文献类型：期刊文献

中文题名：进展期乳腺浸润性导管癌HER-2/neu蛋白表达的稳定性分析

英文题名：Comparative analysis of the stability of HER-2/neu protein expression in advanced breast invasive ductal carcinoma

作者：蒋雄玲[1];田景琦[2];陈菁[3];张剑[4];孙爱静[1,4]

机构：[1]温州医科大学附属第一临床学院病理学教研室;[2]绍兴市人民医院/浙江大学绍兴医院乳腺甲状腺外科;[3]宁波卫生职业技术学院医学检验技术教研室;[4]绍兴文理学院医学院病理教研室

年份：2016

卷号：32

期号：5

起止页码：496

中文期刊名：临床与实验病理学杂志

外文期刊名：Chinese Journal of Clinical and Experimental Pathology

收录：CSTPCD、、北大核心2014、CSCD2015_2016、北大核心、CSCD

语种：中文

中文关键词：乳腺肿瘤;淋巴结转移;HER-2;免疫组织化学;荧光原位杂交

外文关键词：breast neoplasm; lymph node metastases; HER-2; immunohistochemistry; fluorescence in situ hybridization

中文摘要：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。

外文摘要：Purpose To retrospectively investigate the stability of HER-2/neu protein expression between primary lesion of breast invasive ductal carcinoma and the synchronous axillary lymph node metastasis, and to establish a clinical guideline for the sample selection, detection data analysis and application for clinical report. Methods 100 cases of breast invasive duetal carcinomas with their corresponding lymph node metastases were collected over 6 years and 9 months period. HER-2/neu protein expression was evaluated by immunohistochemistry using TMA-based techniques on cores from five typical sites of primary tumor and all microscopically visible metastases sites of synchronous axillary lymph node in each case, and confirmed by FISH for immunohistochemistry 2 ＋ and the heterogeneous cases, the different characteristic and the stability of HER-2/neu protein expression and the relationship among the cores were analyzed. Results With immunohistochemistry, 69% cases showed same staining degree in all sites from the same case （homogeneous expression）. HER-2/neu homogeneous negative （0/1 ＋ ） cases showed the strongest stability when we compared all of the effective sites between primary tumor and lymph node metastasis. HER-2/neu homogeneous positive cases also showed the strong correlation while HER-2/neu uncertain cases showed no direct correlation between them. There was significant difference in above mentioned groups （P 〈 0. 000 1 ）. Nevertheless, in all of the protein uncertain and heterogeneous expression cases, 20 cases and 13 cases were observed gene homogeneous amplification and non-amplification and we also found that 3 cases showed different gene status in different cores within same case in genetic testing by FISH, respectively. Among the cores, 31.65% protein negative sites showed HER-2/neu gene amplification. Conclusions HER-2/neu protein expression between primary tumors and the corresponding synchronous axillary lymph node metastases were highly correlated, especially in the negative cases. Accurate synchronous detection and comprehensive a- nalysis of protein uncertain and heterogeneous expression cases with immunohistochemistry and FISH may provide more effective infor- mation for their treatment and prognosis. Multi-site sampling both from primary lesions and their corresponding metastases lesions using TMA-based techniques can reflect more comprehensive HER-2/neu status information, and it can also be used to further investigate the genotyping of breast cancer and other related biomarkers in the progression of tumor.