【摘要】 目的对比研究免疫组织化学(IHC)与荧光原位杂交(FISH)方法检测乳腺癌中C-erbB-2蛋白表达和HER2基因扩增,评估两种方法的实际应用价值。方法 IHC和FISH法分别检测58例乳腺癌组织中C-erbB-2蛋白表达和HER2基因扩增状况,并进行一致性分析。结果IHC检测蛋白阳性2+和3+共22例,占总病例的37.9%,58例乳腺癌中FISH检测出HER2基因扩增17例,占29.3%。IHC检测C-erbB-2蛋白3+的12例中11例HER2基因扩增阳性,1例无扩增;C-erbB-2蛋白2+者10例,其中5例可见HER2基因扩增;C-erbB-2蛋白1+者11例HER2基因扩增仅1例。C-erbB-2蛋白阴性病例共25例均未检测到基因扩增。结果显示IHC检测C-erbB-2蛋白与FISH检测HER2基因扩增状态有较高的一致性(k=0.681,P<0.01),C-erbB-2蛋白阴性和3+标本与HER2基因扩增阳性率比较差异无统计学意义(P>0.05);而C-erbB-2蛋白1+和2+病例与其HER2基因扩增差异具有统计学意义(P<0.05)。结果 IHC检测C-erbB-2蛋白强阳性(3+)和阴性(0)与HER2基因扩增有较高的一致性,可作为临床是否应用Herceptin治疗的依据,而C-erbB-2蛋白2+和1+病例必须进一步行HER2基因扩增检测。更多还原

【Abstract】 Objective To compare the clinical significance between detecting C-erbB2 protein expression by immunohistochemistry(IHC) and detecting Her-2 gene amplification by flurescence in situ hybridization(FISH) in breast cancer.Methods The expression of C-erbB2 protein and Her-2 gene amplification in 58 cases of breast cancer were detected by IHC and FISH respectively,and the concordance between them was analyzed.Results Of 58 cases,the expression of C-erbB2 protein was strongly and moderately positive in 22 cases(37.9%),and the Her-2 gene amplification existed in 17 cases(29.3%).In 12 cases where the expression of C-erbB2 protein was strongly positive by IHC,Her-2 gene amplification exsited in 11 cases.In 10 cases where the expression of C-erbB2 was moderately positive,Her-2 gene amplification exsited in 5 cases.In 11 C-erbB2 weakly positive cases,Her-2 gene amplication exsited in only 1 case.But in 25 C-erbB2 negative cases,none was amplied.Those data showed good concordance between the two methods,(κ=0.681,P<0.01).In addition,for the cases with strongly positive or negative expression,the difference between IHC and FISH was not statistically significant(P>0.05),but for the cases with moderately and weakly positive expression,the difference was statistically significant(P<0.05).Conclusion There is favourable concordance between Her-2 gene amplification and strongly positive or negative c-erB2 expression.It can be a evidence to decide whether use herceptin in clinical therapy or not.But for the moderately and weakly positive cases,FISH must be applied.更多还原