乳腺癌组织与转移淋巴结HER-2基因表达及检测方法的比较

HER-2 Expression in Breast Cancer Tissues and Metastasis Lymph Nodes and Comparative Study in Detection Methods

目的探讨乳腺癌组织与转移淋巴结中人表皮生长因子受体(human epidermal growth factor receptor-2,HER-2)基因表达的情况,对比荧光原位杂交法(Fluorescence in situ hybridization,FISH)与免疫组织化学法(Immunohistochemistry,IHC)两种检测方法。方法选取187例乳腺癌组织和76例转移淋巴结石蜡包埋标本,采用FISH和IHC方法检测HER-2基因表达,分析HER-2过表达与各临床病理因素的关系以及两种检测方法的差异,比较原发灶与转移灶HER-2表达的状况。结果 187例乳腺癌组织中,FISH检测显示HER-2阳性43例,阴性144例。IHC评分+++者22例、评分++者40例、评分-/+者125例。IHC评分+++者中,FISH阳性率为90.9%(20/22);评分++者中,FISH阳性率为52.5%(21/40);评分0/+者中,FISH阳性率为1.6%(2/125)。两种方法相比差异有统计学意义(P<0.001)。临床病理因素分析示HER-2基因扩增与淋巴结转移呈正相关(P<0.05)。乳腺癌原发灶与其配对转移淋巴结相比,HER-2表达的不一致性为11.8%(9/76)。结论 FISH较之IHC检测HER-2表达准确性更高,尤适用于对IHC++的患者判断HER-2的表达。乳腺癌原发灶与转移灶之间HER-2的表达存在一定的不一致性。

Objective To detect the expression of human epidermal growth factor receptor-2（HER-2）gene in breast cancer tissues and metastasis lymph node and to compare the results from fluorescence in situ hybridization（FISH） and with that from immunohistochemistry assay（IHC）.Methods The expression of HER-2 gene were measured by FISH and IHC methods in 187 cases of breast cancer tissues and 76 cases of metastasis lymph nodes.The results from the two methods were compared and analyzed with clinicopathological data.Results In breast cancer tissues,43 cases present positive and 144 cases present negative for HER-2 gene measured by FISH assay.Twenty-two cases showed ＋ ＋ ＋,40 cases showed ＋ ＋ and 125 cases showed 0/＋ for HER-2 measured by IHC.FISH-positive rate in IHC ＋ ＋ ＋ was 90.9%（20/22）,in IHC ＋ ＋ was 52.5%（21/40） and in IHC-/＋ was 1.6%（2/125）,respectively.There are significant differences between IHC and FISH（P0.001）.HER-2 expression was significantly correlated with lymph node metastasis（P0.05）.The discrepancy of HER-2 expression were 11.8%（9/76） between breast cancer primary tumors and paired lymph node metastasis Conclusion Detecting HER-2 expression by FISH is more accuracy than by IHC,especially for IHC ＋ ＋ patients.The expression of HER-2 is discrepancy between primary breast cancer and metastastic lymph nodes.