Immunocytochemical estrogen and progestin receptor assays in breast cancer with monoclonal antibodies: histopathologic, demographic, and biochemical correlations and relationship to endocrine response and survival

Article Abstract:

Numerous studies have shown that the presence or absence of receptors for estrogen and progesterone on breast cancer cells are valuable prognostic indicators. The biochemical assays for these hormone receptors are best conducted in a well equipped laboratory. The continuing expansion of monoclonal antibody technology has made available antibodies that bind to these receptors and form a basis for newer assays, which are both accurate and easier to perform. The use of immunocytochemical assays using monoclonal antibodies was evaluated on breast cancer specimens from 600 patients and the results were correlated with disease recurrence and survival, as well as other traditional prognostic factors, such as tumor grade and menopausal status. Fifty-three percent of the Stage I and Stage II cancers were found to express estrogen receptors, compared with only 36 percent of the more advanced Stages III and IV. White women were found to have a higher proportion of estrogen-receptor-positive cancers than black women; this difference disappeared, however, when only the more advanced stages were considered. A similar trend was observed for progesterone receptors; 41 percent of white women had positive cancers, in contrast to only 25 percent of the black women. The presence of progesterone receptors, as defined by the monoclonal antibody assay, proved to be the best predictor of outcome by the Cox proportional hazards model for women with Stage I or Stage II breast cancer. Women with progesterone-receptor-positive tumors had almost twice the survival at five years than receptor-negative patients. The role of hormone receptors in breast cancer prognosis remains controversial and continues to be a subject of active research. The data from this study indicate, however, that the monoclonal antibody immunocytochemical assays may be superior to traditional biochemical assays in prognostic value and ease. One drawback of the present method is the subjective interpretation of the microscope slides, which prevents more than a crude quantification of results. The authors anticipate that this will be less of a problem as automated video microscopy becomes more common in clinical laboratories. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Immunocytochemistry, Estrogen, Monoclonal antibodies, Progesterone, Estrogen receptors, Progesterone receptors

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Correlation between histologic grade of malignancy and copy number of c-erbB-2 gene in breast carcinoma

Article Abstract:

Traditional grading systems of cancers generally involve examining the number of visible mitotic (dividing) cells and abnormalities of cellular architecture under the microscope. New techniques of molecular biology and immunocytochemistry may expand the information available upon histopathologic examination. The c-erbB-2 gene has been shown to be amplified in 10 to 33 percent of breast carcinomas. That is, for reasons not entirely clear, there are additional copies of this gene in the cells of some breast cancers. To determine if this property may serve as a useful addition to the pathologic information obtained from tissue sections, 176 consecutive cases of breast carcinoma were examined. The number of copies of the c-erbB-2 gene was determined by extracting DNA from cancer specimens and comparing it with normal DNA from unaffected lymph nodes. The presence of additional copies of c-erbB-2 was strongly correlated with tumor malignancy and unfavorable prognosis. Although the correlation was statistically significant, the additional copies of c-erbB-2 were very highly correlated with histological grade as well. In fact, the independent contribution of the copy number to cancer prognosis disappeared when histological grade was also taken into account. This means that when histological grade is considered, the copy number of the c-erbB-2 gene provides no useful additional information. Although disappointing from the standpoint of clinical usefulness, it does suggest that the c-erbB-2 gene is in some way involved with processes leading to malignancy, rather than merely tumor size or extent of spread. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Genetic aspects, Cancer, Cancer genetics, Gene amplification

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