乳腺癌HER-2基因显色原位杂交与免疫组织化学检测对比研究

目的：对乳腺癌HER-2/neu/c-erbB-2（HER-2）显色原位杂交（chromogenicin situhybridization,CISH）检测和免疫组织化学（immunohistochemistry,IHC）表达两者之间进行对比研究。方法：选择乳腺癌的组织蜡块44例,经HER-2 IHC蛋白表达;阴性9例,（＋）9例,（艹）13例,（）13例。从中选取经HER-2 IHC表达阳性的乳腺癌22例[包括HER-2 IHC表达（＋）9例和HER-2 IHC表达（）13例]作回顾性CISH基因检测。结果：HER-2 IHC表达（＋）9例一组,经CISH基因检测9例均无基因扩增;HER-2 IHC表达（）13例一组,CISH无基因扩增2例（15.38%）,基因检测不理想1例（7.76%）,基因扩增10例,两种检测方法符合率76.92%,两者有高度一致性（P=0.001）。HER-2 IHC表达（）和CISH基因检测扩增与乳腺癌类型间有一定相关性（P〈0.05）。结论：CISH基因检测与IHC表达（）组,两者具有很高的一致性。IHC可作为乳腺癌HER-2筛选的首选方法,对于HER-2 IHC表达（ 卅）病例，经CISH基因检测，两者符合率高，CISH基因检测较IHC更准确，证实HER-2／neu扩增的患者可从采用抗HER-2单克隆抗体治疗中获益。

Comparison of chromogenic in situ hybridization and immunohistochemistry in determining HER-2 gene in status in breast cancer

Objective：To compare the expression of HER-2/neu/c-erbB-2 oncogene detected by chromogenic in situ hybridization （C1SH） and immunohistochemistry（IHC） in breast cancer. Methods：The formalin-fixed paraffin-embedded breast cancer samples（44 cases） were selected and these samples were detected by 1HC. Among them,there were 9 cases with negative expression,9 cases with score（ ＋ ）, 13 cases with score（ ＋＋ ） , 13 cases with score（ ＋＋＋ ）. Twenty-two cases with HER-2 IHC positively expressed were examined retrospectively（ including 9 cases with score（ ＋ ） and 13 cases with score（＋＋＋）. Results：In the nine cases with score（ ＋ ） by IHC,all cases were negatively expressed with CISH. Two of the 13 eases with score（＋＋＋ ） showed CISH-negative（ 15.38% ）, 1 cases failed to show amplification,the remaining 10 cases showed gene amplification,thus the concordant ratio between IHC and CISH was 76.92%. Certain concordance to the examination of HER-2 status （ P = 0. 001 ） was found in the two kinds of methods. The results of gene amplification detected by IHC and CISH had no concordance with types of breast cancer（ P 〈 0.05 ）. Conclusions ：The results of gene amplification detected by CISH have high concordance with IHC. IHC is a choice in primary screening for HER-2 expression status. The concordant ratio between IHC and CISH is high, CISH is more accurate than IHC. Patients with proven amplification of HER-2/nen may benefit from treatment with anti-HER-2 monoclonal antibodies.