全自动免疫组化和荧光原位杂交方法检测胃癌HER2状态  

Auto immunohistochemistry and fluorescence in situ hybridization for determination of HER2 gene status in gastric carcinoma

作　　者：陈敏[1] 刘键平[1] 龙晓雨[1] 陈杰[1] 刘晓羽[1] 王威亚[1] 步宏[1] 

机构地区：[1]四川大学华西医院病理科,四川成都610041

出　　处：《西部医学》2017年第7期902-907,共6页Medical Journal of West China

基　　金：国家自然科学基金(81302027)

摘　　要：目的探讨胃癌中HER2基因状态分布及HER2基因扩增/HER2蛋白表达与临床病理特征间的关系。方法收集四川大学华西医院2009年1月~3月170例手术切除原发性胃或胃食管交界处腺癌石蜡组织标本,同时收集患者的临床和病理信息。所有病例行全自动免疫组化(IHC)和荧光原位杂交(FISH)检测HER2蛋白和基因的表达。结果 170例胃癌组织中,IHC检测蛋白表达为:100例(58.8%)0+,33例(19.4%)1+,14例(8.2%)2+,23例(13.6%)3+。FISH检测HER2基因扩增27例(15.9%),17号染色体多倍体者20例(70.4%)。其中4例(4%)IHC检测0+或1+,FISH检测阳性;有14例(37.8%)IHC检测2+或3+,FISH检测阴性。IHC与FISH结果间差异显著(P<0.01)。HER2过表达和基因扩增与患者的年龄、性别、病理分级、肿瘤部位及TNM分期间没有相关性(P>0.05),与分化程度、Lauren分级有相关性(P<0.01)。结论IHC与FISH检测胃癌HER2基因的阳性率分别为21.7%和15.9%。HER2基因扩增中17号染色体多倍体发生比例较高。分化程度越高,HER2阳性率越高,且主要集中在肠型。IHC可作为胃癌HER2检测的有效筛查手段,其不确定的病例可再行FISH检测确诊。Objective This study was to evaluate the HER2 gene status and to investigate the relationship between the expression/gene of HER2 and the clinicopathological characteristics of gastric carcinomas. Methods One hundred and seventy cases including the clinical and pathological information of primary gastric or gastroesophageal junction ade- nocarcinomas diagnosed and treated surgically from January to March, 2009 at the West China Hospital were enrolled in the study. Automated immunohistechemistry（IHC） staining and FISH were carried out to detect the HER2 status, re spectively. Result Among the 170 cases, HER-2 overexpression showed 100 cases （58.8%） 0＋ ,33 cases （19.4%）1 ＋,14 （8. 2%）2＋ ,23 （13.6%）3＋ by IHC. 27 cases （15.9%） showed HER-2 gene amplification by FISH. 20 cases （70.4 %） showed chromosome 17 polysomy. Four（4%） of the 100 cases negative （0 or 1 ＋） by IHC showed amplification by FISH, whereas 14 （37.8%） of the 37 cases with HER-2 protein overexpression showed HER-2 nonamplification by FISH. The correlation between IHC and FISH results was statistically significant （P^0.01）. HER-2 gene amplification and HER-2 protein overexpression was not correlated with the age and sex of patients, and tumor size, location, patho logical and TNM stage, but with a well-or moderately differentiation according to the World Health Organization classifi- cation （P〈0.01） and in cases of inteotinal type by the Lauren classification （P〈0.01））. Conclusion HER-2 overex- pression and HER-2 gene amplification was 21.7% and 15.9% respectively. The higher difference, the more frequence of overexpression/amplification. At the same time, the positive cases were major in intestinal type with high incidence of chromosome 17 polysomy. To make a definite diagnosis of HER2 positive cases in gastric cancer, IHC was the initial tes- ting method, FISH as a significant detection method.

关 键 词：免疫组化 荧光原位杂交 胃癌 HER2 

分 类 号：R446.8[医药卫生—诊断学] R735.2[医药卫生—临床医学]