Variations in Feulgen stainability of epithelial parenchymal cells extracted from paraffin-embedded salivary gland specimens

Immunohistochemical expression of the mucin-type glycoprotein A-80 and prognosis in human breast cancer

Immunohistochemical expression of the tumour associated mucin-type glycoprotein A-80 was investigated in a series of 173 breast cancer patients with a clinical follow-up between 13 and 19 years. A routine immunoperoxidase technique was used in formalin-fixed, paraffin-embedded surgical tumour specimens. One hundred and fifty of 173 tumours (87%) immunostained with MAb A-80. The degree of A-80 immunoreactivity was related to the tumour grade but not to lymph node status, tumour size, or nuclear DNA distribution pattern. In univariate analysis the degree of A-80 expression was found to be of significant prognostic value both in node negative and in node positive breast cancer patients (P = 0.03). Patients with non-A-80 immunoreactive tumours had significant longer distant metastases-free survival times and fewer relapses than women with carcinomas composed of A-80 immunoreactive tumour cells. This prognostic value was reduced in a multivariate analysis, including lymph node status, tumour size, and nuclear DNA distribution pattern, but retained borderline significance (P = 0.08). In conclusion, the findings of this study indicate that expression of the mucin-type glycoprotein A-80 as determined by immunohistochemistry seems to be related to clinical outcome in breast cancer patients.

Immunoreactivity with monoclonal antibody A-80 and nuclear DNA content in benign and malignant human breast disease

Immunohistochemical analysis with the monoclonal antibody (MoAb) A-80, recognizing a tumor-associated cytoplasmic mucin-type glycoprotein, and cytometric nuclear DNA assessment were performed on 314 surgical specimens of the human mammary gland. The series included 36 benign conditions, 34 epithelial hyperplasias, 40 carcinomas in situ, and 204 primary invasive carcinomas. Normal breast parenchyma, benign tumors, and other nonmalignant lesions were all of DNA diploid (euploid) type and rarely expressed the A-80 glycoprotein. Differences in MoAb A-80 immunoreactivity and nuclear DNA content were noted among subtypes of epithelial hyperplasias. Fifteen of 34 epithelial hyperplasias were of DNA aneuploid type and the majority were A-80 immunoreactive. Of these 15 immunoreactive aneuploid epithelial hyperplasias, atypical intraductal hyperplasia was the most common subgroup. None of the 19 epithelial hyperplasias of DNA euploid type immunoreacted. Most of the intraductal (33 of 40) and invasive (180 of 204) carcinomas immunostained with MoAb A-80. The majority of the A-80 immunoreactive malignant tumors were of DNA aneuploid type (26 of 33 carcinomas in situ and 108 of 180 invasive mammary carcinomas). The results suggest that expression of the A-80 glycoprotein occurs at an early stage of malignant transformation. Genetically stable (euploid) mammary tumors seem to immunoreact with MoAb A-80 less frequently than genetically unstable (aneuploid) tumor variants. Combined analysis with MoAb A-80 and of nuclear DNA content in premalignant and malignant mammary lesions could be a useful tool of differential diagnostic and prognostic value.

Expression of the c-erbB-2 proto-oncogene product and nuclear DNA content in benign and malignant human breast parenchyma

The expression of the c-erbB-2 proto-oncogene product was investigated immunohistochemically in 474 formalin-fixed and paraffin-embedded human breast tissue samples. The series included 32 benign and 26 hyperplastic lesions, 32 carcinomas in situ and 384 invasive breast carcinomas, 107 of which were less than 1 cm in diameter. Cytometric DNA assessments were performed on histopathologically or cytodiagnostically identified cell nuclei, using image analysis. C-erbB-2 immunoreactivity was not seen in normal parenchyma or in benign and hyperplastic lesions. Mammary carcinomas in situ were more frequently immunoreactive (59%) than invasive neoplasms (23%). Invasive tumours more than 1 cm in diameter immunoreacted more often (26%) than small invasive carcinomas (16%). C-erbB-2 expression in regional lymph node metastases was the same as in the corresponding primary tumours. Significant differences were observed between the c-erbB-2 expression in DNA diploid and aneuploid lesions; for carcinomas in situ the figures were 40% and 72%, respectively. Invasive carcinomas of DNA diploid type rarely showed c-erb-B-2 expression, irrespective of tumour size and nodal status (7-11%). DNA aneuploid tumours were more frequently immunoreactive with increasing levels during progression (32-41%). Our data indicate that genetically stable invasive mammary tumours seem rarely to express the c-erbB-2 protein, even during progression, whereas genetically unstable invasive neoplasms frequently show c-erbB-2 immunoreactivity which increases during tumour progression.

