CAJ | 학술논문

目的：比较乳腺癌患者核芯针穿刺标本( core needle biopsy,CNB)和外科手术标本( surgery specimen,SS)免疫组化检查结果的一致性。方法回顾性分析2012-08~2013-11就诊于宣武医院普外科的乳腺癌病人资料,其中术前核芯针穿刺及术后标本均有免疫组化结果的病例55例,比较两者雌激素受体( estrogen receptors,ER)、孕激素受体( progesterone recep-tors,PR)、表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)的表达情况。结果在55例中,核芯针穿刺标本和外科手术标本HER2免疫组化结果差异具有统计学意义(P<0.05)；核芯针穿刺的标本在ER、PR、HER2等免疫组化指标的阳性表达常高于外科手术标本。同时在CNB标本及SS标本ER、PR、HER2免疫组化结果的一致率较高,分别为90%,86.7%,和79.3%；相似性检验中,Kappa值分别为0.791,0.881,0.404。结论在乳腺癌指标ER, PR和 HER2的表达上,核芯针穿刺标本的结果和外科手术标本的结果虽有差别,但一致度高。当核芯针与外科手术标本免疫组化不一致时,核芯针穿刺标本结果可能更可靠。
목적：비교유선암환자핵심침천자표본( core needle biopsy,CNB)화외과수술표본( surgery specimen,SS)면역조화검사결과적일치성。방법회고성분석2012-08~2013-11취진우선무의원보외과적유선암병인자료,기중술전핵심침천자급술후표본균유면역조화결과적병례55례,비교량자자격소수체( estrogen receptors,ER)、잉격소수체( progesterone recep-tors,PR)、표피생장인자수체2(human epidermal growth factor receptor 2,HER2)적표체정황。결과재55례중,핵심침천자표본화외과수술표본HER2면역조화결과차이구유통계학의의(P<0.05)；핵심침천자적표본재ER、PR、HER2등면역조화지표적양성표체상고우외과수술표본。동시재CNB표본급SS표본ER、PR、HER2면역조화결과적일치솔교고,분별위90%,86.7%,화79.3%；상사성검험중,Kappa치분별위0.791,0.881,0.404。결론재유선암지표ER, PR화 HER2적표체상,핵심침천자표본적결과화외과수술표본적결과수유차별,단일치도고。당핵심침여외과수술표본면역조화불일치시,핵심침천자표본결과가능경가고。
Objective To explore the concordance of immunohistochemical results of preoperative core needle biopsy( CNB) and sur-gery specimen(SS)in breast cancer patients. Methods From August 2012 to November 2013,the immunohistochemical results from both core needle biopsy and surgery specimens of 55 patients with breast cancer were collected. The levels of estrogen receptors( ER) , progesterone receptors( PR) ,and HER2 were detected and compared between core biopsy specimens and surgical specimens. Results HER2 positive rate was significantly higher in core needle biopsy specimens than that of surgical specimens(P<0. 05). The positive rates of ER and PR expression were higher in core needle biopsy specimens than those in surgery specimens. The concordance of immu-nohistochemical results of ER,PR and HER2 in core needle biopsy and surgery specimens were 90%,86. 7%,and 79. 3%,respective-ly. Using kappa statistics,the concordance between CNB and SS was almost perfect for ER(k=0. 791)and PR(k=0. 881),and sub-stantial for HER2(k=0. 404). Conclusion CNB has a high coincidence with SS in evaluating ER, PR, and HER2 status in breast cancer patients. When CNB and surgical samples are discordant, the results of core biopsy samples may be more accurate.