应用FISH和IHC技术检测中国乳腺癌患者HER-2基因状态及蛋白表达的前瞻性多中心研究题录附视频

被引：17

作者：

韩晓红 ^{[1
]}

石远凯 ^{[1
]}

马丽 ^{[1
]}

吕铮 ^{[1
]}

杨红鹰 ^{[2
]}

姚嘉瑞 ^{[1
]}

李坚 ^{[1
]}

李博 ^{[1
]}

秦燕 ^{[1
]}

机构：

[1] 中国医学科学院肿瘤医院内科

[2] 中国医学科学院肿瘤医院病理科

来源：

中华检验医学杂志 | 2010年 / 07期

关键词：

乳腺肿瘤; 基因,erbB-2; 受体,erbB-2; 原位杂交,荧光; 免疫组织化学; 多中心研究;

D O I：

暂无

中图分类号：

R737.9 [乳腺肿瘤];

学科分类号：

100214 [肿瘤学];

摘要：

目的对比研究乳腺癌患者IHC检测c-erbB2蛋白表达和FISH检测HER-2/neu基因扩增情况,并探讨HER-2基因状态与各临床病理特征的相关性。方法本研究为全国73家中心参与的前瞻性研究。收集2007年10月至2009年9月乳腺癌患者标本3 249份,应用IHC和FISH两种方法分别检测3 249份乳腺癌患者手术的石蜡标本c-erbB2蛋白表达和HER-2基因扩增情况,并分析HER-2基因状态与患者各临床病理特征的关系。结果全组患者IHC检测c-erbB2蛋白表达阳性率为46.9%(1 477/3 149),FISH检测HER-2基因扩增率为42.6%(1 342/3 149),其中IHC评分为3+和0分时,与FISH检测的一致性较高,分别为94.1%(892/948)和89.9%(660/734),而IHC 1+和2+组与FISH的一致性较低,分别为71.0%(514/725)和55.9%(415/742)。同时,HER-2基因扩增与激素状态中雌激素与孕激素均阴性(r=0.45,P<0.01)、组织分级Ⅲ级(r=0.51,P<0.01)、淋巴结转移数目多于4枚(r=0.35,P<0.01)、临床分期Ⅲ/Ⅳ期(r=0.33,P<0.01)、肿瘤直径>2 cm(r=0.38,P<0.01)、绝经后(r=0.24,P<0.01)有相关性,与年龄(r=0.36,P=0.068)、CA125(r=0.11,P=0.722)、CA153(r=0.23,P=0.45)和CEA(r=0.22,P=0.074)表达情况、淋巴结转移(r=0.15,P=0.18)、肿瘤个数(r=0.21,P=0.056)及脉管瘤栓(r=0.12,P=0.133)无相关性。结论 FISH和IHC两种方法检测HER-2表达状态具有较高的一致性。结合实际情况包括费用仪器等限制,在IHC作为初筛的基础上,仍然推荐FISH作为检测HER-2基因扩增的标准方法。FISH技术检测乳腺癌患者HER-2基因表达状态可为临床指导用药和预后评价提供更可靠的依据。

引用

共 8 条

[1]

Management of HER2-positive breast cancer in Asia: consensus statement from the Asian Oncology Summit 2009[J] Nan Soon Wong;Benjamin O Anderson;Kei Siong Khoo;Peng Tiam Ang;Cheng Har Yip;Yen-Shen Lu;Narind Voravud;Zhi-Ming Shao;Kathleen I Pritchard Lancet Oncology 2009,

[2]

HER2 Testing in a Population-Based Study of Patients With Metastatic Breast Cancer Treated With Trastuzumab[J] O'Malley; Frances P;Thomson; Tom;Julian; Jim;Have; Cherry;Crosby; Roxanne;Gelmon; Karen;Andrulis; Irene;Whelan; Tim Archives of Pathology & Laboratory Medicine 2008,

[3]

Correlation between HER‐2 expression and response to neoadjuvant chemotherapy with 5‐fluorouracil; doxorubicin; and cyclophosphamide in patients with breast carcinoma[J] FanZhang;YingYang;TerrySmith;Shu‐WanKau;Judy M.McConathy;Francisco J.Esteva;Henry M.Kuerer;W. FraserSymmans;Aman U.Buzdar;Gabriel N.Hortobagyi;LajosPusztai Cancer 2003,

[4]

Correlation between immunohistochemistry (HercepTest) and fluorescence in situ hybridization (FISH) for HER‐2 in 426 breast carcinomas from 37 centres[J] MDowsett;JBartlett;IOEllis;JSalter;MHills;EMallon;ADWatters;TCooke;CPaish;PMWencyk;SEPinder J. Pathol. 2003,

[5]

HER2 Testing in Patients With Breast Cancer: Poor Correlation Between Weak Positivity by Immunohistochemistry and Gene Amplification by Fluorescence In Situ Hybridization[J] Edith A. Perez;Patrick C. Roche;Robert B. Jenkins;Carol A. Reynolds;Kevin C. Halling;James N. Ingle;Lester E. Wold Mayo Clinic Proceedings 2002,

[6]

Evaluation of interobserver agreement in scoring immunohistochemical results of HER‐2/neu (c‐erbB‐2) expression detected by HercepTest; Nichirei polyclonal antibody; CB11 and TAB250 in breast carcinoma[J] HitoshiTsuda;HironobuSasano;FutoshiAkiyama;MasafumiKurosumi;TadashiHasegawa;R. YoshiyukiOsamura;GoiSakamoto Pathology International 2002,

[7]

c-erbB-2 Positivity is a factor for poor prognosis in breast cancer and poor response to hormonal or chemotherapy treatment in advanced disease[J] A Jukkola;R Bloigu;Y Soini;E.-R Savolainen;K Holli;G Blanco European Journal of Cancer 2001,

[8]

Time-dependence of hazard ratios for prognostic factors in primary breast cancer[J] Susan G. Hilsenbeck;Peter M. Ravdin;Carl A. de Moor;Gary C. Chamness;C. Kent Osborne;Gary M. Clark Breast Cancer Research and Treatment 1998,

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