(IMMUNOHISTOCHEMISTRY- IHC) HV: PHAN ANG ANH TH

HOA MO MIEN DCH

8/19/2011

NH NGHA:
 

Phng phap nhuom ac biet Xac nh khang nguyen trong to chc = khang the (nh phan ng mien dch KNKT) va hoa chat

8/19/2011

QUA TRNH PHAT TRIEN phat trien hoa mien dch  1940 : Coons


huynh quang tren mau mo cat lanh thap nien 90: Avrameas va cs phat trien KT men (horseradish peroxidase), quan sat c bang KHV quang hoc Tang o nhay HMMD:
   

KT men khang men (peroxidase antiperoxidase) Cau noi Biotin- StreptAvidin (BSA) Cau noi Avidin- Biotin (ABC- avidin-biotin conjugate) KT khuech ai (tyramide, )
8/19/2011

CAC THANH PHAN THAM GIA



Nhng chat phan ng:

   

Khang nguyen mo Khang the (KT 1, KT2..) Chat tao hp chat mau (chromogen solution) Nhuom nhan (Counterstaining)

  

Enzyme Cac phan t phat hien Nhng chat ket noi

8/19/2011

CHAT PHAN NG

8/19/2011

KHANG NGUYEN
 

Phan ln la protein, 1 so carbohydrate Khang nguyen la dau an cua s biet hoa te bao. Gom nhieu loai:
 

Cac si trung gian: keratin, vimentin, desmin Thu the hocmon: estrogen, progesteron, androgen

Epitope- v tr tiep xuc : la v tr gan khang the tren be mat khang nguyen. Mang tnh ac hieu cua khang nguyen. La vung quyet nh khang nguyen (antigenic determinant) 1 khang nguyen co nhieu epitope, va ch gan vi 1 khang the ac hieu
8/19/2011

KHANG THE
    

La cac glycoprotein Gom 1 chuoi nang va hai chuoi nhe Chia thanh 5 loai IgA, IgG, IgM, IgD, IgE da vao chuoi nang Gom vung co nh va vung co the thay oi Phan loai theo phng phap san xuat:  Khang the a dong  Khang the n dong Phan loai theo v tr phan ng vi khang nguyen:  Khang the nguyen phat  Khang the th phat
8/19/2011

  

KHANG THE N DONG ky thuat u lai San xuat bang

T dong te bao lai tao gia tng bao cua chuot va lympho B lach chuot. Sang loc cac dong te bao bang KN dong san xuat KT ac hieu nhan giong trong moi trng nuoi cay te bao hoac dch bang bung c san xuat t 1 dong te bao cua te bao u lai nen khang the rat thuan khiet Ch nhan dien c mot epitope khang nguyen o nhay thap hn khang the a dong 1 so khang the n dong ch phan ng c tren tieu ban cat lanh
8/19/2011

   

8/19/2011

KHANG THE A DONG mien dch  San xuat b ng cach gay



ong vat bang khang nguyen ac hieu Hon hp nhieu khang the ac hieu va khong ac hieu. Cac khang the khong mong muon se c loai bo sau o u iem:
 

De san xuat o nhay cao do nhan dien nhieu epitopes KN Phan ng dng gia do cha cac khang the phan ng khong ac hieu Khuynh hng nhuom nen cao
8/19/2011

Khuyet iem:
 

8/19/2011

KHANG THE NGUYEN PHAT

  

Khang the gan trc tiep vi KN. Khong gan ket (khong anh dau) Cau noi gia khang nguyen va he thong quan sat

8/19/2011

KHANG THE TH PHAT

    

Khang the cua mot loai phan ng trc tiep vi khang the cua loai khac. Phan ng vi KT nguyen phat Gan vi biotin hay enzym hoac chat huynh quang Khuech ai phan ng gia KT nguyen phat va KN ch. Cau noi gia KT nguyen phat va he thong quan sat.

