表皮生长因子受体Her-2/neu基因

Her-2/neu基因是一种癌基因。它编码一种可使细胞生长的特殊生长因子的受体。正常上皮细胞含有两份Her-2/neu基因的拷贝并在其细胞表面产生低水平的Her-2蛋白。在大约20-30%的侵袭性乳腺癌（及其他一些癌症，如卵巢癌和膀胱癌），Her-2/neu基因扩增及其蛋白过度表达。肿瘤有这种过度表达往往会更具侵袭性，并会抵制激素疗法和一些化疗，患者一般预后较差。 

        主要有两种方法来检测Her-2/neu的状态：免疫组织化学法（IHC）和荧光原位杂交法（FISH）。免疫组化法是检测存在的Her-2/neu蛋白的量。荧光原位杂交法是检测实际基因扩增后的基因水平——所有存在的基因拷贝的数量。免疫组化法是目前使用最广泛的初步检测的方法；但是，如果结果不明确或检测阴性，那么荧光原位杂交法则经常作为后续的测试。

一份乳腺癌组织的样本是靠一细针穿刺活检，或手术活检而取得的。有时也用从肘静脉中抽取的血液样本来检测Her-2/neu蛋白。血清中存在的Her-2/neu蛋白的量与现有的肿瘤的量关系不大；只有当肿瘤发展地相当大时，Her-2/neu蛋白才会阳性，因此该检测不被广泛运用。

疾病: 乳腺癌

National Cancer Institute: What You Need to Know About Breast Cancer
ACS: All About Breast Cancer

S1
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

S2
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

S3
Check, W. (2002 February). Making the call on HER2 testing methods [70 paragraphs]. CAP Today, In the News [On-line journal]. Available FTP: http://www.cap.org/html/publications/feature.html

S4
Check, W. (2002 February). Serum HER2 testing [5 paragraphs]. CAP Today, In the News [On-line journal]. Available FTP: http://www.cap.org/html/publications/sidebar1.html

S5
ASCO (1996). c-erbB-2 as a Marker for Breast Cancer [13 paragraphs]. American Society for Clinical Oncology [On-line guideline]. Available FTP: http://www.asco.org/prof/pp/html/guide/tumor/m_tumor14.htm

S6
ACS (2001). Immunotherapy with Trastuzumab (Herceptin) [3 paragraphs]. American Cancer Society [On-line information]. Available online

S7
ACS (2001). How is Breast Cancer Diagnosed? [43 paragraphs]. American Cancer Society, Cancer Reference Information [On-line information]. Available online

S8
Locke, J. (2001 February). HER2/neu Testing [17 paragraphs]. American Association for Clinical Chemistry, Strategies [Newsletter]. Available for AACC (http://www.aacc.org)

S9
Yazifi, H., and Gown, A. (2002 June). Controversies and guidelines in tissue-based HER-2/neu testing in breast cancer [24 paragraphs]. Medical Laboratory Observer [Journal], Vol. 34 (6), pp 12-16,20. Available for MLO (http://www.mlo-online.com)

S10
MEDCEU (1999). Breast Cancer and HER2 [43 paragraphs]. MEDCEU [On-line continuing education]. Available FTP: http://www.medceu.com/course-no-test.cfm?CID=307