The study of endocrine tumors by flow and image cytometry

Both DNA flow and image cytometry are methods that can be used for the quantitative determination of cellular DNA content. Objective, quantitative analysis of cellular morphology can also be obtained using image cytometry. Data thus generated have been shown to be of diagnostic and prognostic use in the study of many solid tumors and would be of particular value in the evaluation of endocrine tumors that show a poor correlation between their histology and biological behavior. The main application of these techniques to endocrine tumors has been in the analysis of thyroid nodules, although a limited number of studies of parathyroid, pituitary, adrenal, and pancreatic neuroendocrine tumors and tumors of the dispersed neuroendocrine system have been reported. Review of these studies shows that in the endocrine organs DNA and morphometric measurements have a very limited role in the diagnosis of individual cases, but are important as prognostic variables. The high incidence of abnormal DNA content in histologically benign lesions of the endocrine glands has important biological implications. Further investigation of this phenomenon may help to elucidate the process of endocrine tumorigenesis.

Methodologic sources of errors in image and flow cytometric DNA assessments of the malignancy potential of prostatic carcinoma

Considerable controversy exists about the value of using cytometric assessments of nuclear DNA ploidy patterns from neoplastic parenchymal cells of prostatic carcinomas as a supplement to conventional clinicopathologic data in an assessment of malignancy potential in neoplastic disease. To a great extent, the controversy is of methodologic origin. By revealing common pitfalls in this kind of DNA cytometry and by suggesting means to avoid or at least to reduce them, a realistic assessment can ultimately be made of the prognostic values of this technique: (1) the results of DNA assessments using flow cytometry and image cytometry should be combined (advantages and disadvantages with the two techniques outbalance each other); (2) the cytometric DNA ploidy pattern must always be correlated with results of histopathologic assessments and clinical data; (3) a standardization of DNA histograms obtained by means of both flow DNA cytometry and image DNA cytometry must be made with precise definitions of "diploidy," "tetraploidy," and "aneuploidy"; (4) the subjective component in classifying DNA histograms can be reduced by means of a computerized evaluation technique; (5) the degree of intratumoral variation in DNA ploidy patterns of neoplastic cell nuclei must be established by means of assessments of multiple biopsy specimens from widely different parts of a carcinoma; and (6) foci of a previously poor recognized neuroendocrine phenotype of neoplastic parenchymal cells are ubiquitous in prostatic carcinomas, particularly in anaplastic adenocarcinomas. Today, the DNA ploidy pattern of this phenotype can be assessed by means of a new image DNA cytometry technique.

Influence of different cell extraction methods on cytometric features

The purpose of this study was to investigate the influence of different cell extraction procedures on relative nuclear DNA content (IOD), nuclear area, and texture features of Feulgen-stained nuclei. In imprints and smears of fine-needle aspirates and suspensions from one human liver specimen, 50 diploid, 50 tetraploid, and 25 octaploid nuclei were measured from each slide. In addition, for DNA measurements, the progressive mean of IOD and tetraploid/diploid and octaploid/diploid ratios was calculated. The results show that the progressive mean of the IOD is constant after measuring 25-30 nuclei. For the three types of specimens, the IOD of diploid nuclei varied slightly. The average coefficient of variation was about 5% for the fine-needle aspirates, imprints, and suspensions. For all tissue sampling methods, the 99% confidence limits of the tetraploid/diploid ratio and octaploid/diploid ratio were within the range of 1.9-2.1 and 3.7-4.3, respectively. The nuclear area and most of the texture features showed a significant difference (p less than 0.01) between the three sampling methods in all nuclear populations. In conclusion, different tissue sampling methods have little or no effect on DNA-related IOD measurements, whereas the outcome of nuclear area and texture features is very dependent of the cell extraction procedure.

Three-dimensional DNA image cytometry by confocal scanning laser microscopy in thick tissue blocks

A method for the quantification of nuclear DNA in thick tissue blocks by confocal scanning laser microscopy is presented. Tissues were stained en bloc for DNA by chromomycin A3. Three-dimensional images, 60 microns deep, were obtained by stacking up confocal fluorescent images obtained with an MRC-500 (Bio-Rad, Richmond, CA). The effects due to bleaching and attenuation by depth of fluorescence emission were corrected mathematically. The DNA contents were estimated by summing up the detected emission intensities (discretized into pixel gray levels) from each segmented nucleus. Applications to an adult rat liver and to a human in situ carcinoma of theesophagus are shown to demonstrate, respectively, the precision of the method and its potential usefulness in histopathology. Comparisons are made with DNA histograms obtained on the same materials by image cytometry on smears and by flow cytometry. Ploidy peaks obtained with the confocal method, although wider than with other methods, are well separated. Confocal image cytometry offers the invaluable advantage of preserving the tissue architecture and therefore allowing, for instance, the selection of histological regions and the evaluation of the degree of heterogeneity of a tumor.