色素原位杂交在检测乳腺癌患者组织中HER2基因应用.docVIP

色素原位杂交在检测乳腺癌患者组织中HER2基因应用 　【摘要】 ［目的］ 探讨色素原位杂交(CISH)在检测乳腺癌患者组织中HER2基因状态的临床应用，比较CISH与免疫组化(IHC)检测组织HER2状态的差异性。［方法］ 采用SPOT-Light HER2 CISHTM试剂盒,以CISH方法对40例IHC EnVision法染色分别为(+++)、(++)、(+)和阴性(-)的乳腺癌石蜡切片标本进行HER2基因状态的检测。［结果］ HER2表达IHC(+++)的8例标本中，7例为HER2基因扩增CISH检测，1例无扩增；(++)的13例标本中，5例为HER2基因扩增，8例无扩增；(+)的10例标本中，2例为HER2基因扩增，7例无扩增；(-)的9例标本均无扩增。两种方法对乳腺癌组织HER-2/neu状态的检测有一定的差异性(kappa=0.458，P=0.003)。［结论］ IHC是HER表达初步筛查的首选方法，由于蛋白表达和基因扩增检测结果存在一定的差异性，建议IHCC（+++~+）患者进一步作CISH检测确诊。 【关键词】 乳腺肿瘤 免疫组织组化 色素原位杂交 基因；HER2（c-erbB-2） Chromogenic in Situ Hybridization for HER-2/neu Status Detecting in Breast Cancer Tissue Samples Abstract： ［Purpose］ To explore the application for clinical assessment of HER2 gene expression status by chromogenic in situ hybridization (CISH) and to compare the results with those obtained by immunohistochemistry(IHC). ［Methods］ CISH for HER2 gene expression status was performed using SPOT-Light HER2 CISHTM on the archival paraffin-embedded sections of breast cancer tissues from 40 cases with immunohistochemical staining scores of (+++), (++), (+) and (-). ［Results］ Of the 8 cases with score (+++) by IHC, 7 cases showed HER2 gene amplification by CISH, 1 case CISH-negative. Five of the 13 cases with score (++) showed HER2 gene amplification, the remaining 8 cases were CISH-negative. Two of 10 cases with score (+) showed HER2 gene amplification, the remaining 8 cases were CISH-negative. All the patients with scores negative (n=9) failed to show amplification. Certain difference to the examination of HER-2/neu status (kappa=0.458，P=0.003) was found in the kinds of method. ［Conclusion］　Immunohistochemistry(IHC) is the first choice in primary screening for HER2 expression status. Because of the obvious discrepancies between protein expression and gene amplification, patients with score (+++～+) by IHC should undergo CISH testing. Key words: breast neoplasms; immunohistochemistry(IHC); chromogenic in situ hybridization(CISH); gene; HER2(c-erbB-2) HER2(c-erbB-2)是表皮生长因子受