56 Ki67expression(r=0.220,r=0.331;P<0.01),butnegativelycorrelatedwithER(r=-0.406, r=-0.382;p<0.01)andprexpression(r=-0.610,r=-0.635;p=0.01).conclusion

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1 ( ) JournalofNanchangUniversity(MedicalSciences)2018,Vol.58No.1 55 HER2 ( ) : IHC HER2 FISH HER2, HER , FISH HER2 IHC HER2 ER PR Ki67 P HER %(165/463),HER % (122/463);HER2 + - HER % 10.00% 8.27% 7.14%;HER2 (r=0.140 r= 0.310, P<0.01) (r=0.103 P<0.05,r=0.499,P<0.01) (r=0.175 r=0.220, P<0.01) Ki67 (r=0.220 r=0.331, P<0.01), ER(r= r=-0.382, P<0.01) PR (r= r=-0.635, P<0.01) FISH IHC, HER2 FISH ;HER2 Ki67 ER PR : ;HER2; ; : R737.9 : A : (2018) DOI: /j.cnki.ncdm RelationshipbetweenHER2ExpressionandClinicopathological CharacteristicsinBreastCancer YANGYa-jie,SUNYan-hua (Departmentof Pathology,Shenzhen Second People s Hospital,Shenzhen518035,China) ABSTRACT:Objective ToinvestigatetheexpressionofHER2inbreastcarcinomasbyperform- ingimmunohistochemistry(ihc)andfluorescentinsituhybridization(fish),andtoanalyzethe relationshipbetween HER2expressionandclinicopathologicalcharacteristics.Methods Theex- pressionofher2genewasdetectedbyfishandtheexpressionofher2,er,pr,ki67andp53 proteinwasmeasuredbyihcin463breastcancersamplescolectedfrom2010to2015.thecon- sistencybetween HER2geneandproteinexpressionandtherelationshipbetween HER2expres- sionandclinicopathologicalcharacteristicswereanalyzed.results HER2geneamplificationrate andproteinexpressionratewere35.64%(165/463)and26.35%(122/463),respectively.further- more,her2geneamplificationrateswere91.50%,10.00%,8.27% and7.14% inihc HER2,,+ and-samples,respectively.thegeneamplificationandproteinexpressionof HER2 werepositivelycorrelatedwithpathologicalgrade(r=0.140,r=0.310;p<0.01),tumorsize(r= 0.103,P<0.05;r=0.499,P<0.01),lymphnodemetastasis(r=0.175,r=0.220;P<0.01)and : : (JCYJ ) : (1986 ), :, syhbeibei@126.com

2 56 Ki67expression(r=0.220,r=0.331;P<0.01),butnegativelycorrelatedwithER(r=-0.406, r=-0.382;p<0.01)andprexpression(r=-0.610,r=-0.635;p=0.01).conclusion The IHCandFISH haveagoodconsistencyandcorrelationfordetecting HER2expression.However, thereisalowconsistencybetween HER2proteinexpressionandgeneamplificationin HER2 cases,suggestingthattheher2shouldbefurtherdetectedbyfish.theexpressionofher2is associatedwithki67,er,pr,lymphnodemetastasis,tumorsizeandpathologicalgrade. KEY WORDS:breastcancer;HER2;immunohistochemistry;fluorescentinsituhybridization HER2 [1], 40 [2], 1.3 HER2 BRCA1 BRCA2 TP53 c-myc 10% 6~ HER2 12h ( 4μm), 7,1 HE,5 IHC,1 (FDA) 2002 HER2 Herceptin( [3] [4], ) Ki-67, p53 ER PR HER2 p53 ER PR HER2 FISH HER2, FDA (FISH),-20 (IHC) HER2 1.4 [5],HER2, [6] HER2 1)IHC:, HER2, FISH IHC Ki-67 p53 ER PR HER2,HER2 HER2 ( ) :ER PR 1 0% ~5% (-),5% ~25% 1.1 (+),25% ~50% ( ), 50% ( );HER2 10% 463, 0,>10% 54 (28~80 ), +,>10% / 425 (91.79%), 20 (4.32%), 10% 3 (0.65%), 8,>10% (1.73%) 4 (0.86%) 3 (0.65%), Elston&Elis I (50 ) I (214 ) Ⅲ (161 ) 1.2 ( )2018 2, 58 1 FISH 1)IHC: MaxVision, HER2 2)FISH: HER2, 2)FISH: 30, HER2 CEP17(17 ), ER PR p53 Ki-67 HER / (AS- / IgG CO/CAP)

: HER2 57 1.5 <2, <4( 1) SPSS19.0, HER2 35.64% (165/463) Kappa IHC FISH IHC :HER2, (%) ( 2);IHC - +, spearman P< 0.05 2 29.16%(135/463) 20.

