Oma Dessiet, Teklemariam Maria, Seifu Daniel, Desalegn Zelalem, Anberbir Endale, Abebe Tamrat, Mequannent Solomon, Tebeje Solomon, Labisso Wajana Lako
Department of Medical Biochemistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Biochemistry, University of Global Health Equity, Kigali, Rwanda.
J Cancer Prev. 2023 Jun 30;28(2):64-74. doi: 10.15430/JCP.2023.28.2.64.
The application of immunohistochemistry (IHC) for molecular characterization of breast cancer (BC) is of paramount importance; however, it is not universally standardized, subject to observer variability and quantifying is a challenge. An alternative molecular technology, such as endpoint reverse transcription (RT)-PCR gene expression analysis, may improve observer variability and diagnostic accuracy. This study was intended to compare IHC with the RT-PCR based technique and assess the potential of RT-PCR for molecular subtyping of BC. In this comparative cross-sectional study, 54 BC tissues were collected from three public hospitals in Addis Ababa and shipped to Gynaecology department at Martin-Luther University (Germany) for laboratory analysis. Only 41 samples were qualified for IHC and RT-PCR investigation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 protein expression analysis. Kappa statistics was used to assess the concordance between the two techniques. The overall percent agreement between RT-PCR and IHC was 68.3% for ER (positive percent agreement [PPA] 71.1%; negative percent agreement [NPA] 33.3%), 39.0% for PR (PPA 14.3%; NPA 92.3%), and 82.9% for HER2 (PPA 62.5%; NPA 87.9%). Cohen's κ-values of 0.018 (< 0.20), 0.045 (< 0.200), and 0.481 (0.41-0.60) were generated for ER, PR, and HER2, respectively. Concordance for molecular subtypes was only 56.1% (23/41) and 0.20 kappa value. IHC and endpoint RT-PCR techniques have shown to be discordant for 43% samples. Molecular subtyping using endpoint RT-PCR was fairly concordant with IHC. Thus, endpoint RT-PCR may give an objective result, and can be applied for BC subtyping.
免疫组织化学(IHC)在乳腺癌(BC)分子特征分析中的应用至关重要;然而,其尚未得到普遍标准化,存在观察者间差异,且定量分析具有挑战性。一种替代分子技术,如终点逆转录(RT)-PCR基因表达分析,可能会减少观察者间差异并提高诊断准确性。本研究旨在比较IHC与基于RT-PCR的技术,并评估RT-PCR在BC分子亚型分类中的潜力。在这项比较性横断面研究中,从亚的斯亚贝巴的三家公立医院收集了54份BC组织,并运至德国马丁-路德大学妇科进行实验室分析。仅41份样本符合雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)和Ki-67蛋白表达分析的IHC和RT-PCR检测要求。使用kappa统计量评估两种技术之间的一致性。RT-PCR与IHC之间的总体一致性百分比对于ER为68.3%(阳性一致性百分比[PPA]为71.1%;阴性一致性百分比[NPA]为33.3%),对于PR为39.0%(PPA为14.3%;NPA为92.3%),对于HER2为82.9%(PPA为62.5%;NPA为87.9%)。ER、PR和HER2的Cohen's κ值分别为0.018(<0.20)、0.045(<0.200)和0.481(0.41 - 0.60)。分子亚型的一致性仅为56.1%(23/41),kappa值为0.20。IHC和终点RT-PCR技术对43%的样本显示出不一致性。使用终点RT-PCR进行分子亚型分类与IHC相当一致。因此,终点RT-PCR可能会给出客观结果,并可用于BC的亚型分类。
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