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目的探讨荧光原位杂交技术检测乳腺癌Her-2基因的表达及其临床应用。方法应用荧光原位杂交技术(FISH)和免疫组化技术(IHC)分别检测了50例乳腺癌患者手术切除标本的Her-2基因和Her-2蛋白的表达。结果 50例乳腺癌患者组织中Her-2基因FISH阳性率为44%(22/50);Her-2蛋白IHC阳性(+～+++)率为54%(27/50);两者同时为阴性的符合率为86.96%。当IHC阳性(+)时与FISH结果的符合率为40%(4/10)I;HC阳性(++)时与FISH结果的符合率为81.81%(9/11)I;HC阳性(+++)时与FISH结果的符合率为100%。在肿块最大径小于2cm病例中,Her-2基因FISH阳性率为18.75%(3/16);在大于2cm的病例中,Her-2基因FISH阳性率为55.88%(19/34),两者间差异显著;在未发生淋巴结转移的患者中Her-2基因FISH阳性率为34.28%(12/35),而在有淋巴结转移的患者中Her-2基因FISH阳性率为66.67%(10/15),两者间差异有统计学意义(χ2=4.47,P<0.05)。结论 IHC检测Her-2阴性或强阳性(+++)时与FISH检测结果符合率较高,而当IHC为阳性(+～++)时需结合FISH实验以确定Her-2基因的表达状态;Her-2基因的表达与肿瘤长径的大小、腋淋巴结的转移呈正相关。
Objective To investigate the expression of Her-2 gene in breast cancer by fluorescence in situ hybridization and its clinical application. Methods The expression of Her-2 gene and Her-2 protein in 50 cases of breast cancer patients undergoing surgical resection were detected by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) respectively. Results The positive rate of Her-2 gene FISH was 44% (22/50) in 50 breast cancer patients and 54% (27/50) in IHC positive Her-2 protein The negative coincidence rate was 86.96%. The coincidence rate with FISH was 40% (4/10) I when IHC positive (+); the coincidence rate with FISH was 81.81% (9/11) I when HC positive (++) ++) coincides with the FISH results was 100%. The positive rate of FISH of Her-2 gene was 18.75% (3/16) in cases with the longest tumor mass less than 2 cm. The positive rate of FISH in Her-2 gene was 55.88% (19/34) in more than 2 cm cases, The positive rate of FISH of Her-2 gene was 34.28% (12/35) in patients without lymph node metastasis, while the positive rate of FISH of Her-2 gene was 66.67% (10/15) in patients with lymph node metastasis ), The difference was statistically significant (χ2 = 4.47, P <0.05). Conclusions The coincidence rate of IHC with FISH in detecting Her-2 negative or strong positive (+++) is high, and when IHC is positive (+ ~ ++), FISH experiment should be combined to determine the expression of Her-2 gene The expression of Her-2 gene was positively correlated with the size of tumor’s major axis and the metastasis of axillary lymph node.