荧光原位杂交技术检测乳腺癌Her-2/neu基因与免疫组化法检测C-erbB2蛋白的相关性研究

目的探讨荧光原位杂交技术(FISH)检测石蜡标本乳腺癌Her-2基因和免疫组化法(IHC)检测C-erbB2蛋白表达结果的相关性。方法采用荧光原位杂交技术(FISH)和免疫组化技术(IHC)分别检测203例乳腺癌患者手术切除标本的Her-2基因和C-erbB2蛋白表达,分析两种方法检测结果的相关性。结果203例中C-erbB2免疫组化阳性110例(54%),阴性93例;FISH结果阳性60例(阳性率29%),阴性143例。93例C-erbB2蛋白为阴性的患者中,Her-2基因表达阴性的87例,符合率93.6%(87/93);58例C-erbB2蛋白为+的患者中,Her-2基因表达为阳性的11例,符合率为19.0%(11/58);29例C-erbB2蛋白为++的患者中,Her-2基因表达为阳性的22例,符合率75.9%(22/29);23例C-erbB2蛋白为+++的患者中,Her-2基因表达为阳性的21例,符合率91.3%(21/23)。结论对于IHC法初筛为阴性(-)或强阳性(+++)的患者符合率(≥91.3%)较高,可选择性的进行FISH实验,尤其对于50岁以上年龄组的患者可基本确诊,对于IHC法初筛为阳性(+～++)的患者应再进行FISH实验以确定Her-2基因的状态。

The relevance between the Her-2 gene examined by the fluorescence in situ hybridization (FISH) and the C-erbB2 protein detected with immunohistochemistry (IHC) in breast cancer

Objective To investigate the relevance between the Her-2 gene examined by the fluorescence in sire hybridization (FISH) and the C-erbB2 protein detected with immunohistochemistry (IHC) in paraffin-embedded tissues specimens of breast cancer. Methods FISH or IHC were employed to detect the Her-2 gene or the expression of C-erbB2 protein, respectively, in paraffin-embedded tissues specimens from patients with breast cancer. The relevance between the results obtained by the FISH and IHC was studied. Results Among 203 cases of patients with breast cancer, 110 cases were positive or 93 cases were negative for C-erbB2 protein, while 60 cases were positive or 143 cases were negative for Her-2 gene. From 93 patients, whose C-erbB2 protein were negative, there were 87 cases showing negative in Her-2 gene and resulted in a coincidence of 93.6% in both C-erbB2 protein and Her-2 gene. From 23 patients, whose C-erbB2 protein were strong positive (+++), there were 21 cases showing positive in Her-2 gene and resulted in a coincidence of 91.3% in both C-erbB2 protein and Her-2 gene. While 29 patients whose C-erbB2 protein were moderately positive (++), there were 22 cases showing positive in Her-2 gene with a coincidence of 75.9%. Nevertheless, In 58 patients whose C-erbB2 protein were slightly positive (+), only 11 cases showing positive in Her-2 gene and resulted in a coincidence of 19%. Conclusion There were a high coincidence between the Her-2 gene examined by FISH and the C-erbB2 protein detected with IHC.