子宫内膜浆液性癌通过免疫组化和原位杂交检测HER2/neu蛋白过表达与基因扩增的对照及可行性研究  

Contrast and Feasibility Study on Detection of HER2/neu Protein Overexpression and Gene Amplification by Immunohis tochemistry and Primary Hybridization in Eneometrial Serous Carcinoma

作　　者：张建筑 袁士成[1] 彭晓峰[1] 赵文丽[1] 易智君[2] 刘镜文 杨红 秦文华 侯卫华 ZHANG Jian-zhu;YUAN Shi-cheng;PENG Xiao-feng(Huizhou First People’s Hospital,Huizhou,Guangdong,516000,China)

机构地区：[1]惠州市第一人民医院病理科,广东惠州516000 [2]惠州市中心人民医院病理科,广东惠州516000 [3]惠州市第一妇幼保健院病理科,广东惠州516000 [4]平煤神马医疗集团总医院病理科,河南平顶山467000 [5]解放军第989医院病理科,河南平顶山467000

出　　处：《黑龙江医学》2020年第9期1241-1246,共6页Heilongjiang Medical Journal

基　　金：惠州市科学技术局计划项目(2018Y061)。

摘　　要：目的研究在子宫内膜浆液性癌(ESC)中免疫组织化学(IHC)与荧光原位杂交技术(FISH)检测人表皮生长因子受体2(HER2)蛋白过表达和/或基因扩增的结果的一致性和FISH检测HER2基因是否扩增的必要性和可行性。方法选取5家医院2010年1月—2018年5月间初发的71例ESC患者,应用抗HER2(兔抗人HER2单克隆抗体SP3)及全自动免疫组织化仪检测HER2蛋白表达情况,采用ASCO/CAP(美国临床肿瘤学会/美国病理医师学院)2013版乳腺癌HER2检测指南对HER2免疫组化结果进行判读;然后应用FISH方法对标本的HER2/neu基因扩增状态进行检测。结果在ESC中,18例HER2(3+)和17例HER2(2+)占49.3%,显示HER2过表达。在ESC中,有约1/3(24例)病例IHC染色出现不同程度的异质性。应用FISH检测35例HER2蛋白IHC过表达病例,有57.1%【20/35,16例IHER2(3+)和4例HER2(2+)】的病例出现HER2/neu扩增;IHC未过表达病例【26例HER2(1+)和10例HER2(0)】中,1例HER2(1+)病例出现HER/neu扩增,HER2(0)的未见扩增病例。除去HER2(2+)病例,免疫组化HER2蛋白表达和FISH基因扩增的一致性为94.4%(51/54)。全部ESC病例HER2/neu扩增比例为29.5%(21/71)。结论(1)采用ASCO/CAP(美国临床肿瘤学会/美国病理医师学院)2013版乳腺癌HER2检测指南ESC中HER2/neu基因扩增情况IHC和FISH符合率高(94.4%,51/54);(2)在ESC病例中近1/3(21/71,29.5%)的病例显示出HER2/neu基因扩增,将HER2/neu作为治疗ESC的靶点,可使较多人获益;(3)鉴于HER2蛋白免疫组化表达的异质性,建议在用免疫组化检测HER2是否过表达时,对肿瘤多切片或大切片。Objective To study the consistency of immunohistochemistry and fluorescence in situ hybridization(FISH)in de tecting HER2 protein overexpression and/or gene amplification in endometrial serous carcinoma and the necessity and feasibility of FISH in detecting HER2 gene amplification.Methods Selecting patients with intrauterine membrane serous carcinoma(ESC)Jan.2010 to May,2018,HER2(rabbit anti HER2 monoclonal antibody SP3)and full automatic immune organized instrument detec tion of HER2 protein expression were applied.ASCO/CAP(the American society of clinical oncology/American college of patholo gist)2013 breast cancer HER2 detection guide interpretation for HER2 immunohistochemical results were gained.Then the HER2/neu gene amplification status was detected by FISH method.Results In ESC,18 HER2(3+)cases and 17 HER2(2+)cases(49.3%,35/71)showed overexpression of HER2.In ESC,about 1/3(24 cases)of IHC staining showed varying degrees of heteroge neity.In 35 cases of HER2 protein IHC overexpression detected by FISH,57.1%[20/35,16 cases of IHER2(3+)and 4 cases of HER2(2+)]showed HER2/neu amplification.IHC was not overexpressed[26 HER2(1+)and 10 HER2(0)cases],of which 1 HER2(1+)case showed HER/neu amplification,while no amplification of HER2(0)case was observed.In addition to HER2(2+)cases,immunohistochemical HER2 protein expression was consistent with 94.4%(51/54)of FISH gene amplification.The HER2/neu amplification ratio in all ESC cases was 29.5%(21/71).Conclusion(1)In the application of ASCO/CAP and 2013 breast can cer HER2 detection guide,the coincidence rate of HER2 detected by IHC and FISH was high(51/54,94.4%).(2)Nearly 1/3(21/71,29.5%)of the cases of ESC showed HER2/neu gene amplification.It is necessary and feasible to study the protein overexpression and/or gene amplification of HER2/neu in ESC.(3)In view of the heterogeneity of HER2 protein immunohistochemical expression,it is recommended to use immunohistochemical detection to detect HER2 overexpression in multiple or large sections of the tumor.

关 键 词：子宫内膜浆液性癌 人表皮生长因子受体2 免疫组化 荧光原位杂交 靶向治疗 

分 类 号：R446[医药卫生—诊断学]