IHC is frequently used in the identification and classification of neoplasias in the GI tract, liver, bile ducts and pancreas. The presentation gives a systematic overview of clinically useful immunomarkers in this field, such as Cytokeratins, CDX2, SATB2, Cadherin 17, MMR-proteins, Synaptotophysin, Chromogranin, SMAD4, Arginase, Glypican 3, CD10, CD66a, CD117 and DOG1. Their diagnostic application as well as technical and clinical pitfalls will be discussed, and aspects of external quality assurance presented.
EQA of mesenchymal markers
A large number of immunomarkers relevant for the identification and classification has been included in NordiQC challenges. The proportion of sufficient results has varied from less than 50% to 95% but the optimal results have ranged considerably lower. The causes of suboptimal results are typically less successful antibodies, too dilute antibodies, inappropriate demasking and platform issues. The use of proper controls and correct interpretation should allow for improved performance. The labs should also take notice of which clones generally seems to give the highest scores (e.g., CD31: JC70A; CD117: YR145; Calretinin: SP65), and which clones perform less well on certain platforms (e.g., Benchmark: smooth muscle actin clone 1A4, podoplanin clone D2-40; Omnis: desmin clone D33).
Mogens Vyberg was board-certified as specialist in pathology 1984. Senior consultant at the Institute of Pathology, Aalborg University Hospital, since 1988 and professor of clinical pathology at Aalborg University since 2012.
Prof. Vyberg’s main clinical expertise and research fields are gastrointestinal, liver and brain pathology, immunohistochemistry and image analysis. He is author and co-author of about 130 peer reviewed scientific papers and conference abstracts, and several book chapters in these fields. He is head of the Laboratory for immunohistochemistry/R&D, which carries out quality control and protocol optimization for the world’s leading diagnostics companies.
Prof. Vyberg is also co-founder and director of the international organization Nordic Immunohistochemical Quality Control (NordiQC, www.nordiqc.org), which was established in 2003 at the Institute of Pathology, Aalborg University Hospital, and currently serves more than 700 pathology laboratories from 85 countries.
Prof. Vyberg is board member of the International Quality Network Pathology and the International Society for Immunohistochemistry and Molecular Morphology.
Stoffel EM, Erichsen R, Frøslev T, Pedersen L, Vyberg M, Koeppe E, Crockett SD, Hamilton SR, Sørensen HT, Baron JA. Clinical and Molecular Characteristics of Post-Colonoscopy Colorectal Cancer: A Population-based Study. Gastroenterology. 2016 Jul 18. pii: S0016-5085(16)34787-4. doi: 10.1053/j.gastro.2016.07.010. [Epub ahead of print] PubMed PMID: 27443823.
Erichsen R, Kelsh MA, Oliner KS, Nielsen KB, Frøslev T, Lænkholm AV, Vyberg M, Acquavella J, Sørensen HT. Prognostic impact of tumor MET expression among patients with stage IV gastric cancer: a Danish cohort study. Ann Epidemiol. 2016 Jul;26(7):500-3. doi: 10.1016/j.annepidem.2016.05.002. Epub 2016 May 12. PubMed PMID: 27318530.
Erichsen R, Baron JA, Hamilton-Dutoit SJ, Snover DC, Torlakovic EE, Pedersen L, Frøslev T, Vyberg M, Hamilton SR, Sørensen HT. Increased Risk of Colorectal Cancer Development Among Patients With Serrated Polyps. Gastroenterology. 2016 Apr;150(4):895-902.e5. doi: 10.1053/j.gastro.2015.11.046. Epub 2015 Dec 8. PubMed PMID: 26677986.
Lange MB, Nielsen ML, Andersen JD, Lilholt HJ, Vyberg M, Petersen LJ. Diagnostic accuracy of imaging methods for the diagnosis of skeletal malignancies: A retrospective analysis against a pathology-proven reference. Eur J Radiol. 2016 Jan;85(1):61-7. doi: 10.1016/j.ejrad.2015.10.012. Epub 2015 Oct
PubMed PMID: 26724650.
Vyberg M, Nielsen S. Proficiency testing in immunohistochemistry-experiences from Nordic Immunohistochemical Quality Control (NordiQC). Virchows Arch. 2016 Jan;468(1):19-29. doi: 10.1007/s00428-015-1829-1. Epub 2015 Aug 26. PubMed PMID: 26306713; PubMed Central PMCID: PMC4751198
Torlakovic EE, Nielsen S, Vyberg M, Taylor CR. Getting controls under control: the time is now for immunohistochemistry. J Clin Pathol. 2015 Nov;68(11):879-82. doi: 10.1136/jclinpath-2014-202705. Epub 2015 Aug 18. Review. PubMed PMID: 26286753; PubMed Central PMCID: PMC4680144.
Panou V, Vyberg M, Weinreich UM, Meristoudis C, Falkmer UG, Røe OD. The established and future biomarkers of malignant pleural mesothelioma. Cancer Treat 2015 Jun;41(6):486-95. doi: 10.1016/j.ctrv.2015.05.001. Epub 2015 May 8. Review. PubMed PMID: 25979846.
Vyberg M, Nielsen S, Røge R, Sheppard B, Ranger-Moore J, Walk E, Gartemann J, Rohr UP, Teichgräber V. Immunohistochemical expression of HER2 in breast cancer: socioeconomic impact of inaccurate tests. BMC Health Serv Res. 2015 Aug 29;15:352. doi: 10.1186/s12913-015-1018-6. PubMed PMID: 26318869; PubMed Central PMCID: PMC4553016.
Torlakovic EE, Nielsen S, Francis G, Garratt J, Gilks B, Goldsmith JD, Hornick JL, Hyjek E, Ibrahim M, Miller K, Petcu E, Swanson PE, Zhou X, Taylor CR, Vyberg M. Standardization of positive controls in diagnostic immunohistochemistry: recommendations from the International Ad Hoc Expert Committee. Appl Immunohistochem Mol Morphol. 2015 Jan;23(1):1-18. doi: 10.1097/PAI.0000000000000163. Review. PubMed PMID: 25474126.
Borrisholt M, Nielsen S, Vyberg M. Demonstration of CDX2 is highly antibody dependant. Appl Immunohistochem Mol Morphol. 2013 Jan;21(1):64-72. doi: 10.1097/PAI.0b013e318257f8aa. PubMed PMID: 22595949.