Androgen receptor in prostate carcinoma: immunohistochemical and ligand saturation analyses.

Status of androgen receptor (AR) in prostate carcinoma is biologically important. Therefore, more methods assessing AR abnormalities are warranted. Immunohistochemical (IHC) and ligand saturation (LSA) assays were not compared in details. AR in 53 cases were tested by monoclonal antibody (Ab) F39.4.1 (Biogenex), polyclonal Ab N-20 (Santa Cruz) and by ligand saturation analysis with (3)H-methyltrienolon. Statistical analyses were performed with Spearman's nonparametric rank test including neoadjuvant therapy subgroups treated by antiandrogens, combined androgen blockade (22 cases; flutamide with gosereline) or without therapy. By using monoclonal Ab we found AR positive tumor nuclei in 46 cases. Mean of positives was 64%, median 75%. The polyclonal Ab was not sufficiently specific. With LSA AR were found in 43 cases. Mean level was 6.6 fmol/mg, median 5.5 fmol/mg. Comparing IHC with LSA, we noted correlation trend only for the monoclonal Ab (r=0.35; p=0.02). With thresholds 70% positive nuclei for IHC and 6 fmol/mg for LSA, there were 66% and 43% cases positive with IHC and LSA, respectively. The LSA and IHC positives did not show significant agreement, concordance level being 58% only. We found significant IHC-LSA correlation (r=0.68; p=0.004) solely in combined androgen blockade subgroup with 82% level concordance. Our study has demonstrated that AR IHC and LSA are independent complementary methods. Significant correlation between LSA and IHC show only cases treated with combined androgen blockade. An explanation hypothesis is discussed concerning LH-RH influence on free AR capable of ligand binding. IHC as well as LSA have specific biologic significance and may be useful for prostate cancer diagnostic and therapy.

Seasonal variation in estrogen and progesterone receptor levels in breast cancer--a factor in data interpretation.

It is still widely accepted that evaluation of estrogen and progesterone receptors (ER, PR) in breast cancer tissue is one of the basic predictive indicators of hormonal therapy success. Evaluation of hormonal receptors is usually done once at the time of biopsy or surgery on the breast regardless of the effect of time. In a retrospective evaluation of 1301 medical records of breast cancer patients the authors wanted to identify any time period dependence in quantitative or qualitative hormonal status. Steroid receptors were measured in breast cancer tissues by cytosol-based ligand-binding technique. The results suggest a strong time period dependence in hormonal status. In premenopausal patients simultaneous evaluation of ER/PR revealed an increased frequency of both positive receptors in the autumn months, and a decrease in the spring months. In postmenopausal patients, both positive receptors were found more likely in the summer months and both negative in the late winter months. Our results suggest that one evaluation of hormonal receptor status does not necessarily provide an accurate estimate of the hormonal status in breast cancer patients.

Phylloid breast tumors and three steroid hormone receptors.

The concentrations of three steroid hormones (estrogen, progesteron and 1,25-dihydroxycholecalciferol) receptors (ER, PgR, DR) in tissue cytosol were analyzed in a group of 17 breast phylloid tumors. Comparison with breast carcinoma tissue samples (n = 37) did not reveal significant differences in average values of ER, PgR, and DR. Comparison with another control set of 30 samples of dysplastic tissue of the mammary gland showed significant differences only in PgR values. Only 18% of phylloid tumor samples contained levels above cut-of-line of all three receptors (ER, PgR, DR-5,10,10 resp. fmol/ mg protein). The most frequent combination was ER+PgR+DR-(41%). As far as we know, DR in phylloid breast tumors have never been examined before. In approximately 60% of our samples we found the expression of DR, in 36% the estimated values were above 10 fmol/mg protein. Cells of the tissue not expressing DR seem to belong to a special phenotype. We found no ER+PgR- or ER-PgR-combinations in them. The group which expresses DR is characterized by a higher dispersion of PgR values.

Biochemical analysis of breast cyst fluid as a possible predictor of breast carcinoma development.

The occurrence of breast cancer in patients with gross cystic disease is 2-5 times higher as compared to control group of women. During 3 years, 183 cyst fluid samples were analyzed in 129 females, in 30 patients of them the samples were analysed repeatedly. The distribution of the Na+/K+ ratio, considered as the measure of cancer risk, was found to be bimodal. In repeated analyses the type I cyst fluid markedly predominated (Na+/K+ < or = 4.0). A direct dependence on this ratio was found in the concentration of glucose, albumin, carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and its specific form, TPS; an indirect dependence was found for the level of uric acid, phosphates, alkaline phosphatase (ALP) and alpha-amylase (AMS). The predominance of apocrine metaplasia cells released into the cyst fluid is characteristic of type I cysts. A definitive assessment of significance of these parameters will be enabled by a long-term follow-up of the disease in the respective patients.

Early diagnosis of breast cancer dissemination by tumor markers follow-up and method of prediction.

A mathematical model of prediction of progression was tested in patients with breast cancer employing long-term monitoring of tumor markers CEA, CA 15-3, MCA and TPA, erythrocyte sedimentation rate (FW), and the enzymes gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and lactate dehydrogenase (LD) in serum. At the same time, specificity, sensitivity, lead time and positive predictive value were evaluated along with false positivity for all these parameters and their combinations. A model was proposed for the follow-up of patients with breast cancer after the completion of basic therapy.

Quality control program of steroid receptor assays: an international study.

