J Pathol Transl Med.  2021 Jan;55(1):33-42. 10.4132/jptm.2020.09.29.

Automated immunohistochemical assessment ability to evaluate estrogen and progesterone receptor status compared with quantitative reverse transcription-polymerase chain reaction in breast carcinoma patients

• Jeon T
• Kim A
• Kim C

• KMID: 2511511
• DOI: http://doi.org/10.4132/jptm.2020.09.29

Abstract

Background
This study aimed to investigate the capability of an automated immunohistochemical (IHC) evaluation of hormonal receptor status in breast cancer patients compared to a well-validated quantitative reverse transcription–polymerase chain reaction (RT-qPCR) method.
Methods
This study included 93 invasive breast carcinoma cases that had both standard IHC assay and Oncotype Dx assay results. The same paraffin blocks on which Oncotype Dx assay had been performed were selected. Estrogen receptor (ER) and progesterone receptor (PR) receptor status were evaluated through IHC stains using SP1 monoclonal antibody for ER, and 1E2 monoclonal antibody for PR. All ER and PR immunostained slides were scanned, and invasive tumor areas were marked. Using the QuantCenter image analyzer provided by 3DHISTECH, IHC staining of hormone receptors was measured and converted to histochemical scores (H scores). Pearson correlation coefficients were calculated between Oncotype Dx hormone receptor scores and H scores, and between Oncotype Dx scores and Allred scores.
Results
H scores measured by an automated imaging system showed high concordance with RT-qPCR scores. ER concordance was 98.9% (92/93), and PR concordance was 91.4% (85/93). The correlation magnitude between automated H scores and RT-qPCR scores was high and comparable to those of Allred scores (for ER, 0.51 vs. 0.37 [p=.121], for PR, 0.70 vs. 0.72 [p=.39]).
Conclusions
Automated H scores showed a high concordance with quantitative mRNA expression levels measured by RT-qPCR.

Keyword

Breast neoplasm; Hormone; RNA; messenger; Analysis

Figure

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  Fig. 1 Correlation between IHC scores and RT-qPCR scores. The number in each graph indicates correlation coefficient (R). ER, estrogen receptor; PR, progesterone receptor; H, histochemical; RT-qPCR, quantitative reverse transcription-polymerase chain reaction; IHC, immunohistochemical.

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  Fig. 2 Distribution of H scores, Allred scores, and RT-qPCR scores. ER, estrogen receptor; PR, progesterone receptor; H, histochemical; RT-qPCR, quantitative reverse transcription-polymerase chain reaction; IHC, immunohistochemical.

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  Fig. 3 PR-IHC stain showed more heterogeneous staining tendency (B) than ER-IHC stain (A) in the same tumor section. ER, estrogen receptor; PR, progesterone receptor; IHC, immunohistochemical.

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  Fig. 4 (A) ER-stained slide with Allred score 8. (B) However, a significant portion of moderate nuclear staining (2+) was present as well as strong nuclear staining (3+) by image analysis. ER, estrogen receptor.

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  Fig. 5 (A) Strong PR-positive intraductal component within PR-negative invasive cancer area. (B) During a secondary review for the case which had false-negative H score, nuclear staining intensity and H score recognized by an image analyzer seemed accurate. PR, progesterone receptor; H, histochemical.

Reference

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