Immunohistochemical assessment of hormone receptor status of breast carcinoma: interobserver variation of the quick score.

BACKGROUND: Immunohistochemical (IHC) assessment of estrogen receptor (ER) and progesterone receptor (PR) status has become a routine practice to predict the likely outcome of Tamoxifen therapy. AIMS: To assess the interobserver variation in scoring hormone receptor status of breast carcinoma, using the Quick Score. MATERIALS AND METHODS: IHC-stained slides of breast carcinomas reported by the two authors during a 28-month period were included in the study. Both authors independently reassessed all the tumors. Both were blinded to each other's assessment. The Quick score with a 0-8 point scale was used to score the hormone receptor status. Weighted Kappa was calculated to assess the interobserver variation. RESULTS: A total of 210 breast carcinomas were included in this study. There was a substantial to almost perfect agreement between the two observers in scoring the hormone receptor status (kappa values; ER=0.856, PR=0.711). Both ER and PR showed an almost perfect agreement in assessing the intensity of staining (kappa value; ER=0.882, PR=0.840), while the scoring of proportion of cells gave lower Kappa values (kappa value; ER=0.778, PR=0.592). Interobserver agreement was less in scoring hormone receptor status of breast carcinomas after mastectomies compared with excision biopsies, wide local excisions and metastatic deposits in lymph nodes. Suboptimal fixation resulting in background staining has contributed to the variation. CONCLUSION: A substantial to almost perfect interobserver agreement was seen in assigning an overall Quick score. Detection of complete negative and strong expression had a moderate to substantial agreement.

Receptores estrogénicos: método de detección rápida en muestras incluídas en parafina / Estrogenes receptors: a quick determination method in formalin fixed paraffin embedded sections

La utilización en inmunohistoquímica (IHQ) del anticuerpo monoclonal de Abbott, ER-ICA, es una valiosa herramienta para la demostración de receptores estrogénicos (RE) en cánceres de mama. Su positividad superior al 20 por ciento indica la sensibilidad del tumor al Tamoxifeno y con ello, un tratamiento alternativo a la cirugía amputante con excelente pronóstico para las pacientes. Las técnicas modificadas para cortes fijados e incluidos en parafina, plantean la problemática de ser largas,costosas y ocupar reactivos adicionales para poner en evidencia los RE. El presente estudio ofrece una solución a estos problemas. Se utilizaron muestras citológicas ER-ICA (1A79); cortes fijados en formalina y en solución fijadora especial, con positividad conocida y muestras problema. Se siguieron los métodos recomendados por Abbott; DeLellis; con hidrólisis ácida (HCl 1N); y con incubación del anticuerpo primario a 37ºC por 60 minutos. Todas las muestras fueron previamente tripsinizadas. Los resultados obtenidos con cada método ponen de manifiesto a los RE en color pardo, en los núcleos de todas las células portadoras (tumorales y normotípicas) de las muestras estudiadas, con intensidad y calidad de reacción cuantificables. Lo anterior permite concluir que el método propuesto de incubación del anticuerpo primario a 37ºC por 60 minutos, es una técnica viable y ventajosa al reducir el tiempo de procesamiento de +/- 48 hrs a sólo 6 hrs., significar menor costo y no requerir reactivos adicionales, proporcionando una mayor rapidez en la entrega del diagnóstico con el consiguiente beneficio a la paciente

Cáncer de la vesícula biliar: expresión inmunohistoquímica de la proteína relacionada con receptor estrogénico (p29) y de la proteína inducida por estrógeno (pS2) / Cáncer of gallbladder: immunohistochemical expression of estrogen receptor related protein (p29) and estrogen induced protein (pS2)

The high frequency of gallblader cancer in women suggest a role for estrogens in its development. The aim of this study was to study the immunohistochemical expression in of p29 estrogen receptor associated protein and pS2 estrogen induced protein in 111 pathological samples of gallbladder carcinoma, coming from 88 women and 23 men, 30 metastases of gallbladder cancer, coming from 25 women and 5 men and in 25 non-tumoral gallbladders. In the latter, p29 protein was positive in 12 samples (48 percent) and pS2 in 15 cases (60 percent). p29 was positive in 40 percent and pS2 in 32 percent of tumors. p29 expressed with higher frequency in metastases than in primary tumors (57 and 31 percent respectively, p<0.02). Early tumors had a significantly lower expression of p29 than advanced tumors or than metastases. Both proteins expressed in 18 percent of samples (synchronic expression) whereas one of both proteins did so in 60 percent of cases (asynchronic expression). We conclude that most gallbladder cancer samples express proteins associated to estrogen receptor or induced by estrogens

Receptores estrogénicos: estandarización de un método para su demostración en muestras incluídas en parafina / Estrogen receptors: standardization of a method for it demonstration in paraffin included samples

Detecting estrogenic receptors on histological samples of breast tumors has a strong significance on the prognosis and treatment of this disease. The clasical detection method involves the incubation of the tissue with a monoclonal antibody from mouse directed against the estrogenic receptor (primary antibody) and a second incubation with another antibody that is directed against with an anti mouse I g G antibody. Afterwards this reaction is identified by an enzyme (generally horseradish peroxidase) that acquires a characteristic color that allows the identification of the cells that have the receptor. We demonstrate here that is possible to simplify the method modifyng qualitatively the treatment of the tissue samples before its exposure to the primary antibody and also shortening the incubation times with this antibody