浸润性乳腺癌HER-2基因扩增和蛋白表达与临床病理特征的关系

The correlation among HER-2 gene amplification,protein express and clinicopathologic features of invasive carcinoma of the breast

目的探讨浸润性乳腺癌HER-2基因扩增和蛋白表达与临床病理特征的关系。方法回顾性分析本院采用FISH法检测HER-2基因状态的256例浸润性乳腺癌,与采用免疫组化En Vision法检测HER-2蛋白表达的结果进行一致性分析,并对HER-2基因扩增与病理特征的关系进行统计学分析。结果 256例浸润性乳腺癌患者中免疫组化显示HER-2蛋白(1+)、(2+)、(3+)的阳性率分别为9.4%、32.0%、21.9%,HER-2蛋白(1+)、(2+)、(3+)的病例中基因扩增率分别为0%(0/24)、46.3%(38/82)、100%(56/56),2种方法的阳性率差异有统计学意义(P<0.05);HER-2蛋白表达及基因扩增与临床相关因素无关(P>0.05),与病理特征有关(P<0.05);HER-2蛋白阳性表达及基因扩增阳性患者其生存率低于阴性者(P<0.05)。结论乳腺癌中免疫组化法检测HER-2蛋白表达是临床使用赫塞汀的"初筛",与FISH法联合检测才能较为准确的指导临床用药;HER-2蛋白过表达和基因扩增提示浸润性乳腺癌预后不良,HER-2与淋巴结转移可作为判断患者预后的重要指标。

Objective To explore the correlation among HER- 2 gene amplification,protein express and clinicopathologic features of invasive carcinoma of breast. Methods The consistency between FISH detection of HER- 2 gene status and En Vision immunohistochemical detection of HER- 2 protein expression in 256 cases of breast invasive carcinomas treated at our hospital was retrospectively analysed. Moreover,the correlation between HER- 2 gene amplification and the pathologic features of the tumors was statistically analysed. Results The positive rates of HER- 2 protein 1 ＋,2 ＋ and 3 ＋ of 256 invasive breast cancer patients were 9. 4%,32. 0%,21. 9%,respectively. The HER- 2 gene amplification rates of HER- 2 protein 1 ＋,2 ＋and 3 ＋ were 0%（ 0 /24）,46. 3%（ 38 /82） and 100%（ 56 /56）,respectively. Therefore,the difference between the HER- 2protein expression and HER- 2 gene amplification was significant（ P〈0. 05） statistically. Moreover,our data showed that the HER- 2 protein expression and HER- 2 gene amplification were not related to clinical relevant factors（ P〉0. 05）,but were related to some pathological features（ P〈0. 05）. The survival rate of the patients with positive HER- 2 protein expression and HER- 2 gene amplification was lower than that of the patients with negative ones. Conclusion Immunohistochemical detection of HER- 2 protein expression can be used as a ＂preliminary screen＂for clinic application of herceptin in the patients with breast carcinoma. However,it is combined with FISH detection of HER- 2 gene amplification could accurately guided the clinic application of the drugs in targeted therapy for breast carcinomas. The overexpression of HER- 2 protein and the amplification of HER- 2 gene indicate a bad prognosis for the patients with breast carcinoma. Thus these two and metastasis of lymph nodes can be used as important marks of prognosis for the patients with invasive carcinoma of the breast.