乳腺癌可溶性HER-2/neu表达水平及其临床意义

The expression level and clinical signification of soluble HER-2/neu in breast cancer

目的分析乳腺癌血清可溶性HER-2/neu水平并探讨其临床意义。方法用ELISA方法分析105例乳腺癌患者、24例乳腺良性疾病及30名健康体检者血清可溶性HER-2/neu水平,并用免疫组化(IHC)方法分析乳腺癌组织切片中癌细胞的着色情况。结果乳腺癌患者血清中可溶性HER-2/neu水平与正常对照和良性乳腺疾病相比,差异有统计学意义(P<0·05)。随病程进展乳腺癌患者可溶性HER-2/neu的阳性率逐步升高,Ⅲ+Ⅳ期的阳性率(63·3%)与Ⅰ期(7·7%)或Ⅱ期阳性率(14·5%)相比,差异有统计学意义(P<0·05);发生转移的乳腺癌患者可溶性HER-2/neu的阳性率(37·5%)与未转移患者(6·1%)相比,差异有统计学意义(P<0·05)。血清HER-2/neu水平与IHC结果有显著正相关(P<0·05)。结论检测血清可溶性HER-2/neu水平可弥补免疫组化的不足,在乳腺癌监测随访、疗效观察尤其是用Herceptin治疗后的疗效观察中发挥其独到的作用。

Objective To analyze the expression level and to dicussion the clinical signification of soluble HER-2/neu in breast cancer. Methods Sera form 105 breast cancer patients, 24 females with benign breast, disease and 30 healthy controls were assayed by ELISA to determine the expression level of the soluble HER-2/neu. IHC was used to analyze the staining in the malignant cancer tissue segment of breast cancer. Results The number of breast cancer patients with elevated serum HER-2/neu levels was significantly greater than that of benign tumor patients and healthy controls （ P 〈 0.05 ）. The positive ratio of soluble HER-2/neu in breast cancer elevated steadily with the stage increasing, which positive ratio of the stage Ⅲ ＋ Ⅳ was significantly greater than that of the stage Ⅰ or Ⅱ （ 63.3 % ： 7.7 % ： 14.5 %, P〈0.05）. The number with elevated serum HER-2/neu levels were detected significantly more often in breast cancer patients with metastases than without metastases （37.5% ：6. 1%, P 〈 0. 05 ）. A significant correlation between the expression levels of serum soluble HER-2/neu and immunohistochemistry results was observed （P 〈 0. 05）. Conclusions Serum HER-2/neu testing by ELISA in breast cancer is complementary to HER-2/neu tissue results and provides quantitative results for HER-2/neu that correlate closely with HER-2/neu immunohistochemistry results. It has play an important and special role in monitoring women with metastatic breast cancer and predicting patients response to Herceptin therapy.