顯色原位雜交評價乳腺癌HER-2狀態的意義及其免疫組化評價建議

Role of chromogenic in situ hybridization(CISH)in the evaluation of HER-2 status in breast carcinoma and proposition of its immunohistochemical valuation

目的檢測乳腺癌人類表皮生長因子受體2(HER-2)基因擴增和蛋白表達,為臨床使用分子靶向藥物Trastuzumab(Herceptin)治療乳腺癌提供依據。方法採用顯色原位雜交法檢測71例福爾馬林固定石蠟包埋的乳腺癌組織HER-2擴增狀態,檢測結果與免疫組化(IHC)比較。結果CISH檢測結果顯示,乳腺癌中HER-2高度擴增為28.2%(20/71)、低度擴增5.6%(4/71)、無擴增66.2%(47/71)。免疫組化染色3+的佔38.0%(27/71)、2+佔31.0%(22/71)、0~1+佔31.0%(22/71)。CISH結果與IHC結果高度相符。結論CISH是一種客觀和準確的評價乳腺癌HER-2狀態的方法。採用改良免疫組化評價標準,IHC檢測也是HER-2蛋白表達的有用指標。

Objective To value HER-2 gene amplification and protein expression in breast carcinoma,and provides an indicator clinically using molecular target therapeutic trastuzumab(Herceptin)in the patient with breast carcinoma.Methods Chromogenic in situ hybridization(CISH)was used to detect HER-2 amplification in 71 cases of formalin-fixed,paraffin-embedded breast carcinomas of different histology.The detected results were compared with immunohistochemistry(IHC).Results The results show that high level amplification detected by CISH was 28.2%(20/71 cases)breast carcinoma,low level amplification 5.6%(4/71)and no amplification 66.2%(47/71).IHC scoring 3+was 38.0%(27/71),2+31.0%(22/71)and 0~1+31.0%(22/71)of all cases.CISH-IHC results showed a good concordance.Although IHC-CISH results showed a good concordance in the 0/1+and 3+groups,while a poor agreement in 2+group was confirmed.If the evaluated criteria is modified according the reactive pattern of IHC in CISH amplified cases,IHC-CISH results are highly concordance.Conclusion CISH is an objective and accurate tool to evaluate breast cancer HER-2 status.After modifying the valued criterion,IHC is also a useful indicator for HER-2 protein expression.