人表皮生长因子受体2在表皮生长因子受体突变中晚期肺腺癌中的表达及其意义

Expression of human epithelial growth factor receptor 2 in advanced lung adenocarcinoma with epithelial growth factor receptor mutation and its significance

目的 检测人表皮生长因子受体2（HER-2）在表皮生长因子受体（EGFR）突变的中晚期肺腺癌中的表达情况,初步探讨其成为治疗EGFR突变患者耐药的潜在靶点的可能性.方法 选取84例EGFR突变的中晚期肺腺癌石蜡组织切片,应用免疫组织化学方法检测HER-2蛋白表达情况,分析其与患者临床病理特征的关系.结果 HER-2蛋白在EGFR突变的中晚期肺腺癌中主要分布于细胞膜.HER-2蛋白在EGFR突变患者组织中的过表达率为33.3%（28/84）.HER-2蛋白在年龄〉50岁患者中的过表达率为40.3%（27/67）,明显高于年龄≤50岁患者的5.9%（1/17）,两者差异有统计学意义（χ2=7.227,P=0.007）.在高分化患者中的过表达率[44.4%（8/18）]较中低分化患者[30.3%（20/66）]有增高趋势,但差异无统计学意义（χ2=1.273,P=0.259）.携带EGFR 21外显子突变患者的HER-2蛋白过表达率[40.5%（17/42）]较EGFR 19外显子突变患者[25.0%（10/40）]有增高趋势,但差异无统计学意义（χ2=2.222,P=0.136）.结论 HER-2蛋白在EGFR突变的中晚期肺腺癌患者中过表达率较高,且与患者年龄和肿瘤分化程度相关.HER-2有望成为EGFR突变患者耐药的潜在治疗靶点.

Objective To detect the expression of human epithelial growth factor receptor 2 （HER-2） in advanced lung adenocarcinoma with epithelial growth factor receptor （EGFR） mutation, and to explore the potential of HER-2 as a therapeutic target for drug resistance in patients with EGFR mutations. Methods HER-2 is commonly expressed in the advanced lung adenocarcinoma with EGFR mutations, mainly in the cell membrane. Results The overexpression rate of HER-2 protein in tissues of advanced lung adenocarcinoma with EGFR mutations was 33.3%（28/84）. The overexpression rate of HER-2 protein in patients〉50 years of age was 40.3%（27/67）, which was significantly higher than that of patients ≤50 years of age [5.9 % （1/17）], the difference was statistically significant （χ2=7.227, P=0.007）. The overexpression rate of HER-2 protein in patients with high pathological differentiation [44.4 % （8/18）] was higher than that in patients with poor pathological differentiation [30.3%（20/66）], but the difference was not statistically significant （χ2=1.273, P=0.259）. The overexpression of HER-2 protein in patients with EGFR 21 exon mutation [40.5 % （17/42）] was significantly higher than that of EGFR19 exon mutation [25.0%（10/40）], but the difference was not statistical significance （χ2=2.222, P=0.136）. Conclusions The overexpression rate of HER-2 protein in advanced lung adenocarcinoma patients with EGFR mutation is high, which is related to the age and tumor differentiation. HER-2 is expected to be a potential therapeutic target for drug resistance patients with EGFR mutations.