胃癌组织中HER2基因扩增与化疗药物敏感性标志物的联合检测及意义  

Significance of combined detection of HER2 gene amplification and markers of chemosensitivity in gastric cancer

作　　者：朱超亚[1] 王仰坤 李芳 王苏南[3] 李滢滢[3] 贠田[4] 潘治宇 

机构地区：[1]新乡医学院,河南省新乡市453000 [2]河南天佑中西医结合肿瘤医院病理科,河南省新郑市451100 [3]深圳职业技术学院电子与通信工程学院图像分析室,广东省深圳市518055 [4]中国人民解放军第150医院病理科,河南省洛阳市471000

出　　处：《世界华人消化杂志》2016年第10期1511-1519,共9页World Chinese Journal of Digestology

基　　金：河南省重点科技攻关计划基金资助项目,No.132102310008~~

摘　　要：目的:探讨胃癌HER2基因扩增与化疗药物敏感性标志物的联合检测及意义.方法:采用免疫组织化学、荧光原位杂交和实时定量PCR检测技术对120例胃癌HER2蛋白表达、HER2基因扩增与ERCC1、TUBB3、TYMS基因m RNA表达水平.结果:HER2蛋白表达率40.8%(49/120),其中HER2蛋白3+,占10.8%(13/120).HER2蛋白2+,占14.2%(17/120).H E R2蛋白1+,占15.8%(19/120).HER2基因扩增率38.8%(19/49).ERCC1、TUBB3、TYMS基因m RNA表达检测,其中单基因中、低表达41例、双基因中、低表达45例,ERCC1、TUBB3、TYMS基因均中、低表达19例、均无中、低表达15例.HER2基因扩增49例和ERCC1、TUBB3、TYMS基因中、低表达19例的患者中有11例接受了化疗联合曲妥珠单抗治疗,随访结果显示HER2基因状态与ERCC1、TUBB3、TYMS基因低表达联合治疗效果呈正相关,其中本组5例HER2蛋白3+广泛型又是HER2基因簇状扩增、ERCC1、TUBB3、TYMS基因低表达的患者总生存期长达19.1 mo.结论:胃癌HER2检测有很大的异质性,同时检测HER2蛋白表达、HER2基因扩增和化疗药物敏感性标志物联合检测,能更好地为抗肿瘤药物治疗过程中受益提供重要的参考指标;胃癌靶向与化疗药物的联合检测来选择个体化方案有推广价值.AIM：Toinvestigate the significance of combined detection of HER2 gene amplification and markers of chemosensitivity in gastric cancer.METHODS： Immunohistochemistry（IHC）fluorescence in situ hybridization（FISH） and fluorescence RT-PCR were used to detect HER2 proteinexpression in 120 c ases of gastric cancer, HER2 gene amplification, and ERCC1, TUBB3, and TYMS mR NA expression respectively.RESULTS： The positive rate of HER2 expression was 40.8%（49/120）, and the rates of strong positivity（＋＋＋）, moderate positivity（＋＋）, and weak positivity（＋） were 10.8%（13/120）, 14.2%（17/120）, and 15.8%（19/120）, respectively. Therate of HER2 gene amplification was 38.8%（19/49）. With regards to ERCC1, TUBB3, and TYMS m RNA expression, 41 cases showed moderate or low expression of only one gene,45 cases showed moderate or low expression of two genes, 19 cases showed moderate or low expression of three genes, and 15 cases showed no moderate or low expression of the genes. Of19 cases showing moderate or low expression of the three genes, 11 cases received chemotherapy combined with trastuzumab treatment. Followup results showed that HER2 gene status and ERCC1, TUBB3, and TYMS gene expression were positively related to treatment response.In 5 cases with strong HER2 expression, HER2 gene amplification, and low expression of ERCC1, TUBB3, and TYMS, overall survival was 19.1 mo.CONCLUSION： HER2 testing in gastric cancer has great heterogeneity, and simultaneous detection of HER2 protein expression, HER2 gene amplification and markers of chemosensitivity provides an important reference index for antitumor drug therapy.

关 键 词：胃肿瘤 HER2基因 HER2蛋白 免疫组织化学 荧光原位杂交 

分 类 号：R735.2[医药卫生—肿瘤]