荧光原位杂交法检测乳腺癌HER-2／neu表达及临床意义

Determination of HER-2/neu Gene Expression in the Tissue of Breast Cancer by FISH and Its Clinicopathological Implications

目的探讨用荧光原位杂交(fluorescent in situ hybridization,FISH)方法检测乳腺癌HER-2/neu基因表达的临床意义。方法应用FISH法对2008年1月至2008年7月在首都医科大学附属北京天坛医院就诊的33例女性新发乳腺癌患者进行HER-2/neu基因检测,分析基因表达程度与临床病理特征之间的关系,比较基因和免疫组化(IHC)法蛋白表达的差别。结果33位受试者中HER-2/neu基因过表达率为39.4%,其过表达与肿瘤大小、绝经与否、临床分期之间差异无统计学意义(P>0.05)。该基因在有腋淋巴结转移组显著高于无淋巴结转移组(P<0.05),ER阴性组高于ER阳性组,差异有统计学意义(P<0.01)。PR阴性组与阳性组间差异无统计学意义。P53基因阳性组显著高于阴性组(P<0.05)。HER-2/neu基因过表达者11例为免疫组化HER-2蛋白强阳性病例;2例为中度阳性病例。结论FISH技术可稳定检测乳腺癌中HER-2/neu基因的表达程度,其过表达与绝经与否、肿瘤大小、临床分期无关,与腋淋巴结转移和P53基因表达成正相关,与ER呈密切负相关。HER-2蛋白高强度表达(3+)与基因扩增有极好的一致性,而中等强度表达(2+)必须进一步行FISH法基因检测。

Objective To explore overexpression of HER-2/neu gene by fluorescence in situ hybridization （FISH） in breast cancer and explore the clinical implications. Methods HER-2/neu gene in 33 cases with kainogeneous female breast cancer was detected by FISH from January 2008 up to now, and the relationship between HER-2/neu gene overexpression with clinical and pathological characters investigated. Results HER-2/neu gene expression rate was 39.4%. The overexpression was not correlated with tumor size, menostasis and clinical tumor stage（ P 〉 0.05 ）. It was positively correlated with axillary lymph node status （P 〈 0.05 ） and P53 gene （P 〈 0.05 ） ; and negatively correlated with ER（ P 〈 0.01 ） , but not correlated with PR （ P 〉 0.05 ）. The overexpression cases with HER-2/neu gene showed 11 strongly and 5 moderately positive expression of HER-2 protein by immunohistochemistry. Conclusion FISH technique could detect the overexpression of HER-2/neu gene in breast cancer. It has favourable concordance with strongly positive expression of HER-2 protein（3 ＋ ） , but in the of moderately positive cases, FISH must be applied.