8/19/2011

CHAT TAO HP CHAT MAU (CHROMOGEN)

8/19/2011

Cac yeu to e chon chat phan ng mau:



  

Mau sac: can mau tng phan vi cac mau khac, v du : chromogen khong co mau nau e tng phan vi melanin o hoa tan o nhay phu hp vi quan sat sieu cau truc

phu hp vi men s dung

8/19/2011

enzyme

Chat phan ng tao mau Diaminobenzidine 3-amino-9ethylcarbazole (AEC)

Mau

Kha nang hoa tan trong alcohol (solubitily) _ +

Nau o

peroxidase

4-chloro-1-naphthol (4-NC) P-phenylenediamine (Hanker-Yates reagent) Tetramethyl benzidine (TMB)

Xanh en

+ _

Xanh

8/19/2011

enzyme

Chat phan ng tao mau

Mau

Kha nang hoa tan trong alcohol (solubitily) + + _ _ _ _ _

Fast blue BB Alkaline phosphatase Fast red TR New Fuchsin BCIP-NBT Tetrazolium Glucose oxidase Tetranitoblue tetrazolium (TNBT) Bac

Xanh o o Xanh Xanh en en

Immunogold

8/19/2011

Diaminobenzidine ( DAB )
     

La chromogen hay dung nhat Cho san pham mau nau, khong tan Lu tr lau Them ion kim loai (cobalt, nikel) cho tng phan mau sac tot Lam lan vi mau melanin, hemosiderine Gay ung th

8/19/2011

AEC (3-amino-9-ethylcarbazole)
 

   

Tao ra san pham mau o AEC co hai phan ng mau :bnh thng cho mau o nhng neu lng enzyme qua nhieu th mau se chuyen t mau o sang mau xanh-nau Hay dung trong cac benh da B hoa tan trong cac dung moi cua mo Khong ben, de phai mau Gay ung th nhng t nguy c hn DAB
8/19/2011

Nhuom nhan
 

Hematoxylin Xanh Methylen (green methylen)

8/19/2011

ENZYMES

8/19/2011

HORSERADISH PEROXIDASE
La mot enzym, 40kD  Bien oi peroxide hydrogen thanh nc  Oxi hoa chromogen nhn thay c  Peroxidase noi sinh mot so te bao: neutrophile, eosinophile, basophile, histiocyte nham lan. -> c che peroxidase noi sinh


8/19/2011

ALKALINE PHOSPHATASE
  

c s dung bi Avrameas, nh la 1 enzyme gan vi khang the th 1. c dung pho bien trong nhuom oi Subtrates dung kem bao gom naphthol salts nh coupling agents, diazonium salts nh la chromogenic capture agents
8/19/2011

GLUCOSE OXIDASE
 

t c s dung Co the s dung trong nhuom oi do cung cap chat tao mau vi mau sac rieng

8/19/2011

HE THONG NHAN BIET

(DETECTION SYSTEM)

8/19/2011

Khong the nhn thay khang the di KHV quang hoc hay KHV ien t  Phai gan ket khang the va 1 chat chuyen biet e co the quan sat c  Cac chat gan ket khang the la phc hp huynh quang hay cac enzyme -> Do o co hai cach quan sat phc hp KN-KT:

 

Mien dch huynh quang Mien dch men

8/19/2011

HOA MIEN DCH HUYNH QUANG

  

Ky thuat n gian: hp chat huynh quang + khang the + mo Anh sang kch thch hp chat huynh quang tia sang. Hp chat huynh quang:
 

Fluorescein isothiocyanate Tetramethylrhodamin isothiocyanate

8/19/2011

HOA MIEN DCH HUYNH QUANG

oi hoi phai co knh hien vi huynh quang  Thi gian gi tieu ban ngan.  Mo cung phat huynh quang.  MDHQ t thong dung trong chan oan GPB, dung ac biet cho sinh thiet than va cac ky thuat FISH, CISH


8/19/2011

HE x 200

Immunofluorescein x 200
8/19/2011

PHNG PHAP GAN KHANG THE VI MEN

8/19/2011

  

Mien dch trc tiep (direct procedure) Mien dch gian tiep (indirect sandwich procedure) Ky thuat unlabeled antibody



Cau noi enzyme Mien dch men khang men (peroxidase antiperoxidase method)

  

Cau noi Biotin-Avidin (Biotin-avidin procedure) Phc hp Biotin-Avidin (Avidin-biotin conjugate procedure) He thong Biotin- streptavidin Polyvalent systems
  

Alkaline phosphatase- antialkaline phosphatase Protein A Men gan khang nguyen (enzyme-labeled antigen 8/19/2011 method)

