ER、Her-2、Ki-67在原发灶和复发灶中表达差异观察

Differential expression of ER,HER-2 and Ki-67 in primary and recurrent lesions

目的研究雌激素受体(ER)、人表皮生长因子受体-2(Her-2)、细胞核增殖抗原(Ki-67)在原发灶和复发灶中的表达差异。方法回顾性选择2017年3月至2021年3月蚌埠医学院第二附属医院收治的82例局部复发乳腺癌患者作为研究对象。使用免疫组织化学法和荧光原位杂交技术(FISH)检测患者原发灶和复发灶中ER、Her-2、Ki-67表达。观察ER、Her-2、Ki-67在原发灶、复发灶中的表达。结果乳腺癌患者原发灶中ER、Her-2、阳性表达率分别为54.88%、24.39%,复发灶中ER、Her-2阳性表达率分别为51.22%、19.51%,两种病灶中ER、Her-2阳性表达率比较,差异均无统计学意义(P>0.05);原发灶和复发灶中Ki-67高表达率分别为52.44%、71.95%,复发灶中Ki-67高表达比率较原发灶高,差异有统计学意义(P<0.05)。原发灶和复发灶中ER、Her-2、Ki-67表达一致率分别为80.49%、86.59%、76.83%。患者年龄、组织学分级与ER、Her-2、Ki-67表达差异无明显相关性(P>0.05);临床分期为Ⅲ或Ⅳ期的患者ER表达不一致率较高(P<0.05)。结论局部复发乳腺癌患者的原发灶和复发灶中ER、Her-2、Ki-67的表达存在较高的一致性,但仍含有部分患者的表达存在一定差异,临床有必要同时检测患者的原发灶和复发灶,可能有助于临床治疗方案的选择。

Objective To study the expression differences of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and nuclear proliferation antigen(Ki-67)in primary and recurrent lesions.Methods A total of 82 patients with locally recurrent breast cancer admitted in the Second Affiliated Hospital of Bengbu Medical College from March 2017 to March 2021 were retrospectively selected and divided into primary group(n=37)and recurrent group(n=45)according to the type of lesion.The expressions of Er,HER-2 and Ki-67 were detected by immunohistochemistry and fluorescence in situ hybridization(FISH).The expressions of ER,HER-2 and Ki-67 in primary and recurrent lesions were observed.Results The positive expression rates of ER,HER-2 and ER-2 were 54.88%and 24.39%in the primary tumor,and 51.22%and 19.51%in the recurrence tumor,respectively.There was no significant difference in the positive expression rates of ER and HER-2 between the two lesions,the difference were no statistically significant(P>0.05).The high expression rate of Ki-67 in primary and recurrent foci was 52.44%and 71.95%,respectively.The high expression rate of Ki-67 in recurrent foci was higher,the difference was statistically significant(P<0.05).The consistent expression rates of ER,HER-2 and Ki-67 were 80.49%,86.59%and 76.83%in the primary group and recurrence group,respectively.There was no significant correlation between age and histological grade and the expression of ER,HER-2 and Ki-67(P>0.05).Patients with clinical stageⅢorⅣhad a higher rate of inconsistent ER expression(P<0.05).Conclusion Compared with primary tumors,the positive rate of Ki-67 expression in breast cancer patients was higher than that in primary lesions,but there was no difference in ER and Her-2 between primary and recurrent foci.This suggests that Ki-67 has higher value in the evaluation of recurrent foci.