Oncology

doi: 10.25005/2074-0581-2020-22-4-558-564
OUR EXPERIENCE OF IMMUNOHISTOCHEMICAL ASSAY IN BREAST CANCER

S.R. Rasulov1, Sh.A. Vasikhov1,2

1Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
2Department of Pathomorphology and Immunohistochemistry of Human Tumors, Republican Cancer Research Center, Dushanbe, Republic of Tajikistan

Objective: Analysis of the first experience of immunohistochemical (IHC) diagnostics of breast cancer (BC) in the Republic of Tajikistan for 2018- 2020.

Methods: The results of the IHC study of tumor samples obtained by trephine biopsy in 142 patients and the surgical material after radical surgery in 110 patients have been studied. DAKO (Denmark) standard sets used for IHC assay. The staining carried out by manual methodology of the standard protocol provided by the company. The expression of ER and PR, HER2/neu and Ki-67 was determined. Receptive body expression of the ER and PR was evaluated by a point system, by the color intensity and the proportion of stained cells. The degree of HER2/neu expression was determined based on the staining of tumor cell membranes. To determine the threshold value of Ki-67 and subtypes of BC, we used the recommendations of the panel of experts of the St. Gallen Conference on Breast Cancer, proposed in 2013.

Results: ER- and PR-positive tumors were found in 54.8% of patients. Negative expression of ER and PR was observed in 38.9% of cases. HER2/neu negative tumor status was found in 68.4%, HER2/neu positive – in 28.8% of cases. Low proliferative activity of Ki-67 was observed in 35.3% of patients, and high proliferative activity – in 64.7% of women. Three times negative BC was found in 23% of patients.

Conclusions: High proliferation of steroid hormone receptors, the low proliferation of Ki-67 and absence of HER2/neu are considered favorable prognostic factors. Overexpression of HER2/neu is an unfavorable prognostic sign. High proliferation of Ki-67 is a direct indication for prescribing chemotherapeutic treatment. If technical capabilities are available, the IHC method should be developed in clinics where diagnostic and treatment of BC are conducted.

Keywords: Breast cancer, immunohistochemical assay, hormone receptors, steroids, prediction.

Download file:


