摘要
目的探讨乳腺癌患者的HER2状态、临床病理特征及预后之间的关系。方法选取福州大学附属省立医院629例同时做过HER2 IHC及FISH检测的浸润性乳腺癌手术病例,应用2019版乳腺癌HER2检测指南分析HER2状态、临床病理特征及预后。结果IHC结果:0~1+、2+、3+分别占53.10%、22.26%、24.64%;FISH结果:阴性和阳性病例分别占66.77%和33.23%。导管癌、小叶癌及特殊类型肿瘤之间FISH检测结果差异具有统计学意义(P=0.001),而IHC检测结果差异无统计学意义(P>0.05)。不同性别、发病年龄、肿瘤最大径、组织学分级、淋巴结转移与否两种方法检测结果差异无统计学意义(P>0.05)。针对女性病例,IHC与FISH两种检测方法比较差异具有统计学意义(P<0.001);明确阴性跟阳性病例中,一致性检验,Kappa=0.925,P=0.000;相关性分析,r=0.696,P=0.000。随访病例生存曲线可见赫赛汀治疗组DFS高于非治疗组,IHC阴性FISH阳性病例组有无赫赛汀治疗患者差异具有统计学意义(P<0.05);一致病例与不一致病例DFS比较,差异无统计学意义(P>0.05)。结论基于2019版乳腺癌HER2检测指南,FISH检测结果与肿瘤类型有关;IHC与FISH检测结果具有很好的一致性,二者结果呈正相关;FISH法的检出率高于IHC法,条件允许时,建议做FISH检测确认;结果不一致时,FISH结果对临床制定治疗决策可能更具指导意义。
Objective To explore the relationship between HER2 status,clinicopathological characteristics and prognosis in patients with invasive breast cancer.Methods Selected 629 invasive breast cancer patients who had undergone HER2 IHC and FISH detection at the same time in Fuzhou University Affiliated Provincial Hospital,and analyzed HER2 status,clinicopathological characteristics and prognosis using the 2019 version of breast cancer HER2 detection guidelines.Results IHC results showed that 0~1+,2+,3+accounted for 53.10%,22.26%,24.64%respectively;The negative and positive cases of FISH results accounted for 66.67%and 33.23%.There was a statistically significant difference in FISH detection results among different tumor types(P=0.001).There was no significant difference in the detection results of the two methods between different gender,age of onset,tumor size,histological grade and lymph node metastasis(P>0.05).For female cases,the difference between IHC and FISH was statistically significant(P<0.001);Identify the consistency test between negative and positive cases,Kappa=0.925,P=0.000;Correlation analysis,r=0.696,P=0.000.The follow-up case survival curve showed that the DFS was higher in the Herceptin-treated group than that in the non-treated group,and the difference in IHC negative FISH positive patients was significant(P<0.05).There was no significant difference between consistent and discordant cases.Conclusion Based on the 2019 version of breast cancer HER2 detection guidelines,FISH detection results are related to tumor type.The results of IHC and FISH are in good agreement,and the two results are positively correlated.The detection rate of FISH method is higher than that of IHC method.When conditions permit,it is recommended to do FISH detection for confirmation.When the results are inconsistent,FISH results may have more guiding significance for clinical treatment decisions.
作者
吴义娟
吴仪萍
俞训彬
陈灵锋
陈新
林洁
Wu Yijuan;Wu Yiping;Yu Xunbin;Chen Lingfeng;Chen Xin;Lin Jie(Department of Pathology,Fujian Medical University Provincial School of Clinical Medicine,Fuzhou University Affiliated Provincial Hospital,Fuzhou 350001;Department of Thyroid and Breast Surgery,The 910th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Quanzhou 362000)
出处
《中国现代医药杂志》
2024年第10期19-25,共7页
Modern Medicine Journal of China
基金
福建医科大学启航基金项目(编号:2020QH1141)。
关键词
浸润性乳腺癌
人类表皮生长因子受体2基因
荧光原位杂交
免疫组化
Invasive breast cancer
Human epidermal growth factor receptor 2
Fluorescence in situ hybridization
Immunohistochemistry
