CAJ | 학술논문

目的分析乳腺癌新辅助化疗前后荧光原位杂交(FISH)检测HER2基因扩增状态与免疫组织化学(IHC)检测HER2表达的一致性,探讨两种检测方法的可行性和必要性.方法以135例行含紫杉醇类或CAF方案新辅助化疗的乳腺癌患者为研究对象,分别对其新辅助化疗前后的肿瘤石蜡切片标本行IHC检测和HER2基因的FISH检测,比较两种检测方法的一致性.结果新辅助化疗前对穿刺组织采用IHC与FISH行HER2检测的检出率差异无统计学意义,一致性较好(P=0.727,Kappa =0.510),而新辅助化疗后组织采用IHC与FISH方法的HER2检出率差异有统计学意义,且一致性较差(P =0.000,Kappa=0.25)；对化疗后肿瘤组织的HER2检测,含紫杉醇类方案组的IHC与FISH结果一致性较CAF方案组低.结论新辅助化疗可能引起HER2基因的IHC与FISH结果的一致性降低,故对于行新辅助化疗特别是行含紫杉醇类新辅助化疗的患者,应行HER2基因的FISH检测,以更好地指导临床决策.
목적 분석유선암신보조화료전후형광원위잡교(FISH)검측HER2기인확증상태여면역조직화학(IHC)검측HER2표체적일치성,탐토량충검측방법적가행성화필요성.방법 이135례행함자삼순류혹CAF방안신보조화료적유선암환자위연구대상,분별대기신보조화료전후적종류석사절편표본행IHC검측화HER2기인적FISH검측,비교량충검측방법적일치성.결과 신보조화료전대천자조직채용IHC여FISH행HER2검측적검출솔차이무통계학의의,일치성교호(P=0.727,Kappa =0.510),이신보조화료후조직채용IHC여FISH방법적HER2검출솔차이유통계학의의,차일치성교차(P =0.000,Kappa=0.25)；대화료후종류조직적HER2검측,함자삼순류방안조적IHC여FISH결과일치성교CAF방안조저.결론 신보조화료가능인기HER2기인적IHC여FISH결과적일치성강저,고대우행신보조화료특별시행함자삼순류신보조화료적환자,응행HER2기인적FISH검측,이경호지지도림상결책.
Objective To evaluate the consistency of HER2 gene status before and after neoadjuvant chemotherapy in breast cancer by FISH (fluorescence in situ hybridization) and IHC (immunohistochemistry) techniques,and analyze the factor of the difference in the result and the feasibility of HER2 gene tested by FISH in the neoadjuvant chemotherapy breast cancer patients.Methods FISH and IHC for HER2 gene expression status was performed on the archival paraffin-embedded sections of breast cancer tissues before and after neoadjuvant chemotherapy from 135 Chinese female patients,x2 test of paired comparison of enumeration data and Kappa analysis were used to compare the difference and consistency of this two techniques.Results The detection rate of HER2 status in punctured cancer tissues before neoadjuvant chemotherapy by FISH and HER2 did not show statistical difference in our research while the opposite result were showed in cancer tissues after neoadjuvant chemotherapy.Moreover,the two techniques of HER2 test were less concordant in patients accepted taxanes neoadjuvant chemotherapy than CAF treatment.Conclusions The consistency of FISH and IHC techniques of cancer tissues before neoadjuvant chemotherapy gained advantage compared to the ones after neoadjuvant chemotherapy.Patients received neoadjuvant chemotherapy especially taxanes should take the test of HER2 gene status by FISH technique.