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Int J Clin Exp Pathol 2010;3(2):169-176

Review Article
Immunohistochemistry in  diagnostic surgical pathology: contributions of protein life-
cycle, use of evidence-based methods and data normalization on interpretation of
immunohistochemical stains

Halliday A. Idikio

Department of Pathology and Laboratory Medicine, University of Alberta, Canada

Received May 8, 2009; Accepted November 17, 2009; Available online November 25, 2009

Abstract: Immunohistochemical (IHC) staining of formalin-fixed and paraffin-embedded tissues (FFPE) is widely used in diagnostic surgical
pathology. All anatomical and surgical pathologists use IHC to confirm cancer cell type and possible origin of metastatic cancer of unknown
primary site. What kinds of improvements in IHC are needed to boost and strengthen the use of IHC in future diagnostic pathology practice?
The aim of this perspective is to suggest that continuing reliance on immunohistochemistry in cancer diagnosis, search and validation of
biomarkers for predictive and prognostic studies and utility in cancer treatment selection means that minimum IHC data sets including
“normalization methods” for IHC scoring, use of relative protein expression levels, use of protein functional pathways and modifications and
protein cell type specificity may be needed when markers are proposed for use in diagnostic pathology. Furthermore evidence based methods
(EBM), minimum criteria for diagnostic accuracy (STARD), will help in selecting antibodies for use in diagnostic pathology. In the near future,
quantitative methods of proteomics, quantitative real-time polymerase chain reaction (qRT-PCR) and the use of high-throughput genomics for
diagnosis and predictive decisions may become preferred tools in medicine. (IJCEP905002).

Key words: Immunoperoxidase, protein lifecycle, surgical pathology, roteomics, evidence based methods, normalization

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Address all correspondence to:
Halliday  A  Idikio,  MD
University of Alberta
Department of Pathology and Laboratory Medicine
5B4.11 Walter MacKenzie Health Sciences Center
8440-112 th Street
Edmonton, ALBERTA T6G 2B7
CANADA
Tel 1-780-407-7271; Fax 1-780-407-3009
E-mail:
hidikio@ualberta.ca