Ballouk F, Boguniewicz A, Ross J S, Jennings T A
Department of Pathology and Laboratory Medicine, Albany Medical College, New York 12208, USA.
Anal Quant Cytol Histol. 1995 Jun;17(3):151-6.
Mucinous carcinoma (MC) of the breast is characterized by abundant extracellular mucin and by variable epithelial cellularity. Since some MCs are extremely hypocellular, we questioned the validity of biochemical (BIO) assays in these tumors. We analyzed paraffin-embedded tissue from 34 cases of MC of the breast for quantitative estrogen receptor (ER) and progesterone receptor (PR) using immunohistochemistry (IHC) on the Cell Analysis System CAS-200. Of the 34 cases, 31 (91%) were positive for ER, whereas 18 (53%) were positive for PR. In 21 cases the quantitative ER and PR were assayed biochemically by a dextran-coated charcoal method. Using the BIO results as the "true" values, the sensitivity of IHC for ER and PR was 100% and 78%, and the specificity was 13% and 64%, respectively. The low specificity of the values obtained by IHC was attributed to the fact that eight cases were "falsely" false positive (negative by BIO and positive by IHC) for ER and/or PR. Review of the histologic patterns of all 21 cases showed that 7 of the 8 falsely false positive cases were significantly hypocellular (epithelial cellularity 5-20%) as compared to the remaining cases (epithelial cellularity 20-75%). We conclude that immunohistochemical analysis of ER/PR status using image analysis in MC is a sensitive method, with the ability to detect receptor content when their concentration might be too low to be demonstrated by the conventional method as a result of sparse cellularity.
乳腺黏液癌（MC）的特征是细胞外黏液丰富且上皮细胞数量不一。由于一些MC的细胞极其稀少，我们对这些肿瘤中生化（BIO）检测的有效性提出质疑。我们使用Cell Analysis System CAS - 200上的免疫组织化学（IHC）方法，分析了34例乳腺MC石蜡包埋组织中的定量雌激素受体（ER）和孕激素受体（PR）。在这34例病例中，31例（91%）ER呈阳性，而18例（53%）PR呈阳性。21例通过葡聚糖包被活性炭法对ER和PR进行了生化定量检测。以BIO结果作为“真实”值，IHC对ER和PR的敏感性分别为100%和78%，特异性分别为13%和64%。IHC获得的值特异性较低，原因是有8例ER和/或PR为“假”假阳性（BIO为阴性而IHC为阳性）。对所有21例病例的组织学模式进行回顾发现，与其余病例（上皮细胞数量为20 - 75%）相比，8例假假阳性病例中有7例细胞极其稀少（上皮细胞数量为5 - 20%）。我们得出结论，在MC中使用图像分析对ER/PR状态进行免疫组织化学分析是一种敏感的方法，当由于细胞稀少导致受体浓度过低而无法通过传统方法检测到时，该方法有能力检测受体含量。
