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Imunohistochemistry (IHC)
Central Dogma
Gene
Genome
Transcription
RNA
Transcriptome
Translation
Protein
Proteome
Methods
DNA
PCR
Southern Blotting
RNA
RT PCR
Real time PCR
In situ hybridization
Northern blot
PROTEIN
Immunohistochemistry
Immunofluorescence
Western Blotting
Elisa
IMMUNOHISTOCHEMISTRY
(IHC)
Immunohistochemistry is a method of
detecting the presence of specific
molecule or proteins in cells or tissues
based on antigen- antibody reaction.
Materials (on glass Slide)
Tissue
(Paraffin block/frozen section)
Cell (smear cell by FNA or Cell Culture)
Goal of IHC
To study cellular markers that define
specific phenotypes for:
1. Diagnostic
2. Prognostic
3. Therapeutic
4. get Any information related to disease status
and biology.
DIAGNOSIS
LCA
AE1/3
VIM
S100
-/+
KARSINOMA -
-/+
SARKOMA
-/+
-/+
MELANOMA
LIMFOMA
History of IHC
Albert H. Coons and his colleagues (1941,
1955) were the first to label antibodies with a
fluorescent dye, and use it to identify
antigens in tissue sections.
1970s new detection systems using
peroxidase-anti-peroxidase system
1980 ABC (Avidin Biotin Complex) system
level.
TERM
Antigen : any molecule that has generated an antibody
response. Epitope is part of antigen which react with
antibody.
Antibody: Immunoglobulin (mainly IgG) or glycoprotein
that bind with high affinity and specificity to antigen.
Polyclonal ab : are produced by different cells
Monoclonal ab : the product of an individual clone of plasma
cell
Antibodies
Polyclonal vs Monoclonal
Polyclonal:
Quicker and simpler to obtain by immunization of
animal
More sensitivity but less specificity than monoclonal,
cause heterogenitas nature of antibody.
Monoclonal:
Monospecifcity (to single epitope)
Consuming time to generate but immortality
DIRECT
The primary antibody has the label
INDIRECT
Using labeled secondary antibody
Indirect detection
Peroxidase anti peroxidase (PAP method)
Localize primary antibody with bridgig ab (secondary
ab) to tertiary complex which contain the labels
Tertiary complex develope from the same animals in
primary ab for succesfull bridging.
Labeling
Enzymes
Horseradish Peroxidase (HRP)
Alkaline Phosphatase (ALK)
Glucose Oxidase
VEGF + in placenta
PROGESTERON RECEPTOR
Staining
Nuclear
staining
judge as
positive
ER,brown
staining in the
nucleus
Immunohistochemistry
Various factor contribute good result in IHC
Preanalytic phase
IHC needs proper tissue handling by the Surgeon
IHC needs proper tissue processing by pathologist
Fixation, processing
Analytic phase
Laboratory of pathology
Reagents, IHC technique and controls
0 (negative)
1+ (negative)
2+ (equivocal)
3+ (positive)
Important Issues
Prognostic factors
Morphology based
molecular based
Prognostic factor
College of American Pathologist 1999
I
Stage
Histological type
Histological grade
Mitosis
ER/PR
III.
EGFR, TGF, BCL2,
Cathepsin D
II
Her2
Proliferation index
Vessel invasion
P53
Conventional therapy
Molecular targeted
therapy
Nonselective
High morbidity
Poor quality of life
Selective
Low morbidity
Better quality of life
IMMUNOHISTOCHEMISTRY (IHC)
ER/PR+
Favorable DFS/OS
Response to hormon
therapy 80%
Response to hormone
therapy 60%
Low grade histology
Cathepsin D +
Metastatic potential
P53
Aggressive course
Resistance to
hormonal th/
Resistance to CMF
Responsive to
antracyclin and anti
her2
High histological
grade
Unfavourable Survival
rate
Recurrence>>
Short survival
Resistance to
chemotherapy
Negative staining of ER
Immunohistochemistry of
Her2/Neu
Cytoplasmic staining
of Her2 positive