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目的:研究浸润性乳腺癌HER2蛋白过表达人群中ER、PR的表达及与HER2基因扩增之间的相关性,并分析ER、PR的表达及HER2基因扩增与淋巴结转移之间的关系。方法:采用免疫组织化学SP法检测浸润性乳腺癌中ER、PR、HER2蛋白的表达情况,并筛选出HER2(++)患者100例,用CISH法检测HER2扩增情况。结果:100例HER2(++)患者中,扩增38例,扩增率为38.0%;低拷贝扩增17例,高拷贝扩增21例;淋巴结转移共41例,转移率为41.0%。其中ER(+)、PR(+)共44例,扩增7例,低拷贝扩增3例,高拷贝扩增4例,扩增率为15.9%,淋巴结转移18例,转移率为40.9%;ER(+)、PR(-)共15例,扩增6例,低拷贝扩增5例,高拷贝扩增1例,扩增率为40.0%,淋巴结转移5例,转移率为33.3%,与ER(+)、PR(+)组扩增率比较,无统计学差异(P>0.05);ER(-)、PR(+)共7例,扩增3例,低拷贝扩增0例,高拷贝扩增3例,扩增率为42.9%,淋巴结转移4例,转移率为57%;ER(-)、PR(-)共34例,扩增22例,低拷贝扩增9例,高拷贝扩增13例,扩增率为64.7%,淋巴结转移14例,转移率为41.2%,与ER(+)、PR(+)比较,扩增率具有统计学差异(P<0.01),且高拷贝扩增率与ER(+)、PR(+)组比较,具有统计学差异(P<0.01)。结论:HER2(++)患者基因扩增与ER、PR的表达存在相关性,ER(-)、PR(-)、HER2(++)患者扩增率明显高于ER(+)、PR(+)、HER2(++)患者,ER(-)、PR(-)高拷贝扩增率也高于ER(+)、PR(+)患者。ER(-)、PR(-)淋巴结转移患者HER2扩增率明显高于ER(+)、PR(+)患者。
OBJECTIVE: To study the correlation between ER, PR expression and HER2 gene amplification in patients with HER2 overexpression in invasive breast cancer and to analyze the relationship between the expression of ER, PR and the amplification of HER2 gene and lymph node metastasis. Methods: Immunohistochemical SP method was used to detect the expression of ER, PR and HER2 protein in invasive breast cancer. 100 cases of HER2 (++) were screened out. The amplification of HER2 was detected by CISH. Results: In 100 cases of HER2 (++), 38 cases were amplified, the amplification rate was 38.0%, 17 cases were low copy amplification and 21 cases were high copy amplification. There were 41 cases with lymph node metastasis and the metastasis rate was 41.0%. There were 44 cases of ER (+) and PR (+), 7 cases of amplification, 3 cases of low copy amplification and 4 cases of high copy amplification. The rate of amplification was 15.9%, lymph node metastasis was 18 cases and metastasis rate was 40.9% ; There were 15 cases of ER (+) and PR (-), 6 cases of amplification, 5 cases of low copy amplification and 1 case of high copy amplification. The amplification rate was 40.0%, lymph node metastasis in 5 cases and metastasis rate in 33.3% (P> 0.05). There were 7 cases of ER (-) and PR (+), 3 cases of amplification and 0 cases of low copy amplification In 3 cases with high copy amplification, the amplification rate was 42.9%, lymph node metastasis in 4 cases and metastasis rate in 57 cases. ER (-), PR (-) were 34 cases, 22 cases were amplified, 9 cases were low copy For example, in 13 cases of high copy amplification, the rate of expansion was 64.7%, the rate of lymph node metastasis was 14.2% and the rate of metastasis was 41.2%. The amplification rate was significantly different from that of ER (+) and PR (+) (P <0.01) ), And high-copy amplification rate with ER (+), PR (+) group, with a statistically significant difference (P <0.01). CONCLUSIONS: There is a correlation between gene amplification and expression of ER and PR in patients with HER2 (++). The amplification rate of patients with ER (-), PR (-) and HER2 (++) (+), HER2 (++) patients, ER (-), PR (-) high copy amplification rate is also higher than the ER (+), PR (+) patients. The amplification rate of HER2 in patients with ER (-) and PR (-) lymph node metastasis was significantly higher than that in patients with ER (+) and PR (+).