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Difference between revisions of "Immunohistochemical staining"
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→Quality control: pre-analytical variables
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#Prognostic markers, e.g. ERBB2 (HER2). | #Prognostic markers, e.g. ERBB2 (HER2). | ||
#Proving clonality - in the context of hematologic malignancies. | #Proving clonality - in the context of hematologic malignancies. | ||
#Mutation specific antibodies, eg. [[IDH-1]] R132H. | |||
Method was introduced in 1941 by Coons.<ref>{{Cite journal | last1 = Coons | first1 = AH. | title = The development of immunohistochemistry. | journal = Ann N Y Acad Sci | volume = 177 | issue = | pages = 5-9 | month = Jun | year = 1971 | doi = | PMID = 4400556 }}</ref> | |||
==Theory== | ==Theory== | ||
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This is an evolving area in pathology that has been ignored for a surprisingly long time. | This is an evolving area in pathology that has been ignored for a surprisingly long time. | ||
It is touched upon the in the ''[[quality]]'' article in the ''[[Quality#Immunohistochemistry|immunohistochemistry]]'' section. | It is touched upon the in the ''[[quality]]'' article in the ''[[Quality#Immunohistochemistry|immunohistochemistry]]'' section. | ||
There are at least 62 pre-analytical variables to be considered, that may affect staining results.<ref>{{Cite journal | last1 = Engel | first1 = KB. | last2 = Moore | first2 = HM. | title = Effects of preanalytical variables on the detection of proteins by immunohistochemistry in formalin-fixed, paraffin-embedded tissue. | journal = Arch Pathol Lab Med | volume = 135 | issue = 5 | pages = 537-43 | month = May | year = 2011 | doi = 10.1043/2010-0702-RAIR.1 | PMID = 21526952 }}</ref> | |||
==Interpretation== | ==Interpretation== | ||
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In cases where the morphology is unclear, it is judicious to have two or more immunostains that support the diagnosis, and negative stains for important entities in the differential diagnosis. | In cases where the morphology is unclear, it is judicious to have two or more immunostains that support the diagnosis, and negative stains for important entities in the differential diagnosis. | ||
Publications with contradicting | Publications with contradicting results are not uncommon. Differences can arise from the fixation, processing protocol, antibody clone and interpretation. | ||
According to Galloway, one third pathologists substantially overestimate the diagnostic significance of unexpected immunohistochemical staining results.<ref name=pmid21660231>{{Cite journal | last1 = Galloway | first1 = M. | title = Base-rate error in the interpretation of immunohistochemistry. | journal = Patholog Res Int | volume = 2011 | issue = | pages = 636495 | month = | year = 2011 | doi = 10.4061/2011/636495 | PMID = 21660231 }}</ref> | According to Galloway, one third pathologists substantially overestimate the diagnostic significance of unexpected immunohistochemical staining results.<ref name=pmid21660231>{{Cite journal | last1 = Galloway | first1 = M. | title = Base-rate error in the interpretation of immunohistochemistry. | journal = Patholog Res Int | volume = 2011 | issue = | pages = 636495 | month = | year = 2011 | doi = 10.4061/2011/636495 | PMID = 21660231 }}</ref> | ||
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===Breast markers=== | ===Breast markers=== | ||
*[[GCDFP-15]] ([[AKA]] BRST-2) -- specific, but NOT sensitive. | *[[GCDFP-15]] ([[AKA]] BRST-2) -- specific, but NOT sensitive. | ||
*ER (estrogen receptor) - in normal [[breast]]. | *[[Estrogen receptor|ER]] (estrogen receptor) - in normal [[breast]]. | ||
*PR (progesterone receptor) - in normal breast. | *PR (progesterone receptor) - in normal breast. | ||
*HER2/neu - pathological, assoc. with worse prognosis. | *HER2/neu - pathological, assoc. with worse prognosis. | ||