摘要
目的:同时应用免疫组织化学(IHC)和荧光原位杂交(FISH)技术,检测278例浸润性乳腺癌组织中的人类表皮生长因子受体2(Human Epidermal Growth Factor Receptor2,HER-2),以探讨两种方法检测HER-2状态的符合率。方法:用IHC和FISH法分别检测278例浸润性乳腺癌组织中HER-2蛋白的表达和HER-2基因状态,以比较两种方法的阳性率和准确率。结果:IHC和FISH检测HER-2的总符合率为83.9%,Kappa系数为0.650(P<0.001)。130例IHC标记HER-2结果显示为++的病例中,44例(33.8%)Fish为阳性,54例结果1HC为阳性或+的病例中的5例(9.3%),经FISH检测证实HER-2基因有扩增。而94例IHC结果显示为+++的病例中,有3例(20.2%)FISH结果为阴性。在130例IHC显示++的病例中,3例FISH结果为模棱两可。结论:IHC和FISH检测HER-2的符合率为83.9%,对IHC标记HER-2结果为++的病例,用FISH检测大多能得到满意结果。对极少数HER-2基因扩增为临界状态的乳腺癌病例需结合其他检查结果综合考虑。
Objective Breast cancer is the most common malignancy in the women.If the patients with HER-2 positive have invasive breast carcinoma,they can obtain beneficial results from the targeting therapy by Herceptin.Therefore,accurate detection the HER-2 gene status is the key point to select the candidates for Herceptin treatment.At present,the IHC and FISH techniques are the most popular methods used to evaluate the HER-2 status.Even though there is high concordance rate between the 2 methods,the discrepancies in positive rate of HER-2 between these two different approaches exist obviously.This research serves to investigate the concordance rate between the two different methods to test the HER-2 status,respectively.Methods Both IHC and FISH techniques were performed separately in 278 cases to detect the status of HER-2 protein expression and gene amplification.Statistically,SPSS11.5 software was applied to analyse the results obtained in both methods.Results The total concordance rate of HER-2 between IHC and FISH trials was 83.9%,with Kappa of 0.650（P0.001）.Forty-four among 130 cases（33.8%） with ＋＋ IHC and 5/54（9.3%） with 0 or ＋ IHC cases were positive in FISH.Three among the 94（20.2%） with ＋＋＋ IHC cases were negative in FISH,and 3 of the 130 cases with ＋＋ IHC were equivocal in FISH.Conclusions The concordance rate in our investigation between IHC and FISH of HER-2 was 83.9%,and FISH could get satisfying result in most of the ＋＋ IHC cases.However,comprehensive consideration should be taken together with other testing results in those few equivocal cases.
出处
《外科理论与实践》
2010年第5期499-503,共5页
Journal of Surgery Concepts & Practice
基金
2009上海市高校人才专项基金
