Briffod M, Le Doussal V, Spyratos F
Service d'anatomie et de cytologie pathologiques, Centre René-Huguenin de lutte contre le cancer, 35, rue Dailly, 92210 Saint-Cloud.
Bull Cancer. 2001 Oct;88(10):1028-35.
We assessed the reliability of hormonal receptors (HR) by means of immunohistochemisty (IHC) on cell blocks obtained from diagnostic fine-needle cytopunctures in a group of 142 primary breast carcinoma. The results were compared to biochemical assessment (EIA) on their corresponding tissue samples (118 surgical specimens and 24 core needle biopsies). Percentage of stained nuclei and a score incorporating the proportion and the intensity of positive nuclei were evaluated. A two-group classification (cutoff 10% of stained nuclei) was used to define HR status. Highly positive tumors (>= 50% of stained nuclei) were also individualized. Regarding HR status, concordance rate between immunostaining and biochemical assessment was 86.6% for ER and 76.8% for PR. Major discrepancies were found in 6.3% and 15.5% of cases for ER and PR, respectively. A good correlation was also observed between quantitative values obtained by the two methods (r = 0.69 for ER and 0.60 for PR). Discrepancies were mainly related to weak positive staining, values close to the respective cutoffs and when biochemical evaluation was performed on core needle biopsies. We conclude that IHC on cell blocks prepared from fine-needle cytopuncture specimens of breast carcinomas is useful as a routine procedure for hormonal receptor determination especially when planning neoadjuvant treatment.
我们通过免疫组织化学(IHC)方法,对142例原发性乳腺癌患者诊断性细针穿刺获得的细胞块中的激素受体(HR)进行了评估。将结果与其相应组织样本(118例手术标本和24例粗针活检标本)的生化评估(EIA)结果进行比较。评估了染色细胞核的百分比以及一个综合阳性细胞核比例和强度的评分。采用两组分类法(以10%的染色细胞核为临界值)来定义HR状态。还对高阳性肿瘤(染色细胞核≥50%)进行了个体化分析。关于HR状态,雌激素受体(ER)免疫染色与生化评估的一致率为86.6%,孕激素受体(PR)为76.8%。ER和PR分别在6.3%和15.5%的病例中发现了主要差异。两种方法获得的定量值之间也观察到良好的相关性(ER的r = 0.69,PR的r = 0.60)。差异主要与弱阳性染色、接近各自临界值的值以及对粗针活检标本进行生化评估时有关。我们得出结论,对乳腺癌细针穿刺标本制备的细胞块进行免疫组织化学检测,作为激素受体测定的常规方法很有用,尤其是在规划新辅助治疗时。