摘要目的 了解乳腺癌雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)免疫组织化学检查结果的可靠性并探讨影响因素.方法 收集2004至2010年北京大学肿瘤医院148例浸润性乳腺癌治疗前肿瘤穿刺标本,重新切片染色(ER:SP1,PR:1E2,HER-2:4B5),自动化影像分析系统Ariol MB-8及一位高年资病理医师分别复核ER、PR与HER-2表达水平,并与原始报告比较.结果 原始报告与自动化影像复核报告的一致率分别为ER:76.35％,PR:49.32％,HER-2:63.51％,Kappa值分别为0.12(P=0.020)、0.18(P=0.002)、0.08 (P =0.200);高年资病理医师复核报告与自动化影像复核报告的一致率分别为ER:93.92％、PR:81.08％、HER-2:76.35％,Kappa值分别为0.77、0.67、0.32(均P＜0.001).结论 对于ER、PR、HER-2的表达,原始报告与自动化影像复核报告的一致性差.抗体,染色方法及读片方法差异可能是导致两者不一致的主要原因.

abstractsObjective To evaluate the reliability of estrogen receptor (ER),progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression in breast cancer by immunohistochemistry and discuss their influencing factors.Methods The pretreatment biopsy specimens were collected from 148 patients (from Beijing Cancer Hospital between 2004 to 2010) with invasive breast cancer.Aftter reslicing and staining (ER:SP1,PR:1E2,HER-2:4B5),the status of ER,PR and HER-2 was analyzed by a pathological expert with automated imaging system Ariol MB-8.And their results were compared with the original reports.Results The concordance rates between original reports and automated image system were ER:76.35％,PR:49.32％,HER-2:63.51％ while Kappa values 0.12(P =0.020),0.18 (P =0.002) and 0.08 (P =0.200) respectively.And the concordance rates between expert reports and automated image system were ER:93.92％,PR:81.08％ and HER-2:76.35％ while Kappa values 0.77 (P ＜ 0.001),0.67 (P ＜ 0.001) and 0.32 (P ＜ 0.001) respectively.Conclusion For the expressions of ER,PR and HER-2,the disaccording results of original reports and automated image system may be mainly due to the differences of antibodies,staining methods and interpretations.