Name of the Procedure:

Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure

Summary

Immunohistochemistry (IHC) or Immunocytochemistry (ICC) is a laboratory technique used to detect specific antigens (proteins) in cells or tissue sections. By applying antibodies that can bind to these proteins and visual markers, the technique allows for the visualization of the presence and distribution of antigens in the specimen. This description focuses on the use of each additional single antibody stain performed beyond the initial staining procedure.

Purpose

The primary purpose of IHC/ICC with additional antibody stains is to provide detailed information about the molecular makeup of cells or tissues. It is often used to diagnose diseases, determine the origin of tumors, and assess the presence of specific molecular markers. The process helps pathologists to make more accurate diagnoses and tailor treatments to individual patients.

Indications

• Cancer diagnosis and classification
• Detection of specific infections or pathogens in tissues
• Identification and localization of proteins in research studies
• Confirmation of autoimmune diseases
• Assessment of tissue structure and cell proliferation

Preparation

• No special preparation is usually required for the patient, as the tissue samples are obtained during biopsies or surgeries.
• Any pre-procedure instructions related to the biopsy or surgery itself (e.g., fasting) should be followed.
• Patients should provide relevant medical history and medication use to the healthcare provider.

Procedure Description

1. Collection of Specimen: Tissue or cell samples are collected through biopsy or surgery.
2. Fixation: The specimen is treated with a fixative to preserve its structure.
3. Sectioning: The fixed tissue is sliced into thin sections and placed on glass slides.
4. Blocking: Non-specific binding sites are blocked using a specific reagent.
5. Primary Antibody Staining: Primary antibodies specific to the target antigen are applied to the specimen.
6. Secondary Antibody Staining: Secondary antibodies, which bind to the primary antibodies and are conjugated to a detectable marker (such as an enzyme or fluorophore), are added.
7. Visualization: The bound antibodies are detected and visualized using appropriate methods, such as colorimetric or fluorescent detection.
8. Additional Staining: Each additional single antibody stain is applied following similar steps, for more detailed analysis.

Equipment used may include microtomes (for sectioning), staining racks, microscopy workstations, and chemical reagents for staining.

Duration

The entire process, including additional stains, may take several hours to a few days, depending on the complexity of the staining and analysis.

Setting

The procedure is typically performed in a pathology lab within a hospital or specialized diagnostic laboratory.

Personnel

• Pathologist
• Medical laboratory technician
• Histotechnologist
• Sometimes, specialized lab personnel for advanced staining techniques

Risks and Complications

• Misinterpretation of results due to improper staining or technical errors
• Potential for false positives or negatives if staining reagents are not properly controlled

Benefits

• Accurate identification and localization of specific antigens
• Enhanced diagnostic precision, especially for cancer and other diseases
• Better guidance for treatment plans based on molecular characterization

Recovery

• As this is a lab-based procedure done on specimens, there is no physical recovery for the patient related to the IHC/ICC itself.
• Recovery would instead relate to the biopsy or surgical procedure done to obtain the specimen.

Alternatives

• Other molecular diagnostic techniques such as Polymerase Chain Reaction (PCR), In Situ Hybridization (ISH), Western blotting
• Pros: Some alternatives may offer quicker results or be more suitable for certain types of analyses.
• Cons: They may lack the spatial resolution and detailed visualization provided by IHC/ICC.

Patient Experience

Since this is a lab-based test performed on previously collected tissue, the patient experiences no direct sensations from the IHC/ICC procedure itself. Any discomfort would be associated with the biopsy or surgical collection of the specimen, for which appropriate pain management and aftercare instructions would be provided.