مقايسه وضعيت ژن گيرنده فاكتور رشد اپيدرمال در سرطان مهاجم پستان توسط روش هاي ايمونوهيستوشيمي وهيبريديزاسيون كروموژنيك درجا

Comparison between Immunohistochemistry and Chromogenic in Situ Hybridization Method in Assessment of HER-2 Status in Breast Cance

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﮊﻥ ﮔﻴﺮﻧﺪﻩ ﻓﺎﻛﺘﻮﺭ ﺭﺷﺪ ﺍﭘﻴﺪﺭﻣﺎﻝ (HER-2 ﺩﺭ ﺗﻐﻴﻴﺮ ﻭ ﺗﺒﺪﻳﻼﺕ ﺳﻠﻮﻟﻲ ﻭ ﺍﻳﺠﺎﺩ ﺗﻮﻣﻮﺭ ﻧﻘﺶ ﻣﻬﻤﻲ ﺩﺍﺭﺩ. ﻭﺟﻮﺩ ﮊﻥ 2-HER ﺩﺭ ﺳﺮﻃﺎﻥ ﭘﺴﺘﺎﻥ ﻧﺸﺎﻧﻪ ﺍﻱ ﺍﺳﺖ ﻛﻪ ﺑﺮ ﻣﺒﻨﺎﻱ ﺁﻥ ﻣﻲ ﺗﻮﺍﻥ ﭘﻴﺶ ﺑﻴﻨﻲ ﻛﺮﺩ ﻛﻪ ﺗﻮﻣﻮﺭ ﺑﻪ ﺩﺭﻣﺎﻥ ﻫﺎﻳﻲ ﮐﻪ ﺑﺮ ﭘﺎﻳﻪ ﺁﻧﺘﺮﻭﺳﻴﮑﻠﻴﻦ ﻫﺎ ﺑﻨﺎ ﺷﺪﻩ ﺍﻧﺪ ﻭ ﻧﻴﺰ ﺩﺭﻣﺎﻥ ﻫﺪﻓﻤﻨﺪ ﺿﺪ 2-HER )(Herceptinﺣﺴﺎﺱ ﺑﺎﺷﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳﻦ ﺑﺮﺭﺳﻲ ﺑﻪ ﻣﻨﻈﻮﺭ ﻣﻘﺎﻳﺴﻪ ﺭﻭﺵ ﺍﻳﻤﻮﻧﻮﻫﻴﺴﺘﻮﺷﻴﻤﻲ )IHC( ﻭﻫﻴﺒﺮﻳﺪﻳﺰﺍﺳﻴﻮﻥ ﮐﺮﻭﻣﻮﮊﻧﻴﮏ ﺩﺭﺟﺎ )CISH( ﺩﺭ ﺍﺭﺯﻳﺎﺑﻲ ﻭﺿﻌﻴﺖ ﮊﻥ HER-2 ﺩﺭ 38 ﺑﻴﻤﺎﺭ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎﻥ ﻣﻬﺎﺟﻢ ﭘﺴﺘﺎﻥ ﻧﻮﻉ ﺩﺍﮐﺘﺎﻝ ﻃﺮﺍﺣﻲ ﺷﺪﻩ ﺍﺳﺖ. ﺑﺮﺍﻱ ﺑﺮﺭﺳﻲ ﻣﻴﺰﺍﻥ ﺗﻮﺍﻓﻖ ﺑﻴﻦ CISH ﻭIHC ، ﺍﺯ ﺭﻭﺵ ﺁﻣﺎﺭﻱPair Wise Grouped ﺍﺳﺘﻔﺎﺩﻩ ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺑﻴﻦ IHC ﻭ CISH ﺩﺭ ﺍﺭﺯﻳـﺎﺑﻲ HER-2 ﺩﺭ 92/1 ﻫﻤـﺎﻫﻨﮕﻲ ﻭﺟـﻮﺩ ﺩﺍﺷﺘـﻪ ﺍﺳـﺖ. ﺿـﺮﻳﺐ ﺗﻮﺍﻓـﻖ ﮐﺎﭘﺎ )(Kappa Statistic ﻧﺸﺎﻥ ﺩﻫﻨﺪﻩ ﻫﻢ ﺧﻮﺍﻧﻲ ﻋﺎﻟﻲ ﺑﻴﻦ ﺍﻳﻦ ﺩﻭ ﺭﻭﺵ ﺍﺳﺖ (Kappa=0.839, P<0.001. ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﺍﻧﺠﺎﻡ CISH ﺑﻪ ﻋﻨﻮﺍﻥ ﻳﻚ ﺭﻭﺵ ﻣﻜﻤﻞ IHC ﺩﺭ ﺍﺭﺯﻳﺎﺑﻲ ﻭﺿﻌﻴﺖ HER-2 ﺩﺭ ﺁﻥ ﺩﺳﺘﻪ ﺍﺯ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﺳﺮﻃﺎﻥ ﭘﺴﺘﺎﻥ ﻛﻪ HER-2 ﺩﺭ ﺁﻧﻬﺎ ﺑﻪ ﻃﻮﺭ ﺿﻌﻴﻒ ﻣﺜﺒﺖ ﺍﺳﺖ +2 ﺗﻮﺻﻴﻪ ﻣﻲ ﺷﻮﺩ

Introduction & Objective: The epidermal growth factor receptor gene (HER-2) plays an important role in cell transformation and tumorgenesis. The presence of HER-2 gene generally predicts a good response to anthracycline-based agents and therapies that specifically target HER-2 (Herceptin). Materials & Methods: Comparison between IHC and CISH methods for assessment of HER-2 status was performed on 38 women suffering from invasive ductal carcinoma. Data analysis was performed by pair wise grouped statistical method. Results: There was a good correlation between IHC and CISH methods for assessment of HER-2 status in 92.1% of cases (Kappa=0.938, P<0.001). Conclusions: CISH method is recommended as a complementary method in the assessment of HER-2 status in invasive ductal carcinoma of breast of those having weakly positive HER-2.