血清HER-2neu ECD水平与乳腺癌临床特征及组织中HER-2neu表达的相关性

Correlations of serum HER-2neu ECD with clinical features and HER-2neu expression of breast cancer tissues in breast cancer patients

目的观察乳腺癌患者血清人类表皮生长因子受体-2(HER-2neu)胞外域部分(ECD)水平,探讨其与乳腺癌临床特征及组织中HER-2neu表达的相关性。方法选取2013年1月-2015年12月浙江省肿瘤医院乳腺癌患者50例作为乳腺癌组,健康志愿者50例作为对照组。采用化学发光法测定血清HER-2neu ECD水平。采用免疫组织化学法测定乳腺癌组织中HER-2蛋白的表达。结果乳腺癌组血清HER-2neu ECD水平高于对照组(P<0.05),乳腺癌组血清HER-2neu ECD阳性率高于对照组(P<0.05)。50例乳腺癌组织标本中,HER-2neu阳性表达20例,阳性率为40.0%。乳腺癌患者TNM分期Ⅲ期、雌激素受体(ER)阴性、孕激素受体(PR)阴性及肿瘤直径≥3 cm患者血清HER-2neu ECD阳性率高于TNM分期Ⅰ、Ⅱ期及ER阳性、PR阳性、肿瘤直径<3 cm患者(P<0.05)。20例乳腺癌组织HER-2阳性患者中,9例血清HER-2neu ECD阳性;30例乳腺癌组织HER-2阴性患者中,29例血清HER-2neu ECD阴性,两种方法一致性较好(Kappa=0.455,P=0.000)。结论乳腺癌患者血清HER-2neu ECD水平升高、乳腺癌组织中HER-2蛋白表达的一致性较好、血清HER-2neu ECD水平与TNM分期、ER、PR及肿瘤大小相关,可作为乳腺癌组织中HER-2蛋白表达的补充检测方法。

Objective To observe the level of extracellular domain （ECD） of human epidermal growth factor receptor-2 （HER-2neu） in patients with breast cancer, and to investigate its relationship with the clinical characteristics of breast cancer and the expression of HER-2neu in breast cancer tissues. Methods Fifty patients with breast cancer were selected as the breast cancer group and 50 cases of healthy volunteers were selected as the control group in Zhejiang Cancer Hospital from January 2013 to December 2015. The serum level of HER-2neu ECD was measured by chemiluminescence. The expression of HER-2 protein in breast cancer tissues was detected by immunohistochemistry. Results The serum level of HER-2neu ECD in the breast cancer group was significantly higher than that in the control group （P〈 0.05）. The positive rate of serum HER-2neu ECD in the breast cancer group was higher than that in the control group （P 〈 0.05）. In the 50 cases of breast cancer tissue specimens, 20 cases had positive expression of HER-2neu, the positive rate was 40.0%. The positive rates of HER-2neu ECD in the patients with TNM stage 111, negative ER,negative PR and tumor I〉3 cm were higher than those in the patients with TNM stage I and Ⅱ, positive ER, positive PR and tumor 〈3 cm （P 〈 0.05）. Of the 20 breast cancer patients with positive HER-2 in the breast cancer tissues, 9 patients were positive for serum HER-2neu ECD. Of the 30 breast cancer patients with negative HER-2 in breast cancer tissues, 29 cases were negative for serum HER-2neu ECD. The two methods were consistent （Kappa = 0.455, P = 0.000）. Conclusions The serum level of HER-2neu ECD in patients with breast cancer is increased, and it is consistent with the expression of HER-2 protein in breast cancer tissues. The serum level of HER-2neu ECD is associated with TNM stage, ER, PR and tumor size, therefore it can be used as the supplementary method for detection of HER-2 protein expression in breast cancer tissues.