原发性乳腺癌中雌激素和孕激素受体的免疫组织化学及生化检测。组织病理学与预后因素的相关性。
Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer. Correlation of histopathology and prognostic factors.
作者信息
Stierer M, Rosen H, Weber R, Hanak H, Spona J, Tüchler H
机构信息
Department of Surgery, Hanusch Medical Center, Vienna, Austria.
出版信息
Ann Surg. 1993 Jul;218(1):13-21. doi: 10.1097/00000658-199307000-00004.
OBJECTIVE
The authors investigated correlations of estrogen-receptor and progesterone-receptor with conventional risk factors as well as histopathology in patients with primary breast cancer.
SUMMARY BACKGROUND DATA
Immunohistochemically determined hormone receptors have gained importance as prognosticators in primary breast cancer, but their definitive role has not yet been evaluated.
METHODS
Tumor samples from 299 patients were examined for estrogen and progesterone receptors by biochemical and immunohistochemical assay. Correlations with established risk factors (tumor size, lymph node status, menopausal status, grading including subfactors) and histopathology were analyzed.
RESULTS
The estrogen receptor, determined by immunohistochemical method revealed positivity in 80.6% of patients; biochemical measurement yielded 76.2% positive results. The progesterone receptor measured by immunohistochemistry yielded 61.3% positivity versus 55.8% detected by biochemical analysis. Invasive lobular, tubular, and ductal invasive carcinoma with prominent stroma content ("scirrhous carcinoma") rather than ductal invasive carcinoma was more frequently estrogen-receptor positive with immunohistochemistry than with biochemical assay. For progesterone receptor, the same pattern of positivity was seen with immunohistochemical assay. With progesterone receptor determined biochemically, "scirrhous" and lobular carcinoma showed positive results in a lower proportion than invasive ductal and tubular carcinoma. Significant correlations were observed between the estrogen-receptor status, the histologic grade of malignancy, nuclear polymorphism, and the rate of mitosis with both methods (p < 0.001 respectively). Different correlations were found between tumor size, menopausal status and estrogen receptor status with both assays respectively. For the progesterone receptor status, immunohistochemistry yielded significant correlations with the histologic grade of malignancy, nuclear polymorphism, rate of mitosis (p < 0.001 respectively) as well as growth pattern (p < 0.01), while biochemical analysis revealed a correlation with nuclear polymorphism (p < 0.05). The correlation analysis of both components of the immunoreactive score revealed a more significant impact of percentage of positive cells than of staining intensity.
CONCLUSIONS
Immunohistochemistry detected a closer correlation between prognostic factors and receptor data than biochemical analysis.
目的
作者研究了原发性乳腺癌患者雌激素受体和孕激素受体与传统危险因素以及组织病理学之间的相关性。
总结背景资料
免疫组化法测定的激素受体作为原发性乳腺癌的预后指标已变得日益重要，但其确切作用尚未得到评估。
方法
采用生化和免疫组化检测法对299例患者的肿瘤样本进行雌激素和孕激素受体检测。分析其与既定危险因素（肿瘤大小、淋巴结状态、绝经状态、分级包括子因素）及组织病理学的相关性。
结果
免疫组化法测定的雌激素受体显示80.6%的患者呈阳性；生化检测阳性率为76.2%。免疫组化法测定的孕激素受体阳性率为61.3%，而生化分析法检测的阳性率为55.8%。具有显著间质成分的浸润性小叶癌、管状癌和导管浸润癌（“硬癌”），与导管浸润癌相比，免疫组化法检测时雌激素受体阳性更为常见。对于孕激素受体，免疫组化检测也呈现相同的阳性模式。生化法测定孕激素受体时，“硬癌”和小叶癌的阳性结果比例低于浸润性导管癌和管状癌。两种方法均显示雌激素受体状态、组织学恶性分级、核多形性和有丝分裂率之间存在显著相关性（分别为p < 0.001）。两种检测方法分别发现肿瘤大小、绝经状态与雌激素受体状态之间存在不同的相关性。对于孕激素受体状态，免疫组化法与组织学恶性分级、核多形性、有丝分裂率（分别为p < 0.001）以及生长模式（p < 0.01）存在显著相关性，而生化分析显示与核多形性存在相关性（p < 0.05）。免疫反应评分两个成分的相关性分析显示，阳性细胞百分比比染色强度的影响更为显著。
结论
与生化分析相比，免疫组化法检测到预后因素与受体数据之间的相关性更紧密。
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