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Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual

CPT4 code

Name of the Procedure:

Morphometric Analysis, Tumor Immunohistochemistry (e.g., Her-2/neu, Estrogen Receptor/Progesterone Receptor), Quantitative or Semiquantitative, Per Specimen, Each Single Antibody Stain Procedure; Manual

Summary

Morphometric analysis with tumor immunohistochemistry is a detailed laboratory procedure used to examine tissue samples. This procedure helps in identifying specific proteins, such as Her-2/neu and hormone receptors like estrogen and progesterone, within tumor cells. The process is carried out manually for precise examination using specific antibody stains.

Purpose

This procedure is utilized for diagnosing and determining the characteristics of certain cancers, including breast cancer. It aims to provide detailed information about the presence and quantity of specific protein markers in tumor cells, which can guide treatment decisions and help predict patient outcomes.

Indications

  • Breast cancer diagnosis and characterization
  • Evaluation of tumor hormone receptor status
  • Assessment of Her-2/neu protein expression in tumor cells
  • Patients with newly diagnosed cancer or recurrent malignancy

Preparation

  • No special preparation needed from the patient since this procedure is performed on already obtained biopsy or surgical specimens.
  • Prior diagnostic tests like a biopsy are necessary to gather tissue samples.

Procedure Description

  1. Tissue samples are embedded in paraffin and sliced into thin sections.
  2. The sections are placed on glass slides.
  3. Specific antibodies are applied to the tissue sections to bind to target proteins (e.g., Her-2/neu, estrogen/progesterone receptors).
  4. Enzymes or fluorescent dyes are used to visualize the bound antibodies.
  5. The slides are examined under a microscope for quantitative or semiquantitative analysis.
  6. Results are documented and analyzed manually for accuracy.

Duration

The procedure typically takes several hours to complete, including preparation, staining, and analysis.

Setting

This procedure is performed in a specialized laboratory equipped for histopathological analysis.

Personnel

  • Pathologists
  • Laboratory technicians trained in immunohistochemistry

Risks and Complications

  • As this is a laboratory-based procedure, it has minimal risks for the patient.
  • The main risk is potential misinterpretation if the staining is not done correctly, leading to incorrect diagnosis or treatment.

Benefits

  • Accurate identification of protein markers helps in tailoring specific treatments.
  • Provides crucial information for prognosis and management of cancer.
  • Can be done on small amounts of tissue from biopsies.

Recovery

  • No recovery is needed since the procedure is performed on tissue samples.
  • Follow-up appointments depend on the results and subsequent treatment planning.

Alternatives

  • Molecular testing methods such as PCR.
  • Other forms of imaging or biopsy studies may provide some similar information but with less detail about specific protein markers.

Patient Experience

Since the procedure is done on already collected tissue samples, the patient does not experience any discomfort or pain from the process itself. Pain management and comfort measures are only relevant if further biopsy procedures are needed.

Medical Policies and Guidelines for Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual

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