Comparison Of Immunohistochemistry Fluorescence In Situ Hybridization And Assessment For Her-2 Status In Breast Cancer And Relationship Between Her-2 Gene Amplification To Clinic Pathological Characteristics

Objective: We contrasted immunohistochemistry(IHC)for detecting Her-2 protein expression in breast cancer patients with fluorescence in situ hybridization(FISH)for detecting the amplification of Her-2 gene.And we explored the correlation between Her-2gene amplification status and clinical pathological characteristics.Method:The present study samples were collected from the Affiliated Tumor Hospital of Xinjiang Medical University from January 2013 to December 2015,389 cases of invasive breast cancer,the Her-2 protein expression and Her-2 gene amplification were detected by IHC and FISH two methods in all cases,respectively,the consistency and positive detection rate of the two methods were statistically analyzed.The Her-2 status in 64 cases,cases of(0),(1+)and(3+)were excluded,only the relationship between states of the over expression of Her-2 state(2+)and the clinical pathological features was analyzed.Result:Select the whole group of patients,the positive expression rate of Her-2 detected by IHC was 6.4%(25/389),the expression rate of Her-2 was 16.7%(65/389)by FISH,FISH detection method has better positive detection rate than IHC detection method,there was significant difference between the two groups(P=0.000<0.05);In the cases of Her-2(0),(1+)and(3+),the consistency of the two detection methods is good,were: 100%,97.1%,88%,while in Her-2(2+),the consistency between the two methods was poor,only 12.9%,the overall consistency of the two detection methods was general(kappa=0.437).In addition,Rank correlation analysis: The positive correlation between FISH and IHC in detecting Her-2(rs=0.459,P=0.000<0.05),that is: the higher the expression degree of Her-2 protein,the higher the amplification rate of Her-2 gene.According to the correlation analysis between 325 cases of Her-2(2+)and clinicopathological characteristics,single factor analysis show: the amplification status of Her-2(2+)gene was significantly correlatedwith hormone status,tumor diameter and p53,but there was no correlation between Ki67 expression,histological grade,tumor number,pathological type,menopausal status,clinical stage,lymph node metastasis,tumor thrombus,age and other factors.Multiple factor logistics regression analysis showed: the expression of estrogen and progesterone in the hormone state were negative,and the negative expression of p53 protein,it may be a predictive correlative factor for Her-2(2+)positive by FISH test.Conclusion: the FISH test had better positive detection rate than IHC,the consistency of the two methods is better in the cases of Her-2(0),(1+),(3+),while in the Her-2(2+)expression state,the consistency of the two detection methods is poor,the overall consistency of the two detection methods was general.Hormone receptor,tumor diameter,p53 protein expression were related to Her-2 over expression,while,Multivariate analysis indicated that the negative expression of estrogen and progesterone and the negative expression of p53 protein may be related to the prediction of Her-2(2+)positive expression by FISH test.