Immunochemical Evaluation of Estrogen Receptor and Progesterone Receptor in Breast Cancer
Recent advances in the preparation of monoclonal antibodies to human estrogen receptor (ER) and progesterone receptor (PR) have led to the development of new quantitative and histochemical immunoassays for these proteins in reproductive tissues and related cancers [1–6] . Stich assays make use of very specific and sensitive probes that do not depend upon the ability of receptor protein to bind its cognate radiolabeled hormone in tissue extracts. In addition, these antibodies can be used to detect and quantify ER and PR directly in fixed tissue sections and cell dispersions, thereby permitting an evaluation of the type, proportion and distribution of cells that contain immunoreactive ER and/or PR. For metastatic breast cancer, a major potential clinical application of receptor immnnoassays is the prediction of response to endocrine therapy and assessment of prognosis (disease-free interval and survival). The clinical utility of ER and PR steroid-binding assays for evaluating these parameters in patients with advanced breast cancer has been well documented [7–9]. However, major limitations of current receptor assays are 1) their inability to predict response to endocrine therapy in 30–40% of the breast cancers defined as ER-or PR-rich and in 5–10% of those that are receptor-poor, and 2) the difficulty of performing such assays on small tumors, metastasies and needle biopsies. In addition, assays performed on extracts of breast tumors cannot provide information about the identity, proportion and distribution of receptor-containing cells.
KeywordsEstrogen Polypeptide Trypsin Tamoxifen Glucocorticoid
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