When a patient receives a pathology report, the most concerned thing is the diagnosis result. When the diagnosis result is clear, the patient's treatment will also be relatively clear. However, some reports may contain words such as suggesting immunohistochemical examination. At this time, the patient is more nervous. My pathology examination has already been done, why should I continue to do the examination? Is my result not good? What is immunohistochemical examination? They are all filled with worry and confusion. Don't be nervous when encountering this situation. Let's delve into the pathology and uncover the mysterious veil of immunohistochemistry.
The so-called immunohistochemical examination is the abbreviation for immunohistochemical examination. The main principle is to use antigen antibody reaction, that is, to detect the presence of corresponding antigens in tissue slices with specific antibodies, in order to analyze tumor cells or tissue types. It sounds very professional and complex. Simply put, immunohistochemistry can help us better diagnose the type and nature of tumors. This is the routine work carried out by the pathology department at present, which plays an important role in both pathological diagnosis and differential diagnosis. Therefore, it is also compared to the capable assistant of pathological examination, the flying wings.
Generally speaking, for common diseases, clear pathological diagnosis can be made based on the morphology of the lesions. However, in routine tumor pathological diagnosis, about 10% of cases are difficult to make a clear diagnosis solely based on basic hematoxylin eosin staining. Some tumor types are rare or have similar morphological manifestations between different tumors. In order to make the diagnosis accurate, it is necessary to further exclude similar lesions and clarify the pathological type through immunohistochemical examination. For example, when the pathological morphology suggests a high-grade small cell malignant tumor, we must use immunohistochemistry to further classify the lesion as small cell carcinoma, lymphoma, or other high-grade small cell sarcoma, especially in the differential diagnosis of poorly differentiated or undifferentiated tumors. Immunohistochemistry can achieve an accuracy rate of 75% in diagnosis. With the advancement of technology, the development of medicine, and the deepening of understanding of diseases, immunohistochemistry has been widely recognized in pathological diagnosis and clinical treatment. In addition to differential diagnosis, immunohistochemistry is also increasingly used in other applications, including ① identifying the location of the primary tumor; ② Provide targets for targeted therapy of malignant tumors; ③ Predicting and assessing the prognosis of tumors, etc.
So what should be done for cases that cannot be diagnosed clearly after immunohistochemical testing? Don't worry, we have another 'magic weapon' - molecular pathology examination, which can achieve accurate diagnosis of diseases at the protein and gene levels. In the era of precision medicine, only with clear pathological diagnosis can clinical doctors provide personalized precision medicine for patients based on their diseases. However, due to the relatively high cost of molecular testing, most cases choose to use immunohistochemical testing first.
Although immunohistochemistry technology is already mature, it is time-consuming and labor-intensive due to the cumbersome steps and strict standards required for experimental operations. Sometimes, positive controls need to be added to assist in judgment. These tasks still need to be completed through routine paraffin sectioning and observed and diagnosed by pathologists under the microscope before they can begin. Therefore, the report of immunohistochemical examination usually takes 7-14 working days to come out. At this time, patients must not be in a hurry. For an accurate pathological report and personalized precise treatment, these waiting times are worth it!