PHNG PHAP TRC TIEP

8/19/2011

Mien dch trc tiep

8/19/2011

PHNG PHAP GIAN TIEP

8/19/2011

Mien dch gian tiep

8/19/2011

Avidin Biotin complex (ABC)

 

Ai lc cao gia avidin va biotin Biotnylated antibodies khuech ai tn hieu KN

8/19/2011

KT TH II GAN BIOTIN

KT TH I

ABC METHOD

GAN VI PHC HP AVIDIN-BIOTINPEROXIDASE GAN VI AVIDIN

8/19/2011

8/19/2011

CAU NOI BiotinStreptavidin



 

Streptavidin, la tetrameric avidin, 60kD, tach t vi khuan Streptomyces avidinii Gan vi Biotin vi ai lc cao Dung thay the avidin trong phc hp A-B :

8/19/2011

Peroxidase-antiperoxidase

8/19/2011

Alkaline phosphatase- antialkaline phhosphatase (APAAP) method

 

 

Giong KT Peroxidaseantiperoxidase (PAP) Dung nhuom mo co peroxidase noi sinh cao nh mo limpho hay tuy xng (cac dd c che peroxidase noi sinh co the lam huy epitope nhng mo nay) Dung nhuom oi Cac chat phan ng mau dung vi pp nay la Fast blue BBN, Fast red TR

8/19/2011

Protein A
Chiet xuat t tu cau khuan ( Staphylococcus aureus), co ai lc cao Co the gan ket vi peroxidase, chat huynh quang fluorescein, gold Gan ket nhanh nhng co the gay nhuom nen

  

8/19/2011

He thong khuech ai bang Tyramide

8/19/2011

QUY TRNH NHUOM HMMD

8/19/2011

CAC BC CHUAN B CAN BAN

8/19/2011

CO NH MO TRONG HMMD

8/19/2011

Mo hoc Khong co nh Ethanol 0/+ ++

Sieu cau truc 0 0

HMMD ++ ++

ac iem dung dch

Gi KN, khong thch hp nhuom ER,PR, S100

Acetone Formaldehyde

++ ++

0 +

++ +/++ Xuyen thau tot. Che giau KN

Glutaldehyde Bouins

+ ++

++ ?

0 +/++
8/19/2011

VUI MO
MO HOC Cat lanh Paraffin Methacrylate Lowicryl LR white Epoxy resin + ++ +++ + + +++ SIEU CAU TRUC 0 + 0/+ + + ++ HMMD ++ +/++ +/++ +/++ +/++ 0

8/19/2011

CHUAN B TIEU BAN



Tieu ban nhuom HMMD phai c nhung trong dung dch Silane (3aminopropyltriethoxy-silane, pha vi acetone) hoac lam trang san silane Tac dung lam gan chat mo vao lam knh khong b troi trong qua trnh boc lo Khang nguyen

8/19/2011

CAT TIEU BAN

 

Cat mong 3-4 m at trong nhiet o phong

8/19/2011

CHUAN B DUNG DCH TBS (Tris-buffer-saline)



Dung dch A-Dung dch Tris HCL ac: Pha loang 60.55g Tris trong 500ml nc cat trong chai 1lit. Them 35 ml HCL ac, lac eu, ieu chnh pH. Bao quan tu lanh Dung dch B- Dung dch NaCl ac: Hoa tan 90g NaCl vao chai 1 lit roi them nc va u, bao quan tu lanh Dung dch TBS s dung: 1 lit TBS pha 100ml dung dch A va 100 ml dung dch B, kiem tra pH (pH =7.2 -7.6). Bao quan tu lanh
8/19/2011

BOC LO KHANG NGUYEN



Ky thuat:  un nong  Dung Proteinase K Dung Proteinase K (PK):  Pha 100 l dd PK trong 50 ml TBS pH=7.6 e c nong o 20 g/ml, bao quan lanh  Moi tieu ban c phu 200 l dung dch PK, u 10 phut, niet o phong  Ra tieu ban 2 lan bang TBS x5 phut Cac khang nguyen c boc lo bang nhiet vi lo vi song trong dung dch Citrate

8/19/2011

BOC LO KHANG NGUYEN



  

