Review Article Immunohistochemistry in diagnostic surgical pathology: contributions of protein life- cycle, use of evidence-based methods and data normalization on interpretation of immunohistochemical stains
Halliday A. Idikio
Department of Pathology and Laboratory Medicine, University of Alberta, Canada
Received May 8, 2009; Accepted November 17, 2009; Available online November 25, 2009
Abstract: Immunohistochemical (IHC) staining of formalin-fixed and paraffin-embedded tissues (FFPE) is widely used in diagnostic surgical pathology. All anatomical and surgical pathologists use IHC to confirm cancer cell type and possible origin of metastatic cancer of unknown primary site. What kinds of improvements in IHC are needed to boost and strengthen the use of IHC in future diagnostic pathology practice? The aim of this perspective is to suggest that continuing reliance on immunohistochemistry in cancer diagnosis, search and validation of biomarkers for predictive and prognostic studies and utility in cancer treatment selection means that minimum IHC data sets including “normalization methods” for IHC scoring, use of relative protein expression levels, use of protein functional pathways and modifications and protein cell type specificity may be needed when markers are proposed for use in diagnostic pathology. Furthermore evidence based methods (EBM), minimum criteria for diagnostic accuracy (STARD), will help in selecting antibodies for use in diagnostic pathology. In the near future, quantitative methods of proteomics, quantitative real-time polymerase chain reaction (qRT-PCR) and the use of high-throughput genomics for diagnosis and predictive decisions may become preferred tools in medicine. (IJCEP905002).
Key words: Immunoperoxidase, protein lifecycle, surgical pathology, roteomics, evidence based methods, normalization
Address all correspondence to: Halliday A Idikio, MD University of Alberta Department of Pathology and Laboratory Medicine 5B4.11 Walter MacKenzie Health Sciences Center 8440-112 th Street Edmonton, ALBERTA T6G 2B7 CANADA Tel 1-780-407-7271; Fax 1-780-407-3009 E-mail: hidikio@ualberta.ca