荧光原位杂交与免疫组化对乳腺癌HER-2检测的对比研究

The comparative study between fluorescence in situ hybridization and immunohistochemistry in detection of breast cancer HER-2

目的探讨荧光原位杂交技术（FISH）检测石蜡标本乳腺癌HER-2基因和免疫组化法（1HC）检测HER-2蛋白表达的结果。方法采用荧光原位杂交技术（FISH）和免疫组化技术（IHC）分别检测203例乳腺癌患者手术切除标本的HER-2基因和HER-2蛋白表达，对两种方法检测结果进行对比分析。结果203例HER2IHC结果阳性110例（54％），阴性93例（46％）；FISH结果阳性60例（阳性率29％），阴性143例（71％）。93例HER-2蛋白为阴性的患者中，HER-2基因表达阴性的87例，符合率93．6％（87／93）；58例HER-2蛋白为＋的患者中，HER-2基因表达为阳性的11例，符合率为19．0％（11／58）；29例HER-2蛋白为＋＋的患者中，HER-2基因表达为阳性的22例，符合率75．9％（22／29）；23例HER-2蛋白为卅的患者中，HER-2基因表达为阳性的21例，两者符合率为91．3％（21／23）。结论对于IHC法初筛为阴性（-）或强阳性（卅）的患者两种方法检测的符合率（≥91．3％）较高，可选择性的进行FISH实验，尤其对于50岁以上年龄组的患者符合率（≥97．7％）更高，而对于IHC法初筛为阳性（＋～＋T）的患者应再进行FISH实验以确定HER-2基因的状态。

Objective：To investigate the correlation between the expression of Her-2 gene observed using the fluorescence in situ hybridization（FISH） and the expression of Her-2 protein observed using immunohistochemistry （IHC） in patients of breast cancer. Methods 203 cases of breast cancer were detected by IHC technique and FISH technique respectively. Results In 203 cases of breast cancer, HER-2 was expressed in 54% （110/203） cases, while HER-2 was expressed in 29 % （60/203） cases. In the 93 cases that the expression of HER-2protein was negative, there are 7 cases that the expression Her-2 gene was negative. In The 58 patients whose expression of HER-2 protein was positive,HER2 was expressed in 11 cases. In The 29 patients whose expression of Her-2 protein was middle positive, HER-2 was expressed in 22 cases. In the 23 patients whose expression of HER-2 protein was strong positive,HER-2 was expressed in 21 cases. Conclusion For the patients that were screened for the negative or strong positive, coincidence of the two methods is higher（≥ 91.3 % ） ,and FISH technique can be selected. In particular, more than 50-year-old age group of patients have a more coincidence（ ≥97.7 % ）, while the patients with positive that were screened with IHC method should be carried out FISH experiments to determine the status of the HER-2 gene.