Bioingeniøren (Mar 2011)
Is immunocytochemical determination of hormone receptors in breast cancer reliable?
Abstract
Background: In breast cancer oestrogen receptor (ER) and progesterone receptor (PR) status can be determined by both immunohistochemistry performed on tissue biopsies and immunocytochemistry performed on fine needle aspirates. However, the reliability of immunocytochemistry as the basis for determining treatment is still uncertain. Material and methods: The study comprised journal records of 612 breast cancer patients diagnosed between 2000 and 2005, all of whom had undergone fine needle aspiration. In 232 cases both immunocytochemistry and immunohistochemistry for hormone receptor status were performed. The results were compared and reasons for any discrepancies were elucidated. Results: There was full agreement for ER in 204/229 cases (Kappa value (ĸ) = 0.56) and for PR in 170/209 (ĸ = 0.68) cases. Sensitivity for ER was 89.4 % and the specificity was 87.5 %. Positive predictive value (PPV) was 97.1 % and negative predictive value (NPV) was 63.6 %. Sensitivity for PR was 78.3 % and specificity was 87.3 %. PPV was 92.3 % and NPV was 67.4 %. Conclusion: Immunocytochemistry for hormone receptors in fine needle aspiration smears is a reliable method in cases with positive immunostaining. In the case of negative immunostaining, examination with immunohistochemistry should be performed on tissue biopsies. Correct preparation of the cytological smear is vital for a successful result.
