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目的:总结分析临床应用荧光原位杂交(fluorescence in situ hybridization,FISH)技术诊断乳腺小管癌和黏液癌表皮生长因子受体2(epidermal growth factor receptor 2,HER-2)基因扩增的经验和临床病理学意义。方法:用FISH和免疫组化技术诊断34例乳腺小管癌和黏液癌HER-2基因状态,分析HER-2基因扩增与HER-2蛋白表达以及临床病理的关系。结果:34例乳腺小管癌和黏液癌HER-2基因扩增阳性率为20.6%(7/34),其中小管癌为9.5%(2/21),黏液癌为38.5%(5/13),HER-2基因扩增多见于黏液癌,r=0.348,P=0.044。乳腺癌HER-2基因扩增与肿瘤大小(r=0.351,P=0.042)、淋巴结转移(r=0.815,P=0.000 1)、临床分期(r=0.549,P=0.001)和HER-2蛋白表达(r=0.361,P=0.036)呈正相关,HER-2基因扩增与与患者年龄无关,r=-0.072,P=0.687。结论:乳腺小管癌与黏液癌存在HER-2基因的扩增,临床应用FISH技术诊断HER-2基因扩增靶标来指导乳腺混合型黏液癌和小管癌的分子靶向治疗可能有助于改善患者的预后。
OBJECTIVE: To summarize the clinical experience and clinical application of fluorescence in situ hybridization (FISH) in the diagnosis of breast cancer and mucinous carcinoma of epidermal growth factor receptor 2 (HER-2) Pathological significance. Methods: FISH and immunohistochemistry were used to detect the HER-2 gene status in 34 patients with breast cancer and mucinous carcinoma. The relationship between HER-2 gene amplification and HER-2 protein expression and clinical pathology was analyzed. Results: The positive rate of HER-2 gene amplification was 20.6% (7/34) in 34 cases of breast cancer and mucinous cancer, 9.5% (2/21) in small duct cancer, 38.5% (5/13) in mucinous cancer, HER-2 gene amplification more common in mucinous carcinoma, r = 0.348, P = 0.044. The amplification of HER-2 gene in breast cancer correlated with tumor size (r = 0.351, P = 0.042), lymph node metastasis (r = 0.815, P = 0.000 1) (R = 0.361, P = 0.036). There was no correlation between HER-2 gene amplification and patient age (r = -0.072, P = 0.687). Conclusion: There is HER-2 gene amplification in breast cancer and mucinous cancer. The molecular targeted therapy of clinical diagnosis of mixed-type breast cancer and small duct cancer with FISH to diagnose HER-2 gene amplification target may be helpful to improve patients The prognosis.