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Rapid immunohistochemistry based on alternating current electric field for intraoperative diagnosis of brain tumors
Mishie Tanino1, Toshio Sasajima, Hiroshi Nanjo
1Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
Insights
Rapid immunohistochemistry (R-IHC) using an electric field improves intraoperative diagnosis of central nervous system (CNS) tumors. This method accurately grades gliomas and differentiates CNS tumors, aiding surgical decisions.
Area of Science:
- Neuropathology
- Oncology
- Medical Technology
Background:
- Intraoperative diagnosis of central nervous system (CNS) tumors is crucial for surgical management.
- Standard immunohistochemistry (IHC) can be time-consuming for rapid intraoperative assessment.
- A novel R-IHC method utilizing an alternating current electric field has been developed to expedite antigen-antibody reactions.
Purpose of the Study:
- To evaluate the diagnostic accuracy of R-IHC for intraoperative CNS tumor diagnosis.
- To assess the utility of R-IHC in glioma grading and differentiating CNS lymphoma from glioma.
- To compare R-IHC on frozen specimens with standard IHC on permanent specimens.
Main Methods:
- Reviewed 183 cases of CNS tumors for diagnostic accuracy without R-IHC.
- Compared R-IHC on frozen specimens with standard IHC on permanent specimens for 33 gliomas.
- Assessed R-IHC for CD20 and Ki-67/MIB-1 expression in four CNS lymphoma frozen specimens.
Main Results:
- Diagnostic accuracy without R-IHC was 90.7%, with 17 cases lacking definitive diagnoses.
- R-IHC demonstrated consistency with standard IHC for Ki-67/MIB-1 indices in gliomas, supporting accurate grading.
- R-IHC successfully differentiated CNS lymphoma from glioma, providing clear CD20 and Ki-67/MIB-1 results comparable to standard IHC.
Conclusions:
- R-IHC significantly enhances diagnostic accuracy for intraoperative CNS tumor assessment.
- The R-IHC method provides crucial supportive information for glioma grading and differential diagnosis.
- R-IHC on frozen specimens is a valuable tool for real-time intraoperative decision-making in neuro-oncology.
Abstract:
Rapid immunohistochemistry (R-IHC) can contribute to the intraoperative diagnosis of central nervous system (CNS) tumors. We have recently developed a new IHC method based on an alternating current electric field to facilitate the antigen-antibody reaction. To ensure the requirement of R-IHC for intraoperative diagnosis, 183 cases of CNS tumors were reviewed regarding the accuracy rate of diagnosis without R-IHC. The diagnostic accuracy was 90.7 % (166/183 cases) [corrected] in which definitive diagnoses were not provided in 17 cases because of the failure of glioma grading and differential diagnosis of lymphoma and glioma. To establish the clinicopathological application, R-IHC for frozen specimens was compared with standard IHC for permanent specimens. 33 gliomas were analyzed, and the Ki-67/MIB-1 indices of frozen specimens by R-IHC were consistent with the grade and statistically correlated with those of permanent specimens. Thus, R-IHC provided supportive information to determine the grade of glioma. For discrimination between glioma and lymphoma, R-IHC was able to provide clear results of CD20 and Ki-67/MIB-1 in four frozen specimens of CNS lymphoma as well as standard IHC. We conclude that the R-IHC for frozen specimens can provide important information for intraoperative diagnosis of CNS tumors.
