Beck T, Weikel W, Brumm C, Wilkens C, Pollow K, Knapstein P G
Gynecological Clinic, University of Mainz, Germany.
Gynecol Oncol. 1994 May;53(2):220-7. doi: 10.1006/gyno.1994.1119.
In a prospective study conducted since 1983, the hormone-receptor status of primary breast carcinomas was investigated using immunohistochemical (ER-ICA, PgR-ICA) and biochemical (DCC) methods. The degree of immunohistochemical staining was evaluated according to the immunoreactive score (IRS) devised by Remmele and Stegner [Frauenarzt 28, 41-43 (1987)]. The findings obtained using the biochemical radioactive-ligand-binding assay (cutoff level, 20 fmol/mg) and those obtained using qualitative immunohistochemical methods were in agreement in 72.5% (ER-ICA) and 72.2% (PgR-ICA) of cases. For the 789 cases of primary breast carcinoma examined, postoperative data were available for a mean follow-up period of 48 months. Using the statistical procedure of Kaplan-Meyer to analyze the probability of disease-free and overall survival, it emerged that ER-ICA- and PgR-ICA-positive breast carcinomas exhibited the most favorable course of disease. Breast carcinomas with negative immunohistochemical findings for both types of receptor were found to have a significantly less favorable disease course. Semiquantitative evaluations of the staining results using the IRS failed to yield significant differences among the 12 IRS groups. Neither the percentage of positive tumor cells nor the immunohistochemical staining intensity proved to be prognostically useful parameters for predicting the course of disease. In comparison to the established biochemical method for the demonstration of hormone receptors, however, the immunohistochemical procedure was found to be superior with respect to prognostic meaningfulness, particularly in the group with conflicting biochemical and immunohistochemical findings with respect to hormone-receptor status. Using Cox analysis, the prognostic usefulness of the immunohistochemical test was compared with that of certain established prognosis parameters (pT, pN, grading, Ki-67), from which it became apparent that PgR-ICA has the greatest prognostic value, with the most lasting influence on the course of disease. The results of the present study demonstrate that, with respect to the prognostic value of its findings, the immunohistochemical test for hormone receptors is superior to the biochemical procedure.
在一项自1983年起开展的前瞻性研究中，采用免疫组化法（雌激素受体免疫细胞化学法、孕激素受体免疫细胞化学法）和生化法（葡聚糖包被活性炭法）对原发性乳腺癌的激素受体状态进行了研究。免疫组化染色程度根据Remmele和Stegner设计的免疫反应评分（IRS）进行评估[《女性医师》28，41 - 43（1987）]。采用生化放射性配体结合分析（临界值为20 fmol/mg）和定性免疫组化方法所得结果在72.5%（雌激素受体免疫细胞化学法）和72.2%（孕激素受体免疫细胞化学法）的病例中一致。对于所检查的789例原发性乳腺癌病例，可获得术后平均48个月的随访数据。使用Kaplan - Meyer统计方法分析无病生存率和总生存率的概率，结果显示雌激素受体免疫细胞化学法和孕激素受体免疫细胞化学法阳性的乳腺癌疾病进程最为有利。两种受体免疫组化结果均为阴性的乳腺癌疾病进程明显较差。使用IRS对染色结果进行半定量评估，在12个IRS组之间未发现显著差异。肿瘤细胞阳性百分比和免疫组化染色强度均未被证明是预测疾病进程的预后有用参数。然而，与已确立的用于检测激素受体的生化方法相比，免疫组化方法在预后意义方面更具优势，尤其是在激素受体状态的生化和免疫组化结果相互矛盾的组中。使用Cox分析，将免疫组化检测的预后有用性与某些已确立的预后参数（pT、pN、分级、Ki - 67）进行比较，结果表明孕激素受体免疫细胞化学法具有最大的预后价值，对疾病进程的影响最为持久。本研究结果表明，就其结果的预后价值而言，激素受体的免疫组化检测优于生化方法。
