This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kieback, D. G. Articles by Jones, L. A. Search for Related Content PubMed PubMed Citation Articles by Kieback, D. G. Articles by Jones, L. A.

Improved Prediction of Survival in Advanced Adenocarcinoma of the Ovary by Immunocytochemical Analysis and the Composition Adjusted Receptor Level of the Estrogen Receptor¹

Experimental Gynecology/Endocrinology Laboratory [D. G. K., S. K. M., C. L. E., R. A. H., L. A. J.], Departments of Gynecologic Oncology [D. G. K., S. K. M., C. L. E., R. A. H., L. A. J.], Surgical Pathology [H. S. G.], and Biomathematics [E. N. A.], The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, and Department of Pathology [M. F. P.], University of Southern Claifornia, Los Angeles, California 90033

Conventional cytosol estrogen receptor analysis is not a significant prognostic variable in serous ovarian carcinoma. Although the use of immunocytochemical receptor analysis for estrogen does provide prognostically useful information in enhanced accuracy of predicting survival in patients with ovarian cancer, its usefulness can still be improved. Surgical samples from ovarian carcinomas are heterogeneous in tissue composition. Immunocytochemical receptor analysis allows for the specific assessment of the tumorous portions of a histological specimen. However, it is limited by its dependence on staining intensity as the determining factor. Biochemical receptor analysis does provide objective information concerning the number of receptor molecules present in a given sample, but the value is not adjusted for histological composition of the tumor section. Therefore, we have attempted to combine the advantages of both methods. By adjusting the conventional receptor analysis for the percentage of tumor present in the specimen, we have eliminated the tissue heterogeneity as a confounding variable. The resulting value is named Composition Adjusted Receptor Level or CARL. A prospective study was performed on the estrogen receptor concentrations in 61 ovarian cancers. Minimum follow-up was 8 years. For the percentage of tumor in the specimen, a highly significant correlation of the assessment of the two pathologists was observed. Stage (P < 0.05) and grade (P < 0.05) as well as cell type (P < 0.05) were found to be significant prognostic variables. In an attempt to eliminate the confounding influences of these variables, the CARL of the estrogen receptor was assessed with regard to its prognostic significance in 32 grade 2 and 3 serous carcinomas of the ovary, stage III and IV. A linear correlation between CARL and survival was found above a threshold estrogen receptor concentration of 15 fmol/mg cytosol protein using a correlation of the Cox proportional hazards model (P < 0.02). Our data suggest that (a) the assessment of the percentage of tumor in a given sample is not significantly observer dependent, (b) CARL is a significant predictor of survival in serous ovarian carcinoma, and (c) a CARL should be determined for the analysis of any cytosol receptor in solid tumors.

¹ This publication is dedicated to C. J. Pauerstein, and this work was supported in part by National Cancer Institute grants CA 16672, CA 31328, and CA 44591 to L. A. J., CA 48780 and CA 50589 to M.F.P., and American Cancer Society grant PDT-411 to M. F. P. Presented at the 1991 Endocrine Society Meeting.

² To whom requests for reprints should be addressed, at Experimental Gynecology/Endocrinology, Department of Gynecologic Oncology Box 304, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030.

Received 5/13/93. Accepted 8/24/93.

This article has been cited by other articles:

				C. F. Verschraegen, W. Hu, Y. Du, J. Mendoza, J. Early, M. Deavers, R. S. Freedman, R. C. Bast Jr., A. P. Kudelka, J. J. Kavanagh, et al. Establishment and Characterization of Cancer Cell Cultures and Xenografts Derived from Primary or Metastatic Mullerian Cancers Clin. Cancer Res., February 1, 2003; 9(2): 845 - 852. [Abstract] [Full Text] [PDF]

				C. D. Katsetos, I. Stadnicka, J. C. Boyd, H. Ehya, S. Zheng, C. M. Soprano, H. S. Cooper, A. S. Patchefsky, D. R. Soprano, and K. J. Soprano Cellular Distribution of Retinoic Acid Receptor-{alpha} Protein in Serous Adenocarcinomas of Ovarian, Tubal, and Peritoneal Origin : Comparison with Estrogen Receptor Status Am. J. Pathol., August 1, 1998; 153(2): 469 - 480. [Abstract] [Full Text] [PDF]