Breast cancer specimens from 600 women were assayed for estrogen receptors (ER) using an immunocytochemical assay (JCA) employing the monoclonal antiestrophilin antibody H222 Sp 7. Results showed significant correlation with biochemical ER determinations as well as with tumor grade and menopausal status. In 449 cases, results of progesterone receptor assay by ICA using the monoclonal anti-PgR antibody KD 68, also correlated significantly with biochemical PgR measurements. The ERICA/PgRICA positivity was significantly more frequent in postmenopausal white women. Colloid carcinomas were most likely to be ERICA positive and PgRICA positive whereas medullary carcinomas were most often negative. In 47 patients with advanced mammary carcinoma, results of ERICA and PgRICA were more closely related to endocrine response than those of ER and PgR by dextran-coated charcoal assay (DCC). In 339 women with Stage I or Stage I1 breast cancer, ERICA was significantly associated with disease-free survival. Analysis by Cox's proportional hazard model, however, showed PgRICA to be the best predictor of survival and disease-free survival in 197 women at the same stages of disease. These data indicate that ICA is more predictive of prognosis than biochemical ER and PgR. The ease of ICA performance coupled with these results indicate that the method is an acceptable substitute for DCC in analyzing breast cancers for ER/PgR.
Breast cancer specimens from 114 patients were assayed for the presence of estrogen receptors (ER) utilizing highly specific, monoclonal antiestrophilin antibodies and the peroxidase‐antiperoxidase technique. Results were compared with conventional ER determinations by the dextran‐coated charcoal method (DCC) and were in agreement as to positivity and negativity in 86%. Semiquantifled immunocytologic assay results were in accord with the level of ER as measured by DCC in 66%. The tumors studied included 43 from patients with Stage IV disease where clinical response to hormonal manipulation was known. In the latter group, the immunohistologic method had a sensitivity similar to that of DCC but showed a superior positive predictive value and a significantly better specificity. These results indicate that this new method is a valuable laboratory tool, enabling prediction of hormone responsiveness in advanced mammary carcinoma and capable of performance at the community hospital level.
Background. It is important to develop parameters that aid in prognosticating which patients with breast cancer are more likely to have a rapid disease course and therefore might benefit from early aggressive therapies.
Methods. Specimens from two groups of women, deliberately selected because their clinical courses differed greatly, were studied to detect amplification of the protooncogenes c‐myc, int‐2, and C‐erbB‐2/neu by slot‐blot assay, the estrogen receptor (ER), and the progesterone receptor (PR) by both biochemical and immunohisto‐chemical procedures (ERICA and PRICA). One group of 50 patients had a prolonged disease‐free interval after initial surgery (mean, 6.4 years); the other group of 52 women had had rapid disease recurrence (mean, 1.4 years) or progression (5 patients died of disease within 1 year of diagnosis). The patients were selected from 1700 consecutively accessioned cases if they fit the study criteria and sufficient tissue was available for oncogene hybridization studies.
Results. The two groups differed statistically by stage, number of involved axillary lymph nodes, ERICA and PRICA results (P = 0.001), and amplification of c‐myc (P = 0.003). The percentage of patients with rapid disease recurrence and progression increased from 0–93% when risk factors changed from best case (ERICA and PRICA results, positive; c‐myc, not amplified; and axillary nodes, not involved) to worst case (ERICA and PRICA findings, negative; c‐myc, amplified; and axillary nodes, involved).
Conclusions. Women with these worst‐case parameters were more likely to have a recurrence sooner and rapidly progressive disease. They might benefit from early aggressive therapeutic measures. Cancer 1993; 71:162‐71.
This AR assay could be prognostically useful in the clinical management of prostate cancer and is suitable for use in the community hospital laboratory.
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