Immunohistochemical detection of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression in breast carcinomas: comparison on cell block, needle-core, and tissue block preparations.

Author(s): Hanley KZ, Birdsong GG, Cohen C, Siddiqui MT

Publication: Cancer Cytopathol, 2009, Vol. 117, Page 279-88

PubMed ID: 19551847 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   ER, PR, and HER2 expression levels were compared between ethanol-fixed cell block (CB) preparations, and formalin-fixed tissue block (TB) and needle core (NC) preparations of 41 primary or metastatic breast carcinomas.

   Summary of Findings:

   The results of ER status showed a high degree of correlation between CB and NC preparations (87.8% concordance) as well as between TB and NC preparations (95.2% concordance). However, there were 5 cases where TB and NC specimens were positive for ER while the corresponding CB specimen was negative. Poor agreement was observed between CB and NC preparations with respect to PR status (73.2% concordance) with CB yielding a significant number of false negative results, if NC is taken as the standard. In fact, in 4 cases, the CB specimen was negative for ER and PR while NC and TB specimens were positive for both, indicating that ethanol fixation may affect tumor cell antigenicity. At the same time, TB and NC preparations showed a concordance rate of 92.7% with respect to PR status. HER2 status by IHC resulted in 85.4% concordance between CB and NC and 92.7% concordance between TB and NC. When HER2 status was determined by FISH analysis, no amplification was observed in 9/12 IHC false positive (3+ or 2+) results for CB specimens.

   Biospecimens

   • Tissue - Breast
   • Tissue - Liver
   • Tissue - Lung
   • Tissue - Lymph Node

   Preservative Types

   • Formalin
   • Ethanol

   Diagnoses:

   • Neoplastic - Carcinoma

   Platform:

   Analyte	Technology Platform
   Protein	Immunohistochemistry
   DNA	FISH

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Preservation	Type of fixation/preservation	Ethanol Formalin (buffered)
   Immunohistochemistry Specific	Targeted peptide/protein	ER PR HER2
   FISH Specific	Targeted nucleic acid	HER2
   FISH Specific	Technology platform	FISH Immunohistochemistry
   Biospecimen Acquisition	Method of tissue acquisition	Core needle biopsy Fine needle aspiration Surgical resection

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