乳腺髓样癌HER-2基因扩增与临床病理因素相关性分析  

Correlative analysis of HER-2gene amplification and HER-2protein expression with clinical Pathological indices in medullary carcinoma of breast

作　　者：姜学革[1] 李晓瑛[1] 吕亚莉[1] 赵坡[1] 

机构地区：[1]解放军总医院病理科,北京100853

出　　处：《中华肿瘤防治杂志》2013年第22期1724-1727,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:总结分析荧光原位杂交(fluorescence in situ hybridization,FISH)技术检测乳腺髓样癌HER-2基因扩增的经验和临床病理学意义。方法:用FISH和免疫组化技术诊断32例乳腺髓样癌患者HER-2基因状态,并分析典型髓样癌和非典型髓样癌HER-2基因扩增的关系。结果:乳腺髓样癌HER-2基因扩增阳性率为37.5%(12/32),其中典型髓样癌为7.7%(1/13),非典型髓样癌为57.9%(11/19)。HER-2基因扩增与髓样癌肿瘤类型(P=0.008)、肿瘤大小(P=0.040)、淋巴结转移(P=0.006)、临床分期(P=0.037)、HER-2蛋白表达(P=0.000 1)和p53蛋白表达(P=0.015)有关,与患者年龄(P=0.438)、ER(P=0.081)和PR(P=0.517)无关。乳腺髓样癌类型与HER-2蛋白表达有关(P=0.010),与患者年龄(P=0.426)、肿瘤大小(P=0.786)、淋巴结转移(P=0.115)、临床分期(P=0.129)、ER(P=0.116)、PR(P=0.773)和p53(P=0.280)无关。结论:HER-2基因扩增可能参与乳腺髓样癌的演化与进展,乳腺典型髓样癌与非典型髓样癌的HER-2基因扩增有显著性差异,临床应用FISH技术诊断HER-2基因扩增靶标有助于指导乳腺非典型髓样癌的分子靶向治疗。OBJECTIVE： To summarize and analyze the experience and clinicopathological significance in application of fluorescence in situ hybridization （FISH） technique to diagnose HER-2 gene amplification in uncommon medullary car- cinoma of breast, and analyze the possible relationship between HER-2 gene amplification and type of medullary carcinoma as typical medullary carcinoma and atypical medullary carcinoma. METHODS： Status of HER-2 gene amplification was di agnosed by FISH technique and analyzed with other biomarkers and clincopathological data in 32 cases of medullary carci- noma of breast. RESULTS： The positive rate for HER-2 gene amplification was 37.5 % （12/32） ,in which typical medul- lary carcinoma was 7. 7% （ 1 / 13 ） and atypical medullary carcinoma was 57. 9 % （ 11/19 ）, respectively. Amplification of HER-2 gene was correlative positively with the type of medullary carcinoma （P=0. 008）, HER-2 protein expression （P= 0. 000 1）, tumor size （P=0. 040）, lymphatic metastasis （P = 0. 006）, clinical stage （P = 0. 037） and p53 （P = 0. 015）, whereas not with age （P=0. 438） ,ER（P=0. 081） and PR（P=0. 517）. The type of medullary carcinoma of breast was correlative with HER-2 protein（P=0. 010）, but not with age（P= 0. 426）, tumor size（P= 0. 786）, lymphatic metastasis （P=0. 115）,clinical stage （P=0. 129）,ER（P=0. 116）,PR（P=0. 773）and P53（P=0. 280）. CONCLUSIONS： Amplifi cation of HER-2 gene may be involved in evolution and progress of breast medullary carcinoma. There is a significant difference in HER-2 gene amplification between the typical type and the atypical type of medullary carcinoma of breast. Clinical application of FISH technique to diagnose the target of HER-2 gene amplification may be helpful to direct molecu lar targeting therapy in breast atypical medullary carcinoma patients.

关 键 词：癌 髓样 病理学 乳腺肿瘤 病理学 HER-2 基因 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]