Keyhani Elahe, Muhammadnejad Ahad, Karimlou Masoud
Genetics Research Center, Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Asian Pac J Cancer Prev. 2012;13(11):5477-82. doi: 10.7314/apjcp.2012.13.11.5477.
The HER-2/neu gene is altered in 15-20% of breast cancer patients. Immunohistochemistry (IHC) is considered to be the most cost-effective method for HER-2 detection in many countries. Approximately 8,000 new cases of breast cancer are observed annually in Iran. The aims of this study were to conduct a systematic review of the literature on the rate of HER-2-positive breast cancer diagnosed by IHC in Iran.
A systematic search of the medical literature using the Medline/PubMed, ISI and SID databases revealed articles published in the English and Persian languages evaluating HER-2-positive breast cancer in Iran.
From 22 studies, 3,033 patients were evaluated, of whom 1,350 were diagnosed as HER-2-positive by IHC HER-2 testing. The mean percentage of HER-2-positive patients was 44.5%, which is higher than that recorded in international statistics. Results of this meta-analysis showed a significant heterogeneity between ratios. There was a statistically significant difference between the results of pre- and post implementation of 2007 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline. IHC HER-2 testing has been performed in Iran for over 10 years. Similar to many other countries, before establishment of an infrastructure for IHC diagnostic tests, HER-2 testing was routinely performed in Iran. Our study showed that the statistics reported from Iran varied widely; for instance, the rate of HER-2-positive cases varied from 23.3% to 81.0%.
Our results demonstrate that the lack of standardization and harmonization of this test have led to marked variations in breast cancer diagnosis in Iran.
15%-20%的乳腺癌患者存在HER-2/neu基因改变。在许多国家，免疫组织化学（IHC）被认为是检测HER-2最具成本效益的方法。伊朗每年约有8000例新发乳腺癌病例。本研究的目的是对伊朗通过免疫组织化学诊断的HER-2阳性乳腺癌发生率的文献进行系统综述。
通过Medline/PubMed、ISI和SID数据库对医学文献进行系统检索，发现了以英文和波斯文发表的评估伊朗HER-2阳性乳腺癌的文章。
从22项研究中，评估了3033例患者，其中1350例通过免疫组织化学HER-2检测被诊断为HER-2阳性。HER-2阳性患者的平均百分比为44.5%，高于国际统计数据。该荟萃分析的结果显示各比率之间存在显著异质性。2007年美国临床肿瘤学会/美国病理学家学会（ASCO/CAP）指南实施前后的结果存在统计学显著差异。免疫组织化学HER-2检测在伊朗已开展了10多年。与许多其他国家类似，在建立免疫组织化学诊断检测基础设施之前，伊朗就常规进行HER-2检测。我们的研究表明，伊朗报告的统计数据差异很大；例如，HER-2阳性病例的发生率从23.3%到81.0%不等。
我们的结果表明，该检测缺乏标准化和统一化导致了伊朗乳腺癌诊断的显著差异。
