摘要目的:探讨人表皮生长因子受体2(HER2)在PDAC组织中的表达及与PDAC患者预后的关系。方法:收集2001年1月至2012年12月间复旦大学附属华东医院病理科存档的109例PDAC组织石蜡标本和27例正常胰腺组织标本，采用免疫组织化学Envision二步法检测胰腺组织HER2蛋白的表达，根据Hercep Test评分标准对HER2表达进行评定，分析其与临床病理特征和患者生存期的关系。结果:PDAC组织HER2蛋白表达阴性(-)、弱阳性(+)、阳性(++)、强阳性(+++)者分别为29.4%、35.8%、25.7%和9.2%，过表达率(++、+++)为34.9%；正常胰腺组织HER2蛋白表达-、+者分别为88.9%、11.1%，无++和+++表达者，过表达率为0，PDAC组织与正常胰腺组织HER2蛋白过表达率差异有统计学意义( P＝0.000)。HER2蛋白过表达与年龄显著相关，其中≥65岁的PDAC患者显著多于<65岁患者( P＝0.043)，而与患者性别、年龄及肿瘤分化程度、T分期、N分期、神经侵犯等均无关( P值均>0.05)。单因素Cox比例风险分析显示，HER2表达与PDAC患者术后生存时间相关( P＝0.032)；多因素Cox比例风险分析显示，HER2表达是影响PDAC患者生存期的独立预后因素( P＝0.040)，HER2表达+++的患者术后中位生存期显著长于HER2表达-～++患者(128.4个月比21.5个月)，差异有统计学意义( P＝0.038)。 结论:PDAC组织HER2过表达与患者年龄相关，HER2表达强阳性的PDAC患者生存期明显延长，可考虑将HER2作为评价PDAC生物学行为及评估预后的指标。

abstractsObjective:To investigate the expression of human epidermal growth factor receptor 2 (HER2) in pancreatic ductal adenocarcinoma(PDAC) and its relationship with the prognosis of patients with PDAC.Methods:From January 2001 to December 2012, 109 paraffin embedded PDAC tissue samples and 27 normal pancreatic tissue samples were collected from the Department of Pathology, Huadong Hospital Affiliated to Fudan University. The expression of HER2 protein in pancreatic tissue was detected by immunohistochemical Envision two-step method. HER2 expression was evaluated according to Hercept test, and its relationship with clinicopathological features and survival time was analyzed.Results:The expression of HER2 protein was negative (-) in 29.4% of PDAC tissues, weakly positive (+ ) in 35.8%, positive (+ + ) in 25.7% and strongly positive (+ + + ) in 9.2%, respectively, and the overexpression rate (+ + , + + + ) was 34.9%; the negative (-) and weakly positive (+ ) expression of HER2 protein in normal pancreatic tissues accounted for 88.9% and 11.1% respectively. There was no expression with positive (+ + ) or strongly positive (+ + + ), therefore, the overexpression rate was 0. The overexpression rate of HER2 protein in PDAC and normal pancreatic tissues was significantly different ( P=0.000). The expression of HER2 protein was significantly correlated with age, and the expression of HER2 protein in patients with PDAC over 65 years old was significantly higher than that in patients with PDAC under 65 years old ( P=0.043), but not with gender, tumor location, tumor grade, T stage, N stage and nerve invasion (all P>0.05). Univariate Cox proportional hazards analysis showed that HER2 expression was associated with postoperative survival time of patients with PDAC ( P=0.032). Multivariate Cox proportional hazards analysis showed that HER2 expression was an independent prognostic factor for survival of patients with PDAC ( P=0.040). The median survival period of patients with HER2 expression + + + was significantly longer than that of patients with HER2 expression -~+ + (128.4 months vs 21.5 months), and the difference was statistically significant ( P=0.038). Conclusions:The overexpression of HER2 in PDAC tissue was related to the age of patients. The survival time of patients with HER2 strongly positive PDAC was significantly longer. HER2 can be considered as an index to evaluate the biological behavior and prognosis of PDAC.