Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
Cancer Cytopathol. 2012 Jun 25;120(3):196-205. doi: 10.1002/cncy.20206. Epub 2012 Feb 1.
Fine-needle aspiration cytology (FNAC) is a well-accepted procedure for the diagnosis and biological characterization of breast carcinoma. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status have a strong prognostic and predictive value in invasive breast carcinoma (IBC). ThinPrep (TP) cytology, which uses an alcohol-based fixative, is increasingly being used for immunocytochemistry. In this study, the authors compared the immunocytochemical evaluation of hormone receptors (HR) and HER2 on TP-processed FNAC with the immunohistochemical analysis performed on the corresponding formalin-fixed paraffin-embedded (FFPE) breast tumor specimens, which are considered the gold standard.
FNACs were performed on 116 primary IBCs at the time of diagnosis and subjected to immunocytochemical evaluation of HR and HER2 using the TP method. The same markers were immunohistochemical evaluated on the corresponding FFPE tissue specimens. HER2 fluorescent in situ hybridization analysis was performed only on the equivocal immunohistochemical results.
The HR results of the TP cytology specimens showed a very good agreement with those of the corresponding FFPE tissue samples (Cohen kappa test = 0.92; concordance rate = 98%) for estrogen receptor, and a good agreement (kappa = 0.76; concordance rate = 90.9%) for progesterone receptor. A perfect agreement (kappa = 1) was observed between TP and FFPE tissue samples in evaluating HER2 status.
Alcohol-based fixation seems not to affect the immunocytochemical evaluation of HR and HER2. Considering the high levels of agreement between the evaluation of HR and HER2, on both cytology specimens and on the corresponding FFPE tissue samples, the authors concluded that the TP technique can be routinely used for the biological characterization of IBC.
细针穿刺细胞学检查（FNAC）是一种广泛接受的诊断和生物特征分析乳腺癌的方法。雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体 2（HER2）状态在浸润性乳腺癌（IBC）中具有很强的预后和预测价值。基于酒精的固定液的 ThinPrep（TP）细胞学越来越多地用于免疫细胞化学。在这项研究中，作者比较了经 TP 处理的 FNAC 上激素受体（HR）和 HER2 的免疫细胞化学评估与相应的福尔马林固定石蜡包埋（FFPE）乳腺肿瘤标本的免疫组织化学分析，后者被认为是金标准。
在诊断时对 116 例原发性 IBC 进行 FNAC，并使用 TP 方法对 HR 和 HER2 进行免疫细胞化学评估。相同的标志物在相应的 FFPE 组织标本上进行免疫组织化学评估。仅对不确定的免疫组织化学结果进行 HER2 荧光原位杂交分析。
TP 细胞学标本的 HR 结果与相应的 FFPE 组织样本非常吻合（Cohen kappa 检验=0.92；一致性率=98%），用于雌激素受体，孕激素受体的一致性较好（kappa=0.76；一致性率=90.9%）。TP 和 FFPE 组织样本在评估 HER2 状态方面表现出完美的一致性（kappa=1）。
基于酒精的固定似乎不会影响 HR 和 HER2 的免疫细胞化学评估。考虑到 HR 和 HER2 在细胞学标本和相应的 FFPE 组织标本上的评估具有很高的一致性，作者得出结论，TP 技术可以常规用于 IBC 的生物学特征分析。
