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目的研究乳腺癌组织中拓扑异构酶Ⅱα基因(TOP2A)和蛋白的表达及与HER2基因的关系。方法采用显色原位杂交(CISH)和免疫组化(IHC)法分别分析96例(曾检测过HER2基因状态)乳腺浸润性导管癌石蜡组织中TOP2A基因扩增及其蛋白表达水平,采用Kappa一致性检验进行统计学分析。结果 96例组织标本中TOP2A蛋白阳性表达52例(54.17%),TOP2A基因扩增26例(27.08%)。52例TOP2A蛋白表达阳性组中,17例(32.69%)出现TOP2A基因扩增;44例TOP2A蛋白表达阴性组中,9例(20.45%)出现TOP2A基因扩增。TOP2A基因扩增率与TOP2A蛋白表达阳性率及二者一致性比较,有显著差异(Kappa值为0.12,P﹤0.005)。59例HER2基因扩增病例中,26例(44.07%)TOP2A基因同步扩增;37例HER2基因无扩增病例,TOP2A基因也全部无扩增。结论 TOP2A基因与其蛋白检测结果之间存在差异,因此以TOP2A基因检测指导临床选择蒽环类药物的化疗方案对乳腺癌治疗可能更为合理。TOP2A基因扩增主要存在于HER2基因扩增患者中。
Objective To investigate the expression of topoisomerase Ⅱ α (TOP2A) and protein in breast cancer and its relationship with HER2 gene. Methods The amplification and protein expression of TOP2A gene in 96 cases of invasive ductal carcinomas of the breast (HER2-positive status) were analyzed by chromosomal in situ hybridization (CISH) and immunohistochemistry (IHC) respectively. Kappa Consistency test for statistical analysis. Results The positive expression of TOP2A in 96 samples was 52 (54.17%) and 26 (27.08%) were TOP2A. TOP2A gene amplification occurred in 17 cases (32.69%) of 52 cases with TOP2A protein expression positive, and 9 cases (20.45%) in 44 cases with TOP2A protein expression negative amplification. TOP2A gene amplification rate and TOP2A protein expression positive rate and consistency between the two, there was significant difference (Kappa value was 0.12, P <0.005). Of the 59 cases of HER2 gene amplification, 26 cases (44.07%) of the TOP2A gene amplified simultaneously; 37 cases of HER2 gene without amplification cases, TOP2A gene also all without amplification. Conclusion TOP2A gene and its protein test results are different, so TOP2A gene test to guide the clinical choice of anthracycline chemotherapy regimen for breast cancer may be more reasonable. TOP2A gene amplification mainly exists in patients with HER2 gene amplification.