The role of immunohistochemical technique by e2f57F39

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									Department of pathology kufa university 2010




                                                   The role of
                                               immunohistochemical
                                                   technique
                                               in histopathology lab.
                                                        By
                                               Dr. kaswer Al Toriahi
Department of pathology kufa university 2010




                                                      ImmunoHistoChemistry

                                               Detection of antigens by antibodies and
                                                   visualized under microscope.
                                                  Loction of antigen
Department of pathology kufa university 2010




                                                                             p63
                                               Antigens everywhere !




                                                                       p16
                                                                                        2007 > 1000 markers
                                                Historical back ground                  for different tumors
Department of pathology kufa university 2010




                                                Coon         Taylor & Huang            Shi
                                               Label. Ab      Protease               HIER               Experience
                                               IgK/L          IgK/L                  B&T cells          >100 CD
                                               Frozen         Paraffin




                                                           1940               1974               1991          2003
                                               Application
Department of pathology kufa university 2010




                                                Essential applications
                                                      * Study of cytological and histological differentation
                                                       and function
                                                      * Study of pathogenic mechanisms
                                                      * Identification and classification of micro-organisms
                                                      * Identification and classification of neoplasms
                                                               ** Histogenetics and subtype classification
                                                                        *** Therapy
                                                                        *** Prognosis
                                               IHC performed on 25-75% off all specimens
Department of pathology kufa university 2010




                                               IHC needed in 10-25% of malignant tumours
                                               IHC studies valuable in 90% (of the 25%)
                                                * 50% gained important information in
                                                      ** Narrowing of possibilities
                                                      ** Specific diagnosis
                                                                 * 90% of anaplastic or undifferentied tumours classified
                                                                 * 50% of malignant lymphomas reclassified
                                                      ** Unsuspected diagnosis
                                                * 40% of diagnosis confirmed
                                                * 10% of case need further investigation
                                                Benefit in cancer classification

                                               Cancers are classified by the type of cell that resembles the
Department of pathology kufa university 2010




                                               tumor and, therefore, the tissue presumed to be the origin of
                                               the tumor. Is that easy?

                                               Carcinoma? Lymphoma ? Sarcoma ? Mesothelioma ?




                                                Rabbit ?                 Dubbit ?                       Duck ?
                                               Surgery & sampling




                                                                                     Pathology workflow
Department of pathology kufa university 2010




                                                       Accessioning, Fixation & Grossing

                                                                                                     Today                                                       Patient
                                                                                                                                                                 record
                                                                                                                                                           Microscopy/image analys

                                                  Tissue
                                                  sample
                                                Processing & Paraffin embedding

                                                                                                                          Microscopy                               IHC staining
                                                                              Patient ID on slide
                                                                                                                                   Approx. 15% for
                                                                                                                                    further testing                           FISH
                                                         sectioning

                                                                         Tissue on slide                           H&E staining                       Target retrieval
                                                                                                    Deparaffinization
                                                                                                                  Special stains
                                               Steps of IHC
Department of pathology kufa university 2010



                                                                 The IHC multiparameter complexity
                                                            The IHC multiparameter complexity
                                                        Fixation            Beast”
                                                                       “The“The Beauty”
                                                        Time, Type, Volume
                                                                                                                             Primary antibody
                                               Decalcification                                                               Clone, Dilution
                                               Preparation                Pre-
                                                                        analytic
                                                  Tissue                                       Pre-treatment
                                                  Type, Dimension,                 Section
                                                                                   Thickness
                                                                                   Storage                                     Analytic
                                                                                                  Visualization
                                                                                                  Sensitivity, Specificity
                                                                         Post-                                                      Methods of
                                                                                                                                    Stain
                                                                        analytic
                                                                                       Interpretation
                                                       Quantification                  Localization
                                                       Reporting                       Positive/Negative - cut-off level
Department of pathology kufa university 2010




                Thank you

								
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