Handa Uma, Kumar Amit, Kundu Reetu, Dalal Usha, Mohan Harsh
Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
Department of General Surgery, Government Medical College and Hospital, Chandigarh, India.
J Cytol. 2015 Jan-Mar;32(1):1-5. doi: 10.4103/0970-9371.155222.
Grading and hormone receptor determination in breast carcinoma are predictive factors for response to hormonal therapy.
This study was undertaken to grade breast carcinoma and to determine estrogen receptor (ER) and progesterone receptor (PR) expression on fine-needle aspiration cytology (FNAC). Furthermore, the objective was to compare the results with histological grading and immunohistochemistry on surgical material.
Fifty cases of breast carcinoma diagnosed on FNAC were included. The cytological grading was done according to the Robinson's grading system. The corresponding histology sections were graded using the modified Bloom-Richardson system. Immunostaining for ER and PR was done on smears and tissue sections.
On both cytological and histological evaluation, 49 cases were infiltrating ductal carcinoma and one case was colloid carcinoma. On comparing cytological and histological grading, 78% were correctly graded on cytology. The sensitivity, specificity, positive predictive value and negative predictive value for ER detection on immunocytochemistry (ICC) were 55.6%, 95%, 93.8% and 61.3%, respectively. The sensitivity, specificity, positive and negative predictive value for PR detection on ICC were 57.7%, 95.2%, 93.8% and 64.5%, respectively. The correlation for ER and PR between cytology and histology was 72.3% and 74.5%.
The grading along with ER and PR immunostaining of breast carcinoma on smears is advocated because of high concordance between cytology and histology. This allows the patient to be treated with hormonal therapy on the basis of FNAC alone.
乳腺癌的分级及激素受体测定是激素治疗反应的预测因素。
本研究旨在对乳腺癌进行分级，并在细针穿刺细胞学检查（FNAC）中测定雌激素受体（ER）和孕激素受体（PR）的表达。此外，目的是将结果与手术材料的组织学分级及免疫组化结果进行比较。
纳入50例经FNAC诊断为乳腺癌的病例。细胞学分级根据罗宾逊分级系统进行。相应的组织学切片使用改良的布鲁姆-理查森系统进行分级。对涂片和组织切片进行ER和PR免疫染色。
在细胞学和组织学评估中，49例为浸润性导管癌，1例为黏液癌。比较细胞学和组织学分级时，78%在细胞学上分级正确。免疫细胞化学（ICC）检测ER的敏感性、特异性、阳性预测值和阴性预测值分别为55.6%、95%、93.8%和61.3%。ICC检测PR的敏感性、特异性、阳性和阴性预测值分别为57.7%、95.2%、93.8%和64.5%。细胞学和组织学之间ER和PR的相关性分别为72.3%和74.5%。
由于细胞学和组织学之间高度一致，提倡对涂片上的乳腺癌进行分级以及ER和PR免疫染色。这使得患者仅基于FNAC就可接受激素治疗。
