A Combined Histological, Immunocytochemical and Biochemical Approach in the Evaluation of Estrogen Receptors in Breast Carcinomas

Value of ER-D5 Immunocytochemical Determination in Routine Tissue Sections of Human Breast Cancer

ER-D5 is a recently identified protein related to estrogen receptors (ER). Generally ER measurement requires fresh frozen tissue and for ER-D5 assay ethanol (E) fixation of the specimen is recommended. We evaluated the possibility of immunocytochemical detection of ER-D5 in routine formalin-fixed (F) sections in 51 breast cancers comparing the results with those obtained in the same specimens using E as fixative. The results of ER-D5 assay were expressed by the staining index (SI) taking values ≥5 as positive. In all tumors ER was also assayed by a biochemical method (DCCA). The sensitivity of ER-D5 detection in F was only 33.3%, while the specificity was 94.4%. A lower cut-off value of SI for F sections (≥2) increased the sensitivity to 66.6%, leaving the specificity unchanged. A strong correlation was found between the SI of ER-D5 in E and F (p<0.001). The SI of ER-D5 in F sections was also well correlated with ER concentrations (p<0.001). These results suggest that immunocytochemical determination of ER-D5 in routine sections may be useful in retrospective studies of hormone dependence in breast cancer.

Effects of estrogens on the testis of transsexuals: a pathological and immunocytochemical study

Testes from five male-to-female transsexuals removed during sex-reversal surgery after administration of estrogens were studied histologically and with immunoperoxidase procedures to locate estrogen receptors (ER) and related antigens. Atrophy of the seminiferous tubules was observed in all cases; its degree, and a marked decrease in Leydig cells, correlated with low plasma gonadotropin levels (rather than with the duration of treatment). In all cases, the rete testis appeared hyperplastic and the other components (efferent ductules, epididymus) well preserved. The efferent ductules proved to be the only structure where ER can be located by the ER-ICA procedure, whereas staining for the p 29 ER-associated antigen is strongly positive both here and in the rete testis. The immunocytochemical data, in parallel with the observed biological effects, indicate that the rete testis and the efferent ductules and, to a minor degree, the epididymus and Leydig cells are the main direct targets of estrogens in the human testis.