Titi Sami
Zakład Patomorfologii Pomorskiej Akademii Medycznej, Szczecin.
Ann Acad Med Stetin. 2006;52(2):5-12.
The objective of the investigation was to describe p185 protein expression using immunohistochemistry (IHC) and HER-2 gene amplification by fluorescence in situ hybridization (FISH), assessment being semi-quantitative and with the more precise computer image analysis, and to determine whether p185 overexpression is associated with some clinical and morphological parameters such as histological type, histological grade, axillary lymph node status, tumor size, estrogen receptor expression, proliferative index, and age in females with invasive breast carcinoma.
Histological preparations from 390 breast carcinomas were studied with the IHC reaction (HercepTest) based on a polyclonal anti-p185 antibody. HercepTest results classified semi-quantitatively as 2+ and 3+ were evaluated using a computer image analyzer and the p185 index was calculated. HER-2 amplification was carried out with FISH using a unique probe (HER-2) with a satellite probe (CEP17). The FISH reaction was assessed routinely by counting red fluorescence signals emitted by the HER-2 gene and additionally with AnalySIS software (AS). The latter method showed that the mean HER-2 amplification index in carcinomas determined as 2+ was significantly lower as compared to carcinomas defined as 3+ (p < 0.0001). On the other hand, the mean amplification indices of carcinomas classified as 3+ and of 2+ cancers which manifested HER-2 amplification did not differ significantly. High HER-2 amplification values (HER-2/CEP17 > 5) were noted in a similar percentage of carcinomas classified by IHC as 2+ (45.5%) or 3+ (55.5%). No correlation was observed between the intensity of the immunohistochemical reaction to p185 as assessed by computer image analysis and the HER-2 amplification index either in breast carcinomas classified semi-quantitatively as 2+ or 3+. The p185 index in 2+ carcinomas without HER-2 amplification might be higher than in some cancers with HER-2 amplification or even higher than in some carcinomas with HER-2 amplification belonging to the 3+ class. Significant differences were noted in p185 expression between ductal and lobular carcinomas (p = 0.0001) and between lobular and medullar carcinomas (p = 0.003). Invasive ductal carcinomas revealed significant differences in p185 expression depending on histological grade (I degree vs III degree p = 0.02; II degree vs III degree p = 0.02), estrogen receptor expression (p = 0.01), and proliferative index (p = 0.02).
本研究的目的是通过免疫组织化学(IHC)描述p185蛋白表达,并通过荧光原位杂交(FISH)检测HER-2基因扩增,采用半定量评估并结合更精确的计算机图像分析,以确定p185过表达是否与某些临床和形态学参数相关,如组织学类型、组织学分级、腋窝淋巴结状态、肿瘤大小、雌激素受体表达、增殖指数以及浸润性乳腺癌女性患者的年龄。
对390例乳腺癌的组织学标本进行基于多克隆抗p185抗体的免疫组织化学(HercepTest)反应研究。使用计算机图像分析仪对免疫组织化学检测结果半定量分类为2+和3+的情况进行评估,并计算p185指数。采用带有卫星探针(CEP17)的独特探针(HER-2)通过荧光原位杂交技术进行HER-2扩增检测。通过计数HER-2基因发出的红色荧光信号并使用分析软件(AS)对荧光原位杂交反应进行常规评估。后一种方法显示,确定为2+的癌组织中HER-2平均扩增指数显著低于定义为3+的癌组织(p<0.0001)。另一方面,分类为3+的癌组织与表现出HER-2扩增的2+癌组织的平均扩增指数无显著差异。免疫组织化学分类为2+(45.5%)或3+(55.5%)的癌组织中,HER-2高扩增值(HER-2/CEP17>5)的比例相似。在半定量分类为2+或3+的乳腺癌中,通过计算机图像分析评估的p185免疫组织化学反应强度与HER-2扩增指数之间均未观察到相关性。无HER-2扩增的2+癌组织中的p185指数可能高于一些有HER-2扩增的癌组织,甚至高于一些属于3+类别的有HER-2扩增的癌组织。导管癌和小叶癌之间(p=0.0001)以及小叶癌和髓样癌之间(p=0.003)的p185表达存在显著差异。浸润性导管癌根据组织学分级(I级与III级,p=0.02;II级与III级,p=0.02)、雌激素受体表达(p=0.01)和增殖指数(p=0.02)在p185表达上显示出显著差异。