بررسی نتایج به دست آمده با تکنیک Immunohistochemistry (IHC) در ارزیابی افزایش بیان HER2 در بافت کارسینومای مهاجم مجرایی پستان با روش Fluorescence in situ hybridization (FISH)

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، گروه پاتولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشجوی پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی بوشهر، بوشهر، ایران

4 متخصص پاتولوژی، اصفهان، ایران

5 کارشناس ارشد، گروه اپیدمیولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: کارسینومای پستان، شایع‌ترین سرطان در میان زنان است. ژن HER2 (2-Human epidermal growth factor receptor) یک پروتو انکوژن است که گیرنده‌ی تیروزین کیناز خانواده‌ی Epidermal growth factor receptor را کد می‌کند و افزایش بیان آن، در برخی موارد کارسینومای پستان دیده می‌شود. مطالعه‌ی حاضر، با هدف ارزیابی تکنیک Immunohistochemistry (IHC) در شناسایی موارد مثبت پروتئین HER2 به روش Fluorescence in situ hybridization (FISH) و بررسی ارتباط متغیرهای آسیب‌شناختی بالینی با بیان ژن HER2 انجام شد.روش‌ها: طی یک مطالعه‌ی مقطعی در سال 1393، 190 نمونه از بیماران مبتلا به کارسینومای مهاجم مجرایی که نتایج IHC آن‌ها از نظر HER2 به صورت ++ یا +++ گزارش شده بود، جمع‌آوری و به روش FISH، میزان بیان HER2 بررسی شد. همچنین، ارتباط بین عوامل آسیب‌شناختی بالینی شامل سن، درجه‌ی تومور و وضعیت هورمون گیرنده با بیان ژن HER2 ارزیابی شد. داده‌های به دست آمده با استفاده از نرم‌افزار SPSS تجزیه و تحلیل گردید.یافته‌ها: از 190 نمونه‌ی مربوط به کارسینومای مهاجم پستان، از نظر HER2 در روش IHC، 160 نمونه ++ و 30 نمونه +++ بود. گیرنده‌ی استروژن (ER یا Estrogen receptor) در 2/64 درصد بیماران و گیرنده‌ی پروژسترون (PR یا Progesterone receptor) در 2/74 درصد آنان بیان شده بود. بلوک‌های مثبت روش FISH، از نظر HER2 در روش IHC، در 5/27 درصد ++ و 3/83 درصد +++ بود. موارد منفی گیرنده‌ی استروژن در بیماران HER2 مثبت، به طور معنی‌داری بیشتر بود (001/0 > P). بیماران HER2 مثبت از نظر گیرنده‌ی پروژسترون نیز بیشتر منفی بودند (013/0 = P).نتیجه‌گیری: در این مطالعه نشان داده شد که روش IHC به تنهایی روش مناسبی برای ارزیابی بیان HER2 و تصمیم‌گیری جهت درمان با Trastuzumab حتی در موارد IHC برابر +++ نیست.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of Immunohistochemistry Technique in Detecting HER2 Overexpression in Invasive Ductal Breast Carcinoma Using Fluorescence in-situ Hybridization Method

نویسندگان [English]

  • Azar Baradaran 1
  • Parvaneh Hajalikhani 2
  • Mohammad Kazem Gheybi 3
  • Mohammad Reza Mohajeri 4
  • Ali Mehrabi-Koushki 5
1 Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, School of Medicine, Boushehr University of Medical Sciences, Boushehr, Iran
4 Pathologist, Isfahan, Iran
5 Department of Epidemiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Breast cancer is the most common cancer among women. HER2 gene is a proto-oncogene that encodes the receptor of tyrosine kinase from epidermal growth factor receptor (EFGR) family. It is an important prognostic factor with a determinant role in treatment of breast cancer. There is no globally accepted method for determining the status of this gene and the method of choice is still a matter of debate. We aimed to evaluate the validity of immunohistochemistry (IHC) method in predicting HER2 status using fluorescence in-situ hybridization (FISH) method and also, to investigate some clinicopathological variables associated with HER2 amplification.Methods: In this cross-sectional study, 190 formalin-fixed and paraffin-embedded tissue specimens of invasive breast carcinoma with HER2 of ++ and +++ in IHC evaluation were enrolled. FISH method was performed on all these samples and the relationship of HER2 status and clinicopathological variables was evaluated.Findings: The studied population included 160 specimens of ++ and 30 specimens of +++ HER2 in IHC evaluation. The estrogen and progesterone receptors (ER and PR) were expressed in 64.2% and 74.2% of the specimens, respectively. HER2 amplification on FISH method was found in 27.5% and 83.3% of specimens of ++ and +++ HER2 in IHC evaluation, respectively. Tumors with HER2 amplification were more likely to be negative for estrogen (52.2% vs. 26.4%, P < 0.001) and progesterone (39.1% vs. 18.2 %, P = 0.013) receptors.Conclusion: This study showed that immunohistochemistry is not a good method for evaluating HER2 status and decision making about trastuzumab therapy even in patients with +++ HER2.

کلیدواژه‌ها [English]

  • Invasive breast carcinoma
  • Human epidermal growth factor receptor-2 (HER2)
  • Immunohistochemistry (IHC)
  • Fluorescent in situ hybridization (FISH)

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مجله دانشکده پزشکی اصفهان
دوره 33، شماره 366 - شماره پیاپی 366
بهمن و اسفند 1394
صفحه 2321-2326

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سابقه مقاله

  • تاریخ دریافت: 19 آذر 1393
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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