Study On The Association Between HER-2/neu And ER,PR In Primary Breast Cancer And The Differences Of Detection

Objective: Our study was to develop TMA of breast cancer, investigate the role of HER-2/neu, ER, PR in the breast cancer and breast benign lesion and go into the degree of interlaboratory and interobserver agreement when HER-2/neu was evaluated by IHC.Methods: TMA of breast benign lesion(48 cases) and carcinoma(217 cases) was constructed by using a microarray. The expression of HER-2/neu, ER, PR was detected on the 4-micron section of tissue microarray by IHC. IHC for HER-2/neu was performed on the same tissue sections from 64 primary breast cancers in three different laboratories. Three pathologists interpreted tumor cell membranous staining on a scale of 0 to 3+ (HercepTest score system)of the 64 cases microarray. All data was processed using x2-test and Spearman rank correlation analysis(SAS 8.1 software).Results:1 , Four breast benign lesion and carcinoma TMAs were developed used the tissue of breast cancer(217 cases) and breast benign lesion(48 cases). After immunohistochemistry stain, there were 180 breast cancer cases and 32 breast benign lesion cases left. The usable rate of TMAs was 80%(212/265).2, The positive rate of the expression of HER-2/neu in 180 cases with breast cancer was 37.78%(68/180). None of the 32 cases with breast benign lesion express HER-2/neu protein. There were significant differences of overexpression of HER-2/neu between breast benign lesion and breast carcinoma (x2=17.80, P < 0.05).3, The positive rate of the expression of HR in 180 cases with breast cancer was 58.33% (105/180) . All of the 32 cases with breast benign lesion express HR protein. There were significant differences of expression of HR between breast benign lesion and breast carcinoma (x2=20.63, P < 0.05).4, The positive rate of the expression of HER-2/neu, ER, PR in 180 cases with breast cancer is 37.78%(68/180), 38.33%(69/180), 47.22%(85/180), respectively. Expression ofHER-2/neu is inversely correlated with HR(xM.32, P < 0.05) but not ER, PR(xER2=2.56, P >0.05; xpR2=0.92, P >0.05) expression respectively.5 Despite the general inverse association between them, 33 cases (18.3%) are both HER-2/neu and hormone receptor(HR) position. In these cases, the levers of HER-2/neu overexpression were inversely correlated with HR levers too (rs'= - 0.4034, P < 0.05) .6 The result of detection of HER-2/neu in the three laboratorys is significantly different( =1.57, P < 0.05).7 The result of score between the three observers is not significantly different =0.89, P > 0.05).Conclusions:1 The development of tissue microarray of breast benign lesion and carcinoma facilitates surveys of breast cancer-related gene candidates.2 The overexpression of HER-2/neu and the expression of HR is closely involved in the carcinogenesis of breast carcinoma.3 The expression and expressive levers of HER-2/neu are inversely correlated with that of HR.4 To test HER-2/neu, ER, PR at the same time is very important for the treatment of breast cancer.5 The interlaboratory agreement is poor if there is no standardization of the procedure.6 Strict standard and proper training can improve the interobserver agreement.