Lyophilized calf uterine cytosol standards were prepared for quality control of estrogen receptor (ER) determination, and lyophilized cytosols and tissue powders were used for quality control of progesterone receptor (PR) analysis. Two series of four samples were analyzed either for ER or PR contents, twice within one month, by 7 laboratories in 5 countries. Coefficient of variation (CV) of the between-laboratory averages assayed in a single run of ER-positive (ER+) and PR-positive (PR+) standards varied from 29.6 to 61.8% and from 32.4 to 76.2%, respectively. All laboratories, with the exception of a single value, could recognize samples of low, medium, an high ER level, as well as a negative sample. Most laboratories evaluated properly also the level of PR samples. The average between-laboratory CV values of protein determination in the relevant standards were 23%.

Carcinoembryonic antigen and alpha-lactalbumin in phylloid tumor tissues.

The concentration of carcinoembryonic antigen and alpha-lactalbumin in tumor tissue cytosol were analyzed in a group of 19 tumors of cystosarcoma phyllodes type. Both antigens were also localized in the tissue of identical tumors by means of immunohistochemical procedure. The cytosol levels of both proteins were found to be higher in the histologically defined malignant type of phylloid tumors. This group was also characterized by the simultaneous occurrence of both antigens. We did not manage to prove any relationship between the presence of alpha-lactalbumin and the steroid hormone receptor positivity in tumor tissue.

Complex biochemical analysis of human breast tumor tissue.

The quantitative biochemical analysis of tissue specimens from 76 human breast carcinomas consisted of examination for cytosolic estrogen receptors (cER), nuclear estrogen receptors (nER), progesterone receptors (PgR), 1,25-dihydroxycholecalciferol receptors (DR), carcinoembryonic antigen (CEA), alpha-lactalbumin (aLA), and gamma-glutamyl transferase (gGT). The highest incidence was found in CEA (76%), DR (70%), and aLA (62%). There was a high percentage of tumors containing only DR, in contrast to the tumors containing only cER or PgR. The simultaneous occurrence of DR and CEA was considerably high (61%). No statistically significant differences were observed in these biochemical parameters in relation to the grade of differentiation of the tumors. The values of aLA in tumors that invaded lymphatic or blood vessels were lower as compared to those tumors that invaded adipose or connective tissues. The level of statistical significance of this difference was close to 5%, the differences in other parameters were statistically insignificant. For prognosis assessed at the time of surgery, after a 2-3-year follow-up of 36 patients the level of gGT in the tumor seems to be the most promising prognostic factor. The values of gGT were significantly lower in those patients whose tumors were in progression during this time. The significance of nER and aLA was also taken into consideration.

Phenotypic variability of chemically induced primary rat mammary tumors.

Rat mammary tumors induced by DMBA (7,12-dimethylbenz(a)anthracene) or MNU (N-methyl-N-nitrosourea) were compared for frequency of histological types. Total tumor incidence in 50-day-old rats (Groups 3, 4, 5) was about 100% independently of the rat strain and carcinogen. There were found no distinct histological tumor types between DMBA and MNU carcinogenesis, although the distribution of fibroadenomas, adenocarcinomas and sarcomas varied markedly among rat groups. In 300-day-old female Wistar rats (Group 1) treated with DMBA, fibroadenomas and adenocarcinomas showed an incidence of 58% and 42% respectively. In 50-day-old rats (Group 3) the proportion of adenocarcinomas increased up to 72% of total DMBA tumors. MNU carcinogenesis induced adenocarcinomas in 98% of total tumors in the Lewis rat strain (Group 5), while only 53% in Wistar rats (Group 4). The rest of tumors were sarcomas occurring in opposite ratio to adenocarcinomas. The relatively high susceptibility of connective tissue to MNU as compared with mammary epithelium was due to the mode of MNU administration and seemed to be strain dependent. Both DMBA and MNU carcinogenic systems are valuable experimental models of mammary tumor. The cell phenotypes of the resulting tumors can be predicted with high probability by the choice of dose regimen of carcinogen and the route of its application.

Quality control study of estradiol and progesterone receptor determination.

Lyophilized calf uterine tissue cytosol standards for estradiol receptor (ER) and progesterone receptor (PR), and freeze-dried tissue powders for PR determination were prepared. For the ER assay 4 standards were produced with no, low, medium, and high ER levels. The ER binding capacities (mean +/- SD) were low--261 +/- 46 (Brno) and 221 +/- 64 (Budapest), medium--451 +/- 100 and 340 +/- 59, high--712 +/- 139 and 581 +/- 102 fmol/mg protein, respectively. Two receptor-positive tissue powders and two positive cytosol standards in lyophilized form were used for the PR assay with receptor contents of 110, 148, 787, and 786 fmol/mg assayed in Brno, and 148, 250, 693, and 671 fmol/mg protein determined in Budapest. The stability of the standards was good for 10 months. All parameters tested in the two laboratories (specific binding capacities, Kd values, variation coefficients of the results) were in good correlation. Lyophilized calf uterine cytosol standards for ER and PR, and freeze-dried tissue powders for PR proved to be suitable materials for interlaboratory quality control of steroid receptor determination.

Quality control study for estradiol receptor determination.

Lyophilized calf uterine cytosol standards for estradiol receptor (ER) were prepared separately in two institutes. The ER binding capacity was determined by dextran-coated charcoaL (DCC)-technique using a multi-point Scatchard analysis. The intra- and inter-assay coefficient of variation determined on the Hungarian preparation were 13.10% and 14.70%. The dissociation constant (Kd) values of all the samples ranged between 1.2 X 10(-9) M and 9.35 X 10(-10) M. Standards stored at--70 degrees C and at 0-4 degrees C proved to be stable for several months. At ambient temperature, a progressive decline of the ER activity was observed during a 1 year storage period. The use of the lyophilized calf uterine cytosol standards stored at 0-4 degrees C is recommended for both intra- and inter-laboratory quality control study in multicentric clinical trials of breast cancer.