Hodi Zsolt, Chakrabarti Jayeta, Lee Andrew H S, Ronan John E, Elston Christopher W, Cheung Kwok Leung, Robertson John F R, Ellis Ian O
Departments of Histopathology and Surgery, Nottingham City Hospital, UK.
J Clin Pathol. 2007 Mar;60(3):299-302. doi: 10.1136/jcp.2006.036665. Epub 2006 May 26.
To assess the reliability of assessment of oestrogen receptor expression on needle core biopsy specimens of invasive carcinomas of the breast. Previous studies have mostly been small, with a range of agreement from 62% to 100%.
Retrospective audit of 338 tumours surgically excised within 60 days of core biopsy, that had had oestrogen receptor assessed on both the core biopsy and tumour specimens. Surgical specimens were incised when fresh to ensure good fixation. External controls including a weakly positive tumour were included in each immunohistochemistry run.
Oestrogen receptor expression was bimodal, with H score in both specimens of either 0 or >50 in 96% of tumours. Using H score cut-off of 10 for positivity, there was an agreement between core and excision in 334 of 338 tumours (98.8%). All discrepancies were between weakly positive and negative tumours. Intratumoral heterogeneity could explain the one tumour that was negative on core and positive on excision. H score tended to be slightly higher on core than excision (means 146 and 136). Better fixation on the core is the most likely explanation for this and for the three tumours that were positive on core and negative on excision. Repeat staining on tumours with discrepant results gave similar results in all except one case. An internal control was present in 97% of excisions and 55% of cores of oestrogen receptor-negative tumours; the internal control stained positively in all except two sections.
Oestrogen receptor can be assessed reliably on needle core biopsies of invasive carcinomas of the breast.
评估乳腺浸润性癌针芯活检标本中雌激素受体表达评估的可靠性。以往的研究大多规模较小，一致性范围在62%至100%之间。
对在针芯活检后60天内手术切除的338个肿瘤进行回顾性审计，这些肿瘤在针芯活检和肿瘤标本上均进行了雌激素受体评估。手术标本在新鲜时切开以确保良好固定。每次免疫组织化学检测均纳入包括弱阳性肿瘤在内的外部对照。
雌激素受体表达呈双峰分布，96%的肿瘤在两个标本中的H评分要么为0，要么>50。采用H评分截断值10作为阳性标准，338个肿瘤中有334个（98.8%）在针芯活检和切除标本之间结果一致。所有差异均存在于弱阳性和阴性肿瘤之间。肿瘤内异质性可以解释1个针芯活检为阴性而切除标本为阳性的肿瘤。针芯活检的H评分往往略高于切除标本（均值分别为146和136）。最可能的解释是针芯活检的固定更好，以及3个针芯活检为阳性而切除标本为阴性的肿瘤。对结果不一致的肿瘤进行重复染色，除1例之外所有结果均相似。雌激素受体阴性肿瘤的切除标本中有97%以及针芯活检标本中有55%存在内部对照；除2个切片外，内部对照均呈阳性染色。
乳腺浸润性癌针芯活检可可靠地评估雌激素受体。
