胃癌HER2基因擴增及其蛋白表達與臨床特征的關係

A study on HER2 gene amplification and its protein expression in gastric cancers:correlations with clinicopathologic features

目的探討胃癌HER2基因擴增狀態及蛋白產物Cerb B2表達,分析其與臨床病理特征的關係。方法收集胃癌活檢標本106例。採用雙重原位雜交(DISH)和IHC檢測HER2基因及Cerb B2蛋白;記錄病人臨床病理特征,包括年齡、性別、腫瘤部位和組織學分型,並分析其與HER2基因和Cerb B2蛋白的關係。結果106例胃癌活檢病例中,HER2基因擴增率為16.0%。HER2基因擴增狀態與Cerb B2為3+及0/1+的相符率分別為100%及98.6%;Cerb B2為2+的病例相符率僅為23.1%。腸型腺癌HER2基因擴增率為36.8%,混合型及彌漫型分別為5.4%及0%。胃食道交界腺癌HER2基因擴增率為32%,其他部位胃癌為11.1%。HER2基因擴增狀態與性別及年齡無統計學意義。結論HER2基因擴增主要見於腸型腺癌及胃食道交界腺癌。對要求靶向治療的病人,Cerb B2為0/1+及3+的病例可不必行DISH檢測,2+者則需進一步行DISH確認有否基因擴增。

Objective To explore the status of HER2 gene amplification and its protein CerbB2expression in gastric cancer and analyze the relationship between HER2 amplification,protein expression and clinicopathologic features.Methods 106 cases of gastric cancer biopsy tissue were collected.The status of HER2 gene amplification in the gastric cancer was detected by dual in situ hybridization(dual-ISH).CerbB2 protein was stained by immunohistochemistry.Patient’s clinical data,including age,sex,tumor location,and histological grade/type were collected to analyze statistically their correlation withHER2 amplification and CerbB2 expression.Results HER2 gene amplification was detected in 16.0%cases of gastric cancer.The concordance of HER2 to Cerb B2 in score 3+and 0/1+is 100%and 98.6%respectively,while in score 2+only 23.1%.Histologically,HER2 amplification rate in the intestinal type adenocarcinoma is 36.8%,while in diffuse type or mixed type is 0%and 5.4%.HER2 amplification rate is 32%in the adenocarcinomas located in gastroesophageal junction,and 11.1%in other positions of the stomach.HER2 amplification is not correlated with sex,age statistically.Conclusion HER2 amplification of HER2 gene mainly occurs in intestinal type adenocarcinoma and adenocarcinoma in gastroesophagealjunctional position.For the patients requiring targeted therapy,if Cerb B2 expression scores 0/1+or3+,it is not necessary to do HER2 detection,but if scores 2+,detection is needed to ensure the presence of gene amplification.