Reliability of immunohistochemical demonstration of oestrogen receptors in routine practice: interlaboratory variance in the sensitivity of detection and evaluation of scoring systems
Reliability of immunohistochemical demonstration of oestrogen receptors in routine practice: interlaboratory variance in the sensitivity of detection and evaluation of scoring systems
复制标题
DOI：
10.1136/jcp.53.2.125
复制
发表时间：
2000-02-01
影响因子：
3.4
通讯作者：
Miller, KD
中科院分区：
文献类型：
--
作者：
Rhodes, A;Jasani, B;Miller, KD
目的-为了调查实验室间的差异，在雌激素受体的免疫组化（IHC）检测，以确定假阴性率，这可能会产生不利影响的决定，给予辅助tamoxifen treatment. Methods，以确保类似的结果是由不同的机构，200个实验室从26个国家加入了英国国家外部质量评估计划免疫细胞化学（NEQAS-ICC）。将具有低、中、高水平雌激素受体表达的乳腺癌组织切片送到每个实验室进行免疫组织化学染色。首先通过估计染色肿瘤细胞的1%和10%的阈值，其次通过快速评分法，由一组四名评估员在单盲基础上独立判断单个切片，对获得的结果进行检测灵敏度评价。结果也进行了评估，使用参与者自己的thresholds.Results-over 80%的实验室能够证明雌激素受体阳性的中，高表达肿瘤，但只有37%的实验室得分充分的低表达肿瘤。大约三分之一的实验室未能登记任何阳性染色在这种肿瘤，而三分之一只显示出最小的positivity. Conclusions，有相当大的实验室间的变异性，特别是在与低雌激素受体阳性乳腺癌的检测，假阴性率为30%和60%之间。这种差异似乎是由方法上的微小差异引起的，可以通过对总体技术进行微调来纠正。
Aims-To investigate interlaboratory variance in the immunohistochemical (IHC) detection of oestrogen receptors so as to determine the rate of false negatives, which could adversely influence the decision to give adjuvant tam oxifen treatment.Methods-To ensure that similar results are obtained by different institutions, 200 laboratories from 26 countries have joined the UK national external quality assessment scheme for immunocytochemistry (NEQAS-ICC). Histological sections from breast cancers having low, medium, and high levels of oestrogen receptor expression were sent to each of the laboratories for immunohistochemical staining. The results obtained were evaluated for the sensitivity of detection, first by estimating threshold values of 1% and 10% of stained tumour cells, and second by the Quick score method, by a panel of four assessors judging individual sections independently on a single blind basis. The results were also evaluated using participants' own threshold values.Results-Over 80% of laboratories were able to demonstrate oestrogen receptor positivity on the medium and high expressing tumours, but only 37% of laboratories scored adequately on the low expressing tumour. Approximately one third of laboratories failed to register any positive staining in this tumour, while one third showed only minimal positivity.Conclusions-There is considerable interlaboratory variability, especially in relation to the detection of breast cancers with low oestrogen receptor positivity, with a false negative rate of between 30% and 60%. This variability appears to be caused by minor differences in methodology that may be rectified by fine adjustment of overall technique.