HER-2阳性乳腺癌临床病理学特征的分析
发布时间：2018-10-26 16:51
【摘要】：背景与目的乳腺癌是现代女性最常见的肿瘤,近年来乳腺癌的发病率在逐年上升。肿瘤分子生物学技术的不断发展证实,肿瘤的发生和转移是一个多因素的复杂过程。近年来在对乳腺癌生物学特点的不断研究中发现影响乳腺癌预后的一个重要因素为人类表皮生长因子受体(HER-2)。在临床治疗中发现HER-2基因扩增乳腺癌患者复发转移率高,生存期较短,预后相对较差。HER-2基因与其他分子生物学特征之间的关系是国内外研究的热点,HER-2基因扩增或过表达与肿瘤组织学特征和其他分子生物学指标的相关性研究中,发现HER-2基因与其他生物学指标如肿瘤大小、组织学分级、淋巴结转移情况、ER表达等之间的关系,结果存在较大差异甚至出现相反结果。这与检测方法和评判标准以及入组标准的不同有很大关系。在不同研究中结果有所不同,难以准确的反应真实的乳腺癌HER-2基因表达的特点,不利于指导临床的治疗。本文通过免疫组化和荧光原位杂交技术联合检测HER-2基因状态,严格遵循指南要求的判读标准。分析研究了HER-2基因扩增和过表达乳腺癌患者的临床特点以及与其他临床病理特点的关系,对进一步认识HER-2基因在乳腺癌中的表达及临床的治疗有指导意义。方法收集了2013年12月至2017年3月于我院行乳腺癌术后标本363例,所有标本均经病理证实为乳腺浸润性导管癌。先经过免疫组化法(IHC)检测标本,对于HER-2不确定的标本在进行荧光原位杂交(FISH)方法检测。根据免疫组化和FISH检测把患者分为HER-2表达组和不表达组,表达组包括HER-2过表达(+++)、FISH结果阳性;不表达组包括HER-2(-、+)、FISH结果阴性。同时收集患者年龄、肿块大小、淋巴结转移情况等临床资料。分析HER-2基因表达乳腺癌患者临床特点,以及两组患者之间各因素之间的关系。应用SPSS17.0软件包,资料分析时采用卡方(χ2)检验,相关性分析采Spearman相关分析,以α=0.05为检验水准。结果1.363例乳腺癌患者组织标本中HER-2不表达组有304例,占83.7%。表达组有59例,比例占16.3%。2.单因素分析结果显示:HER-2表达组和不表达组在淋巴结转移(59.3%vs38.5%)、ER阳性表达(74.6%vs87.2%)、组织学分级(20.3%vs28.3%;64.4%vs63.1%;15.3%vs8.6%)、Ki-67≥14%比率(91.5%vs74.0%)四个因素之间差异均有统计学意义(p0.05)。3.相关性分析结果显示:HER-2表达组和不表达组在淋巴结转移、组织学分级、Ki-67这三项因素与HER-2表达呈正相关(r1=0.28、r2=0.45、r3=0.34、p0.05);在ER表达上呈负相关(r1=-0.38,p0.05)。结论1.HER-2阳性乳腺癌患者HER-2基因表达与淋巴结转移、ER、组织学分级、KI-67之间有相关性。
[Abstract]:Background & objective Breast cancer is the most common tumor in modern women. The incidence of breast cancer is increasing year by year in recent years. With the development of tumor molecular biology technology, the occurrence and metastasis of tumor is a complex process of many factors. Human epidermal growth factor receptor (HER-2) has been found to be an important factor in the prognosis of breast cancer in recent years. In clinical treatment, it was found that the recurrence and metastasis rate of breast cancer with HER-2 gene amplification was high, the survival time was shorter, and the prognosis was relatively poor. The relationship between HER-2 gene and other molecular biological characteristics was a hot topic at home and abroad. In the study of the correlation between the amplification or overexpression of HER-2 gene and tumor histological features and other molecular biological indexes, it was found that HER-2 gene was associated with other biological parameters such as tumor size, histological grade, lymph node metastasis. The relationship between the expression of ER and so on, the result has the big difference even appears the opposite result. This has much to do with the difference between the detection method, the evaluation criteria and the group entry criteria. The results of different studies are different, and it is difficult to accurately reflect the true characteristics of HER-2 gene expression in breast cancer, which is not conducive to guiding clinical treatment. The status of HER-2 gene was detected by immunohistochemistry and fluorescence in situ hybridization (Fish), and the standard of interpretation was strictly followed. The clinical characteristics of breast cancer patients with amplification and overexpression of HER-2 gene and their relationship with other clinicopathological features were analyzed and studied. It is of guiding significance to further understand the expression of HER-2 gene in breast cancer and its clinical treatment. Methods 363 cases of breast cancer were collected from December 2013 to March 2017 in our hospital. All specimens were pathologically confirmed as invasive ductal carcinoma of the breast. The samples were detected by immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) for uncertain HER-2 samples. The patients were divided into HER-2 expression group and non-expression group according to immunohistochemistry and FISH detection. The expression group included HER-2 overexpression (), FISH positive group and non-expression group including HER-2 (-,), FISH result negative result). At the same time, the patient's age, tumor size, lymph node metastasis and other clinical data were collected. To analyze the clinical characteristics of breast cancer patients with HER-2 gene expression and the relationship between the two groups. The data were analyzed by chi-square test (蠂 ~ 2) and correlation analysis by Spearman correlation analysis with 伪 = 0. 05 as the test level. Results there were 304 cases (83.7%) in HER-2 negative expression group in 1.363 cases of breast cancer. There were 59 cases in the expression group, accounting for 16.3%. 2. Univariate analysis showed that the positive expression of), ER (74.6 vs 87.2%) in lymph node metastasis (59.3 vs 38.5%) and histologic grade (20.3vs28.3g) in HER-2 expression group and non-expression group; There were significant differences among the four factors (Ki-67 鈮，
