两种方法对乳腺癌人类表皮生长因子受体2检测的一致性评价

目的  对比分析免疫组织化学法（immunohistochemistry，IHC）和荧光原位杂交法（fluorescence in situ hybridization，FISH）对乳腺癌人类表皮生长因子受体2（human epidermal growth factor receptor-2，HER-2）检测的一致性评价。 方法  选取2013―2018年入住安徽省某三级甲等医院并确诊患乳腺癌的患者组织，分别采用IHC及FISH两种方法检测HER-2，对比其结果的差异及联系。 结果  在选取的276例乳腺癌患者体内发现FISH法检测HER-2扩增与乳腺癌组织学分级相关。IHC法检测HER-2结果为3+的病例与同时做FISH检测结果为阳性扩增的符合率可以达到90%以上。当IHC为-/+和3+时，2种方法检测结果的一致性最好。而HER-2检测为2+的病人，与FISH检测方法相比，两者的符合率仅为67.9%。 结论  HER-2基因扩增与乳腺癌的恶性程度增高有关，IHC筛查HER-2检测结果为2+乳腺癌需加做FISH检测，对于乳腺癌患者的进一步诊疗具有指导意义。

Consistency study of two methods in detection of human epidermal growth factor receptor-2 in breast cancer

  Objective  To evaluate the consistency of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) for the detection of human epidermal growth factor receptor-2 (HER-2) in breast cancer.  Methods  The patients who were diagnosed with breast cancer in a third-class A hospital in Anhui Province from 2013 to 2018 were selected. IHC and FISH were used to detect HER-2, and the differences and connections were compared.  Results  In the selected 276 breast cancer patients, FISH detection of HER-2 amplification was related to the histological grade of breast cancer. For patients with HER-2 of 3+ detected by IHC, the positive amplification rate of FISH could reach higher than 90%. When IHC was -/+ and 3+, the consistency of detection results between the two methods was the best.For patients with 2+ in HER-2 test, compared with FISH test, the coincidence rate of IHC was only 67.9%.  Conclusions  HER-2 gene amplification is associated with increased malignancy of breast cancer, HER-2 screening results of 2+ breast cancer by IHC requires additional FISH test, which is of guiding significance for the further diagnosis and treatment of patients.