title: Semiquantitative assessment of c-erbB-2 (HER-2) status in cytology specimens and tissue sections from breast carcinoma.
abstract: OBJECTIVE
  To determine whether various methods of fixation of surgical pathology specimens from breast carcinomas would influence the outcome of evaluation of the expression levels of c-erbB-2 (HER-2). For this, comparisons were made between (1) alcohol-fixed (95%) and air-dried smears from fresh surgical pathology specimens of breast carcinomas, and (2) formalin-fixed, paraffin-embedded tissue sections of the same specimens.
  
  
  METHODS
  Alcohol-fixed and air-dried smears or touch preparations were made from 30 fresh mastectomy/lumpectomy surgical pathology specimens from breast carcinomas. Immunohistochemistry was performed using the c-erbB-2 primary antibody against the extracellular domain of the c-erbB-2 gene product. Staining was simultaneously performed on formalin-fixed, paraffin-embedded tissue sections of the same specimens. A semiquantitative approach was used for evaluation of immunostaining by three independent investigators, and a consensus was reached.
  
  
  RESULTS
  A total of 30 cases were reviewed. Tissue positivity was determined for c-erbB-2 in: 73% of alcohol-fixed specimens (n = 13 [3+] and n = 9 [2+]), 67% of air-dried smears (n = 9 [+3] and n = 11 [+2]) and 47% (n = 8 [+3]) and n = 6 [+2]) of formalin-fixed, paraffin-embedded tissue specimens. All formalin-fixed tissue specimens that were determined to positively express c-erbB-2 were also found to be positive on the alcohol-fixed smears.
  
  
  CONCLUSIONS
  The incidence of c-erbB-2 expression in fresh cytologic material is significantly higher (P < .05) than in formalin-fixed, paraffin-embedded tissue. Alcohol-fixed smears demonstrate a slightly higher percentage of cell staining and stronger intensity of c-erbB-2 expression than the matched, air-dried smears. This is a sensitive and simple processing method that can be routinely applied in surgical pathology or fine needle aspiration biopsy specimens for the detection of c-erbB-2 (HER-2), with clinical implications.
authors.affiliation: Department of Pathology, Anatomy and Cell Biology and the Cytopathology Laboratory, Jefferson Medical College, Thomas Jefferson University, Pennsylvania, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Solomides
authors.forename: R
authors.initials: R
authors.lastname: Zimmerman
authors.forename: M
authors.initials: M
authors.lastname: Bibbo
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology; D000388:Air; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D000431:Ethanol; D005260:Female; D005404:Fixatives; D005557:Formaldehyde; D006801:Humans; D019044:Image Cytometry; D007124:Immunoenzyme Techniques; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D016707:Tissue Fixation / Q000379:methods*
chemical_list: D000431:Ethanol; D005404:Fixatives; D005557:Formaldehyde; D018719:Erb-b2 Receptor Tyrosine Kinases