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Journal of Histochemistry and Cytochemistry, Vol. 45, 1559-1566, Copyright © 1997 by The Histochemical Society, Inc.

ARTICLE

Application of Photoshop-based Image Analysis to Quantification of Hormone Receptor Expression in Breast Cancer

Hans-Anton Lehra, David A. Mankoffb, David Corwinc, Guiseppe Santeusaniod, and Allen M. Gowna
a Department of Pathology, University of Washington, Seattle, Washington
b Department of Radiology, University of Washington, Seattle, Washington
c Dynacare Laboratory of Pathology, Seattle, Washington
d Cattedra di Anatomia Patologica, II Universita' di Roma, "Tor Vergata," Rome, Italy

Correspondence to: Hans-Anton Lehr, Institute of Pathology, Johannes Gutenberg University, Langenbeckstr. 1, 55101 Mainz, Germany.

The benefit of quantifying estrogen receptor (ER) and progesterone receptor (PR) expression in breast cancer is well established. However, in routine breast cancer diagnosis, receptor expression is often quantified in arbitrary scores with high inter- and intraobserver variability. In this study we tested the validity of an image analysis system employing inexpensive, commercially available computer software on a personal computer. In a series of 28 invasive ductal breast cancers, immunohistochemical determinations of ER and PR were performed, along with biochemical analyses on fresh tumor homogenates, by the dextran-coated charcoal technique (DCC) and by enzyme immunoassay (EIA). From each immunohistochemical slide, three representative tumor fields (x20 objective) were captured and digitized with a Macintosh personal computer. Using the tools of Photoshop software, optical density plots of tumor cell nuclei were generated and, after background subtraction, were used as an index of immunostaining intensity. This immunostaining index showed a strong semilogarithmic correlation with biochemical receptor assessments of ER (DCC, r = 0.70, p<0.001; EIA, r = 0.76, p<0.001) and even better of PR (DCC, r = 0.86; p<0.01; EIA, r = 0.80, p<0.001). A strong linear correlation of ER and PR quantification was also seen between DCC and EIA techniques (ER, r = 0.62, p<0.001; PR, r = 0.92, p<0.001). This study demonstrates that a simple, inexpensive, commercially available software program can be accurately applied to the quantification of immunohistochemical hormone receptor studies. (J Histochem Cytochem 45:1559-1565, 1997)

Key Words: quantitative, immunohistochemistry, image analysis, estrogen receptor, progesterone receptor, personal computer


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