Shidham Vinod B, Layfield Lester J
Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Detroit, Michigan, USA.
Department of Pathology and Anatomical Sciences, University of Missouri, One Hospital Drive, Columbia, Missouri, United States.
Cytojournal. 2021 Jan 30;18:2. doi: 10.25259/Cytojournal_83_2020. eCollection 2021.
The interpretation of results on immunostained cell-block sections has to be compared with the cumulative published data derived predominantly from formalin-fixed paraffin-embedded (FFPE) tissue sections. Because of this, it is important to recognize that the fixation and processing protocol should not be different from the routinely processed FFPE surgical pathology tissue. Exposure to non-formalin fixatives or reagents may interfere with the diagnostic immunoreactivity pattern. The immunoprofile observed on such cell-blocks, which are not processed in a manner similar to the surgical pathology specimens, may not be representative resulting in aberrant results. The field of immunohistochemistry (IHC) is advancing continuously with the standardization of many immunomarkers. A variety of technical advances such as multiplex IHC with refined methodologies and automation is increasing its role in clinical applications. The recent addition of rabbit monoclonal antibodies has further improved sensitivity. As compared to the mouse monoclonal antibodies, the rabbit monoclonal antibodies have 10 to 100 fold higher antigen affinity. Most of the scenarios involve the evaluation of coordinate immunostaining patterns in cell-blocks with relatively scant diagnostic material without proper orientation which is usually retained in most of the surgical pathology specimens. These challenges are addressed if cell-blocks are prepared with some dedicated methodologies such as NextGen CelBloking™ (NGCB) kits. Cell-blocks prepared by NGCB kits also facilitate the easy application of the SCIP (subtractive coordinate immunoreactivity pattern) approach for proper evaluation of coordinate immunoreactivity. Various cell-block and IHC-related issues are discussed in detail.
免疫染色细胞块切片结果的解读必须与主要来自福尔马林固定石蜡包埋（FFPE）组织切片的累积已发表数据进行比较。因此，重要的是要认识到固定和处理方案不应与常规处理的FFPE手术病理组织不同。接触非福尔马林固定剂或试剂可能会干扰诊断性免疫反应模式。在这些细胞块上观察到的免疫图谱，如果其处理方式与手术病理标本不同，可能不具有代表性，从而导致异常结果。随着许多免疫标志物的标准化，免疫组织化学（IHC）领域在不断发展。多种技术进步，如采用精细方法和自动化的多重IHC，正在增加其在临床应用中的作用。最近添加的兔单克隆抗体进一步提高了灵敏度。与小鼠单克隆抗体相比，兔单克隆抗体的抗原亲和力高10至100倍。大多数情况涉及在细胞块中评估协调免疫染色模式，这些细胞块的诊断材料相对较少且没有正确的方向，而大多数手术病理标本通常保留有正确方向。如果使用一些专用方法（如下一代细胞块制备（NGCB）试剂盒）制备细胞块，这些挑战就能得到解决。用NGCB试剂盒制备的细胞块也便于轻松应用SCIP（减法协调免疫反应模式）方法来正确评估协调免疫反应。本文将详细讨论各种与细胞块和免疫组化相关的问题。
