Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas (original) (raw)
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PLOS ONE, 2016
Background & Aims Adenocarcinomas of the pancreatobiliary system are currently classified by their primary anatomical location. In particular, the pathological diagnosis of intrahepatic cholangiocarcinoma is still considered as a diagnosis of exclusion of metastatic adenocarcinoma. Periampullary cancers have been previously classified according to the histological type of differentiation (pancreatobiliary, intestinal), but overlapping morphological features hinder their differential diagnosis. We performed an integrative immunohistochemical analysis of pancreato-biliary tumors to improve their diagnosis and prediction of outcome. Methods This was a retrospective observational cohort study on patients with adenocarcinoma of the pancreatobiliary system who underwent diagnostic core needle biopsy or surgical resection at a tertiary referral center. 409 tumor samples were analyzed with up to 27 conventional antibodies used in diagnostic pathology. Immunohistochemical scoring system was the percentage of stained tumor cells. Bioinformatic analysis, internal validation, and survival analysis were performed. Results Hierarchical clustering and differential expression analysis identified three immunohistochemical tumor types (extrahepatic pancreatobiliary, intestinal, and intrahepatic cholangiocarcinoma)
Immunohistochemistry of pancreatic neoplasia
Methods in molecular biology (Clifton, N.J.), 2013
Immunohistochemistry (IHC) is a valuable tool to visualize the distribution and localization of specific cellular components within morphologically preserved tissue sections or cell preparations. It combines the histologic morphology of tissues for detecting the actual antigen distribution, specificity of antibody-antigen interaction for optimal detection, and sensitivity of immunochemical methods for assessing the amount of antigen in tissues. It is routinely used clinically to diagnose type (benign or malignant), stage, and grade of cancer using specific tumor markers. The application of IHC ranges from disease diagnosis and prognosis to drug development and analysis of the pathobiological roles of various molecular players during disease development. Due to better availability of highly specific antibodies and optimal methodologies for performing immunohistochemical studies, IHC is being used at an expanding rate to understand pancreatic tumor biology as well as to study the fate...
Role of Immunoscintigraphy in Clinical Assessment of Gastrointestinal Tumors
Tumori Journal, 1990
From June 1986 until April 1989 31 patients with gastrointestinal tumors were studied at follow-up for recurrences by Immunoscintigraphy (IS) using F(ab)2 fragments of monoclonal antibodies anti CEA and anti CA 19-9. IS was employed to confirm the presence of metastases already found (group A) and to verify metastases suspected following physical and Instrumental examinations and/or increases in CEA and/or CA 19-9 (group B). Thirty-four IS findings have been evaluated to date: 19 in group A, with 18 true positive and 1 false negative results; 15 in group B. In these patients there were 12 cases of pathologic high fixation: 6 were confirmed using standard examinations after a median follow-up of 1 month (range 1-12); 6 cases had no metastatic evolution at the suspected site after a follow-up of 5-28 months. In 3 cases IS was negative, these patients are disease free at 13, 14 and 24 months. In group B, 5 of 8 abdominal intense fixations were early diagnoses of local or peritoneal rec...
Clinical Oncology, 1992
Twenty-five patients treated surgically for gastrointestinal carcinomas (16 rectum-sigmoid colon, 6 colon, 3 stomach) were investigated by immunoscintigraphy (IS) using H~In-labelled anti-CEA antibody (mouse monoclonal F023C5) F(ab')2 fragments in order to visualize questionable abdominopelvic recurrences (excluding the liver). Fifteen (60%) patients showed a rise in serum CEA levels above 5 ng/ml. Planar scans and emission computed tomographic (ECT) imaging were carried out without reference to the results of computed tomographic (CT) scans and gastrointestinal endoscopic examinations done 1-2 weeks before IS. Final diagnoses were based on biopsies and autopsies (13 cases) or on follow-up findings over at least 2 years (12 cases). Sixteen patients had a final diagnosis of recurrent malignant disease in the extrahepatic abdomen or pelvis. Of these, six were correctly diagnosed by both IS and conventional diagnostic procedures, six by IS only and two by conventional methods only. Two tumour recurrences remained undetected by both diagnostic approaches. However, five tumour recurrences were detected by IS more than 4 months earlier than by any other diagnostic procedures performed during clinical follow-up. Of the nine disease-free patients (disregarding the liver) three were correctly identified by both IS and the other diagnostic methods, four by IS only and two by conventional diagnostic procedures only. Overall sensitivity (75%) and specificity (89%) of HIIn-IS were higher than figures obtained using CT scanning and endoscopy (50% and 78% respectively). True positive IS was observed in 6/15 (40%) CEA seropositive patients and in 6/10 (60%) CEA seronegative patients. Our comparative study (performed blind) supports the main role of immunoscintigraphy with fragments of anti-CEA monoclonal antibodies in the early detection of extrahepatic recurrences of Correspondence and offprint requests to: gastrointestinal carcinomas in both CEA seropositive and seronegative patients.
