乳腺癌组织中HER2和Topo Ⅱα的表达及其临床意义

Expressions of HER2 and Topo Ⅱα in breast cancer and its clinical significance

目的:检测人类表皮生长因子受体(human epidermal growth factor 2,HER2)和Topo IIα在乳腺癌组织中的表达情况,并分析二者的表达对蒽环类药物新辅助化学治疗(化疗)的临床意义。方法:采用荧光原位杂交(fluorescence in situ hybridization,FISH)和免疫组织化学(免疫组化)方法对189例临床资料完整的浸润性乳腺癌组织样本进行HER2和Topo IIα基因和蛋白表达检测,并对乳腺癌患者接受TAC新辅助化疗后的客观有效率(objective response rate,ORR)和病理完全缓解率(pathological complete rate,p CR)进行统计和分析。结果:在189例乳腺癌患者组织中,经免疫组化检测的HER2蛋白表达46例(24.3%)3+,Topo IIα蛋白表达55例(29.1%)3+;FISH检测,HER2蛋白表达阳性49例(25.9%),Topo IIα蛋白表达阳性94例(49.0%)。HER2阴性患者ORR为47.4%,p CR为20.3%;阳性患者ORR为32.7%,p CR为16.3%,两者差异均有统计学意义(均P<0.05)。Topo IIα阳性患者ORR为69.1%,p CR为36%;阴性患者ORR为28.4%,p CR为2.2%,两者差异均有统计学意义(均P<0.05)。结论:FISH和免疫组化检查HER2和Topo IIα对于乳腺癌治疗具有重要指导意义,Topo IIα基因扩增可以有效改善蒽环类药物辅助治疗效果。

Objective： To detect the expressions of human epidermal growth factor receptor 2（HER2） and Topo IIα in breast cancer, and to analyze the clinical significance of neoadjuvant chemotherapy for the anthracycline-based drugs.Methods： The HER2 and Topo IIα gene and protein expressions in cancer tissues from 189 patients with breast cancer were detected by fluorescence in situ hybridization（FISH） and immunohistochemistry（IHC）. And the objective response rate（ORR） and pathological complete rate（p CR） were analyzed.Results： Th e HER2 protein expression in 46 patients（24.3%） and Topo IIα protein expression in 55 patients（29.1%） was 3＋ by IHC or they were 49（25.9%） and 94（49.0%） by FISH, respectively.The ORR and p CR in HER2 negative or positive patients were 47.4% and 20.3% or 32.7% and 16.3%, respectively, with significant differences（All P〈0.05）. The ORR and p CR in Topo IIα positive or negative patients were 69.1% and 36.0% or 28.4% and 2.2%, respectively, with significant differences（All P〈0.05）.Conclusion： FISH and IHC were consistent in the determination of HER2 expression whereas they were inconsistent in the determination of Topo IIα expression. The amplification of Topo IIα can effectively improve the effect of the adjuvant treatment effect of the anthracyclines.