两种方法对乳腺癌人类表皮生长因子受体2检测的一致性评价

Consistency study of two methods in detection of human epidermal growth factor receptor-2 in breast cancer

目的对比分析免疫组织化学法(immunohistochemistry,IHC)和荧光原位杂交法(fluorescence in situ hybridization,FISH)对乳腺癌人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)检测的一致性评价。方法选取2013―2018年入住安徽省某三级甲等医院并确诊患乳腺癌的患者组织,分别采用IHC及FISH两种方法检测HER-2,对比其结果的差异及联系。结果在选取的276例乳腺癌患者体内发现FISH法检测HER-2扩增与乳腺癌组织学分级相关。IHC法检测HER-2结果为3+的病例与同时做FISH检测结果为阳性扩增的符合率可以达到90%以上。当IHC为-/+和3+时,2种方法检测结果的一致性最好。而HER-2检测为2+的病人,与FISH检测方法相比,两者的符合率仅为67.9%。结论HER-2基因扩增与乳腺癌的恶性程度增高有关,IHC筛查HER-2检测结果为2+乳腺癌需加做FISH检测,对于乳腺癌患者的进一步诊疗具有指导意义。

Objective To evaluate the consistency of immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)for the detection of human epidermal growth factor receptor-2(HER-2)in breast cancer.Methods The patients who were diagnosed with breast cancer in a third-class A hospital in Anhui Province from 2013 to 2018 were selected.IHC and FISH were used to detect HER-2,and the differences and connections were compared.Results In the selected 276 breast cancer patients,FISH detection of HER-2 amplification was related to the histological grade of breast cancer.For patients with HER-2 of 3+detected by IHC,the positive amplification rate of FISH could reach higher than 90%.When IHC was-/+and 3+,the consistency of detection results between the two methods was the best.For patients with 2+in HER-2 test,compared with FISH test,the coincidence rate of IHC was only 67.9%.Conclusions HER-2 gene amplification is associated with increased malignancy of breast cancer,HER-2 screening results of 2+breast cancer by IHC requires additional FISH test,which is of guiding significance for the further diagnosis and treatment of patients.