乳腺癌空芯针穿刺标本与手术标本的免疫组织化学检测一致性分析  

Immunohistochemical concordance of core-needle biopsy specimens and surgically removed specimens in breast cancer

作　　者：简文静[1,2] 王先明[2] 宋淑芬[2] 盛海艳[2] 刘霞 许美权[3] 胡楚婷 刘云龙 Jian Wenjing;Wang Xianming;Song Shufen;Sheng Haiyan;Liu Xia;Xu Meiquan;Hu Chuting;Liu Yunlong(Department of Thyroid and Breast Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China;Department of Thyroid and Breast Surgery, Shenzhen Second People’s Hospital, Shenzhen 518035, China;Department of Pathology, Shenzhen Second People’s Hospital, Shenzhen 518035, China)

机构地区：[1]中山大学附属第三医院甲状腺乳腺外科,广州510630 [2]深圳市第二人民医院甲乳外科,518035 [3]深圳市第二人民医院病理科,518035

出　　处：《中华乳腺病杂志（电子版）》2019年第2期93-97,共5页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：深圳市技术创新技术攻关项目(JSGG20160226202029158);深圳市知识创新基础研究(自由探索)(JCYJ20160425103015129)

摘　　要：目的探讨乳腺癌空心针穿刺标本与手术标本免疫组织化学(ER、PR、HER-2、Ki67)检测结果的一致性。方法回顾性分析2014年1月至2017年10月间就诊于深圳市第二人民医院甲乳外科的305例术前未行新辅助治疗的乳腺癌患者临床资料。采用配对计数资料的Kappa检验比较本组乳腺癌患者术前穿刺标本与术后切除标本中ER、PR、HER-2、Ki67免疫组织化学检测结果的一致性。结果乳腺癌患者空心针穿刺标本与手术标本中ER、PR表达的一致率均为93.1%(284/305)(Kappa=0.837、0.858,P均<0.001),ER阳性染色强度判读的一致率为50.0%(101/202)(Kappa=0.244,P<0.001),PR阳性染色强度判读的一致率为68.8%(117/170)(Kappa=0.433,P<0.001),HER-2和Ki67表达判读的吻合度均为中度一致(Kappa=0.543、0.535,P均<0.001)。2种方式获取标本的ER、PR及Ki67阳性细胞百分比完全一致率分别为60.7%(185/305)、53.1%(162/305)和36.1%(110/305)。结论空芯针穿刺标本与手术标本的ER、PR免疫组织化学检测结果一致性很高,但其阳性染色强度及HER-2、Ki67表达的一致性均为中度一致。2种方式获取的标本,其ER、PR及Ki67阳性细胞百分比一致率均不高。Objective To analyze the concordance of ER, PR, HER-2, Ki67 results in immunohistochemical detection of specimens from core-needle biopsy (CNB) and open surgery in breast cancer patients. Methods The clinical data of 305 breast cancer patients who received no neoadjuvant therapy before surgery in the Department of Thyroid and Breast Surgery, Shenzhen Second People’s Hospital from January 2014 to October 2017 were retrospectively analyzed. The Kappa test of paired count data was used to compare the concordance of immunohistochemistry results (ER, PR, HER-2 and Ki67) between preoperative CNB specimens and surgically removed specimens of breast cancer patients. Results The concordant rate of ER and PR expression was 93.1%(284/305) and 93.1%(284/305) between CNB specimens and surgically removed specimens (Kappa=0.837, 0.858, both P<0.001). The concordant rate of ER positive staining intensity was 50.0%(101/202) between CNB specimens and surgically removed specimens (Kappa=0.244, P<0.001). The concordant rate of PR positive staining intensity was 68.8%(117/170) between CNB specimens and surgically removed specimens (Kappa=0.433, P<0.001). The HER-2 expression and Ki67 index showed a moderate consistency between CNB specimens and surgically removed specimens (Kappa=0.543, 0.535, both P<0.001). The concordant rate of the percentage of ER/PR/Ki67 positive cells was 60.7%(185/305), 53.1%(162/305) and 36.1%(110/305), respectively. Conclusions In the immunohistochemical detection, ER and PR expression shows high concordant rates between CNB specimens and surgically removed specimens, while the positive staining intensity of ER and PR, HER-2 expression and Ki67 index shows a moderate concordance. The percentage of ER/PR/Ki67 positive cells presents a moderate concordance between two kinds of specimens.

关 键 词：乳腺肿瘤 免疫组织化学 活组织检查 受体 雌激素 受体 孕激素类 基因 ERBB-2 KI-67抗原 

分 类 号：R737.9[医药卫生—肿瘤]