Receptor analysis
Receptor analysis is a diagnostic testing process used to evaluate the presence and functionality of specific receptors in cells or tissues, particularly in the context of cancer. This analysis is vital for understanding how tumors may respond to various treatments, as many cancer types—including breast, prostate, lung, and colorectal cancers—are influenced by receptor signaling pathways. The assessment typically involves obtaining tissue samples through biopsy or surgery, which are then processed for techniques such as immunohistochemistry (IHC) or DNA sequencing to identify receptor expression patterns.
Key receptors examined include estrogen and progesterone receptors in breast cancer, androgen receptors in prostate cancer, and epidermal growth factor receptors (EGFR) in lung and colorectal cancers. The results of receptor analysis can guide therapeutic decisions, such as the use of targeted monoclonal antibodies or hormone therapies that are designed to inhibit tumor growth. For example, the presence of HER2 receptors in breast cancer can indicate the effectiveness of the antibody treatment trastuzumab (Herceptin).
Receptor analysis is not only crucial for diagnosis and treatment but is also integral to advancements in immunotherapy and the development of CAR T cell therapies for haematological malignancies. As cancer research progresses, the exploration of additional receptor types continues to enhance potential treatment options and improve patient outcomes.
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Subject Terms
Receptor analysis
ALSO KNOWN AS: Receptor status test
DEFINITION: Receptor analysis refers to diagnostic testing procedures carried out on cells or tissues to determine the abundance or functional integrity of specific receptors.
Cancers diagnosed: Breast cancer, cancer, prostate cancer, lung cancer, leukemia
Why performed: Many factors that stimulate cell growth start the mitogenic cascade by binding to specific cellular receptors, and one of the hallmarks of cancer is cell growth in the absence of these factors. This observation points to the critical role that receptors play in tumor cell growth and provides the basis for selecting drug regimens that target receptor-signaling pathways. Breast cancer is the most prominent tumor type in which receptor analysis plays a role, but abnormal growth factor receptors may also be a feature of other solid tumors (colorectal, prostate, lung) and some hematologic (blood) malignancies.
Patient preparation: Tissue samples are required and are obtained as part of tumor surgery or biopsy. Procedures done under general anesthetic require an overnight fast. Receptor analysis is performed on removed tumor tissue, and the patient requires no special or additional postoperative care. Sample collection in and patients is by a simple blood draw, which requires no fasting or special post-venipuncture care.
Steps of the procedure: After the appropriate tumor tissue samples are collected by the surgeon or phlebotomist, receptor analysis proceeds by fixing and processing the tissue for immunohistochemistry (IHC) or deoxyribonucleic acid (DNA) sequence analysis. IHC involves placing a very thin tumor slice on a microscope slide and incubation of it with preparations that react with the receptors of interest. After a washing step, other reagents are added that bind to the antireceptor antibodies and lead to chemical reactions that produce a visible color in cells with the receptors. Pathologists then examine the tissue to determine the percentage of tumor cells that express the receptor. In breast cancer, receptors for estrogen and progesterone are routinely determined by IHC, as is the orphan receptor HER2/neu (Erb B2). IHC is also used to determine androgen receptor expression in prostate cancer. In lung and colorectal cancer, DNA sequence analysis is done to characterize mutations in the epidermal growth factor receptor (EGFR). In suspected lymphoproliferative disorders, analysis of the T-cell receptor gene by polymerase chain reaction can be used to determine monoclonal expansion (a sign of malignancy).
After the procedure: The operative or site is kept clean and dry to avoid infection. No special instructions regarding receptor analysis are required.
Risks: The risks and side effects of the sample acquisition procedure may be significant; however, receptor analysis carries no additional risk to the patient. Some assays for the estrogen receptor have large interlaboratory variability and high false negative rates for tumors with low receptor expression.
Results: The retention of normal receptor status by cells is a favorable prognostic sign and forms the basis for a range of endocrine-based therapeutic options. In breast cancer patients, 15 to 40 percent of patients are expected to have amplified HER2/neu receptors, and a humanized monoclonal antibody to HER2 overexpressing breast cancer cells inhibits the growth of the cells. The antibody trastuzumab (marketed as Herceptin) increases the clinical benefit of first-line in metastatic breast cancer that overexpresses HER2. Breast cancers expressing estrogen and progesterone receptors may grow in response to these hormones, and patients may therefore benefit from antiestrogen drugs such as tamoxifen.
In prostate cancer cells, androgen receptors (ARs) are often overexpressed, and loss of the receptors is an unfavorable sign. AR-positive prostate cancer patients can be treated with leuprolide, which acts at the pituitary to decrease the secretion of gonadotropins. Lower gonadotropin levels result in lower androgen levels, which slows the growth of AR-positive tumor cells.
Tumors found to overexpress the EGFR may be treated with cetuximab, a monoclonal antibody that competitively inhibits the receptor, or with small molecules that inhibit the receptor's kinase activity.
Tumors can express various other growth factor receptors, notably those for insulin-like growth factor I(IGF-I) and vascular endothelial growth factor (VEGF). Inhibiting these receptors with specific compounds is a promising area of cancer research.
Receptor analysis plays a significant role in cancer diagnosis and treatment in the twenty-first century. Receptor analysis is critical in immunotherapy-based cancer treatments. The study of dependence receptors, which researchers hope will contribute to future cancer treatments, and sigma receptors, which play a role in tumor progression and spread, continue to revolutionize cancer study. Finally, receptor analysis has played a significant role in developing CAR T cell therapies used to treat lymphoma, leukemia, and multiple myeloma.
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