乳腺癌中EGFR蛋白表达和基因扩增的检测结果比较

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目的:比较免疫组织化学技术检测乳腺癌中EGFR蛋白表达和荧光原位杂交检测EGFR基因扩增的结果的符合率,为EGFR靶向治疗病例的选择提供依据。方法:随机选取2005年1月到2011年12月冷水江市人民医院和湖南省肿瘤医院病理科的147例乳腺癌档案病例,采用免疫组织化学技术检测乳腺癌组织中EGFR蛋白表达,荧光原位杂交检测EGFR的基因扩增,比较两种方法阳性结果的符合率。结果:免疫组化染色结果显示EGFR在原发性和转移性乳腺癌中的阳性表达率分别为85%(105/123)和79%1(9/24),两组比较无显著差异(P>0.05)。FISH检测结果显示原发性和转移性乳腺癌中分别有12%(15/123)和8%(2/24)存在EGFR基因扩增,两组比较结果无显著差异(P>0.05)。所有存在EGFR基因扩增的原发性和转移性乳腺癌的EGFR免疫组织化学结果均为阳性。在原发性和转移性乳腺癌中,免疫组化阳性和基因扩增程度间呈显著正相关(P<0.05),但免疫组化结果预测基因扩增的特异性较低。结论:免疫组织化学检测EGFR只能作为EGFR靶向治疗病例选择的初步筛选,进一步进行荧光原位杂交检测EGFR基因扩增是必须的。 OBJECTIVE: To compare the coincidence rate of EGFR protein expression detected by fluorescence immunohistochemistry and EGFR gene amplification in breast cancer by immunohistochemistry, and to provide a basis for the selection of EGFR targeted therapy. Methods: A total of 147 breast cancer cases from January 2005 to December 2011 in Lengshuijiang People’s Hospital and Hunan Cancer Hospital were enrolled in this study. Immunohistochemistry was used to detect the expression of EGFR protein in breast cancer tissues. The gene amplification of EGFR was detected by hybridization and the coincidence rate of positive results of two methods was compared. Results: The positive rate of EGFR expression in primary and metastatic breast cancer was 85% (105/123) and 79% 1 (9/24) respectively, there was no significant difference between the two groups (P > 0.05). The results of FISH showed that there was EGFR gene amplification in 12% (15/123) and 8% (2/24) of primary and metastatic breast cancer, respectively. There was no significant difference between the two groups (P> 0.05). EGFR immunohistochemistry was positive in all primary and metastatic breast cancers with EGFR gene amplification. In primary and metastatic breast cancer, there was a significant positive correlation between the immunohistochemistry and the extent of gene amplification (P <0.05), but the immunohistochemical results predicted the specificity of gene amplification was low. Conclusion: Immunohistochemical detection of EGFR can only be used as a primary screening of EGFR targeted therapy cases, further fluorescence amplification in situ hybridization detection of EGFR gene amplification is necessary.
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