IHC与FISH在乳腺癌HER2蛋白表达和基因扩增检测中的应用

The DifferenceBetween IHC and FISH in Detecting HER2 Protein Expression and Gene Amplification in Breast Cancer

目的比较免疫组织化学法(immunohistochemisity,IHC)和荧光原位杂交法(fluorescence in situ hybridization,FISH)在乳腺癌患者中检测人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)的应用。方法2019年2月至2022年1月本院收治158例乳腺癌患者作为研究对象,均采用IHC和FISH检测HER2的蛋白表达和基因扩增情况,比较两种方法的检测结果和一致性。结果IHC结果显示158例患者中HER2(1+)、HER2(2+)、HER2(3+)分别为5例(3.16%)、97例(61.39%)、56例(35.44%),FISH结果显示HER2扩增73例(46.20%),未扩增85例(53.80%),其中,HER2(1+)患者FISH均显示未扩增,阴性符合率为100%;HER2(3+)患者FISH均显示扩增,阳性符合率为100%;97例HER2(2+)患者FISH显示扩增17例,阳性符合率为17.52%。两种方法检测HER2一致性较好且具有统计学意义(Kappa值=0.775,P<0.05)。结论HIC与FISH在乳腺癌患者HER2表达检测中一致性较好,可在临床推广使用,必要时需结合两种方法检测。

Objective To conduct comparison of immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)for human epidermal growth factor receptor 2(HER2)detection in breast cancer patients.Methods We selected a cohort of 158 breast cancer patients who received treatment at our hospital from February,2019 to January,2022.We utilized IHC and FISH techniques to identify the protein expression and gene amplification of HER2.We subsequently scrutinized the outcomes of these two methods and evaluated their concurrence.Results According to the results of immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)tests on 158 patients,3.16%(5)had HER2(1+),61.39%(97)had HER2(2+),and 35.44%(56)had HER2(3+).Among these patients,46.20%(73)showed HER2 amplification,while 53.80%(85)did not.The negative concordance rate for all FISH tests was 100%.FISH tests for all HER2(3+)patients confirmed amplification with a positive concordance rate of 100%.In addition,17 out of 97 HER2(2+)patients showed amplification by FISH,with a positive concordance rate of 17.52%.The agreement between the two methods for detecting HER2 was acceptable and statistically significant(Kappa value=0.775,P<0.05).Conclusion The consistency between the IHC and FISH methods is good.Genetic testing methods can be selected according to the actual situation to guide clinical treatment.