Toi Pampa Ch, Neelaiah Siddaraju, Dharanipragada Kadambari, Surendra Kumar
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
J Cytol. 2018 Oct-Dec;35(4):223-228. doi: 10.4103/JOC.JOC_127_17.
There has been a limited literature with regards to comparison between the pre-operative hormonal/Her-2 neu assessment by immunostaining on fine-needle aspiration (FNA) versus core needle biopsies (CNBs) and their correlation with grading of breast carcinoma.
Two hundred fifty FNAs and 201 CNBs from 252 patients with breast carcinoma were subjected immunocytochemical/histochemical (ICC/IHC) staining along with the grading by the Robinson cytologic and modified Scarff-Bloom-Richardson scoring systems, respectively. Depending on the material adequacy, IHC was also performed on cell blocks. Sensitivity, specificity, and predictive values of ICC were calculated. The kappa statistics was performed to see the power of the study. Cytologic versus histologic gradings were compared and analysed by percentage analysis.
Sensitivity of ICC on FNAs for ER, PR, and Her-2neu was 49%, 28.8%, and 46%, respectively, while specificity was 84.5%, 90.6%, and 86.6%, respectively, with a fair agreement on kappa statistics. Her-2neu positivity on CNB versus FNA had a moderate agreement. Her-2neu staining of 3+ was seen in most of the Grade-2 tumours on FNA.
Fairly reliable results on grading and hormonal/Her-2neu status are possible when ICC is performed on qualitatively superior FNA material. This is particularly useful in the management of patients in certain settings like inoperable cases.
关于通过细针穿刺（FNA）免疫染色与粗针活检（CNB）进行术前激素/Her-2 neu评估及其与乳腺癌分级的相关性的文献有限。
对252例乳腺癌患者的250例FNA和201例CNB进行免疫细胞化学/组织化学（ICC/IHC）染色，并分别采用罗宾逊细胞学评分系统和改良的斯卡夫-布卢姆-理查森评分系统进行分级。根据材料充足性，也对细胞块进行IHC检测。计算ICC的敏感性、特异性和预测值。进行kappa统计以评估研究效能。通过百分比分析比较和分析细胞学分级与组织学分级。
ICC对FNA的雌激素受体（ER）、孕激素受体（PR）和Her-2 neu的敏感性分别为49%、28.8%和46%，而特异性分别为84.5%、90.6%和86.6%，kappa统计显示一致性尚可。CNB与FNA的Her-2 neu阳性具有中等一致性。FNA上大多数2级肿瘤可见3+的Her-2 neu染色。
对质量上乘的FNA材料进行ICC检测时，在分级和激素/Her-2 neu状态方面可获得相当可靠的结果。这在某些情况下，如不可手术的病例中，对患者的管理特别有用。