本文编号：2296377
[Abstract]:Background & objective Breast cancer is the most common tumor in modern women. The incidence of breast cancer is increasing year by year in recent years. With the development of tumor molecular biology technology, the occurrence and metastasis of tumor is a complex process of many factors. Human epidermal growth factor receptor (HER-2) has been found to be an important factor in the prognosis of breast cancer in recent years. In clinical treatment, it was found that the recurrence and metastasis rate of breast cancer with HER-2 gene amplification was high, the survival time was shorter, and the prognosis was relatively poor. The relationship between HER-2 gene and other molecular biological characteristics was a hot topic at home and abroad. In the study of the correlation between the amplification or overexpression of HER-2 gene and tumor histological features and other molecular biological indexes, it was found that HER-2 gene was associated with other biological parameters such as tumor size, histological grade, lymph node metastasis. The relationship between the expression of ER and so on, the result has the big difference even appears the opposite result. This has much to do with the difference between the detection method, the evaluation criteria and the group entry criteria. The results of different studies are different, and it is difficult to accurately reflect the true characteristics of HER-2 gene expression in breast cancer, which is not conducive to guiding clinical treatment. The status of HER-2 gene was detected by immunohistochemistry and fluorescence in situ hybridization (Fish), and the standard of interpretation was strictly followed. The clinical characteristics of breast cancer patients with amplification and overexpression of HER-2 gene and their relationship with other clinicopathological features were analyzed and studied. It is of guiding significance to further understand the expression of HER-2 gene in breast cancer and its clinical treatment. Methods 363 cases of breast cancer were collected from December 2013 to March 2017 in our hospital. All specimens were pathologically confirmed as invasive ductal carcinoma of the breast. The samples were detected by immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) for uncertain HER-2 samples. The patients were divided into HER-2 expression group and non-expression group according to immunohistochemistry and FISH detection. The expression group included HER-2 overexpression (), FISH positive group and non-expression group including HER-2 (-,), FISH result negative result). At the same time, the patient's age, tumor size, lymph node metastasis and other clinical data were collected. To analyze the clinical characteristics of breast cancer patients with HER-2 gene expression and the relationship between the two groups. The data were analyzed by chi-square test (蠂 ~ 2) and correlation analysis by Spearman correlation analysis with 伪 = 0. 05 as the test level. Results there were 304 cases (83.7%) in HER-2 negative expression group in 1.363 cases of breast cancer. There were 59 cases in the expression group, accounting for 16.3%. 2. Univariate analysis showed that the positive expression of), ER (74.6 vs 87.2%) in lymph node metastasis (59.3 vs 38.5%) and histologic grade (20.3vs28.3g) in HER-2 expression group and non-expression group; There were significant differences among the four factors (Ki-67 鈮，
本文编号：2296377
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