尿路上皮癌HER2表达与临床病理特征的相关性  

Correlation between HER2 expression and clinicopathological features in urothelial carcinoma

作　　者：周晓蝶 王璇 余波 王建军[2] 石群立 饶秋 鲍炜 ZHOU Xiao-die;WANG Xuan;YU Bo;WANG Jian-jun;SHI Qun-li;RAO Qiu;BAO Wei(Department of Pathology,Nanjing Jinling Hospital,Nanjing University School of Medicine,Nanjing 210002,China;Department of Pathology,Affiliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属金陵医院/东部战区总医院病理科,南京210002 [2]南京大学医学院附属鼓楼医院病理科,南京210008

出　　处：《诊断病理学杂志》2024年第9期823-829,共7页Chinese Journal of Diagnostic Pathology

基　　金：江苏省第十六批六大人才高峰项目(WSN-043);江苏省第六期333高层次人才项目[(2022)3-28-020];江苏省青年医学重点人才项目(QNRC2016918);国家自然科学基金面上项目(81572453)。

摘　　要：目的 探讨尿路上皮癌(UC)患者HER2表达情况与其临床病理特征、分子分型及预后的相关性。方法 回顾性分析2017年5月至2020年2月东部战区总医院及南京鼓楼医院收治的115例UC患者,免疫组化检测HER2蛋白表达及荧光原位杂交(FISH)检测HER2基因扩增情况;免疫组化标记GATA3、CK20、CK5/6、CD44对UC进行分子分型(腔面型、基底样型、零表型),分析HER2表达与临床病理特征、分子分型之间的关系。结果 HER2过表达率(IHC 2/3+)为41.7%(48例),而HER2基因扩增率只有17.4%(20例),两者的符合率为42.1%。其中膀胱UC的符合率达46.7%,而上尿路UC则为25.0%。在7例HER2扩增阳性的病例中,3例IHC评分为0,4例IHC评分为1+。微乳头变异型的HER2 IHC阳性比例最高,而鳞状分化型的则最低。HER2 IHC阳性病例更容易发生淋巴结转移。腔面型HER2 IHC的表达率明显高于基底样型、零表型。IHC HER2阳性的UC患者预后差于IHC HER阴性的患者,但无明显统计学意义(P=0.099);而HER2基因扩增与无基因扩增的UC患者预后并无明显差异(P=0.911)。结论 UC HER2的表达情况与其分子分型、淋巴结转移密切相关,与其组织学亚型有一定相关性。UC HER2过表达与基因扩增存在不一致性。Objective To investigate the correlation of HER2 expression in urothelial carcinoma(UC)with its clinicopathologic features,molecular types and prognosis.Methods A total of 115 UC patients admitted to the Eastern Theater Command General Hospital and Nanjing Drum Tower Hospital from May 2017 to February 2020 were retrospectively analyzed.HER2 protein expression was detected by immunohistochemistry and HER2 gene amplification was detected by fluorescence in situ hybridization(FISH).Immunohistochemical markers GATA3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null type),and the relationship between HER2 expression and clinicopathological features and molecular typing was analyzed.Results The HER2 overexpression rate(IHC 3+)was 41.7%(48 cases),while the HER2 gene amplification rate was only 17.4%(20 cases).The coincidence rate of bladder urothelial carcinoma was 46.7%and that of upper urinary tract urothelial carcinoma was 25.0%.Of the 7 HER2-amplification positive cases,3 had an IHC score of 0 and 4 had an IHC score of 1+.The proportion of HER2 IHC positivity was highest in the micropapillary variant and lowest in the squamous variant.HER2 IHC-positive patients were more likely to develop lymph node metastasis.The expression rate of HER2 IHC was significantly higher than that of basal-like type and zero phenotype.The prognosis of IHC HER2-positive UC patients was poorer than that of IHC HER2-negative patients,but there was no statistically significant difference(P=0.099).There was no significant difference in prognosis between HER2 amplified and unamplified urothelial carcinoma patients(P=0.911).Conclusion The expression of HER2 in urothelial carcinoma is closely related to its molecular type,lymph node metastasis,and histological subtype.There is inconsistency between HER2 overexpression and gene amplification in urothelial carcinoma.

关 键 词：尿路上皮癌 临床病理 HER2 荧光原位杂交 

分 类 号：R737.15[医药卫生—肿瘤]