Determination of steroid hormone-dependency of tumours utilizing tissue sections. Survey of histochemical techniques and their application in surgical pathology

Abstract

The growth of neoplasms originating from steroid hormone target tissues may be hormone-dependent. It has been clearly demonstrated that the oestrogen and/or progestagen receptor status predicts the response to endocrine treatment and the prognosis of breast cancer. However steroid receptor determination in tumour cytosols has several limitations, which can partly be resolved by (immuno) histochemical detection of steroid hormone-responsive tumour cells. A variety of histochemical techniques including autoradiography of tritiated steroids, immunohistochemistry with antibodies to steroid hormones, histochemistry with fluorescent ligands of low molecular weight and fluorochrome- or enzyme-labelled macromolecular probes are discussed. It is concluded that there is as yet no substantial evidence that these methods visualize steroid receptors or detect steroid hormone-responsiveness of tumour cells. On the other hand, immunohistochemical demonstration of oestrogen receptors with monospecific antibodies seems validated and indications have been obtained that this information is clinically relevant. Recent developments suggest that immunocytochemistry of receptors and specific hormone-induced proteins, flow cytometric analysis and probably hybridocytochemistry in the future will help to improve management of steroid hormone-dependent tumours.