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Immunohistochemistry in diagnostic surgical pathology: contributions of protein life-cycle use of evidence-based methods and data normalization on interpretation of immunohistochemical stains

机译:免疫组织化学在诊断性手术病理学中的作用:蛋白质生命周期的贡献基于证据的方法的使用和数据标准化对免疫组织化学染色的解释

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摘要

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.
机译:福尔马林固定和石蜡包埋组织(FFPE)的免疫组织化学(IHC)染色广泛用于诊断性手术病理学。所有解剖​​和外科病理学家都使用IHC来确认癌细胞类型以及原发部位未知的转移性癌症的可能来源。为了在将来的诊断病理学实践中促进和加强对IHC的使用,需要对IHC进行哪些改进?该观点的目的是表明,在癌症诊断,寻找和验证生物标志物以进行预测和预后研究以及在癌症治疗选择中的效用方面继续依赖免疫组化手段意味着,最低的IHC数据集包括IHC评分的“归一化方法”,当提出将标记物用于诊断病理时,可能需要相对蛋白表达水平,蛋白功能途径和修饰以及蛋白细胞类型特异性的使用。此外,基于证据的方法(EBM),诊断准确性的最低标准(STARD)将有助于选择用于诊断病理的抗体。在不久的将来,蛋白质组学的定量方法,定量实时聚合酶链反应(qRT-PCR)以及将高通量基因组学用于诊断和预测决策的方法可能会成为医学中的首选工具。

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