【摘要】 目的比较荧光原位杂交(FISH)和免疫组化(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,并探讨HER-2基因扩增与临床病理特征的关系。方法回顾性分析本院采用FISH法检测HER-2基因状态的112例乳腺癌,与IHC结果进行一致性分析,并对HER-2基因扩增与年龄、组织学分级、淋巴结转移及激素受体的关系进行统计学分析。结果 112例浸润性乳腺癌中,HER-2基因扩增57例,其中IHC检测HER-2(3+)者27例,(2+)者29例,(1+)者1例,分别占IHC病例总数的96.4%(27/28)、48.3%(29/60)和5.3%(1/19)。HER-2基因扩增与雌/孕激素受体呈负相关,而与年龄、组织学分级、淋巴结转移差异不显著。结论对于IHC检测HER-2(3+)、(+或0)的病例可选择性做FISH进行确认,对于HER-2(2+)病例应常规进行FISH检测,以便更加准确和客观地对治疗和预后进行评价。更多还原

【Abstract】 Objective To investigate the concordance between fluorescence in situ hybridization and immunohistochemistry assessment for HER-2 status of patients with invasive breast cancer and to evaluate the association between HER-2 gene amplification and clinicopathological characteristics.Methods Retrospective analysis of 112 cases of patients with invasive breast cancer with HER-2 gene detected by FISH,the FISH findings were compared with IHC test results by analyzing the concordance between two results.The associations between HER-2 gene amplification and other clinicopathological factors such as age,tumor grade,estrogen/progesterone receptor and lymph node status were evaluated using χ2 test.Results HER-2 amplifications by FISH were seen in 57 patients,including 27 IHC(3+) patients(96.4%,27/28 of all(3+) patients),29 IHC(2+) patients(48.3%,29/60 of all(2+) patients),1 IHC(1+) patients(5.3%,1/19 of all(1+) patients) and none IHC(0) negative patient(0,0/5 of all negative cases).The overall coincidence rate of IHC test and FISH was 96%.And the discordance was mainly found in the IHC(2+) group.HER-2 gene amplification was negatively correlated with estrogen/progesterone receptor status and no significant difference was found between HER-2 gene amplification and age,tumor grade,lymph node status.Conclusion For patients with HER-2 IHC(3+,1+,0),FISH can be selected,while the patients with HER-2 IHC(2+) should be verified by FISH to accurately determine the status of the HER-2 gene.更多还原