乳腺癌组织中HER2基因的扩增和表达及其临床意义

目的:比较免疫组化法(IHC)检测HER2蛋白表达和荧光免疫原位杂交法(FISH)检测HER2基因扩增在评价乳腺癌HER2状态时的差异性、相关性,及其临床意义。方法:分别用IHC及FISH法检测石蜡包埋乳腺癌组织中的HER2蛋白表达及HER2基因扩增状况,并进行分析。结果:100例乳腺癌组织中,HER2蛋白表达(+++)者25例,其中23例(92%)有HER2基因扩增;HER2蛋白表达(++)者12例,其中2例有HER2基因扩增;HER2蛋白表达(+)者10例,其中1例有HER2基因扩增;HER2蛋白表达(-)者53例,其中2例有HER2基因扩增。IHC与FISH结果的总符合率为85%,吻合度一般,呈正关关系(χ2=42.5,P0.0001)。结论:IHC可作为HER2状态的初步筛查方法,而HER2蛋白表达阳性(+++)则可代表HER2状态。

Evaluation of HER2 oncogene amplification and overexpression in breast cancer and their clinical significance

Objective To evaluate the difference and coincidence between the overexpression of HER2 protein by immunohistochemistry（IHC） and HER2 oncogene amplification by fluorescence in situ hybridization（FISH） in breast cancer,and to compare their clinical significance.Methods The overexpression of HER2 protein and HER2 gene amplification on paraffin embedded specimens from breast cancer patients were detected by IHC and FISH,respectively.Results Among 100 breast cancer specimens,25 showed HER2 protein overexpression（＋＋＋）,and 23 were found to have HER2 gene amplification;there were 12 cases with positive IHC score（＋＋） were detected to have HER2 gene amplification in 2 cases;and 120 cases with HER2 protein expression（＋） were detected to have HER2 gene amplification in 1 case;53 cases with HER2 protein expression（-） were detected to have HER2 gene amplification in 2 cases.The correlation between FISH and IHC was 85%（χ^2=42.5,P0.0001）.Conclusions IHC could be used as a means for initial screening of HER2 status;and a positive IHC score of（＋＋＋） could be presumed to indicate breast cancer with HER2 amplification status.