Effect of morphological preservation artifacts on the quality of immunohistochemical staining for ER and Her-2

Abstract

Introduction: The most commonly encountered morphological preservation artifacts in the histological assessment of breast cancer include retraction of tumour cell clusters from the stroma, cytoplasmic retraction and alterations in nuclear morphology. This study intended to assess how these artifacts affect the quality of immunohistochemical (IHC) staining for ER and Her-2. nd rd Methods: For this retrospective study, 120 cases of consecutive breast cancers reported by the 2 and 3 authors during 2009 to 2010 were included. Haemotoxylin and Eosin stained sections of each breast cancer were assessed to obtain a consensus score for the degree of morphological preservation artifacts present. For each artifact (Retraction of tumour cell clusters, cytoplasmic retraction and alterations in nuclear morphology) a consensus score was given (0, 1, 2, 3) depending on the percentage of cell clusters/cells affected. Each IHC slide was assessed to obtain a consensus score for the quality of IHC staining for ER and Her-2. Parameters measured were uniformity of staining (0, 1), background staining (0, 1, 2), and adequacy of counterstaining (0, 1). Results: The study included a total of 120 consecutive breast cancer cases. There was no statistically significant relationship between the consensus score for the commonly encountered morphological preservation artifacts and the quality of IHC staining of ER (p = 0.44) and Her-2 (p = 0.51). Conclusions: Commonly encountered morphological preservation artifacts have no significant effect on the quality of IHC staining for ER and Her-2 measured in terms of uniformity of staining, background staining and adequacy of counterstaining.