乳腺癌患者人表皮生长因子受体2基因扩增状态与临床病理特征的关系

目的探讨乳腺癌患者人表皮生长因子受体2(HER2)基因的扩增状态与患者临床病理特征相关性,并分析乳腺癌患者腋窝淋巴结转移的影响因素。方法收集2016年1月至2019年3月在滕州市中心人民医院病理科做常规病理检查且HER2免疫组织化学(IHC)结果为++的262例乳腺癌患者病理资料,包括年龄、肿瘤长径、组织学分级、病理类型、是否有淋巴结转移、肿瘤数量、肿瘤部位;用IHC法检测石蜡标本p53、Ki-67、雌激素受体(ER)、孕激素受体(PR)的表达结果;用荧光原位杂交(FISH)法检测HER2基因的扩增状态;分析HER2基因扩增是否与上述临床病理特征相关,以及腋窝淋巴结转移是否与上述特征相关。结果262例乳腺癌患者有69例HER2扩增阳性,阳性扩增率为26.3%;HER2基因扩增与Ki-67增殖指数和ER、PR的表达状态相关,差异有统计学意义(χ^2=13.27,P<0.01;χ^2=34.97,P<0.01;χ^2=38.31,P<0.01);与年龄、肿瘤长径等其余临床病理特征均无关(均P>0.05)。262例乳腺癌患者中发生腋窝淋巴结转移106例(40.5%);淋巴结转移与肿瘤长径显著相关(χ^2=29.10,P<0.01),与其余临床病理特征均无相关(均P>0.05)。结论乳腺癌HER2基因扩增状态与Ki-67增殖指数和ER、PR的表达相关,肿瘤大小为影响乳腺癌患者腋窝淋巴结转移的因素,准确判断上述指标能更好地指导乳腺癌患者的治疗和评估预后。

Relationship between gene amplification status of human epidermal growth factor receptor 2 and clinicopathological features in breast cancer

Objective To explore the relationship between gene amplification status of human epidermal growth factor receptor 2(HER2)and its clinicopathological features in breast cancer,and to analyze the affecting factors of axillary lymph node metastasis in breast cancer.Methods The clinicopathological data of 262 patients with breast cancer at Tengzhou Central People's Hospital between January 2016 and March 2019 were collected,including age,tumor diameter,histological grade,pathological type,lymph node metastasis,tumor number,tumor location.The patients had routine pathology examination and the immunohistochemistry(IHC)result of HER2 was++.The expressions of p53,Ki-67,estrogen receptor(ER),progesterone receptor(PR)were detected by using IHC.The gene amplification status of HER2 was detected by using fluorescence in situ hybridization(FISH).The relationship between gene amplification status of HER2 and clinicopathological features,the relationship between axillary lymph node metastasis and clinicopathological features was respectively analyzed.Results HER2 gene amplification-positive was detected in 69 cases of 262 breast cancer patients,and the positive amplification rate was 26.3%.The gene amplification status of HER2 was correlated with Ki-67 proliferation index and the expression of ER as well as PR,and the differences were statistically significant(χ^2=13.27,P<0.01;χ^2=34.97,P<0.01;χ^2=38.31,P<0.01).There was no correlation with age,tumor diameter and other clinicopathological features(all P>0.05).Among 262 cases of breast cancer,106(40.5%)cases had axillary lymph node metastasis.Lymph node metastasis was correlated with tumor diameter(χ^2=29.10,P<0.01),and there was no correlation with other clinicopathological features(all P>0.05).Conclusions HER2 gene amplification of breast cancer is associated with Ki-67 proliferation index,the expression of ER and PR.The tumor diameter is a factor for affecting axillary lymph node metastasis.Accurate judgment of the above indicators can better guide the treatment and evaluate the prognosis of breast cancer.