Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Pathology, Chulalongkorn University, Bangkok, Thailand.
Curr Hematol Malig Rep. 2019 Oct;14(5):368-375. doi: 10.1007/s11899-019-00533-9.
Immunohistochemistry is an integral technique for tissue-based diagnostics and biomarker detection with broad worldwide adoption. Advances in core chemistries, antibody design, and automation have ushered unprecedented sensitivity, specificity, and reproducibility in immunohistochemistry assays. As a result, clinical immunohistochemistry assays that utilize dual-color approaches and mutation-specific antibodies provide novel tools in clinical diagnostics that until recently were in the realm of investigational research. This review provides an overview of innovations in clinical immunohistochemistry assays with emphasis on those used for patients with hematopoietic neoplasms.
Advances in clinical-grade immunohistochemistry techniques have allowed labs to develop and validate multiplex assays that improve diagnostic utility-such as CD5/PAX5 and TCF4/CD123 dual-color stains-and have the potential to enhance the specificity of biomarker detection. In addition, the increased availability of immunohistochemistry assays that detect mutant proteins (e.g., BRAF V600E and IDH1 R132H) provides a helpful replacement and/or adjunct for molecular testing. These techniques are highly reproducible, entail reasonable technical and interpretation complexity, and are relatively cost-effective, making them valuable novel tools in modern cancer care. Multiplex and mutation-specific immunohistochemistry assays represent important innovations that provide improved utility in the context of personalized medicine and targeted therapy.
免疫组织化学是一种基于组织的诊断和生物标志物检测的重要技术，在全球范围内得到广泛应用。核心化学、抗体设计和自动化方面的进步，为免疫组织化学检测带来了前所未有的灵敏度、特异性和重现性。因此，利用双色方法和突变特异性抗体的临床免疫组织化学检测为临床诊断提供了新的工具，这些工具在不久前还处于研究领域。本文综述了临床免疫组织化学检测的创新，重点介绍了用于血液系统恶性肿瘤患者的检测。
临床级免疫组织化学技术的进步使实验室能够开发和验证多重检测方法，提高诊断效用，如 CD5/PAX5 和 TCF4/CD123 双色染色，并有可能提高生物标志物检测的特异性。此外，更多可检测突变蛋白的免疫组织化学检测方法（如 BRAF V600E 和 IDH1 R132H）的出现，为分子检测提供了有益的替代和/或辅助手段。这些技术具有高度的可重复性，技术和解释的复杂性适中，且相对具有成本效益，因此成为现代癌症治疗中极具价值的新工具。多重和突变特异性免疫组织化学检测是重要的创新，在个性化医疗和靶向治疗方面提供了更好的应用。
