بررسی ارزش تشخیصی IHC در مقایسه با FISH در تعیین تکثیر ژن HER2 در بلوک‌های پارافینه در سرطان پستان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه ژنتیک پزشکی، پژوهشگاه ملی مهندسی ژنتیک و زیست فناوری، تهران، ایران.

2 استاد گروه جراحی عمومی، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی تهران، تهران، ایران.

3 دانشجوی دکتری تخصصی ژنتیک مولکولی، پژوهشگاه ملی مهندسی ژنتیک و زیست فناوری، تهران، ایران.

چکیده

مقدمه: سرطان پستان، علت اصلی مرگ‌و‌میر ناشی از بدخیمی در زنان در سراسر جهان به شمار می‌رود. در 30-20% سرطان‌های پستان، تکثیر یا بیان بیش از حد HER2 مشاهده می‌شود. تکثیر ژن HER2 عمدتاً توسط تکنیک‌های IHC جهت اندازه‌گیری بیان پروتئینی آن در سطح سلول و FISH جهت بررسی تکثیر ژن انجام می‌شود. مطالعه حاضر با هدف بررسی حساسیت و اختصاصیت IHC در مقایسه با آزمایش FISH انجام گردید.
روشکار: در این مطالعه که در سال 1399 انجام شد، 44 بلوک پارافینه از بافت کارسینوم پستان متعلق به زنان مبتلا به سرطان پستان که قبلاً با تکنیک IHC بررسی شده بود، با استفاده از روش FISH برای تعیین تکثیر بیش از حد HER2 مورد ارزیابی قرار گرفتند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار GraphPad (ver8 Anova) انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: IHC در مقایسه با FISH شامل 16% مثبت کاذب و 9% منفی کاذب بود، بنابراین حساسیت IHC در شناسایی HER2+ در مثبت واقعی برابر با 6/66% و اختصاصیت IHC در تعیین منفی­ های واقعی برابر با 1/78% بود. نتایج نشان دادند که روش IHC شامل خطاهای زیادی است.
نتیجه­ گیری: سطح اطمینان نتایج مثبت و نتایج منفی به‌ترتیب برابر با 3/53% و 2/86% بود، بنابراین روش FISH باید به‌عنوان یک روش جایگزین در کنار روش IHC مورد استفاده قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

Diagnostic value of IHC and FISH methods for HER2 gene amplification detection in paraffin embedded blocks of breast cancer

نویسندگان [English]

  • Seyed Ahmad Aleyasin 1
  • Esmaeil Akbari 2
  • Fatemeh Saadati 3
1 Associate professor, Department of Medical Genetic, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.
2 Professor, Department of Surgery, Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran.
3 PhD student in Molecular Genetic, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.
چکیده [English]

Introduction: Breast cancer is the leading cause of malignancy related deaths in women worldwide. In 20%-30% of breast cancers, HER2 gene amplification or overexpression is observed. Determination of HER2 amplification is performed mainly by IHC technique to measure its protein expression on the cell surface and by FISH to check gene amplification. This study was aimed to compare the sensitivity and specificity of IHC in comparison to the FISH method for detection of HER2 gene amplification.
Methods: In this study which was performed in 2020, 44 paraffin embedded breast carcinoma tissues belonging to women with breast cancer which have been already examined with IHC technique have been analyzed using FISH technique to determine HER2+ overexpression. Data were analyzed using GraphPad (Anova ver8) software. P<0.05 was considered statistically significant.
Results: Comparison of IHC results with FISH represented 16% false positive and 9% false negative, therefore the sensitivity of IHC for identifying of HER2+ the meaning of true positive was equal to 66.6% and the specificity of IHC in determining true negatives was equal to 78.1%. The results showed that IHC has many errors.
Conclusion: The confidence level of positive results and negative results was equal to 53.3% and 86.2%, respectively. Therefore, FISH method should be used as an alternative method in conjunction with IHC.

کلیدواژه‌ها [English]

  • Breast cancer
  • FISH
  • HER2+
  • IHC
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