摘要
目的探讨胃癌内镜活检组织和手术标本中人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)蛋白表达情况及临床意义,比较活检标本HER-2状态评估是否可替代胃癌手术大标本HER-2状态评估。方法200例胃癌活检标本及对应200例手术标本,采用免疫组织化学(immunohistochemistry,IHC)方法检测HER-2蛋白表达状态,并对HER-2蛋白表达2+的胃癌组织应用荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测HER-2扩增状态。分析其与患者性别、年龄、肿瘤生长部位、分化程度、病理类型的关系,比较HER-2在胃癌活检标本和手术标本中表达状态。结果活检标本中22例HER-2阳性表达(11.0%),其中16例HER-2蛋白表达IHC 3+阳性,6例IHC 2+阳性表达经FISH验证为阳性;手术标本中23例HER-2表达阳性(11.5%),其中17例HER-2蛋白表达3+阳性,6例2+阳性表达后经FISH验证,胃镜活检标本和手术标本阳性符合率为87.5%;胃癌手术标本HER-2蛋白阳性表达在患者性别、年龄、分化程度上差异无统计学意义(P>0.05);在病理类型、肿瘤部位、浸润深度和淋巴结转移上差异有统计学意义(P<0.05)。结论胃癌活检标本HER-2状态评估可替代胃癌手术大标本,可为胃癌患者合理选择靶向药物赫赛汀提供可靠理论依据。
Objective To evaluate the expression of human epidermal growth factor receptor-2 （HER-2） protein in the biopsy specimens and corresponding surgical specimens of gastric cancer and its clinical significance, and to explore the possibility of HER-2 in biopsy specimens to replace HER-2 in surgical specimens. Methods The expression of HER-2 was detected retrospectively by immunohistochemistry （IHC） method in 200 paraffin-embedded biopsy specimens as well as corresponding surgical specimens. Fluorescence in situ hybridization （FISH） was also used to detect HER-2 expression in IHC 2 ＋ positive specimens. The relationships of HER-2 expression with the age, gender, cancer location, differentiate degree and pathological type were analyzed to compare the HER-2 expression between biopsy specimens and surgical specimens. Results In biopsy specimens, HER-2 was positive in 22 specimens （11.0 %）, in which IHC 3＋ was positive in 16 specimens, and IHC 2＋ was confirmed positive by FISH. In surgical specimens, HER-2 was positive in 23 specimens （11.5%）, in which IHC 3＋ was positive in 17 specimens, and 6 specimens of IHC 2＋ were confirmed by FISH. The coincidence rate of biopsy specimens was 87.5% in comparison with corresponding surgical specimens. The positive expression of HER-2 was not correlated with the age, gender and differentiate degrees （P〉0.05） in surgical specimens of gastric cancer and was correlated with pathological type, cancer location, infiltrative depth and lymph node metastasis. Conclusion HER-2 detection in biopsy specimens can replace HER-2 detection in surgical specimens, and provides a reliable theoretical basis for the choice of herceptin for gastric cancer patients.
出处
《中华实用诊断与治疗杂志》
2016年第2期153-156,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
江苏省中医院科研项目(Y13032)
关键词
胃癌
人表皮生长因子受体-2
免疫组织化学
荧光原位杂交
Gastric cancer
human epidermal growth factor receptor-2
immunohistochemistry
fluorescence in situ hybridization
