单双侧原发性乳腺癌HER-2基因扩增差异及与临床预后关系分析

发布时间：2018-08-24 07:15

【摘要】：目的:应用荧光原位杂交(FISH)检测法,分别检测原发性单侧乳腺癌、原发性双侧乳腺癌HER-2基因的表达,探讨原发性双乳癌与单侧乳腺癌的预后差异性。方法:收集2003-2010年江西省肿瘤医院单侧乳腺癌、原发性双侧乳腺癌病例各30例(均为浸润性癌,含或不含导管内癌成分),采取同年份配对抽样法选取病例。蜡块共90份(单侧乳腺癌蜡块30份、双侧乳腺癌蜡块60份),制备组织芯片,用荧光原位杂交(FISH)检测HER-2基因的表达。结果:1、60例共90份普通切片IHC检测HER-2蛋白表达阳性(3+)13例、可疑阳性(2+)42例、阴性(1+或0)35例;利用组织芯片进行FISH检测结果显示,HER-2扩增的有11例,无扩增的为79例。IHC和FISH结果符合率为87.7%(79/90),两者相关(P0.01),利用组织芯片检测双侧乳腺癌标本更加直观。2、30例单侧乳腺癌患者中HER-2基因扩增9例、扩增率为30%,30例双侧原发性乳腺癌患者中HER-2基因扩增2例(均为单侧)、扩增率为3.3%,两组数据x2=10.91、P0.01,有显著性差异。3、30例单侧乳腺癌患者3年生存22例(73%),30例双侧原发性乳腺癌患者3年生存28例(93%);x2=4.32、P0.05,有显著性差异。30例单侧乳腺癌患者5年生存18例(60%),30例双侧原发性乳腺癌患者3年生存22例(73%);x2=1.66、P0.05,有显著性差异。结论:制备组织芯片后,应用荧光原位杂交(FISH)检测HER-2扩增更加准确直观,原发性双乳癌患者中HER-2基因阳性表达率低于单侧乳腺癌患者,原发性双乳癌患者预后优于单侧乳腺癌患者,HER-2基因作为独立评估预后因素,其过度表达的乳腺癌患者预后较差。
[Abstract]:Objective: to detect the expression of HER-2 gene in primary unilateral breast cancer and primary bilateral breast cancer by fluorescence in situ hybridization (FISH), and to explore the difference of prognosis between primary double breast cancer and unilateral breast cancer. Methods: 30 cases of unilateral breast cancer and 30 cases of primary bilateral breast cancer were collected from 2003 to 2010 in Jiangxi Cancer Hospital. A tissue microarray was prepared from 90 paraffin lumps (30 unilateral breast cancer and 60 bilateral breast cancer). The expression of HER-2 gene was detected by fluorescence in situ hybridization (FISH). Results the positive expression of HER-2 protein was detected in 13 (3), suspicious (42) and negative (1 or 0) 35 cases by IHC in 90 specimens of 60 cases with 1: 1T, and 11 cases were detected by FISH using tissue microarray, the results showed that the expression of HER-2 protein was positive in 13 cases, suspicious in 42 cases and negative in 35 cases, and the results of FISH analysis showed that the expression of HER-2 protein was amplified in 11 cases. The coincidence rate of the results of FISH and IHC was 87.7% (79 / 90) in 79 cases without amplification. The correlation between them was significant (P0.01). The results of HER-2 gene amplification were more intuitive in 9 cases of unilateral breast cancer. The amplification rate of HER-2 gene in 30 patients with bilateral primary breast cancer was 30. The amplification rate of HER-2 gene was 3.3% in 2 cases (all unilateral). There was significant difference between the two groups (x210.91 P 0.01). There was significant difference between 30 cases of unilateral breast cancer and 22 cases (73%) of 30 patients with unilateral primary breast cancer. 22 cases (73%) of bilateral primary breast cancer survived 3 years. 28 cases (93%) of cancer patients survived 3 years (93%), there was significant difference. 30 cases of unilateral breast cancer patients survived for 5 years 18 cases (60%) and 30 cases of bilateral primary breast cancer patients survived 3 years 22 cases (73%). Conclusion: after the preparation of tissue microarray, the detection of HER-2 amplification by fluorescence in situ hybridization (Fish) was more accurate and intuitive. The positive expression rate of HER-2 gene in patients with primary double breast cancer was lower than that in patients with unilateral breast cancer. The prognosis of patients with primary double breast cancer was better than that of patients with unilateral breast cancer.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9

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