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Estrogen and progesterone receptor status determined by the Ventana ES 320 automated immunohistochemical stainer and the CAS 200 image analyzer in 236 early‐stage breast carcinomas: Prognostic significance
Author(s) -
Layfield Lester J.,
Saria Elizabeth A.,
Conlon Debbi H.,
Kerns BillieJo M.
Publication year - 1996
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199603)61:3<177::aid-jso3>3.0.co;2-8
Subject(s) - immunohistochemistry , medicine , stage (stratigraphy) , estrogen , estrogen receptor , progesterone receptor , gynecology , pathology , breast cancer , oncology , cancer , biology , paleontology
The quantitation of estrogen and progesterone receptors (ER and PgR) has become the standard of care in the evaluation of patients with primary breast carcinoma. It has been demonstrated that ER and PgR detected by immunohistochemical methods in formalin‐fixed paraffin‐embedded tissue can be quantified by computerized image analysis. In this study, ER and PgR levels were determined by using an automated immunohistochemistry stainer (Ventana ES 320) and an image analyzer (CAS 200) in a series of 236 patients with stage I/II carcinoma of the breast. The degree of correlation of the ER and PgR levels determined by the dextran‐coated charcoal method (DCC) with image analysis quantitation was high (r = 0.75). The agreement between both methods was 77% for ER and 73% for PgR. Hormone receptor levels were correlated with prognosis as determined by overall survival. An ER level of 30 fmol/mg as determined by image analysis was established to stratify the patient population most effectively into favorable and unfavorable prognostic groups ( P = 0.003). An ER level of 20 fmol/mg for prognostic stratification reached statistical significance ( P = 0.03). The DCC method was not able to stratify the patients into prognostic groups at the traditionally accepted cutpoint of 10 fmol/mg ( P = 0.52). We conclude that when used in combination, automated immunohistochemistry and quantitative image analysis offer a favorable alternative to the DCC method in assessment of ER and PgR status in human mammary carcinoma. In addition, quantitative immunocytochemistry techniques may prove superior to the DCC method in specimens in which there is limited tumor volume (including fine‐needle aspirates), stromarich tumors, and early‐stage lesions including intraductal carcinoma. © 1996 Wiley‐Liss, Inc.