HER2阳性胃癌临床病理特征分析

Clinicopathological Characteristics of HER2-positive Gastric Cancer

[目的]分析胃癌HER2阳性率,探讨HER2阳性胃癌临床病理特征。[方法]采用免疫组织化学法(IHC)检测HER2蛋白表达,采用荧光原位杂交(FISH)检测HER2基因扩增。[结果]110例胃癌组织HER2 IHC阳性率为6.4%(7/110),FISH阳性率为14.5%(16/110)。排除IHC2+,IHC与FISH检测结果符合率为96%。HER2总体阳性率为10.9%。Lauren分型肠型胃癌HER2阳性率高于混合型和弥漫型(18.0%vs 5.0%,P<0.05)。WHO分型管状腺癌HER2阳性率高于其他类型(19.3%vs 2.3%,P<0.05),中、高分化胃癌HER2阳性率高于低分化胃癌(20.0%vs 5.7%,P<0.05)。HER2阳性率在不同年龄、性别、肿瘤部位、肿瘤大小、淋巴结转移和TNM分期胃癌中无统计学差异(P>0.05)。[结论]胃癌HER2阳性与Lauren分型及WHO分型、分级有关。

[Purposel To investigate the positive rate of HER2 in gastric cancer and the clinico- pathologic characteristics of HER2-positive gastric cancer. [Methodsl HER2 expression was de- tected by immunohistochemistry （IHC）. HER2 gene amplification was analyzed by fluorescence in situ hybridization （FISH）. [Results] In 110 cases of gastric cancer,positive rates of HER2 IHC and FISH testing were 6.4% （7/110） and 14.5% （16/110） respectively. A coincidence rate of 96% between IHC and FISH results was demonstrated when IHC2＋ was excluded. The overall HER2 positive rate was 10.9%. Intestinal type gastric carcinomas by Lauren＇s classification showed sig- nificantly higher HER2 positive rate than that in mixed and diffuse types （18.0% vs 5.0% ,P〈0.05）. Tubular adenocarcinoma by WHO classification revealed markedly higher HER2 positive rate than that in others（19.3% vs 2.3%,P〈0.05）. HER2 positive rate in well and moderately differenti- ated gastric cancer was significantly higher than that in poorly differentiated type （20.0% vs 5.7%, P〈0.05）. There was no statistical differences in HER2 positive rates in gastric cancer sub- groups stratified by age,gender,tumor location,tumor size,lymph node metastasis or TNM stages （P〉0.05）. [ Conclusion ] HER2-positive is associated with Lauren classification and WHO classifi- cation/differentiation in gastric cancer.