免疫组化法与双色银染原位杂交法用于乳腺癌HER-2检测诊断中的应用价值分析

An Comparison of the Value of Immunohistochemistry and Double-Color Silver Staining in Situ Hybridization for Detection of HER-2 in Breast Cancer

目的探讨免疫组化法与双色银染原位杂交(DISH)法用于乳腺癌HER-2检测诊断中的价值情况。方法选取本院收治的乳腺癌患者242例,单侧肿瘤患者201例,双侧肿瘤患者41例,比较分析免疫组化法与双色银染原位杂交对肿瘤组织HER-2检测诊断的阳性率情况等,完成比较评价。结果本研究中共纳入242例,均为女性,平均年龄43.7±5.4岁;单侧肿瘤患者201例,平均年龄42.3±5.9岁,淋巴转移患者23例,占11.44%;双侧肿瘤患者41例,平均年龄41.9±5.8岁,6例淋巴转移(14.63%)。使用DISH法检测HER-2的阳性率为83.06%,略低于免疫组化法的检出阳性率87.19%,P<0.05。进一步分析DISH和免疫组化检测HER-2阳性情况,发现DISH和IHC检测方法检测HER-2阴性的一致率为100%,IHC(+)与DISH检测一致率为83.72%,IHC(++)与DISH检测一致率为97.37%,IHC(+++)与DISH检测一致率为98.91%。结论原位杂交法和免疫组化方法两种不同方法在检测乳腺癌HER-2表达中检出阳性率均良好,IHC检出HER-2表达越高,DISH检测的阳性率与其一致性也越高。作为新方法的DISH法值得临床推广。

Objective To investigate the value of immunohistochemical staining and in situ hybridization （DISH） for the detection of HER-2 in breast cancers.Methods The expression levels of HER-2 in tumor tissues from 242 cases of breast cancer patients, 201 cases of unilateral tumor patients and 41 cases of bilateral tumor patients were detected by immunohistochemistry and in situ hybridization of silver staining, then analyzed.Results The average age was 42.3±5.9 years, and lymphatic metastasis was detected in 23 cases, with accounting for 11.44%;among 41 cases of bilateral tumor patients, the average age was 42.32±5.90 years, and the mean age was 43.7±5.4 years;mean age of 6 cases of lymphatic metastasis was 41.9±5.8 years （14.63%）.The positive rate of HER-2 detected by DISH was 83.06%, which was slightly lower than that by immunohistochemistry （87.19%, P 〈0.05）.Further analyses were done with DISH and immunohistochemical （IHC） to detect HER-2 positive cases.The results showed that HER-2 negative agreement rate between DISH and IHC was 100%.Rate of IHC （＋） to DISH detection was 83.72%.The coincidence rate between IHC （＋＋） and DISH was 97.37%, while that between IHC（＋＋＋） and DISH was 98.91%.Conclusion Both DISH and IHC methods can be used to detect HER-2 expression in breast cancers.While HER-2 （＋） detection by IHC was higher, DISH detection rate and its consistency were also higher.DISH method might be a good new method in clinical application.