Dung dch citrat:  Dung dch A: 21g acid citric/100ml  Dung dch B: 14,75 g sodium citrate/ 500ml  Dung dch Citrate = 9ml ddA + 41 ml ddB + 450 ml nc cat Cac khang nguyen c boc lo bang nhiet vi lo vi song trong dung dch Citrate Mot so khang nguyen can boc lo vi nhiet o cao hn va dung dch citrate nh CD117, ER, PR Hoac co the boc lo khang nguyen bang dung dch pha san cua DAKO (target retrieval) oi vi cac khang nguyen p53, Ki67, Ki1, CD30 Mot so khang nguyen khong can boc lo nh B cell, T cell, EMA
8/19/2011

KH HOAT ONG MEN NOI SINH



Chuan b dung dch H202: 50 ml H202 30% trong 450 ml nc cat, lac eu, bao quan lanh Sau khi tay paraffin, at vao dung dch H202 trong 5 ph nhiet o phong , sau o ra nc cat trong 2 ph

8/19/2011

PHA LOANG KHANG THE

 

Pha loang bang dung dch PBS vi 0.2% bovine serum albumin Nong o pha loang: 10ml khang the vi t le pha loang 1/10 , ta can 1ml khang the am ac roi them 9 ml dung dch pha loang Pha loang khang the bao am ket qua chnh xac.
 

Khang the qua loang -> nhuom nhat, hay khong bat mau Khang the qua ac -> nhuom nen khong ac hieu, hoac dng tnh gia

8/19/2011

CAC BC NHUOM HMMDbc stt Cac

1 2 3 4 5 6 7 8 9 10 Cat mong 3-4 m, say kho 37 0C Loai bo paraffin bang Xylen, con, nc cat Phuc hoi cau truc KN Dung dch em TBS (pH=7.2) c che peroxidase noi sinh bang dung dch Hydrogen peroxide 0.5% PBS (Phosphate Buffered Salin) ho c TBS Phu dd blocking (3 giot) Ra sach dd blocking Khoanh tron anh dau mo tren lames U vi Khang the th nhat 100l

Ghi chu 12 gi 10 ph Lo vi song 5ph 6ph

5ph 15-20 ph

45 ph
8/19/2011

CAC BC NHUOM HMMD

stt 11 12 13 14 15 16 17 18 19 20 Cac bc DD PBS/ TBS U vi Khang the th th hai co gan biotin (3 giot) DD PBS/TBS U vi phc hp Streptavidine peroxidase (3 giot) DD PBS/TBS U trong chromogen EAC (hoac DAB) 500l Ra nc cat Nhuom nhan vi Hematoxyline tao nen tng phan Ra nc Dan lamen bang palsam canada Ghi chu 5ph 30ph 5ph 20ph 3_5ph 10-15 ph 5 ph 1 ph 5 ph

Neu dung DAB th kh nc tiep bang con va lam trong sang mo bang xylen

8/19/2011

KET QUA NHUOM

 

Am tnh: Ch co mau xanh tm cua Hematoxylin nhuom nhan Dng tnh: Neu co hien dien khang nguyen tren be mat te bao, phc hp KN-KT-streptavidinemau se cho mau o ( neu dung EAC) va cho mau vang nau (neu dung DAB)

8/19/2011

HER-2/NEU

AM TNH

DAB

AEC

8/19/2011

V TR BAT MAU NHUOM

DAU AN Bieu mo EMA CEA CK CK20 AE1/AE3 Trung mo Vimentin Desmin SMA NHAN BAO TNG + + + + + + + + MANG BAO TNG + +

8/19/2011

DAU AN

NHAN

BAO TNG + + +

MANG BAO TNG

Than kinh/noi tiet

Chromogranin synaptophysin NSE S-100 + + + ER PR Her-2/neu HMB-45 CD 117 CD 99 AFP p 53 +

Dau an ac biet

+ + + + +
8/19/2011

DAU AN Dau an limpho CD 45 CD 44 CD 34 CD30 CD 15

NHA N

BAO TNG

MANG BAO TNG +

+ + + +

8/19/2011

HNH MINH HOA

BAT MAU MANG BAO TNG

8/19/2011

HNH MINH HOA

BAT MAU BAO TNG

8/19/2011

HNH MINH HOA

BAT MAU NHAN

8/19/2011

HAN CHE CUA HMMD

8/19/2011

       

