S Biesterfeld — Page 5

PubMedDate not supplied

Epidermal growth factor receptor-immunohistochemical detection and clinical significance for treatment of primary breast cancer.

Epidermal growth factor receptor is considered to play an important role in the carcinogenesis and progression of breast cancer, but its clinical significance remains controversial mainly due to different methods and methodical problems. We determined EGF-R expression by an immunohistochemical assay on paraffin-embedded primary breast cancer tissue by means of the anti EGF-R mab E30 (Merck, FRG) and streptavidin-peroxidase technique. Material and clinical data were available from 111 patients with a mean follow-up time of 75.4 +/- 1.1 months (range 61-90 months). 21 (18.9%) of the breast cancer specimens showed positive staining for EGF-R 5 year-overall survival in patients with EGF-R negative tumors was 61.7% compared with 41.6% of patients with EGF-R positive breast carcinomas. No correlation was found between the expression of EGF-R and other prognostic factors except an inverse relationship with the expression of the estrogen receptor (p < 0.05). Whereas EGF-R expression demonstrated prognostic significance in univariate analysis, this could not be confirmed by multivariate analysis. Immunohistochemical determination of EGF-R represents a reliable and simple method to obtain more data about the biological behavior of malignant breast disease with increasing impact on therapeutic procedures.

Aged↗

PubMedDate not supplied

Simultaneous immunohistochemical and biochemical hormone receptor assessment in breast cancer provides complementary prognostic information.

The prognostic value of the biochemical and the immunohistochemical assessment of estrogen- and progesterone receptor (ER, PR) status was tested in 111 breast cancer patients, mostly focusing on whether the results reveal complementary prognostic information. The biochemical receptor analysis was performed on snap-frozen tumor tissue using a standard protocol (ER-DCC, PR-DCC). The immunohistochemical staining was done on 4 microns thick paraffin sections and was evaluated semiquantitatively (ER-IHC, PR-IHC) and immunohistometrically by means of image analysis (ERMEAN, PRMEAN). 74% of the ER-DCC and 50% of the PR-DCC assays were interpreted as positive. The positivity rates of the immunohistochemical reactions ranged between 78% and 81% for ER and between 66% and 82% for PR, depending on the interpretation mode. The concordance rate for the DCC method was 68%, and ranged between 77% and 85% for the immunohistochemical results on paraffin sections. ER-DCC and PR-DCC showed a better survival for receptor-positive patients; however, this tendency was only statistically significant for the PR-DCC (p = 0.0294). Patients with immunohistochemically determined ER- or PR-positivity revealed a significantly better survival than receptor-negative patients, the effect being stronger for the progesterone receptor (ER: p = 0.0253, PR: p = 0.0005). Combining the different methods and receptors in a multivariate analysis, we observed that a) ER and PR reveal complementary prognostic information to each other after immunohistochemical determination (p < or = 0.0018) and that, b) complementary prognostic information was also obtainable by comparing the biochemical and the immunohistochemical PR-analysis (p < or = 0.0084); slightly more significant results were obtained for ERMEAN and PRMEAN compared to ER-IHC and PR-IHC. Considering the lymph node status and a combined receptor analysis (PR-DCC, ERMEAN, PRMEAN) as the two strongest prognosticators in multivariate Cox models, the combined receptor analysis was able to discover for each of the three groups of NO- and N1-patients different survival probabilities (p < 0.0001). In conclusion, the ER-DCC appears to be dispensable in all patients. In lymph node-negative patients, the PR-DCC has no outstanding merit, indicating that the neccessity of this method is also controversial. In priamry tumors of lymph node-positive patients, however, all three remaining types of receptor analysis should be evaluated for their therapeutic implications.

Breast Neoplasms↗