EXPRESSION OF ESTROGEN AND PROGESTERONE RECEPTORS IN CYTOLOGIC SPECIMENS USING VARIOUS FIXATIVES

Estrogen and progesterone receptor reactivity may be useful in identif ying possible primary sites of metastatic disease ai directing therapy in tumors of the female genital tract, including breast, ovary, and e ndometrium. Various methods have been described for the immunocytochem ical evaluation of estrogen receptor (ER) and progesterone receptor (P R) status of cytologic specimens but our results have been variable We evaluated the effectiveness of various fixatives [cytospin collection fluid, Shandon, Pittsburgh, PA (SH); ethanol (ETH); and formalin (FOR )] for fixation of smears (SM) and cell black (CB) material. The perce ntage and intensity of tumor nuclei of SM, CB, and tissue sections (TS ) stained for ER and PR by tire avidin-biotin-peroxidase complex techn ique were compared. Samples were considered ER ar PR positive when gre ater than or equal to 20% of tumor nuclei were stained. The sensitivit y of ER analysis of SMs and CBs in each fixative compared to formalin- fixed paraffin-embedded tissue sections were as follows: Sn-l (SH) 88% , SM (ETH) 14%, CB (SH) 58%, CB (ETH) 43%, and CB (FOR) 70%. The sensi tivity of PR determination on SMs and CBs was Sill (SH) 71%, SM (ETH) 6.0%, CB (SH) 25%, CB (ETH) 33%, CB (FOR) 80%. These findings indicate that of the fixatives evaluated for ER analysis, SMs fixed in SH prov ided the best results. For PR evaluation, CBs fixed in FOR gave the be st results. (C) 1996 Wiley-Liss, Inc.