荧光原位杂交技术与免疫组化对乳腺癌HER2检测的对比研究

Comparative study on fluorescence in situ hybridization and immunohistochemistry for HER2 monitoring of breast cancer

目的:对比分析荧光原位杂交技术(fluorescence in situ hybridization,FISH)与免疫组化(immunohistochemistry,IHC)法对乳腺癌人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER2)检测的效果,为临床检测乳腺癌HER2蛋白的方法选择提供理论依据。方法:随机选取2014年1月至2016年1月到医院就诊并确诊患乳腺癌的患者80名记为实验组,无乳腺疾病患者80名记为对照组。所有患者皆取乳腺石蜡标本,均采用IHC和FISH法检测,观察比较2组患者在不同检测方式下的HER2蛋白检出率的差异,对2种检测手段的应用效果进行评价。结果:观察组患者使用FISH后的阳性率为97.50%,使用IHC的阳性率为88.75%,FISH的阳性检出率大大高于IHC,差异有统计学意义(P<0.05);对照组患者使用FISH的阴性率为80.0%,而使用IHC的阴性率为92.50%,IHC的阴性率明显高于FISH,差异有统计学意义(P<0.05)。结论:FISH有较高的阳性检出率,能够明显减少假阴性的发生,适用于乳腺癌的确诊实验和对转移及预后的评估;IHC有较高的阴性率,能够明显减少假阳性的发生,更适合于乳腺癌的筛查和排除诊断。

Objective To compare and analyze the effects of fluorescence in situ hybridization （FISH） and immunohistoche- mistry （IHC） on HER2 monitoring of breast cancer, and to provide a theoretical basis for the detection of HER2 protein in breast cancer. Methods Totally 80 breast cancer patients from January 2014 to January 2016 were enrolled into an experimental group, and another 80 healthy persons were involved into a control group. The breast paraffin specimens of the 160 subjects were detected with IHC and FISH, and then the detection rates of HER2 protein by the two methods were compared to evaluate their effects. Results In the experimental group, the positive rate by FISH （97.50%） was significantly higher than that by IHC （88：75%）; in the control group, the negative rate by FISH （80.0%） was obviously different with that by IHC （92.50%）. Conclusion FISH gains high positive rate and decreases the false negative rate, and thus is suitable for the final diagnosis as well as the evaluation of metastasis and prognosis of breast cancer. IHC has high negative rate and reduces false positive rate, and is fitful for the screening and exclusion of breast cancer.