乳腺癌HER2指南更新要点对判读结果的影响及HER2阳性乳腺癌的特征
The Impact of the Update of Breast Cancer HER2 Guidelines on Interpretation Results and the Characteristics of HER2-Positive Breast Cancer
DOI: 10.12677/ACM.2021.114223, PDF,   
作者: 吴思雨, 魏志敏, 曾满芹, 张龙宵, 董娴宁：青岛大学附属医院病理科，山东 青岛；徐瑞祥：青岛大学附属医院脊柱外科，山东 青岛
关键词: 乳腺癌；HER2；免疫组织化学；原位杂交；指南更新；Breast Cancer； HER2； Immunohistochemistry； In Situ Hybridization； Guide Update
摘要: 目的：比较2014版与2019版乳腺癌HER2检测指南对乳腺癌中人表皮生长因子受体2 (HER2)基因扩增与蛋白表达状态判读结果的影响及其临床意义。方法：根据2014版与2019版判读标准对青岛大学附属医院的3102例乳腺癌标本进行重新判读，并对结果异同之处进行分析。结果：1、在依据2014版及2019版标准判读的免疫组织化学(IHC)结果中，2019版判读结果为不确定的病例数减少，阴性病例数增加，经计算，两版结果差异有统计学意义(X² = 1604.13, P < 0.05)。2、在依据2014版及2019版判读的荧光原位杂交(FISH)结果中，2019版判读结果为阳性及不确定的病例数减少，阴性病例数增加，经统计学检验，两版结果差异有统计学意义(P = 0.000, P < 0.05)。3、HER2阳性组和阴性组的组织学分级、肿瘤大小等临床病理学特征的差异有统计学意义。结论：HER2阳性组和阴性组的组织学分级、肿瘤大小等临床病理学特征均有显著差异(P < 0.05)。采用2019版指南使乳腺癌HER2检测阴性率提高，阳性率及不确定率有所下降，应用2019版乳腺癌HER2检测指南判读结果更明确，在乳腺癌治疗方面具有更好的适用性。
Abstract: Objective: To compare the effects of the 2014 version and 2019 version of the breast cancer HER2 detection guidelines on the interpretation of human epidermal growth factor receptor 2 (HER2) gene amplification and protein expression status in breast cancer and its clinical significance. Methods: According to the interpretation standards of the 2014 and 2019 editions, 3102 breast cancer specimens from the Affiliated Hospital of Qingdao University were re-interpreted, and the similarities and differences of the results were analyzed. Results: 1. Among the results of immunohistochemistry (IHC) interpreted according to the standards of the 2014 and 2019 editions, the number of undefined cases in the 2019 edition decreased and the number of negative cases increased. After calculation, the difference between the results of the two editions was statistically significant (X² = 1604.13, P < 0.05). 2. In the fluorescence in situ hybridization (FISH) results interpreted according to the 2014 and 2019 editions, the number of positive and uncertain cases in the 2019 edition has decreased, and the number of negative cases has increased. After statistical testing, there are differences in the results of the two editions; statistical significance (P = 0.000, P < 0.05). 3. There are statistically significant differences in the histological grade, tumor size and other clinicopathological characteristics between the HER2 positive group and the negative group. Conclusion: There are significant differences in the histological grade, tumor size and other clinicopathological characteristics between the HER2 positive group and the negative group (P < 0.05). The 2019 version of the guidelines has increased the negative rate of breast cancer HER2 detection, and the positive rate and uncertainty rate have decreased. The application of the 2019 version of the breast cancer HER2 detection guidelines has a clearer interpretation and has better applicability in the treatment of breast cancer.
文章引用：吴思雨, 魏志敏, 徐瑞祥, 曾满芹, 张龙宵, 董娴宁. 乳腺癌HER2指南更新要点对判读结果的影响及HER2阳性乳腺癌的特征[J]. 临床医学进展, 2021, 11(4): 1558-1565. https://doi.org/10.12677/ACM.2021.114223

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