335例乳腺癌HER-2基因扩增及17号染色体多体的临床病理学分析

Clinicopathological analysis of HER-2 gene amplification and chromosome 17 polysomy in 335 cases of breast carcinoma

目的探讨乳腺癌HER-2基因扩增及17号染色体多体异常的临床病理学意义。方法回顾性分析335例乳腺癌荧光原位杂交结果,并分析HER-2基因扩增和17号染色体多体与年龄、组织学分级、淋巴结转移及HER-2蛋白表达的关系。结果335例乳腺癌患者中HER-2基因扩增156例(44.6%),17号染色体多体异常73例(21.8%),均为浸润性导管癌,占浸润性导管癌的53.4%和25%。HER-2基因扩增和HER-2蛋白表达及17号染色体多体与HER-2基因扩增和HER-2蛋白均密切相关(P<0.01)。本文结果提示,HER-2基因扩增或17号染色体多体与乳腺癌癌细胞的组织学分级(P=0.002或P=0.002)以及淋巴结转移有关(P=0.002或P=0.021),进而提示与患者的预后差有关,但与乳腺癌患者的年龄无关(P=0.222或P=0.502)。结论HER-2基因扩增和17号染色体多体可能与乳腺癌患者的预后不良有关。

Objective To investigate the clinicopathological significance of HER-2 gene amplification and chromosome 17 polysomy in breast carcinoma. Methods A retrospective study in 335 eases of breast carcinoma based on fluorescence in situ hybridization （FISH） was performed to analyze the relationship between HER-2 gene amplification or chromosome 17 polysomy and age, histological grade, lymphatic metastasis, and HER-2 protein expression. Results One hundred fifty-six cases （44.6%） of HER-2 gene amplification and 73 cases （21.8%） of chromosome 17 polysomy were detected in 335 cases of breast ductal carcinoma, in which all of them were invasive ductal carcinoma and thus the percentage of HER-2 amplification and chromosome 17 polysomy for invasive ductal carcinoma was up to 53.4% （156/292）and 25.0% （73/292）, respectively. In this study HER-2 gene amplification was associated with HER-2 expression （ P 〈 0.001 ）, and chromosome 17 polysomy was corresponding to HER- 2 gene amplification （P 〈 0.001）and HER-2 protein expression （P 〈 0.001）. It was suggested that HER-2 gene amplification or chromosome 17 polysomy was correlated with histological grade （ P = 0.002 or P = 0.002）and lymphatic metastasis （ P = 0.002 or P = 0.021）, and therefore, with the poor prognosis of breast cancer patients. It was also showed that either HER-2 amplification or chromosome 17 polysomy was not related to the age of patients （ P = 0.222 or P = 0.502）. Conclusion Both HER-2 gene amplification and chromosome 17 polysomy may be correlated to the histological grade, metastasis and HER-2 expression in breast carcinoma.