Lack of correlation of a histochemical method for estrogen receptor analysis with the biochemical assay results

Forty‐nine specimens of carcinoma of the breast were analyzed for estrogen receptor content using the sucrose gradient method and a histochemical method using a conjugate of estradiol (6‐BSA‐Fluor‐CMO‐17β‐estradiol). The specimens analyzed by the histochemical method were graded for fluorescent intensity, percentage of cells fluorescing, and cellularity. Only 53.1% (26/49) of the specimens were classified into the same three categories (positive, negative and ambiguous) as classified by the biochemical assay. If the negative and ambiguous categories were combined, the degree of correspondence rose to only 63.3% (31/49). Because the classification scheme was arbitrary and because the results of the biochemical assay might be correlated with one or more factors, univariate and multivariate analyses were used to examine the data for any underlying relationships. Only the age of the patient was significantly correlated with the results of the biochemical assay. Importantly, neither the percentage of cells fluorescing nor the fluorescent intensity was correlated with the results of the biochemical assay. Terms to account for various interactions of parameters did not enhance the association with the biochemical results. While this histochemical assay may eventually prove to be effective in selecting patients for endocrine therapy, it does not seem to be a substitute for the standard biochemical assay for estrogen receptors presently used.