荧光原位杂交法对胃癌组织HER-2基因状态的检测

Evaluation of HER-2 gene status in gastric cancer by fluorescence in situ hybridization

目的:比较荧光原位杂交(FISH)法与免疫组织化学(IHC)染色法检测胃癌组织HER-2基因状态的一致性.方法:选择本课题组前期IHC染色法检测775例胃腺癌标本中HER-2蛋白表达为(2+)及(3+)的病例,应用FISH法对HER-2基因扩增情况进行验证.结果:FISH结果显示,86例HER(3+)标本中,60例存在HER-2基因扩增,符合率69.77%;26例阴性病例中10例为多倍体,占38.46%.43例HER-2(2+)的病例中,6例(13.95%)存在H E R-2基因扩增;37例阴性病例中20例为多倍体,占54.05%.全组扩增效果不满意率1.97%(3/152).结论:IHC可作为HER-2状态的初步筛查方法,对于IHC检测HER-2(3+)及HER-2(2+)拟行靶向治疗的病例仍有必要进一步行FISH检测,以确定HER-2基因状态,同时在评价HER-2基因状态时,要考虑17号染色体多体的影响因素.

AIM： To compare immunohistochemistry （IHC） and fluorescence in situ hybridization （FISH） for detection of HER-2/neu gene status in gastric cancer. METHODS： HER-2 protein expression was ex- amined by IHC in 775 gastric adenocarcinoma specimens. The amplification of HER-2 gene in gastric cancer specimens which were demon- strated to be HER-2 （2＋） and （3＋） by IHC was detected by FISH. RESULTS： There are 60 cases of gene amplifica- tion in 86 HER-2 （3＋） specimens （69.77%）, and in 26 cases of HER-2 （3＋） specimens without gene amplification, 10 （38.46%） cases of chromosome 17 polyploidy were detected. However, there are only 6 cases of gene amplification in 43 HER-2 （2＋） specimens （13.95%）, and in 37 cases of HER-2 （2＋） specimens without gene amplifica- tion, 20 （54.05%） cases of chromosome 17 poly- ploidy were detected. CONCLUSION： IHC can be used for initial de- tection of HER-2 gene status. HER-2 （3＋） and HER-2 （2＋） cases should be further detected by FISH to analyze HER-2 gene status. Chromo- some 17 polyploid should be considered in the evaluation of HER-2 gene status.