FISH及免疫组化技术检测乳腺癌Her-2基因与蛋白的临床应用价值

Relationship between IHC and FISH in detecting Her-2 /Her-2 status in 98 cases with breast cancer

目的分析免疫组化技术(IHC)检测石蜡标本乳腺癌组织中原癌基因-2(Her-2)蛋白表达与荧光原位杂交技术(FISH)检测Her-2基因扩增状态的临床应用价值。方法 IHC和FISH技术分别检测98例乳腺癌癌组织中的Her-2蛋白表达和Her-2基因扩增。结果 98例石蜡包埋乳腺癌组织中1例Her-2表达蛋白为阴性的患者中,Her-2基因扩增亦为阴性,符合率100%(1/1);15例Her-2蛋白表达为(+)的患者中,Her-2基因扩增为阴性的12例,符合率为80.0%(12/15);49例Her-2蛋白表达为(++)的患者中,Her-2基因扩增为阳性的25例,符合率51%(25/49);33例Her-2蛋白表达为(+++)的患者中,Her-2基因扩增为阳性的27例,符合率81.8%(17/21)。IHC法初筛为阴性(-～+)和强阳性(+++)检测结果与FISH检测结果一致性较高(Kappa=0.602>0.40,P<0.01),且两法检测差异无统计学意义(χ2=0.508,P>0.05)。结论 IHC方法检测乳腺癌组织中Her-2蛋白表达阴性和强阳性与FISH检测结果一致性较高。

Objective To investigate the relevance between the Her-2 protein detected by Immunohistochemistry（IHC） and the Her-2 gene examined by the fluorescence in situ hybridization（FISH） in 98 paraffin-embedded tissues specimens of breast cancer.Methods Her-2 protein expression and Her-2 gene amplification was detected by IHC and FISH in 98 cases of breast cancer.The relevance between the results obtained by the IHC and FISH was studied.Results Among 98 patients with breast cancer,from one patient whose Her-2 protein were negative,there was one case showing negative in Her-2 gene amplification and resulted in a coincidence of 100% in both Her-2 protein and Her-2 gene.From 15 patients whose Her-2 protein were slightly positive（＋）,12 cases showing negative in Her-2 gene amplification and resulted in a coincidence of 80.0%.From 33 patients,whose Her-2 protein were strong positive（3 ＋）,there were 27 cases showing positive in Her-2 gene amplification and resulted in a coincidence of 81.8% in both Her-2 protein and Her-2 gene.While 49 patients whose Her-2 protein were moderately positive（2 ＋）,there were 25 cases showing positive in Her-2 gene with a coincidence of 51%.The coincidence rate between IHC and FISH was better in Her-2（3 ＋） and（-/ ＋） groups（Kappa = 0.602 0.40;P 0.01）,there were no statistics difference in two methods（χ2 = 0.508,P 0.05）.Conclusion The coincidence rate between IHC and FISH in detecting Her-2 protein states is better in（-/ ＋） and（3 ＋） groups in breast cancers.