浸润性乳腺癌HER2基因扩增与雌、孕激素受体及淋巴结转移的相关性

目的:研究浸润性乳腺癌HER2蛋白过表达人群中ER、PR的表达及与HER2基因扩增之间的相关性,并分析ER、PR的表达及HER2基因扩增与淋巴结转移之间的关系。方法:采用免疫组织化学SP法检测浸润性乳腺癌中ER、PR、HER2蛋白的表达情况,并筛选出HER2(++)患者100例,用CISH法检测HER2扩增情况。结果:100例HER2(++)患者中,扩增38例,扩增率为38.0%;低拷贝扩增17例,高拷贝扩增21例;淋巴结转移共41例,转移率为41.0%。其中ER(+)、PR(+)共44例,扩增7例,低拷贝扩增3例,高拷贝扩增4例,扩增率为15.9%,淋巴结转移18例,转移率为40.9%;ER(+)、PR(-)共15例,扩增6例,低拷贝扩增5例,高拷贝扩增1例,扩增率为40.0%,淋巴结转移5例,转移率为33.3%,与ER(+)、PR(+)组扩增率比较,无统计学差异(P>0.05);ER(-)、PR(+)共7例,扩增3例,低拷贝扩增0例,高拷贝扩增3例,扩增率为42.9%,淋巴结转移4例,转移率为57%;ER(-)、PR(-)共34例,扩增22例,低拷贝扩增9例,高拷贝扩增13例,扩增率为64.7%,淋巴结转移14例,转移率为41.2%,与ER(+)、PR(+)比较,扩增率具有统计学差异(P<0.01),且高拷贝扩增率与ER(+)、PR(+)组比较,具有统计学差异(P<0.01)。结论:HER2(++)患者基因扩增与ER、PR的表达存在相关性,ER(-)、PR(-)、HER2(++)患者扩增率明显高于ER(+)、PR(+)、HER2(++)患者,ER(-)、PR(-)高拷贝扩增率也高于ER(+)、PR(+)患者。ER(-)、PR(-)淋巴结转移患者HER2扩增率明显高于ER(+)、PR(+)患者。

HER2 gene amplification and expression of estrogen receptor, progestin receptor in invasive breast cancer and relationship wih lymph node metastasis

Objective:To investigate HER2 gene amplification and expression of estrogen receptor(ER),progestin receptor(PR) in invasive breast cancer and study the relationship between their expression with lymph node metastasis.Methods:100 cases of invasive breast cancer with formalin-fixed and paraffin-embedded tumor tissues with HER2(2+) protein overexpression were tested by CISH for HER2 gene amplification.Expression of HER2,ER and PR proteins were performed by immunohistochemistry analysis.Results:HER2 gene amplification was identified in 38 cases(38%),which included 17 cases with low amplification(17%),21 cases with high amplification(21%).lymph node metastasis was observed in 41 cases(41%).Both ER and PR positive cases were observed in 44 cases,HER2 gene amplification was identified in 7 cases(7/44,15.9%),which included 3 cases with low amplification,4 cases with high amplification.Lymph node metastasis was observed in 18 cases(18/44,40.9%).ER positive and PR negative cases were observed in 15 cases.HER2 gene amplification was identified in 6 cases(6/15,40%),which included 5 cases with low amplification,1 cases with high amplification.Lymph node metastasis was observed in 5 cases(5/15,33%).There was no significant difference between ER,PR positive and ER positive and PR negative cases(P>0.05).ER negative and PR positive cases were observed in 7 cases.HER2 gene amplification was identified in 3 cases(3/7,42.9%),which included 3 cases with high amplification.Lymph node metastasis was observed in 4 cases(4/7,57%).There was no significant difference between ER,PR positive and ER negative and PR positive cases(P>0.05).Both ER and PR negative cases were observed in 34 cases,HER2 gene amplification was identified in 22 cases(22/34,64.7%),which included 9 cases with low amplification.There was significant difference between ER,PR positive and ER,PR negative cases(P<0.01).13 cases were with high amplification.Lymph node metastasis was observed in 14 cases(14/34,41.2%).There was no significant difference between ER,PR positive and ER,PR negative cases(P>0.05).Conclusion:Expression of ER and PR are capable of affecting HER2 gene amplification in invasive breast cancer.