乳腺癌中EGFR蛋白表达和基因扩增的检测结果比较

Comparative Study on EGFR Protein Expression and gene Amplification in Breast Carcinoma

目的:比较免疫组织化学技术检测乳腺癌中EGFR蛋白表达和荧光原位杂交检测EGFR基因扩增的结果的符合率,为EGFR靶向治疗病例的选择提供依据。方法:随机选取2005年1月到2011年12月冷水江市人民医院和湖南省肿瘤医院病理科的147例乳腺癌档案病例,采用免疫组织化学技术检测乳腺癌组织中EGFR蛋白表达,荧光原位杂交检测EGFR的基因扩增,比较两种方法阳性结果的符合率。结果:免疫组化染色结果显示EGFR在原发性和转移性乳腺癌中的阳性表达率分别为85%(105/123)和79%1(9/24),两组比较无显著差异(P>0.05)。FISH检测结果显示原发性和转移性乳腺癌中分别有12%(15/123)和8%(2/24)存在EGFR基因扩增,两组比较结果无显著差异(P>0.05)。所有存在EGFR基因扩增的原发性和转移性乳腺癌的EGFR免疫组织化学结果均为阳性。在原发性和转移性乳腺癌中,免疫组化阳性和基因扩增程度间呈显著正相关(P<0.05),但免疫组化结果预测基因扩增的特异性较低。结论:免疫组织化学检测EGFR只能作为EGFR靶向治疗病例选择的初步筛选,进一步进行荧光原位杂交检测EGFR基因扩增是必须的。

Objective： The coincidence rate of detection of EGFR gene expression by immunohistochemical techniqueof and EGFR gene amplification by fluorescence in situ hybridization in breast cancer compared was compared, which provide the basis for selection for EGFR targeted therapy patients. Methods： From 2005 January to 2011 December, 147 cases of breast cancer cases in the archives were randomly selected in Department of pathology of Lengshuijiang Municipal People＇s Hospital and Hunan Tumor Hospital. To detect EGFR protein expression in breast carcinoma by immunohistochemistry technique, and detect EGFR gene amplification by fluorescence in situ hybridization, and the rate of positive results through two methods were compared. Results： Immunohistochemical staining showed positive expression rate of EGFR was 85% in primary breast cancer（105/123）, the positive expression in metastatic breast cancer rate of 79%1（9/24）, the expression of EGFR protein in primary and metastatic breast cancer expression was no significant difference（P0.05）. FISH results showed that the primary breast cancer 12%（15/123） EGFR gene amplification, metastatic breast cancer 8%（2/24） EGFR gene amplification, EGFR gene amplification in primary and metastatic breast cancer expression was no significant difference（P0.05）. All existing EGFR gene amplification in primary and metastatic breast carcinoma EGFR immunohistochemistry showed positive results. In primary breast cancer immunohistochemical staining and gene amplification was significantly positive correlation（P=0.01） in metastatic breast cancer, immunohistochemical staining and gene amplification was significantly positive correlation（P=0.05）, but the results of immunohistochemistry predict specific gene amplification in low. Conclusion： Preliminary screening of EGFR can only be detected with immunohistochemistry for EGFR targeting therapy for patient selection, it is necessary to further detect of EGFR gene amplification by fluorescence in situ hybridization.