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通过显色原位杂交和免疫组织化学检测人肝外胆管癌中HER-2/neu的基因扩增和蛋白过表达:其对淋巴结阳性患者的预后意义

Gene amplification and protein overexpression of HER-2/neu in human extrahepatic cholangiocarcinoma as detected by chromogenic in situ hybridization and immunohistochemistry: its prognostic implication in node-positive patients.

作者信息

Kim H J, Yoo T W, Park D I, Park J H, Cho Y K, Sohn C I, Jeon W K, Kim B I, Kim M K, Chae S W, Sohn J H

机构信息

Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyukwan University School of Medicine, Pyung-Dong, Jongro-Ku, Seoul, South Korea.

出版信息

Ann Oncol. 2007 May;18(5):892-7. doi: 10.1093/annonc/mdm006. Epub 2007 Feb 23.

Abstract

BACKGROUND

In cholangiocarcinoma (CC), HER-2/neu protein overexpression has rarely been reported and the results are conflicting. The present study aimed to clarify the rates of HER-2/neu protein overexpression and gene amplification in human extrahepatic CC and to evaluate the correlation between HER-2/neu and several clinicopathologic features.

PATIENTS AND METHODS

We investigated HER-2 gene amplification by chromogenic in situ hybridization (CISH) and HER-2/neu protein overexpression by immunohistochemistry in 55 extrahepatic CC patients who underwent curative surgery at our institution.

RESULTS

Overexpression of HER-2/neu protein (staining intensity score > or = 2) was found in 16 out of 55 patients (29.1%). CISH revealed that HER-2 gene signals were increased in 10 out of 55 patients (18.1%). There was a positive and significant correlation between HER-2 gene amplification and HER-2/neu protein overexpression (Spearman's rho = 0.718, P < 0.01). In subgroup with lymph node metastases, HER-2 gene amplification by CISH was significant prognostic factor for survival (OR 43.6, 95% confidence interval 1.6-1219.6).

CONCLUSIONS

HER-2/neu protein overexpression by HER-2 gene amplification may occur in human extrahepatic CC and constitute an independent prognostic factor in patients with lymph node metastases. In subgroup with lymph node metastases who exhibit HER-2/neu overexpression might constitute potential candidates for new adjuvant therapy, such as humanized monoclonal antibodies.

摘要

背景

在胆管癌(CC)中,HER-2/neu蛋白过表达鲜有报道,且结果相互矛盾。本研究旨在明确人肝外胆管癌中HER-2/neu蛋白过表达和基因扩增的发生率,并评估HER-2/neu与几种临床病理特征之间的相关性。

患者与方法

我们对在本机构接受根治性手术的55例肝外胆管癌患者,通过显色原位杂交(CISH)检测HER-2基因扩增情况,通过免疫组织化学检测HER-2/neu蛋白过表达情况。

结果

55例患者中有16例(29.1%)出现HER-2/neu蛋白过表达(染色强度评分≥2)。CISH显示,55例患者中有10例(18.1%)HER-2基因信号增强。HER-2基因扩增与HER-2/neu蛋白过表达之间存在显著正相关(Spearman秩相关系数=0.718,P<0.01)。在有淋巴结转移的亚组中,CISH检测的HER-2基因扩增是生存的显著预后因素(比值比43.6,95%置信区间1.6 - 1219.6)。

结论

HER-2基因扩增导致的HER-2/neu蛋白过表达可能发生在人肝外胆管癌中,并构成有淋巴结转移患者的独立预后因素。在有淋巴结转移且HER-2/neu过表达的亚组中,可能是新型辅助治疗(如人源化单克隆抗体)的潜在候选者。

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