Immunohistochemical concordance of core-needle biopsy specimens and surgically removed specimens in breast cancer

doi:10.3877/cma.j.issn.1674-0807.2019.02.006

Abstract

Abstract:

Objective

To analyze the concordance of ER, PR, HER-2, Ki67 results in immunohistochemical detection of specimens from core-needle biopsy (CNB) and open surgery in breast cancer patients.

Methods

The clinical data of 305 breast cancer patients who received no neoadjuvant therapy before surgery in the Department of Thyroid and Breast Surgery, Shenzhen Second People’s Hospital from January 2014 to October 2017 were retrospectively analyzed. The Kappa test of paired count data was used to compare the concordance of immunohistochemistry results (ER, PR, HER-2 and Ki67) between preoperative CNB specimens and surgically removed specimens of breast cancer patients.

Results

The concordant rate of ER and PR expression was 93.1% (284/305) and 93.1% (284/305) between CNB specimens and surgically removed specimens (Kappa=0.837, 0.858, both P<0.001). The concordant rate of ER positive staining intensity was 50.0% (101/202) between CNB specimens and surgically removed specimens (Kappa=0.244, P<0.001). The concordant rate of PR positive staining intensity was 68.8% (117/170) between CNB specimens and surgically removed specimens (Kappa=0.433, P<0.001). The HER-2 expression and Ki67 index showed a moderate consistency between CNB specimens and surgically removed specimens (Kappa=0.543, 0.535, both P<0.001). The concordant rate of the percentage of ER/PR/Ki67 positive cells was 60.7% (185/305), 53.1% (162/305) and 36.1% (110/305), respectively.

Conclusions

In the immunohistochemical detection, ER and PR expression shows high concordant rates between CNB specimens and surgically removed specimens, while the positive staining intensity of ER and PR, HER-2 expression and Ki67 index shows a moderate concordance. The percentage of ER/PR/Ki67 positive cells presents a moderate concordance between two kinds of specimens.

Key words: Breast neoplasms, Immunohistochemistry, Biopsy, Receptors, estrogen, Receptors, progestins, Genes, erbB-2, Ki-67 antigen

Wenjing Jian, Xianming Wang, Shufen Song, Haiyan Sheng, Xia Liu, Meiquan Xu, Chuting Hu, Yunlong Liu. Immunohistochemical concordance of core-needle biopsy specimens and surgically removed specimens in breast cancer[J]. Chinese Journal of Breast Disease(Electronic Edition), 2019, 13(02): 93-97.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2019.02.006

https://zhrxbzz.cma-cmc.com.cn/EN/Y2019/V13/I02/93

Figures/Tables 7

References 19

[1]	于双全，于志勇．乳腺癌分子分型及其临床意义[J]．国际肿瘤学杂志，2012，39(6):432-435.
[2]	Hammond ME, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer[J]. J Clin Oncol, 2010, 28(16):2784-2795.
[3]	Wolff AC, Hammond ME, Schwartz JN, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer[J]. J Clin Oncol, 2007, 25(1):118-145.
[4]	Cheang MC, Chia SK, Voduc D, et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer[J]. J Natl Cancer Inst, 2009, 101(10):736-750.
[5]	Kundel HL, Polansky M. Measurement of observer agreement [J]. Radiology, 2003, 228(2):303-308.
[6]	Landis JR, Koch GG. The measurement of observer agreement for categorical data[J]. Biometrics, 1977, 33(1):159-174.
[7]	Skriver SK, Laenkholm AV, Rasmussen BB, et al. Neoadjuvant letrozole for postmenopausal estrogen receptor-positive, HER2-negative breast cancer patients, a study from the Danish Breast Cancer Cooperative Group (DBCG)[J]. Acta Oncol, 2018, 57(1):31-37.
[8]	Raphael J, Gandhi S, Li N, et al. The role of quantitative estrogen receptor status in predicting tumor response at surgery in breast cancer patients treated with neoadjuvant chemotherapy [J]. Breast Cancer Res Treat, 2017, 164(2):285-294.
[9]	Ogiya A, Yamazaki K, Horii R, et al. Post-relapse survival in patients with the early and late distant recurrence in estrogen receptor-positive HER2-negative breast cancer[J]. Breast Cancer, 2017, 24(3):473-482.
[10]	Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2):69-90.
[11]	Coates AS, Winer EP, Goldhirsch A, et al. Tailoring therapies--improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015 [J]. Ann Oncol, 2015, 26(8):1533-1546.
[12]	Li S, Yang X, Zhang Y, et al. Assessment accuracy of core needle biopsy for hormone receptors in breast cancer: a meta-analysis[J]. Breast Cancer Res Treat, 2012, 135(2):325-334.
[13]	王记红，张艳. 乳腺癌粗针穿刺与术后活检标本病理分级及免疫组化的比较研究[J]. 中国继续医学教育，2016，8(21):42-44.
[14]	张雁，腾梁红，康骅，等. 乳腺癌患者核芯针穿刺标本和外科手术标本免疫组化结果的一致性探讨[J]. 山西医科大学学报，2014，45(12):1213-1215.
[15]	张钰梓，陈小松，沈坤炜. 乳腺癌的治疗困境：肿瘤异质性与个体化治疗[J]. 上海医学，2012，35(11):917-919.
[16]	张众，王华新，谢丰培. 乳腺癌异质性及其临床意义[J]. 临床与实验病理学杂志，2014，30(5):473-477.
[17]	Hammond ME, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer[J]. Arch Pathol Lab Med, 2010, 134(6):907-922.
[18]	Yildiz-Aktas IZ, Dabbs DJ, Bhargava R. The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma[J]. Mod Pathol, 2012, 25(8):1098-1105.
[19]	Khoury T, Sait S, Hwang H, et al. Delay to formalin fixation effect on breast biomarkers[J]. Mod Pathol, 2009, 22(11):1457-1467.

CNB标本ER表达	手术标本ER表达		合计
CNB标本ER表达	阴性	阳性	合计
阴性	82	4	86
阳性	17	202	219
合计	99	206	305

CNB标本ER表达	手术标本ER表达		合计
CNB标本ER表达	阴性	阳性	合计
阴性	82	4	86
阳性	17	202	219
合计	99	206	305

CNB标本PR表达	手术标本PR表达		合计
CNB标本PR表达	阴性	阳性	合计
阴性	114	9	123
阳性	12	170	182
合计	126	179	305

CNB标本PR表达	手术标本PR表达		合计
CNB标本PR表达	阴性	阳性	合计
阴性	114	9	123
阳性	12	170	182
合计	126	179	305

CNB标本PR阳性染色强度	手术标本PR阳性染色强度			合计
CNB标本PR阳性染色强度	1＋	2＋	3＋	合计
1＋	83	22	2	107
2＋	8	23	3	34
3＋	9	9	11	29
合计	100	54	16	170

Please choose a citation manager

Content to export