References
  1. Mirzoeva DS. Khirurgicheskoe lechenie disseminirovannogo raka molochnoy zhelezy [Surgical treatment of disseminated breast cancer]. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2016;3:20-4.
  2. Mirzoeva DS. Znachenie immunoterapii v palliativnom lechenii bol’nykh disseminirovannym rakom molochnoy zhelezy [Significance of immune therapy in palliative treatment of the patients with disseminated breast cancer]. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2017;2:35-8.
  3. Rasulov SR, Rafieva ZKh, Rasulov KS. Tendentsii raka molochnoy zhelezy v Respubliki Tadjikistan (zabolevaemost’, smertnost’) [Trends of breast cancer in the Republic of Tajikistan (morbidity, mortality)]. Vestnik poslediplomnogo obrasovaniya v sfere zdravookhraneniya. 2018;2:83-7.
  4. Mirzoeva AB, Akhmedov A, Boev KhK. Sovremennye metody ranney diagnostiki zabolevaniy molochnykh zhelyoz i puti eyo vnedreniya v sisteme zdravookhraneniya Respubliki Tadzhikistan [Modern ways of early diagnosis of mammary glands diseases and their implementation in the healthcare system of Tajikistan]. Zdravookhranenie Tadzhikistana. 2019;2:86-97.
  5. Krylov AYu, Zubritskiy MG, Kurstak IА, Lyalikov SА, Basinskiy VА. Rezultaty immunogistokhimicheskoy diagnostiki raka molochnoy zhelezi v Grodnenskoy oblasti s uchyotom mutatsii BRCA1 v troynom negativnom rake [Results of immunohistochemical diagnostics of breast cancer in the Grodno region taking into account the BRCA1 mutation in triple negative cancer]. Al’manakh klinicheskoy meditsiny. 2017;45(4):302-8.
  6. Kwon MJ, Park S, Choi JY, Oh E, Kim YJ, Park YH, et al. Clinical significance of CD151 overexpression in subtypes of invasive breast cancer. Br J Cancer. 2012;106(5):923-30.
  7. Xie W, Yang J, Cao Y, Peng C, Ning H, Zhang F, et al. Expression of Y-Box-binding protein 1 in Chinese patients with breast cancer. Tumour Biol. 2012;33(1):63- 71.
  8. Savostikova MV, Korotkikh IYu, Laktionov KP. Immunotsitokhimicheskoe opredelenie vazhneyshikh faktorov prognoza u bolnykh rakom molochnoy zhelezy [Immunocytochemical determination of the most important prognostic factors in breast cancer patients]. Onkologiya. 2014;1:33-6.
  9. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ; Panel members. Strategies for subtypes – dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22(8):1736- 47. Available from: https://doi.org/10.1093/annonc/mdr304
  10. Coates AS, Winer EP, Goldhirsch A, Gelber RD, Gnant M, Piccart-Gebhart M, et al. Panel Members. Tailoring therapies – improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Ann Oncol. 2015;26(8):1533-46. Available from: https://doi.org/10.1093/annonc/mdv221
  11. Kolyadina IV, Poddubnaya IV, Frank GA, Komov DV, Ozhereliev AS, Karseladze AI. Prognosticheskoe znachenie retseptorov statusa opukholi pri rannem rake molochnoy zhelezy [Prognostic value of the tumor receptor status in early breast cancer]. Klinicheskaya meditsina. 2012;4:48-53.
  12. Shchepotin IB, Zotov АS, Lyubota RV, Anikusko NF, Lyubota II. Molekulyarnye tipy raka grudnoy zhelezy, opredelyonnye na osnove immunogistokhimicheskikh markyorov: kliniko-biologicheskie osobennosti i prognoz techeniya [Molecular types of breast cancer determined on the basis of immunohistochemical markers: clinical and biological features and prognosis of the course]. Klinicheskaya onkologiya. 2012;8(4):51-4.
  13. Nevozhay VI, Myuller ES. Immunogistokhimicheskoe issledovanie retseptorov steroidnykh gormonov pri rake molochnoy zhelezy [Immunohistochemical study of steroid hormone receptors in breast cancer]. Pacific Medical Journal. 2007;4:79-80.
  14. Goldhirsch A, Ingle JN, Gelber RD. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer. Ann Oncol. 2009;20:1319-29.
  15. Lazukin V. Faktor proliferatsii Ki-67 kak pokazatel’ prognoza pri rake molochnoy zhelezy [Factor of proliferation Ki-67 as a prognosis indicator for breast cancer]. Rossiyskiy bioterapevticheskiy zhurnal. 2014;13(2):29-34.
  16. Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, Senn HJ. Panel members. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 2013;24(9):2206-23. Available from: https://doi.org/10.1093/annonc/ mdt303
  17. Bashlyk VO, Semiglazov VF, Kudayberganova АG, Artemieva АS, Semiglazov ТYu, Chirskiy VS, i dr. Otsenka izmeneniya morfologicheskikh i immunogis tokhimicheskikh kharakteristik kartsinom molochnoy zhelezy pri provedenii neoad’uvantnoy sistemnoy therapii [Evaluation of changes in morphological and immunohistochemical characteristics of breast carcinomas during neoadjuvant systemic therapy]. Opukholi zhenskoy reproduktivnoy sistemy. 2018;14(1):12-9.
  18. Rodionova MV, Vorotnikov IK, Rodionov VV, Dudko EА, Chikvadze NV, Kometova VV, i dr. Prognosticheskaya i prediktivnaya znachimost’ dinamiki izmeneniya indeksa proliferatsii Ki67 v modeli predoperatsionnoy gormonoterapii bol’nykh rakom molochnoy zhelezy [Prognostic and predictive significance of dynamics of changes in the Ki67 proliferation index in the model of preoperative hormone therapy for breast cancer patients]. Siberskiy onkologicheskiy zhurnal. 2015;5:102-9.
  19. Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. N Engl J Med. 2010;363(20):1938-48. Available from: https://doi.org/10.1056/NEJMra1001389
  20. Podo F, Buydens LM, Degani H, Hilhorst R, Klipp E, Gribbestad IS, et al. FEMME Consortium. Triple-negative breast cancer: present challenges and new perspectives. Mol Oncol. 2010;4(3):209-29. Available from: https://doi. org/10.1016/j.molonc.2010.04.006
  21. Hugh J, Hanson J, Cheang MC. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 trial. J Clin Oncol. 2009;27(8):1168-76
  22. Penault-Llorca F, Andre F, Sagan C. Ki67 expression and docetaxel efficacy in patients with estrogen receptor-positive breast cancer. J Clin Oncol. 2009;27(17):2809-15

Authors informations:

Rasulov Same Rakhmonberdievich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Researcher ID: ABA-3326-2020
ORCID ID: 0000-0003-3910-4563
SPIN: 8692-8727
Author ID: 848614
E-mail: same_rasulov@mail.ru

Vasikhov Shokirdzhon Anvarovich
Head of the Department of Pathomorphology and Immunohistochemistry of Human Tumors, Republican Cancer Research Center; Assistant of the Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
SPIN: 3542-3222
Author ID: 1087258
E-mail: Shokir-vosikhov@mail.ru

Information about the source of support in the form of grants, equipment, and drugs

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflict of interest: No conflict

Address for correspondence:

Rasulov Same Rakhmonberdievich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan

734026, Republic of Tajikistan, Dushanbe, I. Somoni Ave., 59

Tel.: +992 (918) 682186

E-mail: same_rasulov@mail.ru

Materials on the topic: