Immunohistochemistry: Difference between revisions
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The main methods for evaluating immunohistochemistry results are: | The main methods for evaluating immunohistochemistry results are: | ||
*Looking up each differential diagnosis at for example '''[https://www.pathologyoutlines.com/ Pathology Outlines]''' and comparing their expected staining to see which entity is most likely. | *Looking up each differential diagnosis at for example '''[https://www.pathologyoutlines.com/ Pathology Outlines]''' and comparing their expected staining to see which entity is most likely. | ||
*Paying for a subscription to '''ImmunoQuery'''<ref group= | *Paying for a subscription to '''ImmunoQuery'''<ref group=note name=ImmunoQueryCOI/>, where you can enter immunohistochemistry results and generate a list of most likely conditions with that profile. | ||
Preferably, immunohistochemistry results will be very specific or sensitive for a suspected condition, thereby confirming it if positive, or excluding it if negative, respectively. Even when that is not the case, immunohistochemistry can at least '''alter the likelihoods''' of different differential diagnoses. In practice, clinicians or pathologists do not state exact or even approximate numbers of likelihoods of differential diagnoses ({{further|Reporting}}<includeonly>see the [[Reporting]] chapter for phrasing uncertainty</includeonly>), since reality is too complex for that, but to demonstrate the general principle of how immunohistochemistry results can be calculated, the following formula can be used: | Preferably, immunohistochemistry results will be very specific or sensitive for a suspected condition, thereby confirming it if positive, or excluding it if negative, respectively. Even when that is not the case, immunohistochemistry can at least '''alter the likelihoods''' of different differential diagnoses. In practice, clinicians or pathologists do not state exact or even approximate numbers of likelihoods of differential diagnoses ({{further|Reporting}}<includeonly>see the [[Reporting]] chapter for phrasing uncertainty</includeonly>), since reality is too complex for that, but to demonstrate the general principle of how immunohistochemistry results can be calculated, the following formula can be used: | ||
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In the same way, the corresponding gross likelihood of pleomorphic rhabdomyosarcoma is calculated as: | In the same way, the corresponding gross likelihood of pleomorphic rhabdomyosarcoma is calculated as: | ||
*70% x 95% x (100% - 71%) = 19% | *70% x 95% x (100% - 71%) = 19% | ||
As a result in this case, immunohistochemistry resulted in pleomorphic rhabdomyosarcoma going from about twice as likely compared to pleomorphic liposarcoma to about 4 times as likely. Although results like these do not make major differences individually, detailed calculations of results from a large panel of immunohistochemistry stains can have a major impact when taken together, even if each stain has relatively low sensitivity and specificity.<ref group= | As a result in this case, immunohistochemistry resulted in pleomorphic rhabdomyosarcoma going from about twice as likely compared to pleomorphic liposarcoma to about 4 times as likely. Although results like these do not make major differences individually, detailed calculations of results from a large panel of immunohistochemistry stains can have a major impact when taken together, even if each stain has relatively low sensitivity and specificity.<ref group=note>More detailed explanations about likelihood calculations on differential diagnoses in general can be read at:<br>-{{cite journal | last=Häggström | first=Mikael | title=An epidemiology-based and a likelihood ratio-based method of differential diagnosis | journal=WikiJournal of Medicine | publisher=Wikiversity Journal of Medicine | volume=1 | issue=1 | year=2014 | issn=2002-4436 | doi=10.15347/wjm/2014.002}}</ref> | ||
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{{General notes}} | {{General notes}} | ||
{{Bottom}} | {{Bottom}} | ||
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