Monoclonal antibodies (mAbs) are produced by clones of a unique parent cell which has monovalent affinity and can bind to the same epitope. The chronological breakthrough in mAbs clinical utilization was in 1975, when it becomes possible to produce mAbs to known antigens and immortalize the cell lines. However, the clinical usefulness of mAbs was hampered for many years, basically because of their immunogenicity due to the murine origin. This situation lasted until 1988 when a technique to humanize mAbs was defined. Nuclear Medicine researchers were very quick to gathered the opportunity provided by the development of mAbs. The first papers reporting the preclinical use of radiola-belled mAbs date the early 80's soon followed by the first pivotal use in humans. However, mAbs did not gain a wide clinical use for several reasons connected to the chemistry and biochemistry of radiolabelled mAbs the emergence of clinical 18 F-FDG PET. However, the " magic bullet " concept has resisted in the cultural background of Nuclear Medicine physicians for almost twenty years, and has regained importance with the development of engineered mAbs. Herein we present a selected review of preclinical and clinical studies of PET/CT with mAbs in gastrointestinal malignancies.
Clinics in Laboratory Medicine, 2013
Pancreatic neoplasms, including ductal adenocarcinoma, solid pseudopapillary neoplasm, pancreatic endocrine neoplasms, acinar cell carcinoma, and pancreatoblastoma, are associated with different genetic abnormalities. Hepatic adenomas with b-catenin exon 3 mutation are associated with a high risk of malignancy. Hepatic adenoma with arginosuccinate synthetase 1 expression or sonic hedgehog mutations are associated with a risk of bleeding. Hepatocellular carcinoma and cholangiocarcinoma display heterogeneity at both morphologic and molecular levels. Cholangiocellular carcinoma is most commonly associated with IDH 1/2 mutations.
Annals of Hepatology, 2011
Introduction. A variety of primary and secondary malignant tumours may present in the liver. In clinical practice the most commonly encountered hepatic tumours are primary hepatocellular carcinoma, metastatic carcinoma and primary cholangiocarcinoma, each with its separate prognostic and management implications. When these tumours are poorly differentiated and the biopsy size is limited to a needle core, the distinction can be extremely difficult. Material and methods. All liver tumours reported between 1994 and 2004 were examined. Slides from each case were tested separately with each of nine antibodies (HepPar1, CD10, MOC31, Villin, pCEA, mCEA, CK7, CK19, and CK20). Results. Liver biopsy tissue from 53 patients was examined in this retrospective study. The 53 liver biopsies were classified thus: hepatocellular carcinoma (n = 23); metastatic adenocarcinoma (n = 15); cholangiocarcinoma (n = 5); metastatic small cell carcinoma (n = 7); liver cell dysplasia (n = 1); carcinoid (n = 1); and unclassified (n = 1). Sensitivity and specificity values for different antibodies in relation to their positive staining of specific tumours was as follows: HepPar1 for HCC-81.8% and 100%; MOC31 for MA-73.3% and 92.1%; MOC31 for MA and CC as a combined group-65% and 100%; pCEA (canalicular) for HCC-82.6% and 83.3%; mCEA for MA-93.3% and 75.6%; CK7 for CC-100% and 68%; CK19 for MA and CC as a combined group-90% and 86.3%. Conclusions. An antibody panel consisting of HepPar1, pCEA, CK19 and CK7 together with either MOC31 or mCEA is recommended for use in the differential diagnosis of HCC, MA and CC.
The Role of Immunohistochemistry in the Evaluation of Undifferentiated Gastric Cancer
مجلة جامعة دهوك, 2017
Background: With the advance in medical practices, gastric cancer remains one of the deadly diseases with poor prognosis. Appropriate diagnosis of the histological gastric cancer type may improve the treatment and the prognosis. The objective of this study is to apply immunohistochemical (IHC) markers for the diagnosis of undifferentiated gastric malignancies. Among 126 patients diagnosed as cases with malignant gastric tumors, from September 2008 to September 2013, 55 cases were assigned as undifferentiated tumors and were subjected to IHC evaluation by application of many IHC markers and special stains for further categorization; Results: After the application of different IHC markers and special stains, the 55 cases which were assigned as undifferentiated revealed to be carcinoma (37 cases), lymphoma (9 cases), gastrointestinal stromal tumors (GIST) (7 cases) and leiomyosarcoma and neuroendocrine tumor one case for each. IHC findings had changed the primary diagnoses based on morphological data in 4 instances; two cases were thought to be signet ring carcinoma and proved by IHC to be lymphomas and other two cases were thought to be poorly differentiated adenocarcinoma and proved to be GIST. Therefore; IHC is a valuable tool for the diagnosis of undifferentiated malignant gastric tumors.