非特殊型浸润性乳腺癌HER-2检测方法的对比研究

Comparison of different methods for HER-2 status detection in non-special invasive breast carcinoma

目的应用实时定量PCR技术(quantitive real-time PCR,q PCR)检测石蜡包埋非特殊型浸润性乳腺癌标本的HER-2表达状况,与免疫组织化学技术(immunohistochemistry,IHC)和荧光原位杂交技术(fluorescence in situ hybridization,FISH)相应检测结果进行比较,以验证q PCR技术检测HER-2方法的可靠性和实用性。方法采用FISH和q PCR技术对IHC检测结果分别为HER-2(0、1+、2+、3+)的乳腺癌标本各100例进行检测,用kappa检验分析三者的一致性。结果 100例HER-2(0)和HER-2(1+)的标本FISH和q PCR的检测结果均无扩增,符合率100%;IHC检测HER-2(2+)的标本,FISH和q PCR检测结果之间k=0.731(P<0.001),二者一致性强;IHC检测HER-2(3+)的标本,FISH与q PCR检测结果 k=0.634(P<0.001),二者具有较好的一致性,与IHC检测结果也具有较强的一致性。三者对乳腺癌患者的临床病理指标反应具有较好的一致性。结论 q PCR方法简便、实用、有效,检测乳腺癌HER-2基因状况可与FISH法互为补充。

Objective To compare quantitative polymerase chain reaction（qPCR） with immunohistochemistry（IHC） and fluorescence in situ hybridization（FISH） for the detection of HER-2 in non-special invasive breast carcinoma.Methods HER-2 expression levels in carcinoma tissue were detected using IHC,and the HER-2 gene expression levels were determined by FISH and qPCR.According to IHC results,all patients were divided into 4 groups[（HER-2（0）,HER-2（1＋）,HER-2（2＋） and HER-2（3＋）]with 100 cases in each.The kappa test was used to measure the consistency among the results of IHC,FISH and qPCR.Results In HER-2（0） and HER-2（1＋） groups,there were no differences between the results of qPCR and FISH.In HER-2（3＋） group,a few discrepancies were found between qPCR and FISH[k=0.634（P〈0.001）].In HER-2（2＋） group,the diagnostic consistency was good between qPCR and FISH[k=0.731（P〈0.001）].Using FISH test,there was consistency in correlation between HER-2 expression and clinicopathological parameters in the results of qPCR,FISH and IHC.Conclusion qPCR is a convenient,objective and efficient method,which may be used as an alternative to FISH,for the detection of HER-2 gene state of non-special invasive breast carcinoma.