Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York, USA.
Breast J. 2011 Mar-Apr;17(2):180-6. doi: 10.1111/j.1524-4741.2010.01051.x. Epub 2011 Feb 10.
Therapeutic decision-making for women diagnosed with breast cancer requires accurate determination of the estrogen receptor (ER) and progesterone receptor (PR). Decisions about adjuvant therapy are often based on the immunohistochemical (IHC) profile of the core needle biopsy sample (CNB) because the staining is not repeated on the final excisional biopsy (EB). The purpose of this study was to assess the concordance of breast cancer IHC receptor assays on CNB and EB. We identified 176 patients with matching breast CNB and EB that had available ER and PR. While the CNBs were processed and stained in different laboratories, the EB were processed and stained in our institution. The following antibodies were used 1D5, 6F11 and SP1 for ER, and PgR636, 16 and 1E2 for PR, from Dako, Leica and Ventana respectively. Correlation of scores of CNBs with matching EB was analyzed using Spearman correlation coefficients. Sensitivity, specificity, overall agreement and the kappa statistic were used to measure the concordance between CNB and EB. For CNB, there were 141 (80.1%) cases positive for ER and 118 (67%) cases positive for PR. For EB, there were 143 (81.3%) cases positive for ER and 130 (73.9%) cases positive for PR. Overall agreement for ER and PR was seen in 93% (95% CI = 0.88, 0.96) and 90% (95% CI = 0.84, 0.94) respectively. Overall, ER- CNB/ER+ EB was seen in seven (4%) cases and PR- CNB/PR+ EB in 15 (8.5%) cases. ER+ CNB/ER- EB was seen in five (2.8%) cases and PR+ CNB/PR- EB in three (1.7%) cases. To avoid erroneous omission of life-saving endocrine therapy ER and PR should be repeated on the EB for patients whose CNB has negative hormonal receptors.
对诊断为乳腺癌的女性进行治疗决策需要准确确定雌激素受体 (ER) 和孕激素受体 (PR)。辅助治疗的决策通常基于核心针活检样本 (CNB) 的免疫组织化学 (IHC) 特征，因为最终的切除活检 (EB) 不会重复染色。本研究的目的是评估 CNB 和 EB 上乳腺癌 IHC 受体检测的一致性。我们确定了 176 例具有匹配的 CNB 和 EB 的乳腺癌患者，并且 ER 和 PR 均可用。虽然 CNB 在不同的实验室进行处理和染色，但 EB 在我们的机构进行处理和染色。使用了以下抗体：Dako 的 1D5、6F11 和 SP1 用于 ER，Leica 的 PgR636、16 和 1E2 用于 PR。使用 Spearman 相关系数分析 CNB 与匹配的 EB 评分的相关性。使用灵敏度、特异性、总一致性和 Kappa 统计来衡量 CNB 和 EB 之间的一致性。对于 CNB，有 141 例（80.1%）ER 阳性，118 例（67%）PR 阳性。对于 EB，有 143 例（81.3%）ER 阳性，130 例（73.9%）PR 阳性。ER 和 PR 的总一致性分别为 93%（95%CI=0.88，0.96）和 90%（95%CI=0.84，0.94）。总的来说，在 7 例（4%）中观察到 ER-CNB/ER+EB，在 15 例（8.5%）中观察到 PR-CNB/PR+EB。在 5 例（2.8%）中观察到 ER+CNB/ER-EB，在 3 例（1.7%）中观察到 PR+CNB/PR-EB。为了避免错误地遗漏救命的内分泌治疗，对于 CNB 激素受体阴性的患者，应在 EB 上重复 ER 和 PR。