01), FISH :HER2 1 ; A: ;B: HER2 1 FISH IHC A: HER2 +;B: HER2 ;C: HER2 2 IHC HER2 (MaxVision 100) 1 FISH IHC FISH - 133 0 2 135 + 80 0 16 96

3 : HER <2, <4( 1) SPSS19.0, HER % (165/463) Kappa IHC FISH IHC :HER2, (%) ( 2);IHC - +, spearman P< %(135/463) 20.73% (96/463) 23.76%(110/463) 26.35%(122/463) IHC HER2 - + FISH (Kappa= ,P<0.01) (r=0.725,p<0.01), FISH :HER2 1 ; A: ;B: HER2 1 FISH IHC A: HER2 +;B: HER2 ;C: HER2 2 IHC HER2 (MaxVision 100) 1 FISH IHC FISH ( P<0.05) 2 P53 HER2 ( P>0.05) HER2 ER PR HER2 ( P< 0.01),Ki67 HER2 ( P< 2.2 HER2 0.01) 2 P53 HER2 ER PR HER2 ( P>0.05) 2 ( P<0.01),Ki67 HER2

4 58 ( )2018 2, 58 1 / n 2 HER2 FISH Her-2 IHC Her-2 P r - + P r > I < < I I l/cm < < < ~< < < ER < < PR < < P Ki67 14% < < >14% [9-10] HER2 17q HER2/CEP17 >2.0 HER2 < 4.0 [11] 2014,IHC, 30% 10%, [11] >10% / (ASCO/CAP) HER2,HER2 HER [7] [8] HER2 22% ~30%,,HER2 11% ~44%, FISH HER2/CEPl7, 256,HER %,HER %;

5 : HER ,HER %, HER %, HER2 HER2 (P <0.01) HER2,IHC HER2 FISH [12] [13] 150 HER2 :, [1], 2009: HER2, HER2 463 IHC FISH, :HER %, 90% [14],HER FISH HER2,ASCO/ CAP HER2 IHC -, IHC FISH HER FISH,3 FISH, 33.64%(37/110) FISH, Hammock [15],IHC-HER2 FISH-HER2, HER2 [9],. 17, [16] FISH, FISH 15% HER2, IHC-HER2 FISH-HER2 (GPA) HER2 Hou [17] HER2,ER PR HER2,, Pathol,1996,27(9): Ki67 HER HER2 Panjwani [18],HER2 Ki67 ER PR 18: ,HER2 FISH IHC. [M]. :, ture,2012,486(7403): [2] StephensPJ,TarpeyPS,Davies H,etal.Thelandscapeof cancergenesandmutationalprocessesinbreastcancer[j].na- [3] AlbanelJ,CodonyJ,RoviraA,etal.Mechanism ofactionof anti-her2monoclonalantibodies:scientificupdateontrastu- zumaband2c4[j].advexp MedBiol,2003,532: [4],. [J].,2006,28(4): [5] SwiatoniowskiG,Dabrowska M,KlaniewskiT,etal.Erb-2 overexpressioninbreastcancer[j].ginekolpol,2003,74(4): [6] VandenBI,VanLP,Drijkoningen M,etal.Polysomy17in breastcancer:clinicopathologic significance and impact on HER2testing[J].JClinOncol,2008,26: [7] HER2 (2014 ). HER2 :2014 [J].,2014,43(4): [8] HER2 (2009 ). HER2 :2009 [J].,2009,38(12): / HER HER2 [J].,2015,44(1): [10], ASCO/CAP HER [11]. HER2 (2014 ) [J].,2015,44(4): [12] MaleyFP,SaadZ,KerkvlietN,etal.Thepredictivepower ofsemiquantitativeimmunohistochemicalassessmentofp53 andc-erbb-2inlymphnode-negativebreastcancer[j].hum [13],,,. HER2 [J].,2016,45(6): 1780 HER2 [J].,2016,45(8):545- [14] BerryD A,MussH B,ThorA D,etal.HER2/neuandP53 expressionversustamoxifenresistanceinestrogenreceptor- positivenode-positivebreastcancer[j].jclin Oncol,2000, ( 64 )

