志栋
王冬
李勇
赵群
ZHENG Tao;GUO Hong-hai;DING Ping-an;TAN Bi-bo;ZHANG Zhi-dong;WANG Dong;LI Yong;ZHAO qun(Department of Third Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《社区医学杂志》
CAS
2021年第12期719-723,共5页
Journal Of Community Medicine
基金
河北卫健委县级公立医院适宜卫生技术推广入库项目(2019024)
政府资助临床医学优秀人才培养项目(2019012)
2020年度河北医科大学教育教学研究立项课题(2020CGPY-12,2020CHYB-23)。
关键词
胃肿瘤
粗针多点穿刺活检
人类表皮生长因子受体2
策略及技术
gastric neoplasms
multiple needle biopsy
human epidermal growth factor receptor 2
strategy and technology
