title: Prognostic value of cathepsin D in breast cancer: comparison of immunohistochemical and immunoradiometric detection methods.
abstract: OBJECTIVE
  To test whether immunoradiometric or immunohistochemical detection of lysosomal protease cathepsin D in breast cancer is more predictive of outcome.
  
  
  METHODS
  Tumour tissues from 270 primary breast cancer patients were evaluated for the expression of cathepsin D using immunohistochemistry (IH; paraffin embedded tissues) and an immunoradiometric assay (IRMA; cytosol from frozen tissues). Immunohistochemical scores were based on immunoreaction in tumour cells and tumour associated macrophages.
  
  
  RESULTS
  IRMA values (cut off 40 fmol/mg cell protein) correlated significantly with IH values. Recorded incidences of positive immunoreaction in tumour cells using two different cut off values were 52% and 35%, respectively. Macrophages stained positive in 31% of tissues. Combined evaluation of tumour cells and macrophages resulted in positivity rates of 59% and 48%, respectively. Node status was the only variable found to correlate with cathepsin D expression. IH results correlated significantly with clinical outcome (median observation time 68 months) in node negative patients (n = 120) but not in node positive patients (n = 145). Cathepsin D positivity as measured by IRMA was not related to clinical outcome in either group. On multivariate analysis in the node negative group, IH detection of cathepsin D appeared to be the only independent factor indicating prognosis. For node positive patients, tumour grade, size, and receptor status were of prognostic relevance.
  
  
  CONCLUSIONS
  Because of the simple methodology and the minimal amount of tissue used for analysis, immunohistochemistry was preferred to immunoradiometry for cathepsin D measurement; it also provided more predictive data with respect to prognosis.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Cologne, Germany.
authors.forename: U J
authors.initials: UJ
authors.lastname: Göhring
authors.forename: A
authors.initials: A
authors.lastname: Scharl
authors.forename: U
authors.initials: U
authors.lastname: Thelen
authors.forename: A
authors.initials: A
authors.lastname: Ahr
authors.forename: G
authors.initials: G
authors.lastname: Crombach
authors.forename: B R
authors.initials: BR
authors.lastname: Titius
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000201:enzymology*; D002402:Cathepsin D / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015592:Immunoradiometric Assay; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002402:Cathepsin D