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Estrogen receptor analyses. Correlation of biochemical and immunohistochemical methods using monoclonal antireceptor antibodies.
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1985
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Breast OncologyEstrogen ReceptorGynecologyPathologyFemale Reproductive FunctionTumor BiologyOvarian CancerPublic HealthMonoclonal AntibodySteroid MetabolismMedicineHormonal ReceptorImmunohistochemical MethodsMonoclonal Antireceptor AntibodiesEndocrinologyPharmacologyEndocrine-related CancerPeroxidase-antiperoxidase Immunoperoxidase TechniqueEstrogen Receptor AnalysesBreast CancerOncologyReproductive Hormone
Previous histochemical attempts to localize estrogen receptors using anti‑steroid antibodies or fluorescent estrogens have shown poor sensitivity and specificity relative to biochemical assays or clinical outcomes. The study employed the monoclonal antibody H222 Sp γ in a peroxidase‑antiperoxidase immunoperoxidase assay on cryostat sections of freshly frozen breast tumors, while receptor levels were quantified by dextran‑coated charcoal chromatography across three patient cohorts. Nuclear staining correlated semiquantitatively with biochemical receptor levels, yielding sensitivities of 95 % (A), 88 % (B), 93 % (C) and specificities of 89 % (A), 94 % (B), 89 % (C) at defined thresholds.
Attempts at histochemical localization of estrogen receptor with anti-steroid antibody or some fluoresceinated estrogens have given unacceptable sensitivities and specificities when compared with biochemical methods or clinical response. In the present study a monoclonal antibody against estrogen receptor (H222 Sp gamma) was used on cryostat sections of freshly frozen breast tumors with a peroxidase-antiperoxidase immunoperoxidase technique. Biochemical receptor analyses were by dextran-coated charcoal analyses. Tumors from three separate cohorts of patients were studied as follows: population A, 62 primary breast cancers from 1983; population B, 72 primary lesions stored from 1976 to 1983; and population C, 23 patients with metastases, treated with hormonal therapy. Distinct staining was seen in the cell nucleus. A semiquantitative relationship was seen between histochemical score assessment of staining and biochemical assay in each cohort. The sensitivity and specificity using a threshold of 75 for the histochemical score and more than 20 femtomoles/mg of protein for dextran-coated charcoal analyses were as follows: population A, specificity, 89%, and sensitivity, 95%; population B, specificity, 94%, and sensitivity 88%; and for population C, the comparison was with objective clinical response yielding specificity, 89%, and sensitivity, 93%.