应用双重原位杂交检测胃癌HER2基因扩增  

Amplification of HER2 gene in gastric carcinoma detected by dual in-situ hybridization

作　　者：冼丽芳 黄香婷 文剑明[1] 叶玉清[1] 

机构地区：[1]澳门镜湖医院病理科

出　　处：《中华病理学杂志》2012年第3期168-171,共4页Chinese Journal of Pathology

摘　　要：目的探讨胃癌HER2基因扩增状态及其基因产物蛋白表达，以协助临床筛选抗HER2靶向治疗患者。方法收集胃癌活检标本共85例，进行HER2基因扩增和蛋白表达检测。HER2基因扩增状态采用双重原位杂交检测（HER2dual—ISHdetection），而HER2基因蛋白采用免疫组织化学[全程在全自动染色机（Ventana）]进行检测。结果85例胃癌病例中，有HER2基因扩增10例，扩增率为11．8％，无扩增75例，占88．2％。在有HER2基因扩增的10例病例中，7例HER2蛋白免疫组织化学为3＋，2例为2＋，1例为-／1＋；75例无基因扩增的病例，HER2蛋白免疫组织化学3＋为0例、2＋为18例（24．0％），-／1＋为57例（76．0％）。HER2基因扩增与HER2蛋白表达的相符率为77．6％。组织学上，有HER2阳性扩增的胃癌绝大多数为中等分化管状腺癌。结论双重原位杂交技术是检测胃癌活检组织HER2基因扩增的可靠和客观方法。临床上，仅少数有HER2基因扩增的胃癌适合抗HER2靶向治疗。Objective To explore the status of HER2 gene amplification and its product HER2 protein expression in gastric carcinoma, so as to aid in patient selection for anti-HER2 targeted chemotherapy. Methods Eighty-five cases of gastric carcinoma biopsy tissues were collected. The status of HER2 gene amplification was detected by dual in situ hybridization （dual-ISH）. And HER2 protein was detected by immunohistochemistl7. Results HER2 gene amplification was detected in 10/85 （ 11.8% ） cases of gastric carcinoma, and no amplification was detected in 75/85 （88.2%） cases. In the 10 cases with HER2 amplification, HER2 immunoreaction scorings of 3 ＋ , 2 ＋ and 0/1 ＋ were present in 7, 2 and 1 cases, respectively. In the 75 cases without HER2 amplification, HEI：L2 immunoreaction scorings of 3 ＋ , 2 ＋ and 0/1 ＋ were present in 0, 18 （24. 0% ） and 57 （76. 0% ） cases, respectively. Histologically, most gastric carcinoma with amplification of HER2 gene was moderately differentiated tubular adenocarcinoma. Conclusions HER2 gene dual-ISH technique is a reliable and objective method for detecting HER2 gene amplification in gastric carcinoma biopsy. Clinically, only few gastric carcinomas show HER2 gene amplification and are suitable candidates for anti-HER2 targeted chemotherapy.

关 键 词：胃肿瘤 基因 ERBB-2 原位杂交 荧光 

分 类 号：R735.2[医药卫生—肿瘤]