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Fluoro-Chromogenic Labelling for Detection of MCM2 to Assess Proliferation Activity in HER2-amplified Breast Carcinomas.

Abstract
Minichromosome Maintenance Protein 2 (MCM2) is critical in initiating DNA replication during the cell division process. As expressed intensively in all phases of the active cell cycle, MCM2 has been proposed as a novel biomarker to determine cellular proliferation. We aimed at clarifying the prevalence and clinical significance of MCM2 in HER2-amplified breast cancer subtype. MCM2 expression was studied in 142 primary HER2-amplified breast carcinomas by applying a novel fluoro-chromogenic immunohistochemistry and tailored digital image analysis to determine labelling index (MCM2-LI). The presence of MCM2 was detected with HRP-conjugated polymer and visualized with 3, 3'-diaminobenzidine tetrahydrochloride, in cytokeratin (CK)-positive and Cy2-IgG-labelled breast cancer cells of epithelial origin. Stained slides were digitized by scanning sequentially under bright field (for MCM2) and fluorescence (for CK) illumination. Multilayer JPEG2000 images were analyzed with ImmunoRatio 2.5 (accessory in SlideVantage 1.2 software) utilizing its bright field and fluorescence image-blending mode to display MCM2-CK dual-positive cells. MCM2-LI was retrospectively compared with histopathologic characteristics and patients' clinical outcome. MCM2 protein-expressing cells (median MCM2-LI, 63.5%) were more frequent than those of Ki67 (median Ki67 labelling index, 33%). Significant correlations were found between high MCM2-LI, high Ki67 labelling index, negative hormone receptor (ER, PR) statuses, high grade of malignancy, and high cyclin E expression. MCM2-LI was not shown to be predictive of disease recurrence during the median follow-up of 5.3 years but was shown to be useful to distinguish aggressive-type HER2-amplified breast carcinomas with high malignancy grade and hormone receptor negativity. The fluoro-chromogenic double-labelling immunohistochemistry accompanied with digital image analysis provides an accurate carcinoma-specific determination of MCM2-LI on a single tumor section.
AuthorsSatu Luhtala, Teppo Haapaniemi, Synnöve Staff, Jorma Isola
JournalApplied immunohistochemistry & molecular morphology : AIMM (Appl Immunohistochem Mol Morphol) Vol. 28 Issue 3 Pg. 175-186 (03 2020) ISSN: 1533-4058 [Electronic] United States
PMID30358612 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • MCM2 protein, human
  • Minichromosome Maintenance Complex Component 2
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms (genetics, metabolism, pathology)
  • Cell Proliferation
  • Female
  • Follow-Up Studies
  • Gene Amplification
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Minichromosome Maintenance Complex Component 2 (genetics, metabolism)
  • Receptor, ErbB-2 (genetics, metabolism)
  • Retrospective Studies
  • Staining and Labeling

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