多蜡块检测HER2在胃癌中的应用价值

Clinical applications of multiple paraffin blocks for the detection of HER2 status in gastric cancer

目的探讨多蜡块检测HER2在胃癌中的临床应用价值。方法采用免疫组化法检测830例胃癌中HER2的表达并分析其与临床病理学特征的相关性,其中547例使用单个蜡块检测,283例使用多个蜡块检测。多蜡块组将评分最高者作为该例的综合判读结果。结果HER2评分0/1+在单、多蜡块组分别占69.7%(381/547)、42%(119/283),而HER2评分2+/3+在单、多蜡块组分别为30.3%(166/547)、58.0%(164/283)。在多蜡块组中,使用多个蜡块综合判断时HER2评分2+/3+的检出率显著高于使用一个或两个蜡块的检出率,差异显著(P<0.01)。HER2评分2+/3+在单、多蜡块组中均与肿瘤分化程度相关,在高-中分化癌中的表达率显著高于低分化癌(P均<0.01)。两组中HER2蛋白表达与性别、年龄、肿瘤部位、浸润深度、脉管侵犯以及淋巴结转移均无显著相关性(P均>0.05)。结论多蜡块检测能显著提高HER2评分2+/3+的检出率,HER2评分2+/3+与肿瘤分化程度显著相关。

Objective To study the practicability of multiple paraffin blocks for the detection of HER2 status in gastric cancer.Methods The expression of HER2 in gastric cancer was detected by immunohistochemistry,and 830 specimens of gastric cancer were divided into two groups:one group of 547 specimens were investigated in single paraffin blocks,and the other group of 283 specimens were examined in multiple paraffin blocks.In the group of multiple paraffin blocks,the higher score of HER2 was regarded as the final result,and the corresponding clinicopathological characteristics of the two groups were analyzed.Results The percentage of HER2 score with 0/1+ was 69.7%(381/547)and 42%(119/283)in the single and multiple paraffin block group,respectively.The percentage of HER2 score with 2+/3+ was 30.3%(166/547)and 58.0%(164/283)in the single and multiple paraffin block group,respectively.In multiple paraffin block group,the rates of HER23+ and 2+ of multiple paraffin blocks was significantly higher than that of single blocks and double paraffin blocks(P<0.001).The expression of HER2 in gastric cancer was correlated with tumor differentiation(P<0.001).However,HER2 expression was not correlated with gender,age,tumor location,infiltration depth,vascular invasion and lymph node metastasis(all P>0.05).Conclusion The rate of HER2 2+/3+ is significantly higher in multiple paraffin blocks than single paraffin blocks.The expression of HER2 in gastric cancer is correlated with tumor differentiation.