The effects of fixation, processing and evaluation criteria on immunohistochemical detection of hormone receptors in breast cancer
- 161 Downloads
A task force of the Japanese Breast Cancer Society has proposed a recommendation for adequate eval-uation of hormone receptors in routine practice, in order to standardize handling of tissues, staining tech-niques and scoring systems. As a part of the study, several examinations were conducted to detect the effect of technical problems, including the influence of fixation time and other fixation and processing conditions, on the immunoreactivity for ERa.
There is little influence of prolonged fixation on the immunoreactivity for ERa, except for cases in which particularly over-fixed blocks are used. A delay in the onset of fixation could decrease the immuno-histochemical findings of steroid receptors, compared with shorter or longer fixation, and the situation is similar to the fixation of a whole large surgical specimen in formalin in a big bucket. Incomplete fixation might be an important cause of heterogeneiety of immunoreactivity for ERa.
Manual and automated immunohistochemical (IHC) staining by DAKO (Glostrup, Denmark) and Bio-genex (San Ramon, CA) and automated IHC staining by Ventana Medical Systems (Tucson, AZ) each employ different methods. Using a scoring system, in which the proportion of cells stained in each speci-men was recorded as 0, less than 1%, 1% or more and less than 10%, and 10% or more, the intermethod variability of those IHC staining methods exhibited substantial multi-rater kappa values concerning the ER and PgR (kappa for ER according to the percentage of positive cells = 0.67; PgR = 0.72). Concerning intermethod consistency, the scoring system based on the percentage of positive cells was advantageous over other scoring systems, based on the intensity of nuclear staining.
Using double staining, patients with ER-positive and HER2-positive tumors can be classified as those with co-expressed tumors and those with differently expressed tumors. As such, the co-expressed tumor might be resistant to antiestrogen therapy in ERa-positive and HER2-positive breast cancer and double staining might lead to the development of new therapeutic strategies for hormone and HER2-positive breast cancer.
Key wordsBreast cancer Immunihistochemstory ERα Fixation Staining method
Unable to display preview. Download preview PDF.
- 2).Fisher ER, Anderson S, Dean S, Dabba D, Fisher B, Siderits R, Pritchard J, Pereira T, Geyer C, Wolmark N: (Solving the dilemma of the immunohistochemical and other methods used for scoring estrogen receptor and progesterone receptor in patients with invasive breast carcinoma).Cancer 103:164–173, 2005.CrossRefGoogle Scholar
- 4).Umemura S, Kurosumi M, Moriya T, Oyama T, Arihi-ro K, Yamashita H, Umekita Y, Komoike Y, Shimizu C, Fukushima H, Kajiwara H, Akiyama F: (Immunohistochemical evaluation for hormone receptors in breast cancer: a practically useful evaluation system and handling protocol).Breast Cancer 13:232–235, 2006.CrossRefGoogle Scholar
- 14).Umemura S, Itoh H, Ohta M, Suzuki Y, Kubota M, Tokuda Y, Tajima T, Osamura RY: (Immunohistochemical evaluation of hormone receptor for routine practice of breast cancer: highly sensitive procedures significantly contribute to the correlation with biochemical assays).Appl Immunohistochem Mol Morphol 11:62–72, 2003.PubMedGoogle Scholar
- 18).Umemura S, Kurosumi M, Moriya T, Oyama T, Arihi-ro K, Yamashita H, Umekita Y, Komoike Y, Shimizu C, Fukushima H, Kajiwara H, Akiyama F: (Immunohistochemical evaluation for hormone receptors in breast cancer: a practically useful evaluation system and handling protocol).Breast Cancer 13:232–235, 2006.CrossRefGoogle Scholar
- 19).Arihiro K, Umemura S, Kurosumi M, Moriya T, Oyama T, Yamashita H, Umekita Y, Komoike Y, Shimizu C, Fukushima H, Kajiwara H, Akiyama F: (Compari son of evaluations for hormone receptors in breast carcinoma using two manual and three automated immunohistochemical staining).Am J Clin Pathol 127:356–365, 2007.CrossRefGoogle Scholar
- 21).Horiguchi J, Koibuchi Y, Iijima K, Yoshida T, Takata D, Rokutanda N, Nagaoka R, Oyama T, lino Y, Morishita Y: (Co-expressed type of ER and HER2 protein as a predictive factor in determining resistance to antiestrogen therapy in patients with ER-positive and HER2-positive breast cancer).Oncol Rep 14:1109–1116, 2005.PubMedGoogle Scholar