This article illustrates the two main methods for routine measurement of cytoplasmic estrogen receptor status in neoplastic biopsy. The first is the Dextran Coated Charcoal Technique (D.C.C. Assay) which is still the method of choice in the majority of clinical laboratories for its simplicity, reproducibility and low cost. The second is a more advanced technique based on the specific binding, enzimatically displayed, of commercially available antiestrogen monoclonal antibodies (Enzyme Immuno Assay - ABBOTT).
The sui generis characteristics of endocrine sensitivity assessment on tumor tissues and the importance of decision-making connected with the assay justify rigorous quality assurance schemes. The quality control design proposed by the Italian Committee concerned the evaluation of several lyophilized preparations with scalar receptor content; this permits the identification through linear regression analysis of systematic and non-systematic errors. The Italian Committee has currently connected 50 labs from most regions of the country.
LippmanM.E., The NIH consensus development conference on adjuvant chemotherapy for breast cancer. A commentary.Breast Cancer Res Treat1985; 6: 195–200.
2.
JensenE.V.Intracellular localization of estrogen receptors: implications for interaction mechanism.Lab Invest1984; 51: 487–488.
3.
GorskyJ., ToftD., ShyamaleG., SmithD., NotidesA.Hormone receptors: studies on the interaction of estrogen with the uterus.Rec Prog Horm Res1968; 24: 45–49.
4.
JanssensJ., PyesersK., BekaertJ.. Biochemical and histochemical analyses of steroid hormone binding sites in human primary breast cancer.Cancer1985; 55: 2600–2611.
5.
NenciI.Estrogen receptor cytochemistry in human breast cancer: status and prospects.Cancer1981; 48: 2674–2686.
6.
KingW.J., GreenG.L.Monoclonal antibodies localize estrogen receptor in the nuclei of target cells.Nature1984; 307: 745–747.
7.
KorenmanS.G., PerrinL.E., Mc CallumT.P.A radioligand binding assay system for estradiol measurement in human plasma.J Clin Endocrinol1969; 29: 879.
8.
ScatchardG.The attraction of proteins for small molecules and ions.Ann NY Acad Sci1949; 51: 660–672.
9.
EORTC Breast Cancer Cooperative Group.Standards for the assessment of estrogen receptors in human breast cancer. Report of a workshop on September 29, 1972, at the Antony van Leeuwenhoekhuis. Amsterdam.Eur J Cancer1973; 9: 379–381.
10.
EORTC Breast Cancer Cooperative Group.Revision of the standards for the assessment of hormone receptors in human breast cancer. Report of the second EORTC workshop held on 16-17 March 1979, in the Netherlands Cancer Institute.Eur J Cancer1980; 16: 1513–1515.
11.
PiffanelliA., FumeroS., PelizzolaD., BerrutoG.P.. Protocollo del metodo con charcoal-destrano5D.C.C. per il dosaggio dei recettori dell'estradiolo e del progesterone nel tessuto neoplastico.Lab J Res Lab Med1982; IX(1): 13–21.
12.
PiffanelliA., GiovanniniG., PelizzolaD., ReggianiA.. Steroid receptor microassay on human prostate biopsy. Advances in Urological Oncology and Endocrinology.Acta Medica Ed e Cong1984: 413–417.
13.
ClarkJ.H., MarkaverichB.M.The agonist and atagonist actions of estradiol.J Steroid Biochem1984; 20: 1005–1013.
14.
KoendersA., ThorpeS.M.Standardization of steroid receptor assays in human breast cancer. I.Reproducibility of estradiol and progesterone receptor assays, Eur J Cancer Clin Oncol1983; 19: 1221–1229.
15.
KoendersA., ThorpeS.M.Standardization of steroid receptor assays in human breast cancer. II. Samples with low receptor content.Eur J Cancer Clin Oncol1983; 19: 1467–1472.
16.
KlotzI.M.Numbers of receptor sites from Scatchard graphs. facts and fantasies.Science1982; 217: 1247–1249.
17.
GreenG.L., NolanC., EnglerJ.P., and JensenE.V.Monoclonal antibodies to human estrogen receptors.Proc Nat Acad Sci1980; 77: 5115–5119.
18.
EkinsR.P.The future development of immunoassay.IAEA Radioimmunoassay and related procedure in Medicine 1977 Vol. I, 241–275, IAEA Vienna 1978.
RaamS., GelmanR., CohenJ., BacharachA., FischingerA.J., JacobsonH.I., KeshgegianA.A., KonopkaS.J., WittliffJ.L.Estrogen receptor assay: interlaboratory and intrala-boratory variations in the measurement of receptors using dextran-coated charcoal technique: a study by ECOG.Eur J Cancer1981; 17: 643–649.
21.
NashA.R., SarfatyG.A.Laboratory variability in estrogen receptor (ER) assays.The Australian Experience. In Estrogen Receptor Assay in Breast Cancer by Sarfaty; Nash Keigtley Massons 1981 pp 57–68.
22.
KoendersA., Geurts-MoespotJ., HendriksT., BenraadTh. The Netherlands interlaboratory quality control program of steroid receptor assays in breast cancer. In Estrogen Receptor Assay in Breast Cancer, by Sarfaty; Nash; Keightley Masson 1981; pp 83–84.
23.
FumeroS., BerruttoG.P., PelizzolaD., GrilliS., ButtazziC., Di FronzoG., RonchiE., BozzettiE., MoriP., ConcolinoG., MarocchiA., Robustelli Della CunaG., ZiberaC., CerruttiG., RosA., PiffanelliA.Results of the Italian interlaboratory quality control program for estradiol receptor assay.Tumori1981; 67: 301–306.
24.
LeclerqG.Routine Assays for Steroid Hormone Receptors. In Recent Results in Cancer Research, SpringerVerlag1984; Vol. 91: 12–17.
25.
KingR.J.B.Quality control of estradiol receptor analysis: the United Kingdom experience.Eur J Cancer Clin Oncol1983; 19: 357–363.
26.
OxleyD.K., HavenG.T., WittliffJL, GilboD.Precision in estrogen and progesterone assay, results of the first CAP pilot survey.Am J Clin Path1982; 78: 587–589.
27.
WelsonW.V., LiebermanM.E., GorskiJ.Nuclear localization of unoccupied estrogen receptors.Nature1984; 307: 747–749.
28.
JensenE.V.Intracellular localization of estrogen receptors: implications for interaction mechanism.Lab Invest1984; 51: 487–488.
29.
HorwitzK.B., WeiL.L., SedlacekS.M., D'arvilleC.N.Proge-stin action and progesterone receptor structure in human breast cancer: a review.Rec Progr Horm Res1985; 41: 249–316.
30.
KnowlerJ.T., BeaumontJ.M.The mechanism of action of estrogen.Assays in Bioch1985; 20: 1–39.
31.
KrisR.M., LibermannT.A., AviviA., SclessingerJ.Growth factors, growth-factor receptors and oncogenes.Biotechnology1985; 135–138.
32.
GreenS., WalterP., KumarV.. Human oestrogen receptor cDNA: sequence, expression and homology to v-erb-A.Nature1986; 320: 134–139.
