QUANTIFICATION OF RELATIVE AREA OF PS2 IMMUNOHISTOCHEMICAL STAINING AND EPITHELIAL PERCENTAGE IN BREAST CARCINOMAS - THE EFFECT OF THE LATTER ON THE INTERPRETATION OF A CYTOSOLIC PS2 ASSAY
F. Willemse et al., QUANTIFICATION OF RELATIVE AREA OF PS2 IMMUNOHISTOCHEMICAL STAINING AND EPITHELIAL PERCENTAGE IN BREAST CARCINOMAS - THE EFFECT OF THE LATTER ON THE INTERPRETATION OF A CYTOSOLIC PS2 ASSAY, Modern pathology, 8(5), 1995, pp. 521-525
In immunochemical assays of specific cell constituents in cytosols fro
m tumors, the relationship between epithelial and stromal fractions is
not taken into account. This may influence the outcome of the measure
ments and result in incorrect categorization as negative or positive.
In a setting addressing pS2 (only detectable in epithelial cells) in b
reast carcinomas, we investigated three possibilities that may overcom
e this problem using histologic sections of breast carcinomas of 50 pa
tients: (a) visual estimation of area percentage of immunohistochemica
l staining of the cell constituent of interest performed by three inde
pendent individuals, (b) quantification of area percentage of the immu
nohistochemical results by true color image analysis, and (c) quantifi
cation of the epithelial and stromal compartments of the tumors in Hei
denhain's-azan-stained tissue sections, using the true color image ana
lysis system, to assess the epithelial percentage in the tumors. This
percentage was used as a correction factor for data on pS2 obtained by
cytosolic determinations. Visual estimation appeared to be subject to
interobserver variation and, subsequently, becomes less applicable in
the absence of strict scoring rules. Based on tests for correlation,
image analysis system quantification seemed reproducible in both quant
ification procedures. However, due to the high magnification necessary
to visualize the immunohistochemical staining product, the effect of
field selection caused systematic differences between repeat measureme
nts (Friedman test). As a result of the contrasting colors of the azan
staining, the calculation of the epithelial percentage could be perfo
rmed at a low magnification. Consequently, here the effect of field se
lection was not present. Correction of cytosolic values for epithelial
percentage resulted in 8% of the cases changing category. In conclusi
on, the combined results of the two disciplines (histology and biochem
istry) may provide more information than either of them alone.