6 64 VAS 12h (T 4-6 ), 0.5%,TPVB, , Dex,Dex(0.1~1μg kg -1 ) 2014,17:E589-E598. [10-11], R,DR PCA, 24~48h (T 7-9 ) VAS Dex [7],, R,DR IL-6 TNF-α MMSE Dex [8], 143. Dex :α2 G [12],Dex P [13], [11], Dex [12] Dex : sches rzteblatinternational,2014,111(8):119. [2]. [J].,2013,29(1): [1] RundshagenI.Postoperativecognitivedysfunction[J].Deut- [3] Chen W,LiuB,ZhangF,etal.Theefectsofdexmedetomidine onpost-operativecognitivedysfunctionandinflammatoryfac- torsinsenilepatients[j].intjcliniexperimentalmed,2015, 8(3). [4] AbdalahF W,BrulR.Facilitatoryefectsofperineuraldexme- detomidineonneuraxialandperipheralnerveblock:asystematic reviewandmeta-analysis[j].britj Anaesth,2013,110(6): [5] MohamedSA,FaresK M,MohamedA A,etal.Dexmedetomi- dineasanadjunctiveanalgesicwithbupivacaineinparaverte- bralanalgesiaforbreastcancersurgery[j].pain Physician, ativecognitivedysfunction:involvementofneuroinflammation andneuronalfunctioning[j].brain BehavImmun,2014,38: ,. [J].,2016,32(5): [6] HovensIB,SchoemakerR G,vanderZeeE A,etal.Postoper-,. [J].,2016,36(2):140- [9] Pace M M,SharmaB,AndersonDamJ,etal.Ultrasound-guided thoracicparavertebralblockade:aretrospectivestudyoftheinci- denceofcomplications[j].anesthanalg,2016,122(4):1186- vacaine[j].janaesthesiolclinpharmacol,2011,27(3):339.. [J].,2015,2:008.,. [J].,2016,32(12): [13] YoshitomiT,KohjitaniA,MaedaS,etal.Dexmedetomidine enhancesthelocalanestheticactionoflidocaineviaanα-2a adrenoceptor[j].anesthanalg,2008,107(1): ( : ) 櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐櫐 ( 59 ) [10] GuptaR,VermaR,BograJ,etal.A Comparativestudyofin- trathecaldexmedetomidineandfentanylasadjuvantstobupi- [15] HammockL,Lewis M,PhilipsC,eta1.Strong HER2/neu proteinoverexpressionbyimmunohistochemistryoftendoes notpredictoncogeneamplificationbyfluorescenceinsituhy- bridization[j].hum Pathol,2003,34(10): ogistsclinicalpracticeguidelineupdate[j].j Clin Oncol, 2013,31(31): [17] HouY,NitaH,LiZ.HER2geneproteinassayisusefulto determineher2statusandevaluateher2heterogeneityin HER2equivocalbreastcancer[J].Am JClinPathol,2017, 147(1): [18] PanjwaniP,EpariS,KarpateA,etal.AssessmentofHER2/ [16] PerezE A,Clinic M E.Recommendationsforhumanepider- malgrowthfactorreceptor2testinginbreastcancer:ameri- cansocietyofclinicaloncology/colegeofamericanpathol- neustatusinbreastcancerusingfluorescenceinsituhybrid- ization &immunohistochemistry:experience of a tertiary cancerreferralcentreinindia[j].indianj Med Res,2010, 132: ( )2018 2, 58 1 ( : )

36 tientswithendometrioidovarianadenocarcinoma(p>0.05)butwascorrelatedwiththeclinical stageandpathologicalgrade(p<0.05).furthermorethere wasapositivec

36 tientswithendometrioidovarianadenocarcinoma(p>0.05)butwascorrelatedwiththeclinical stageandpathologicalgrade(p<0.05).furthermorethere wasapositivec ( )2017 57 1 JournalofNanchangUniversity(MedicalSciences)2017Vol.57No.1 35 1 2a 2b (1. 510120; 2. a. ;b. 330006) : B7-H4 Elivision 30 15 30 20 CA125 96.7% (29/ 30) 53.3%(8/15) 30.0%(9/30) 5.0%(1/20) (P=0.000