乳腺癌Her-2/neu蛋白表达与基因扩增的相关性分析  

Correlation between Her-2/neu protein expression and gene status in invasive breast cancer

作　　者：李莉[1] 朱健[2] 马妍慧[1] 庄明[2] 张文竹[3] 沈立松[1] 吴萍[2] 

机构地区：[1]上海交通大学医学院附属新华医院检验科,上海200092 [2]上海交通大学医学院附属新华医院普外科,上海200092 [3]上海交通大学医学院附属新华医院病理科,上海200092

出　　处：《诊断学理论与实践》2011年第3期234-238,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:应用免疫组织化学(IHC)法和荧光原位杂交(FISH)法分析乳腺癌相关蛋白Her-2/neu表达情况及其与基因状态间的相关性,并探讨其临床价值。方法:采用PathVysionTM探针试剂盒中基因识别位点探针(LSI)Her-2/neu基因探针和着丝粒17探针(CEP 17),以FISH法分析96例浸润性乳腺癌患者的石蜡切片病理标本中17号染色体和Her-2/neu基因状态,并分析已经IHC证实的Her-2/neu不同表达水平与FISH结果间的一致性,同时分析Her-2/neu基因状态与相应蛋白表达水平间的关系。结果:96例浸润性乳腺癌患者的病理标本中,FISH法检测的Her-2/neu阳性率为26.0%。IHC检测结果为(-)或(+)者的FISH阳性率为13.2%(7/53),IHC(++)者的FISH阳性率为31.4%(11/35),IHC(+++)者的FISH阳性率为87.5%(7/8),三者都以Her-2/neu高度扩增(Her-2/neu/CEP17﹥10)为主。所有患者中17号染色体为非整体性者占45.8%(44/96),其中亚二体性(CEP17﹤2)占7.3%(7/96),多体性占38.5%(CEP17﹥2)(37/96)[包括低多体性(2<CEP 17<4)18.8%(18/96),高多体性(CEP17≥4)19.8%(19/96)]。IHC检测结果为(-)或(+)者中,17号染色体非整体性占41.5%(22/53),IHC(++)者中为42.9%(15/35),IHC(+++)者中为87.5%(7/8)。在37例17号染色体多体性的病例中,IHC检测结果为(-)或(+)者占48.6%(18/37),18例中3例为低多体性,15例为高多体性;IHC(++)者占32.4%(12/37),12例中9例为低多体性,3例为高多体性;IHC(+++)者占18.9%(7/37),7例中6例为低多体性,1例为高多体性。25例FISH阳性患者中,17号染色体多体性者占68.0%(17/25),而71例FISH阴性者中,其占28.2%(20/71)。1例IHC(+++)、FISH阴性患者和7例IHC(++)、FISH阴性患者的17号染色体为多体性。结论:IHC法检测Her-2/neu为阴性者中,存在相当数量FISH法检测结果为阳性者;IHC法检测结果可能存在假阳性,而17号染色体多体性可能使FISH法检测结果出现假阴性,两者均可直接导致出现Her-2/neu蛋白过表达与其基因扩增状态不一致,因此评价Her-2Objective To analyze the correlation between Her-2 /neu protein expression and gene status in invasive breast cancer by immunohistochemistry（IHC） and fluorescence in situ hybridization（FISH）.Methods FISH was performed with paraffin section specimens to analyze the chromosome 17 and Her-2/neu gene status of 96 cases of invasive breast cancer using PathVysion kit [Her-2/neu gene probe and centromere 17 probe（CEP 17）].The concordance between the expression of Her-2/neu determined by IHC and the results of FISH was analyzed.Results Of the 96 cases of invasive breast cancer,the positive rate of Her-2/neu identified by FISH was 26.0%.The FISH positive rate of IHC score（-or ＋） cases was 13.2%（7/53）,IHC score（＋＋） cases was 31.4%（11/35）,and IHC score（＋＋＋） cases was 87.5%（7/8）.All were predominantly of high amplification status（Her-2/neu/CEP1710）.Chromosome 17 was found to be aneuploidy in 44（45.8%） of 96 cases,of these cases hypodiploidy（CEP 172） was 7.3%（7/96）,polyploidy（CEP172） was 38.5%（37/96） [low polyploidy（2CEP174） 18.8%（18/96）],high polyploidy（CEP17≥4）19.8%（19/96））.The polyploidy rate in IHC score（-of ＋） cases was 41.5%（22/53）,IHC score（＋＋） cases was 42.9%（15/35） and IHC score（＋＋＋） cases was 87.5%（7/8）.Of the 37 cases with chromosome 17 polyploidy,48.6%（18/37） was IHC score（-or＋）（3 low polyploidy and 15 high polyploidy）,32.4%（12/37） was IHC score（＋＋）（9 low polyploidy and 3 high polyploidy）,and 18.9%（7/37） was IHC score（＋＋＋）（6 low polyploidy and 1 high polyploidy）.Of the 25 FISH positive cases,68.0%（17/25） had chromosome 17 polyploidy,whereas 28.2%（20/71） of the FISH negative cases had chromosome 17 polyploidy.One IHC score（＋＋＋）,FISH negative case and 7 IHC score（＋＋）,FISH negative cases were of chromosome 17 polyploidy.Conclusions A certain proportion of Her-2/neu IHC score negative cases may be positive when assessed

关 键 词：乳腺癌 荧光原位杂交 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]