胃癌组织中人类表皮生长因子受体2的表达及与临床病理特征的相关性分析

Association between HER-2 expression and clinicopathological features and the clinical significance in gastric carcinoma

目的检测胃癌组织中的人类表皮生长因子受体(HER)-2蛋白和HER-2基因的表达,探讨其与胃癌患者临床病理特征的关系。方法采用免疫组织化学法(IHC)检测115例胃癌活检标本中的HER-2蛋白表达,对HER-2蛋白过表达(IHC评分为++和+++)的标本采用荧光原位杂交技术(FISH)检测其HER-2基因水平和17号染色体倍体分析。结果①115例胃癌标本中,HER-2蛋白过表达率为40.0%(46/115)。HER-2蛋白的过表达与胃癌的Lauren分型、分化程度、浸润深度、淋巴结转移有关(P<0.05),与患者的年龄、性别、肿瘤大小、肿瘤部位等因素无关(P>0.05)。②HER-2基因的扩增率在HER-2蛋白(+++)组为90.5%(19/21),明显高于HER-2蛋白(++)组28.0%(7/25),差异有统计学意义(P<0.05)。③17号染色体多体在HER-2蛋白(++)组和(+++)组中的发生率分别为36.0%(9/25)和47.6%(10/21),差异无统计学意义(P>0.05)。结论①HER-2蛋白过表达的肿瘤细胞存在17号染色体多倍体现象,提示17号染色体多倍体可能引起HER-2蛋白过表达。②HER-2蛋白的过表达和HER-2基因的扩增与胃癌发生发展密切相关,这将为临床预测胃癌的预后及选择性靶向治疗提供理论依据。

Objective To detect the expression of HER-2 protein and gene in gastric cancer tissues, and to explore their relationship with the clinicopathological features of gastric cancer. Methods Immunohistochemistry as-say was applied to detect HER-2 protein expression in 115 cases with gastric cancer. The HER-2 gene expression and chromosome 17 polyploidy was, by using fluorescence in situ hybridization （FISH）, evaluated in the biopsy specimens with HER-2 protein overexpression （IHC score of＋＋and＋＋＋）. Results Of the 115 specimens of gastric cancer, the rate of HER-2 protein overexpression was 40.0%（46/115）. The magnitude of HER-2 protein overexpression was close-ly correlated to the Lauren′s type, the degree of differentiation, depth of invasion and lymph node metastasis （all P〈0.05）, but not the patient′s age, gender, tumor size or tumor location （all P〉0.05）. The rate of HER-2 gene amplifica-tion in HER-2 protein （＋＋＋） group was 90.5% （19/21）, which was significantly higher than that in group HER-2 （＋＋） （28.0%, 7/25, P〈0.05）. The difference in the rate of chromosome 17 polyploidy in protein HER-2 （＋＋） and （＋＋＋） group did not reach statistical significance [36.0%（9/25） vs 47.6%（10/21）, P〉0.05]. Conclusion Chromosome 17 polysomy can be found in tumor cells with HER-2 protein overexpression, suggesting that it could be the consequence of chromosome 17 polyploidy. The HER-2 protein and gene overexpression was closely related with the pathogenesis and development of gastric carcinoma, which will provide the theoretical basis for predicting the prognosis and target-ing the treatment in patients with gastric cancer.