摘要
目的 探讨荧光原位杂交（FISH）和免疫组织化学（IHC）检测乳腺癌组织中人表皮生长因子受体2（HER-2）基因扩增及蛋白表达的一致性和相关性,及其与乳腺癌患者的临床病理特征的关系.方法 采用FISH法检测128例乳腺癌患者HER-2基因扩增状态,与IHC结果进行一致性及相关性分析,并比较其与乳腺癌患者的临床病理特征的相关性.结果 128例乳腺癌标本中,IHC与FISH结果符合率为90.6%,存在一致性（Kappa=0.405,P=0.000）.两种检查结果呈正相关（r=0.655,P=0.000）.ER表达与HER-2基因扩增及其蛋白表达状态呈负相关（r=-0.300,P=0.001;r=-0.223,P=0.011）,而ER/PR状态与HER-2基因扩增状态呈负相关（r=-0.213,P=0.016）.肿瘤分级与HER-2蛋白表达呈负相关（r=-0.293,P=0.008）,而与HER-2基因扩增状态无关（P＞0.05）.结论 IHC（＋＋＋）与基因扩增有较好的一致性,而IHC（＋～＋＋）者有必要进一步行FISH法检测基因状态.ER、ER/PR状态及肿瘤分级与HER-2基因扩增和（或）蛋白表达存在相关性.
Objective To investigate the concordance and correlation between fluorescence in situ hybridization （FISH） and immunohistochemistry （IHC） assessment for HER-2 status in breast cancer patients and analyze their relationship to clinical characteristics. Methods A total of 128 samples of breast cancer tissue were analyzed retrospectively. FISH was employed to detect the HER-2 gene amplification. And the FISH findings were compared with IHC test results by analyzing the concordance and correlation between two results. And their relationships to the clinical characteristics were analyzed. Results The overall coincidence rate of IHC and FISH was 90. 6% （ kappa = 0.405, P = 0. 000 ）. And the discordance was mainly found in the IHC （ ＋ ＋ ） group. A positive correlation was found between the two results （ r =0. 655, P=0. 000）. The ER （estrogen receptor） expression was negatively correlated with HER-2 gene amplification and the expression of Her-2 protein （ r = - 0. 300, P = 0. 001;r = - 0. 223, P = 0.011 ）.There was a negative correlation between ER/PR status and HER-2 gene amplification （r = -0.213, P=0.016）. The similar results were found in subgroup analysis. Tumor grade was negatively correlated with the expression of Her-2 protein （ r = - 0. 293, P = 0. 008 ）, but not with HER-2 gene amplification （ P 〉0. 05）. Conclusion IHC is a preferred method to detect the Her-2 status in breast cancer. The strong positive expression （ ＋ ＋ ＋ ） of HER-2 protein tested by IHC is strongly consistent with HER-2 gene amplification by FISH. But HER-2 gene amplification should be further detected by FISH in patients with HER-2 positive expression （ ＋ - ＋ ＋ ） in order to guide the clinical diagnosis and treatment. ER, ER/PR （progesterone receptor）status and tumor grade are correlated with HER-2 gene amplification and/or the expression of Her-2 protein. This study helps improve the accuracy of judging HER-2 gene amplification according to the clinical and pathological features such as ER status and the results of IHC.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第2期76-80,共5页
National Medical Journal of China
基金
基金项目：国家自然科学基金（30972934）
分子生物学国家重点实验室开放课题（SKL-KF-2010-03）
关键词
乳腺肿瘤
人表皮生长因子受体2
免疫组织化学
荧光原位杂交
Breast neoplasms
Human epidermal growth factor receptor 2
Immunohistochemistry
Fluorescence in situ hybridization
