Comparison of immunocytochemical and biochemical assays for estrogen receptor in fine needle aspirates and histologic sections from breast carcinomas

An immunocytochemical assay using a monoclonal antibody specific for estrogen receptor (ER-ICA) was performed on needle aspirates and on histologic sections (mastectomy and biopsy specimens) from 55 patients with breast cancer. A total of 82 ER-ICAs were performed, with matched cytologic and histologic specimens in 27 patients, cytology alone in 15, and histology alone in 13. ER-ICA results were described by a histochemical score (H score) based on intensity-weighted percentages of staining cells. The H scores were compared with results of sucrose density gradient (SDG) analysis of histologic specimens (mastectomy, resection, or biopsy). An H score greater than or equal to 10 and an SDG value greater than or equal to 10 fmol/mg protein were considered positive. The sensitivity of cytologic ER-ICA was 94%, the specificity 100%. The sensitivity of histologic ER-ICA was 67%, the specificity 90%. Correlating cytologic H score with Black's nuclear grade showed that grade 1 (the most anaplastic) carcinomas demonstrated the lowest H scores (mean, 7.3 +/- 29.8), whereas the highest H scores were noted in grade 3 tumors (mean, 150.0 +/- 88.1). Both SDG and ER-ICA showed ER values to be lower in premenopausal than postmenopausal women. There was no correlation between H score and presence of axillary nodal metastases or tumor size. An overall good correlation was demonstrated between immunohistochemical methods and biochemical analysis.

Use of Ulex europaeus agglutinin I in the identification of lymphatic and blood vessel invasion in previously stained microscopic slides

Lymphatic and blood vessel invasion is one of the most important diagnostic and prognostic parameters used by pathologists in the evaluation of neoplastic conditions. Although a variety of tissue artifacts can make the recognition of vascular, capillary, and lymphatic permeation by tumor cells extremely difficult, recent immunohistochemical studies have employed a variety of tissue markers that appear to have great value in establishing the diagnosis of lymphovascular involvement. In the present study, we applied an immunoperoxidase staining technique to previously stained microscopic tissue sections using Ulex europaeus agglutinin I lectin, an endothelial marker that can be used in paraffin-embedded tissues. Our results indicate that this technique can be successfully applied on microscopic slides previously stained with a variety of histochemical stains. It can also be used in those cases in which paraffin blocks are not available or the area in question is absent from the recut tissue sections.