乳腺癌HER-2基因的表达及其临床意义

目的分析HER-2表达的临床意义及病理特征,观察HER-2表达对乳腺癌预后的影响。方法用LSAB免疫组织化学法检测267例乳腺癌石蜡标本HER2癌基因的表达,结合临床表现、病理学指标及随访资料,进一步分析其对乳腺癌预后的影响。结果HER2在年轻患者及ER、PR阴性者表达率高,分别为78.0%、63.0%和60.5%。HER-2阳性表达与病理类型无关(P=0.60)。有淋巴结转移组HER-2阳性表达率明显高于无淋巴结转移组,差异有显著性(P<0.001)。HER-2阳性的乳腺癌患者生存时间明显短于阴性者(P<0.001)。结论癌基因HER2的过度表达与乳腺癌腋窝淋巴结有转移、雌、孕激素受体缺乏及预后差有关。HER2基因的表达是乳腺癌中腋淋巴结状况之外的又一个独立预后因素。该基因表达的检测作为乳腺癌常规病理检查,可用于判断乳腺癌的预后及拟定术后治疗方案。

Expression of HER-2 gene and its clinical significance in breast cancer

Objective To analyse the clinical and pathological characteristicsofHER2 expression and observe prognostic significance of HER-2 in breast cancer.Methods The expression of HER-2 gene in breast cancer was examined in 267 cases with immunohistochemical technique LASB.Their clinical and pathological indices and follow up data were analyzed.Moreover,the influence of HER-2 upon prognosis was observed.Results The rates of HER-2 expression in young patients and the patients with negative estrogen receptor(ER) and progestin receptor(PR) were high,being 78.0%,63.0% and 60.5%,respectively.There were no obvious correlation between the expression of HER-2 and histological types(P=0.60).Compared with breast cancer without lymph node metastasis,the expression of HER-2 was up regulated(P<0.001)in breast cancer with lymph node metastasis.The HER-2 positive patients' survival time was obviously shorter than that in the HER-2 negative patients(P<0.001).Conclusion There were significant association of HER-2 expression with positive axillarynode status,the absence of ER and PRand poor prognosisin breast cancer.In addition to axillarynode,HER-2 expressioncan be an independent prognosticfactor.Detection of HER-2 gene expression can be arranged as a regular pathological examination in breast cancer and the results can be used for determining the prognosisand planningthe postoperative treatment programm.