乳腺癌HER-2基因显色原位杂交与免疫组织化学检测对比研究
Comparison of chromogenic in situ hybridization and immunohistochemistry in determining HER-2 gene in status in breast cancer
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摘要: 目的:对乳腺癌HER-2/neu/c-erbB-2(HER-2)显色原位杂交(chromogenic in situ hybridization,CISH)检测和免疫组织化学(immunohistochemistry,IHC)表达两者之间进行对比研究。方法:选择乳腺癌的组织蜡块44例,经HER-2 IHC蛋白表达;阴性9例,(+)9例,(++)13例,(+++)13例。从中选取经HER-2 IHC表达阳性的乳腺癌22例包括HER-2 IHC表达(+)9例和HER-2 IHC表达(+++)13例作回顾性CISH基因检测。结果:HER-2 IHC表达(+)9例一组,经CISH基因检测9例均无基因扩增;HER-2 IHC表达(+++)13例一组,CISH无基因扩增2例(15.38%),基因检测不理想1例(7.76%),基因扩增10例,两种检测方法符合率76.92%,两者有高度一致性(P=0.001)。HER-2 IHC表达(+++)和CISH基因检测扩增与乳腺癌类型间有一定相关性(P<0.05)。结论:CISH基因检测与IHC表达(+++)组,两者具有很高的一致性。IHC可作为乳腺癌HER-2筛选的首选方法,对于HER-2 IHC表达(+)的病例,CISH检测无基因扩增;HER-2 IHC表达(+++)病例,经CISH基因检测,两者符合率高,CISH基因检测较IHC更准确,证实HER-2/neu扩增的患者可从采用抗HER-2单克隆抗体治疗中获益。Abstract: Objective: To compare the expression of HER-2/neu/c-erbB-2 oncogene detected by chromogenic in situ hybridization(CISH) and immunohistochemistry(IHC) in breast cancer. Methods: The formalin-fixed paraffin-embedded breast cancer samples(44 cases) were selected and these samples were detected by IHC.Among them,there were 9 cases with negative expression,9 cases with score(+),13 cases with score(++),13 cases with score(+++).Twenty-two cases with HER-2 IHC positively expressed were examined retrospectively(including 9 cases with score(+) and 13 cases with score(+++).Results: In the nine cases with score(+) by IHC,all cases were negatively expressed with CISH.Two of the 13 cases with score(+++) showed CISH-negative(15.38%),1 cases failed to show amplification,the remaining 10 cases showed gene amplification,thus the concordant ratio between IHC and CISH was 76.92%.Certain concordance to the examination of HER-2 status(P=0.001) was found in the two kinds of methods.The results of gene amplification detected by IHC and CISH had no concordance with types of breast cancer(P<0.05).Conclusions: The results of gene amplification detected by CISH have high concordance with IHC.IHC is a choice in primary screening for HER-2 expression status.The concordant ratio between IHC and CISH is high,CISH is more accurate than IHC.Patients with proven amplification of HER-2/neu may benefit from treatment with anti-HER-2 monoclonal antibodies.