乳腺癌人表皮生长因子受体-2基因扩增和蛋白表达差异及其临床意义

Differential Expression and Its Clinical Significance of Amplification in Her-2 gene and Protein with Breast Cancer

目的研究乳腺癌人表皮生长因子受体-2(Her-2)基因扩增和蛋白表达的差异及其临床意义。方法乳腺癌手术患者87例分别采用荧光原位杂交(FISH)技术和免疫组化(IHC)法检测乳腺癌组织中Her-2基因及其蛋白表达,比较两者差异,分析其临床意义。结果 87例乳腺癌组织中,IHC法检测Her-2蛋白阳性(+++)表达33例(37.9%)。FISH法检测基因扩增36例(41.38%),无扩增51例(58.62%)。免疫组化法Her-2蛋白评分(0^+)25例中基因扩增2例(20%),(++)30例中基因扩增8例(26.67%),(+++)32例中26例基因扩增(81.25%)。结论IHC法检测可作为Her-2表达状态的初筛,其检测Her-2蛋白评分(0^+)、(+++)与Her-2基因扩增具有较高的一致性,可直接指导临床用药,而Her-2蛋白评分(++)的病例则需行FISH检测确定有无基因扩增。

Objective To study the differential expression and its clinical significance of amplification in Her-2 gene and protein with breast cancer. Methods Fluorescence in situ hybridization（ FISH） technique and immunohistochemistry（ IHC） method were adopted in the 87 patients with breast cancer respectively by detecting the expression of Her-2 in breast cancer gene and its protein,then the difference between the two were compared to analyze its clinical significance. Results In 87 cases of breast cancer tissues,IHC method was used to detect the expression of Her-2 protein,33 cases（ 37.9%） being positive（ ＋＋＋）.The amplification of Her-2 gene was assayed in 36 cases（ 41.38%） with FISH,and no amplification in 51 cases（ 58.62%）.Gene amplification was detected in 2 cases（ 20%） out of 25 cases of（ 0~ ＋） with Immunohistochemistry Her-2 protein score,8 cases（ 26.67%） out of 30 cases of（ ＋＋）gene,26 cases（ 81. 25%） out of 32 cases of（ ＋ ＋ ＋）. Conclusion IHC assay can be used as Her-2 expression screening,the detection of Her-2 protein score（ 0 ~ ＋）,（ ＋＋＋） amplification with high consistency with the Her-2 gene,which can directly guide the clinical medication,whereas Her-2 protein score（ ＋＋） cases required FISH testing to determine whether the gene amplification.