Molina R, Ciocca D R, Tandon A K, Allred D C, Clark G M, Chamness G C, Gullick W J, McGuire W L
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7884.
Anticancer Res. 1992 Nov-Dec;12(6B):1965-71.
Three hundred and one primary breast cancers from patients with tumor infiltrated lymph nodes were analyzed for the presence of HER-2/neu oncoprotein by two procedures: Western blot (WB) and immunohistochemistry (IHC). Overexpression of this protein was found by WB in 16.6% of the tumors, and by IHC in 16.3%. Concordance between the two methods was found in 95% of tumors (286/301). In 7 cases we found HER-2/neu by IHC but not by WB, while the opposite was found in the remaining 8 patients. This discrepancy was found mainly in samples with HER-2/neu values just above the cut points and were therefore close to the sensitivity limits of the procedures used here. This study helps to define the parameters that should be considered to evaluate the immunostaining for HER-2/neu as positive (i.e., membrane staining, IHC score of 2 or more). The results obtained by both techniques were correlated with several currently used prognostic factors. Higher HER-2/neu protein expression was found in tumors lacking estrogen or progesterone receptors, in tumors with high S-phase fraction and in patients with more than 3 positive lymph nodes. In contrast, no relationship was found between overexpression of this protein and tumor size, ploidy, or age of the patient. Patients with elevated HER-2/neu expression showed a significantly worse overall survival by both methods, IHC (p = 0.05) and WB (p = 0.001). In conclusion, there is very high agreement between IHC and WB when measuring expression of HER-2/neu and both techniques showed prognostic significance.
对301例伴有肿瘤浸润淋巴结的原发性乳腺癌患者，通过两种方法检测HER-2/neu癌蛋白的存在情况：蛋白质印迹法（WB）和免疫组织化学法（IHC）。蛋白质印迹法检测到16.6%的肿瘤中该蛋白过表达，免疫组织化学法检测到16.3%的肿瘤中该蛋白过表达。两种方法在95%的肿瘤（286/301）中检测结果一致。在7例患者中，免疫组织化学法检测到HER-2/neu，但蛋白质印迹法未检测到，而在其余8例患者中情况相反。这种差异主要在HER-2/neu值略高于切点的样本中发现，因此接近此处所用检测方法的灵敏度极限。本研究有助于确定评估HER-2/neu免疫染色为阳性（即膜染色，免疫组织化学评分≥2）时应考虑的参数。两种技术获得的结果与几种目前使用的预后因素相关。在缺乏雌激素或孕激素受体的肿瘤、S期分数高的肿瘤以及有3个以上阳性淋巴结的患者中，发现HER-2/neu蛋白表达较高。相反，未发现该蛋白过表达与肿瘤大小、倍体或患者年龄之间存在关联。HER-2/neu表达升高的患者，通过免疫组织化学法（p = 0.05）和蛋白质印迹法（p = 0.001）检测，总体生存率均显著较差。总之，在检测HER-2/neu表达时，免疫组织化学法和蛋白质印迹法之间具有很高的一致性，且两种技术均显示出预后意义。
