目的 分析免疫组织化学法检测经胃镜活检与手术标本中人类表皮生长因子2（HER-2）表达的一致性。方法 322例胃镜活检标本和390例胃癌手术标本（两种标本源自同一患者101例）入选本研究。采用HER-2免疫组织化学染色检测所有标本中HER-2的表达，参照ToGA试验的标准进行结果判定和分析。结果 活检标本HER-2阳性率11.5%，15.8%的病例2+；手术标本HER-2阳性率4.4%，10.0%的病例2+。活检标本与手术标本HER-2表达的总体一致率为75.2%（76/101），其中活检结果判定偏高的有22例，偏低的有3例。若将HER-2表达2+和3+定义为阳性，则总体一致率为77.2%，阴性一致率为95.9%，阳性一致率为39.4%；灵敏度为88.5%，特异度为76.5%。结论 对于无法手术的患者，胃镜活检标本HER-2的免疫组织化学检测是一种可行的筛查方法，但现行的ToGA试验标准在实际应用中仍有待改进。

Objective To analyze the consistency of expressions of human epidermal growth factor receptor 2 (HER-2) of gastroscopic biopsy and surgical specimens of gastric cancer by the immunohistochemistry method. Methods A total of 322 gastroscopic biopsy specimens and 390 surgical specimens of gastric cancer were selected (101 patients provided both two kinds of specimens). Expressions of HER-2 of all specimens were detected by the HER-2 immunohistochemistry staining and analyzed according to the ToGA standard. Results The 11.5% of the biopsy specimens were HER-2 positive and HER-2 expressions of 15.8% of the biopsy specimens were 2+, while 4.4% of surgical specimens were HER-2 positive and HER-2 expressions of 10.0% of surgical specimens were 2+. The general consistency rate of HER-2 expression of biopsy and surgical specimens was 75.2% (76/101). HER-2 expressions of 22 biopsy specimens were higher and HER-2 expressions of 3 biopsy specimens were lower. If HER-2 expressions of 2+ and 3+ were considered as HER-2 positive, the general consistency rate, negative consistency rate, positive consistency rate, sensitivity, and specificity were 77.2%, 95.9%, 39.4%, 88.5%, and 76.5%, respectively. Conclusion HER-2 immunohistochemistry detection for gastroscopic biopsy specimens is a feasible screening method for patients who are inoperable. However, the current ToGA standard still needs to be improved for practical applications.