【摘要】：目的:應(yīng)用熒光原位雜交(FISH)檢測(cè)法,分別檢測(cè)原發(fā)性單側(cè)乳腺癌、原發(fā)性雙側(cè)乳腺癌HER-2基因的表達(dá),探討原發(fā)性雙乳癌與單側(cè)乳腺癌的預(yù)后差異性。方法:收集2003-2010年江西省腫瘤醫(yī)院?jiǎn)蝹?cè)乳腺癌、原發(fā)性雙側(cè)乳腺癌病例各30例(均為浸潤(rùn)性癌,含或不含導(dǎo)管內(nèi)癌成分),采取同年份配對(duì)抽樣法選取病例。蠟塊共90份(單側(cè)乳腺癌蠟塊30份、雙側(cè)乳腺癌蠟塊60份),制備組織芯片,用熒光原位雜交(FISH)檢測(cè)HER-2基因的表達(dá)。結(jié)果:1、60例共90份普通切片IHC檢測(cè)HER-2蛋白表達(dá)陽(yáng)性(3+)13例、可疑陽(yáng)性(2+)42例、陰性(1+或0)35例;利用組織芯片進(jìn)行FISH檢測(cè)結(jié)果顯示,HER-2擴(kuò)增的有11例,無(wú)擴(kuò)增的為79例。IHC和FISH結(jié)果符合率為87.7%(79/90),兩者相關(guān)(P0.01),利用組織芯片檢測(cè)雙側(cè)乳腺癌標(biāo)本更加直觀。2、30例單側(cè)乳腺癌患者中HER-2基因擴(kuò)增9例、擴(kuò)增率為30%,30例雙側(cè)原發(fā)性乳腺癌患者中HER-2基因擴(kuò)增2例(均為單側(cè))、擴(kuò)增率為3.3%,兩組數(shù)據(jù)x2=10.91、P0.01,有顯著性差異。3、30例單側(cè)乳腺癌患者3年生存22例(73%),30例雙側(cè)原發(fā)性乳腺癌患者3年生存28例(93%);x2=4.32、P0.05,有顯著性差異。30例單側(cè)乳腺癌患者5年生存18例(60%),30例雙側(cè)原發(fā)性乳腺癌患者3年生存22例(73%);x2=1.66、P0.05,有顯著性差異。結(jié)論:制備組織芯片后,應(yīng)用熒光原位雜交(FISH)檢測(cè)HER-2擴(kuò)增更加準(zhǔn)確直觀,原發(fā)性雙乳癌患者中HER-2基因陽(yáng)性表達(dá)率低于單側(cè)乳腺癌患者,原發(fā)性雙乳癌患者預(yù)后優(yōu)于單側(cè)乳腺癌患者,HER-2基因作為獨(dú)立評(píng)估預(yù)后因素,其過(guò)度表達(dá)的乳腺癌患者預(yù)后較差。
[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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R737.9

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