O'Keane J C, Okon E, Moroz K, Burke B, Sheahan K, O'Brien M J
Mallory Institute of Pathology, Boston City Hospital, MA 02118.
Am J Surg Pathol. 1990 Feb;14(2):121-7. doi: 10.1097/00000478-199002000-00003.
We evaluated a commercially available polyclonal antibody to 17 beta-estradiol as the basis for an estrogen receptor (ER) assay of breast carcinoma in formalin-fixed paraffin tissues and then compared it with both the ER-ICA antibody in serial paraffin sections and the biochemical assay of corresponding fresh tissue. Using the estradiol antibody, 49 of 50 cases showed some cytoplasmic staining; 38 cases had nuclear staining. Sensitivity and specificity for different proportions of positive nuclear and cytoplasmic staining were calculated using receiver-operator characteristic curves. The optimum correlation with the biochemical assay was obtained with nuclear staining alone. Greater than 30% nuclear positivity as a cut-off point yielded a sensitivity of 76% and a specificity of 82%. The corresponding ER-ICA values in 38 cases yielded a sensitivity of 93% and a specificity of 56%. The methodology for the ER-ICA assay was more technically demanding in paraffin sections than that of the estradiol antibody and considerably more expensive. This study is the first to show that with nuclear staining only, and not cytoplasmic staining, as the parameter of positivity, the immunocytochemical assay of ER with anti-17 beta-estradiol antibody in routinely processed, formalin-fixed, archival material is an accurate and specific method for the determination of the ER status of breast carcinoma.
我们评估了一种市售的抗17β - 雌二醇多克隆抗体，作为福尔马林固定石蜡组织中乳腺癌雌激素受体（ER）检测的基础，然后将其与连续石蜡切片中的ER - ICA抗体以及相应新鲜组织的生化检测进行比较。使用雌二醇抗体，50例中有49例显示出一些细胞质染色；38例有细胞核染色。使用受试者工作特征曲线计算不同比例的阳性细胞核和细胞质染色的敏感性和特异性。单独细胞核染色与生化检测的相关性最佳。以大于30%的细胞核阳性作为截断点，敏感性为76%，特异性为82%。38例中相应的ER - ICA值敏感性为93%，特异性为56%。在石蜡切片中，ER - ICA检测方法在技术上比雌二醇抗体检测要求更高，且成本高得多。本研究首次表明，仅以细胞核染色而非细胞质染色作为阳性参数，在常规处理的福尔马林固定存档材料中用抗17β - 雌二醇抗体进行ER免疫细胞化学检测是确定乳腺癌ER状态的一种准确且特异的方法。
