Immunocytochemistry Assay in Breast Cancer Specimens by Thin-Layer Cytology Slides

Objective To detect overexpression of ER,PR,HER-2 by TLC in breast cancer,compare,the results of immunocytochemistry (ICC) with that of immunohistochemistry (IHC),and observe their available in advanced breast cancer. Methods The methods of ICC and IHC were used in breast cancer specimens. Results The satisfied slides for ER,PR and HER-2 were 195,194 and 202 cases in all 205 cases,respectirely.There were 2 exfoliative slides.They occupied 1.0%.One hundred and seventy cases have histopathology results.The positive expression rate of ER was 60.0% in IHC,58.5% in ICC (P=0.765),PR was 70.6% in IHC,59.3% in ICC(P<0.05),and HER-2 was 57.5% in IHC,38.1% in ICC (P<0.05).The patients were mostly in the age group 51~61years old (59 cases,32.3%).50.8% patients had lymph node metastasis in this group.47.1% patients had lymph node metastasis in 40~50 years old age group.14 out of 16 cases had lymph node metastasis in 29~39 years old age group.They occupied 87.5%.ER+/PR+/HER-2- overexpression were the highest in 73 years old age group,and the lowest in 29~39 years group.This was consistant with clinical feature and cytologic morphology.The results of assessment of FNA specimens agreed with those of the histological sections in 150 of the 160 cases in ER.Their sensitivity,specificity,positivity predictive value,negative predictive value,false positive rate,false negative rate were 94.1%,93.2%,96.0%,90.2%，2.5% and 3.8%,respectively.The results of assessment of FNA specimens agreed with those of the histological sections in 140 of the 159 cases in PR.Their sensitivity,specificity,positivity predictive value,negative predictive value,false positive rate,false negative rate were 88.5%,87.0%,94.3%,75.5%，3.8%,and 8.2%,respectively.The results of assessment of FNA specimens agreed with those of the histological sections in 134 of the 167 cases in HER-2.Their sensitivity,specificity,positivity predictive value,negative predictive value,false positive rate,false negative rate were 67.7%,97.2%,97.0%,69.0%，1.2% and 18.6%,respectively. Conclusion The results of assessment of ICC have a good correlation with that of IHC.When only cytologic material might be available,it would be useful to be able to identify ER,PR status by using FNA specimens.The intratumoral heterogeneity of positive cells was the main reason for discordant results between cytological and histologic specimens.HER-2 diagnosis standard of ICC should not be the same as that of IHC in HER-2 test.Her-2 overexpression can be tested in FNA specimens,whereas positive HER-2 staining on TLC would require further validation by FISH.