人类表皮生长因子受体2表达与胃癌组织学的相关性研究

目的 分析内镜下不同活检部位胃癌组织中人类表皮生长因子受体2（HER2）表达阳性率及与胃癌组织学特点相关性。方法 收集本院2017年1月至2020年1月收治的胃癌患者87例列入胃癌组,选取同期住院治疗的慢性浅表型胃炎患者21例列入正常胃黏膜组,入院后将内镜或手术获得的标本行病理检查,比较内镜标本中不同活检部位组织的HER2阳性率和胃癌病理学特征与人类表皮生长因子受体2表达水平的关系。结果 胃癌组HER2阳性率较胃黏膜正常组更高（17.2%和0.0%,P<0.05）,内镜下肿瘤浅表弥漫部、溃疡隆起部、溃疡床及肿块突起部组织HER2阳性率分别是100%、90%、44%、100%,病理类型为管状腺癌及镜下不含印戒细胞较其他组织类型癌和镜下含印戒细胞HER2阳性率高（分别是23.0%、23.6%和3.8%、6.3%,P<0.05）。结论 胃癌HER2表达水平与其病理组织学特点具有相关性,镜下不含印戒细胞的胃癌组织HER2阳性率可能更高,在评估内镜活检标本HER2表达时应着重选择肿瘤浅表弥漫部和肿块突起部,可以为胃癌靶向治疗提供参考。

The correlation between human epidermal growth factor receptor 2 expression and gastric carcinoma histology

Objective To analysis the positive rate of human epidermal growth factor receptor 2 （HER2） expression among different endoscopic biopsy sites of gastric cancer and its correlation withgastric cancer histological characteristics. Methods Totally 108 cases（87 cases were gastric cancer group and 21 cases were chronic superficial gastritis patientsas normal gastric mucosa group） of inpatients who underwent therapy in The Second Affiliated Hospital of Xinjiang Medical University from January 2017 to January 2020 were collected retrospectively. After admission, the specimens obtained by endoscopy or surgery were pathologically examined. The HER2 positive rates among different biopsy sites in endoscopy and expression of human epidermal growth factor receptor 2 and clinicopathologic features were compared. Results Compared with the normal gastric mucosa group, the gastric cancer group had higherpositive rate of HER2 （17.2% vs. 0.0%,P<0.05）. HER2 positive rates from biopsy specimen were 100%, 90%, 44% and 100% in the surperfical spreading portion, ulcer mound, ulcer bed, and mass portion, respectively. The pathological type of tubular adenocarcinoma and the microscopically free signet ring cells had higher positive rate of HER2 than other tissue types of carcinomas and the microscopically visible signet ring cells（23.0%, 23.6% vs. 3.8%, 6.3%, respectively,P<0.05）. Conclusion The expression of human epidermal growth factor receptor 2 in gastric cancer is correlated with the histopathological characteristics, the positive rate of HER2 in gastric cancer with microscopically free signet ring cells may be higher,when evaluating the expression of HER2 in endoscopy biopsy specimens, the surperfical spreading portion and mass portion should be selected, which can provide reference for comprehensive targeted therapy of gastric cancer.