Geethamala Kempula, Murthy Venkataramappa Srinivasa, Vani Bangalore Ramalingiah, Rao Madireddi Sudha, Thejaswini Malugnalli Uddappa, Padmaja Krishnarajapet Padmanabha
Department of Pathology, Belagavi Institute of Medical Sciences, Belagavi, Karnataka, India.
Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
J Lab Physicians. 2017 Jan-Mar;9(1):5-10. doi: 10.4103/0974-2727.187915.
Breast carcinoma is the most common cancer among women in the urban Indian population. Conventionally, immunohistochemistry (IHC) is done to determine the hormone receptor status of the tumor. Immunocytochemistry (ICC) on fine-needle aspiration cytology (FNAC) was carried out to determine the same hormone receptor status of the tumor.
The study was undertaken to evaluate the diagnostic reliability of performing estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2/neu) receptor status on FNAC by ICC and to compare the results with IHC.
A 2 years 6 months prospective study conducted in the Department of Pathology, ESIC Medical College and PGIMSR and ESIC Model Hospital, Rajajinagar, Bengaluru, wherein 100 breast carcinoma patients' samples both cytology and histology were collected. IHC and ICC were done by peroxidase antiperoxidase technique. Validations of the receptor status were analyzed using sensitivity, specificity, positive and negative predictive values (PPV and NPV), and kappa statistics for agreements between ICC and IHC.
ICC was positive for ER, PR, and Her2/neu in 53, 50, and 22 cases, respectively. For ER, a cytohistologic correlation of 98%, with a sensitivity of 96.3%, specificity of 100%, and PPV and NPV being 100% and 95.7%. For PR, concordance of 97%, with a sensitivity of 94.3%, specificity of 100%, and PPV and NPV being 100% and 94%. Her2/neu had an agreement of 89%, with a sensitivity of 72%, specificity of 95.5%, and PPV and NPV being 85.7% and 90.1%.
ICC has been a boon and can be a paramount diagnostic adjunct to the routine investigations.
在印度城市女性人群中，乳腺癌是最常见的癌症。传统上，通过免疫组织化学（IHC）来确定肿瘤的激素受体状态。在细针穿刺细胞学检查（FNAC）上进行免疫细胞化学（ICC）以确定肿瘤相同的激素受体状态。
本研究旨在评估通过ICC对FNAC进行雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her2/neu）受体状态检测的诊断可靠性，并将结果与IHC进行比较。
在班加罗尔拉贾吉纳加尔的ESIC医学院和PGIMSR以及ESIC模范医院病理科进行了一项为期2年6个月的前瞻性研究，收集了100例乳腺癌患者的细胞学和组织学样本。采用过氧化物酶抗过氧化物酶技术进行IHC和ICC。使用敏感性、特异性、阳性和阴性预测值（PPV和NPV）以及ICC与IHC之间一致性的kappa统计分析受体状态的验证情况。
ICC检测中，ER、PR和Her2/neu分别在53例、50例和22例中呈阳性。对于ER，细胞组织学相关性为98%，敏感性为96.3%，特异性为100%，PPV和NPV分别为100%和95.7%。对于PR，一致性为97%，敏感性为94.3%，特异性为100%，PPV和NPV分别为100%和94%。Her2/neu的一致性为89%，敏感性为72%，特异性为95.5%，PPV和NPV分别为85.7%和90.1%。
ICC是一项福音，可成为常规检查的重要诊断辅助手段。
