双色银染原位杂交检测HER2基因在乳腺癌中的临床应用研究  

Clinical Application Research of Dual-color Silver-enhanced in-situ Hybridization for Determination of HER2 Gene Amplification in Breast Carcinoma

作　　者：曾玉梅[1] 曹晓珊[1] 杜娟[1] 陈应智[1] 储兵[1] 

机构地区：[1]广东省中山市人民医院中山大学附属中山医院病理科,广东中山528400

出　　处：《新疆医学》2017年第5期498-501,共4页Xinjiang Medical Journal

摘　　要：目的本实验应用双色银染原位杂交(dual-color silver-enhanced in-situ hybridization,DISH)和免疫组化(immunohistochemical,IHC)检测乳腺癌组织中HER-2基因扩增及蛋白表达,并挑选出其中的导管内癌伴微小浸润的病例及具有肿瘤异质性的病例,应用荧光原位杂交(fluorescence in situ hybridization,FISH)检测癌组织HER2基因状态,探讨DISH在的临床应用中的价值。方法对198例乳腺浸润性癌,分别行IHC及DISH检测HER2蛋白表达及基因状态,对其中7例微小导管内癌伴微小浸润灶(直径<0.5 cm)及4例具有肿瘤异质性的病例同时应用FISH检测,判读标准采用2013版美国临床肿瘤学会/美国病理医师学院(ASCO/CAP)HER-2指南。结果 56例HER2表达(3+)的标本中,55例DISH检测基因扩增,36例IHC为(2+)的标本中,11例DISH检测出现扩增;IHC为(1+/0)的106例标本,1例DISH检测基因扩增;具肿瘤异质性的4例标本,DISH检测均为her2基因扩增,其中2例FISH检测阳性;7例导管内癌伴微小浸润灶的标本,2例DISH检测阳性,而FISH仅2例标本可判读,其中1例结果为不确定,1例为阴性。结论 DISH作为评估乳腺癌HER2基因状态的新选择,在微小浸润癌及具有异质性的浸润癌的检测中具有优势,其临床应用远期价值需待更多临床随访跟踪。DISH检测结果需参考IHC,推荐DISH与IHC同时应用检测her2基因与蛋白表达。Objective To compare dual color in situ hybridization（DISH）with immunohistochemistry（IHC）and fluorescence in situ hybridization（FISH）in evaluating the human HER2 gene status in invasive breast cancer. Methods HER2 gene status in 198 eases of breast invasive ductaI carcinomas was investigated by IHC and DISH and especially investigate the her2 gene express by FISH in micro-invasive cancer and heterogeneity. Results 55 of the 56 patients with score（3 ＋）by IHC were positive for HER2 by DISH,with1 cases being polysomy. The patients with scores（1 ＋/0）by IHC failed to show amplification. HER2 gene status in 4 ceases of breast invasive carcinomas with heterogeneity showed amplification by DISH and 2 cases by FISH. 2 cases micro-invasive cancer showed amplification by DISH and 1 case showed uncertainty by FISH. 2013 ASCO（Amefican Society of Clinical Oncology）/CAP（College of American Pathologists） HER2 guideline were used respectively to evaluate the agreement between these two techniques. Conclusion Automated DISH can be used to detect the HER2 gene status as a new technology. Immunohistochemistry and DISH are recommended to detect the her2 gene status at the same time.

关 键 词：乳腺癌 HER2基因 双色银染原位杂交技术 基因扩增 

分 类 号：R655.7[医药卫生—外科学]