论文部分内容阅读
目的探讨HER-2/neu蛋白在进展期乳腺浸润性导管癌原发灶和同期腋窝淋巴结转移灶中的表达,指导临床检测标本的选择以及检测报告的分析与应用。方法收集进展期乳腺浸润性导管癌标本100例制备全信息组织芯片,采用免疫组化法检测HER-2/neu蛋白表达,FISH法检测HER-2/neu基因扩增状态,分析其特点、稳定性及其相互关系。结果 69%病例HER-2/neu蛋白呈均质性表达,与同期腋窝淋巴结转移灶相比,原发灶蛋白均质阴性病例一致性最强,均质阳性病例次之,均质不确定病例最差;三者相比差异有统计学意义(P<0.000 1)。36例HER-2/neu蛋白不确定和异质性病例的FISH检测显示20例为基因均质扩增,13例为基因均质非扩增,3例为基因异质性,其中31.65%的蛋白阴性位点HER-2/neu基因扩增。结论乳腺浸润性导管癌HER-2/neu蛋白表达在肿瘤原发灶和同期腋窝淋巴结转移灶之间稳定性较高,尤以阴性病例最稳定;免疫组化与FISH同步检测及对比分析可能为乳腺癌患者的治疗及预后提供更为精准的信息;应用全信息组织芯片更能全面检测HER-2/neu蛋白表达及基因状态,并可用于深入分析乳腺癌基因分型及其它相关指标在肿瘤进展中的变化。
Objective To investigate the expression of HER-2 / neu protein in primary breast cancer with invasive ductal carcinoma and axillary lymph node metastasis in the same period, and to guide the selection of clinical specimens and the analysis and application of the test report. Methods 100 samples of invasive ductal carcinoma of the breast were collected to prepare total informational tissue microarray. The expression of HER-2 / neu protein was detected by immunohistochemistry. The amplification status of HER-2 / neu gene was detected by FISH. Sex and its relationship. Results The positive expression of HER-2 / neu in 69% of the cases was homogenous. Compared with the axillary lymph node metastases in the same period, the homogeneity of primary protein homogeneity was the strongest, followed by the homogenization positive cases and homogeneous homogeneity cases The worst among the three groups (P <0.000 1). FISH detection of 36 cases of HER-2 / neu protein uncertainty and heterogeneity showed that 20 cases were homogeneous amplification of genes, 13 cases of non-amplification of gene homogeneity and 3 cases of gene heterogeneity, of which 31.65% Protein-negative HER-2 / neu gene amplification. Conclusions The expression of HER-2 / neu protein in breast invasive ductal carcinoma is more stable between primary tumor and axillary lymph node metastasis in the same period, especially in the negative case. The synchronous detection and comparative analysis of immunohistochemistry and FISH may be Breast cancer patients with treatment and prognosis to provide more accurate information; the application of all-information chip more comprehensive detection of HER-2 / neu protein expression and gene status, and can be used for in-depth analysis of breast cancer genotyping and other related indicators in the tumor Changes in progress.