乳腺癌患者HER2表达水平的不同检测方法比较及临床意义

目的 分析免疫组化法与荧光原位杂交技术(Fish)两种检测方法对乳腺癌患者人类表皮生长因子受体2(HER2)表达水平的检测价值.方法 选择248例乳腺癌患者,分别使用免疫组化法和Fish法检测乳腺癌组织中HER2的表达情况,随访3年,采用生存曲线分析HER2阳性乳腺癌患者的术后复发率.结果108例(43.55%)患者的免疫组化结果为HER2(-),54例(21.77%)患者为HER2(+),43例(17.34%)患者为HER2(++), 43例(17.34%)患者为HER2(+++).81例(32.66%)患者的Fish检测结果为阳性,167例(67.34%)患者为阴性.免疫组化法和Fish法对乳腺癌患者HER2检测结果的一致性较好,Kappa=0.937,P=0.000.生存曲线显示Fish阳性的乳腺癌患者术后复发率明显高于Fish阴性的乳腺癌患者(P=0.000),免疫组化HER2阳性的乳腺癌患者术后复发率明显高于HER2阴性的乳腺癌患者(P=0.000).结论 免疫组化法和Fish法对乳腺癌患者HER2检测结果的一致性较好,均可较好地反映患者预后.

Clinical significance of different detection method for HER2 expression in patients with breast cancer

Objective To analyze the values of the detection of HER2 by immunohistochemistry and fluorescence in situ hybridization(Fish)in patients with breast cancer.Method 248 consecutive breast cancer patients were enrolled in this study.The expression of HER2 in tissue of breast cancer were detected by immunohistochemistry and Fish.More-over,all patients were followed up for 3 years,and the postoperative recurrence rate of HER2 positive breast cancer was analyzed by survival curve.Result By immunohistochemistry,108(43.55%)patients were HER2(-),54(21.77%)were HER2(+),43(17.34%)were HER2(++),and 43(17.34%)were HER2(+++).While using Fish,81(32.66%)were posi-tive,and 167(67.34%)were negative.The expression of HER2 detected by immunohistochemistry and Fish were highly consistent (Kappa=0.937, P=0.000). Survival curves showed that the recurrence rate of Fish positive breast cancer pa-tients was higher than that of Fish negative disease(P=0.000).The recurrence rate of HER2(detected by immunohisto-chemistry)positive breast cancer patients was significantly higher than that of patients with HER2 negative disease(P=0.000).Conclusion The results of HER2 detected by immunohistochemistry is consistent with the findings of Fish,both of which can reflect the prognosis of patients with breast cancer.