Clinical Significance Of DdPCR Detection Of HER2 Changes In Breast Cancer Before And After Neoadjuvant Chemotherapy

ObjectiveTo explore the consistency of microdroplet digital PCR(ddPCR)and immunohistochemistry(IHC)combined with fluorescence in situ hybridization(FISH)in detecting the expression of human epidermal growth factor receptor 2(HER2)in breast cancer specimens before and after neoadjuvant chemotherapy,and then to analyze whether HER2 gene status has changed before and after neoadjuvant chemotherapy of breast cancer by ddPCR detection,and to analyze the relationship between HER2 gene expression and main clinicopathological parameters and TCM syndrome types,and to explore the clinical significance of HER2 changes before and after neoadjuvant chemotherapy for breast cancer,so as to provide certain experimental basis for clinical follow-up adjuvant therapy scheme selection.Methods1.In this study,collected biopsy specimens before neoadjuvant chemotherapy and radical surgical specimens after chemotherapy in Guangdong Provincial Hospital of Traditional Chinese Medicine through the in-patient medical record system and Langa pathological system.100 cases of breast invasive ductal carcinoma were confirmed by pathological examination,and 62 cases with complete clinical and pathological data and standardized new adjuvant therapy were selected and included in the study.2.The basic information,main clinical pathological parameters and TCM syndromes of the patients were collected,and the four main clinical pathological biological markers of estrogen receptor(ER),progesterone receptor(PR),tumor cell proliferation factor(Ki67)and human epidermal growth factor receptor 2(HER2)were detected by immunohistochemistry,and the specimens with HER2 integral 2+of immunohistochemistry were detected by fluorescence in situ hybridization.3.Microdrop digital PCR was used to detect HER2 gene in breast cancer biopsy specimens before neoadjuvant chemotherapy and surgical specimens after chemotherapy.4.In this study,SPSS19.0 statistical software was used to analyze the changes of HER2 expression in coarse needle biopsy specimens before neoadjuvant chemotherapy and surgical radical resection specimens after chemotherapy by chi-square test of paired data in four tables.Kappa was used to analyze the consistency of HER2 gene amplification status by microdroplet digital PCR(ddPCR)and immunohistochemistry(IHC)combined with fluorescence in situ hybridization(FISH).Spearman correlation was used to analyze the relationship between HER2 expression before and after neoadjuvant chemotherapy and ER,PR,Ki67,Luminal typing,other clinicopathological parameters and TCM syndrome types.Results1.The results of ddPCR and IHC combined with FISH for HER2 detection in biopsy specimens before neoadjuvant chemotherapy and surgical specimens after chemotherapy are consistent.2.The quantitative expression of HER2 will change before and after neoadjuvant chemotherapy for breast cancer.The overall change rate of HER2 is 21.0%(13/62),and the difference between the two is.statistically significant(P=0.000<0.05).3.The quantitative expression of HER2 in biopsy specimens before neoadjuvant chemotherapy for breast cancer has no obvious correlation with ER,PR,Ki67,Luminal classification and TCM syndrome types(P>0.05).4.The quantitative expression of HER2 was positively correlated with the expression of Ki67 in radical mastectomy specimens after neoadjuvant chemotherapy(rs=0.318,P=0.012<0.05),but had no significant correlation with ER,PR,Luminal typing,other clinicopathological parameters and TCM syndrome types(P>0.05).Conclusion1.The results of ddPCR detection and IHC combined FISH detection for detecting HER2 in breast cancer biopsy specimens before neoadjuvant chemotherapy and surgical specimens after chemotherapy are consistent,which proves that ddPCR is reliable for detecting HER2 expression in breast cancer.2.The gene expression of HER2 will change before and after neoadjuvant chemotherapy for breast cancer,and there is significant difference.It is suggested that HER2 detection should be performed on surgical specimens after neoadjuvant chemotherapy to accurately understand the amplification status of HER2 gene and provide certain experimental basis for clinical follow-up adjuvant therapy scheme selection.3.The quantitative expression of HER2 before and after neoadjuvant chemotherapy for breast cancer has no obvious correlation with TCM syndrome types.4.The quantitative expression of HER2 in biopsy specimens before neoadjuvant chemotherapy of breast cancer has no obvious correlation with ER,PR,Ki67 and Luminal typing.5.The quantitative expression of HER2 in radical mastectomy specimens after neoadjuvant chemotherapy is positively correlated with the expression of Ki67,but has no obvious correlation with ER,PR,Luminal typing and other clinicopathological parameters.