Khong bat mau hoac bat yeu Dng tnh gia Am tnh gia Mo b troi Mo b thoai hoa at tien oi luc khong phan biet c lanh ac Can kinh nghiem cua ngi oc

8/19/2011

Khong bat mau hoac bat yeu

Nguyen nhan Nong o KT thap Thi gian u KT ngan Con parafin Khac phuc Tang nong o KT Tang thi gian u KT Tang thi gian trong xylen, thay xylen

KT nguyen phat va th Dung KT th phat phu phat khong phu hp hp Khang nguyen khong Boc lo khang nguyen c boc lo

8/19/2011

DNG TNH GIA



Dng tnh gia  Nhuom nen qua am  Hieu ng ra  Hieu ng bat mau do nhiet  Bat mau do co rut mo

8/19/2011

NHUOM NEN (BACKGROUND)

8/19/2011

Nen bat mau manh

Nguyen nhan Nong o KT th phat cao Thi gian u KT qua lau Nhieu chat mau Thi gian ra ngan Kh khong het peroxidase noi sinh Mo b kho

8/19/2011

HIEU NG RA
8/19/2011

BAT MAU DO CO RUT MO

8/19/2011

BAT MAU DO NHIET

8/19/2011

AM TNH GIA
      

Khang nguyen khong c boc lo tot KN b pha huy do co nh Khang the b hong do bao quan khong k Lng khang the qua t Thi gian u qua ngan pH cua dung dch em khong ung Nhiet o qua nong
8/19/2011

Can tieu ban chng am , chng dng

Tuan thu nghiem ngat qui trnh nhuom: - nong o khang the - pH cua dung dch em - thi gian
8/19/2011

 

Lam chng am: giup khang nh tnh ac hieu cua phan ng mien dch Lam chng dng: cho biet khang the van con tac dung tot.  Lam chng dng ly tng la mo bnh thng khong benh ly v du nh mo day than kinh ngoai bien lam lam chng cho S-100  Lam chng dng vi mo khong b c che peroxidase noi sinh cho thay chat phan ng tao mau (chromogen) con hoat ong
8/19/2011

Dau an

Khang nguyen Mo chng dng CD3, CD8 CD20, CD43 Bcl-2, CD45 RO LCA, CD68 CD15, CD30 CD 31, CD 34 FVIII CEA EMA Keratin AE1 Amydale, hach limpho

U thuoc dong limpho

Benh Hodgkin Hach Mo phoi ai trang ai trang, vu Da

8/19/2011

Dau an huyet quan Dau an bieu mo

Dau an

Khang nguyen Keratin AE3 CK 7

Mo chng dng Gan Vu Ruot U hac to U hac to Sarcom Ewing Ruot Ruot ruot
8/19/2011

Dau an bieu mo CK 20 U hac to S-100 HMB-45 CD 99 Dau an Sarcom Muscle-specific actin (SMA) Desmin Vimentin

Dau an

Khang nguyen Chromogranin Synaptophysin

Mo chng dng Tuy

Dau an than kinh noi tiet

Neuron specific Enolase ER, PR

Tuy, si than kinh Mo CTC lanh, mo vu lanh Mo TLT Nhau thai gan

Dau an bieu mo ac hieu

PSA HCG AFP Her-2/neu

Dau an yeu to tang sinh

Ki-67 P 53

Hach tang san nang

8/19/2011

CHNG DNG/ CK

8/19/2011

CHNG AM/ HER-2

8/19/2011

NG DUNG HMMD

8/19/2011

Xac nh nguon goc u khong biet hoa  Xac nh yeu to tien lng  Chan oan phan biet u lanh hay ac  D oan ap ng ieu tr  Phat hien nhiem 1 so loai virus va vi khuan

8/19/2011

XAC NH NGUON GOC U

8/19/2011

XAC NH U CHA RO NGUON GOC

U CHA RO NGUON GOC
VIMENTIN

CYTOKERATIN

EMA

LCA

(+)
SARCOM

(-)

(-) (+)

(+) (-) (-)

(+)
LYMPHOM

CARCINOM

U KHAC
DESMIN HMB45 S100 NSE

(+)
C VAN C TRN

(+)
MELANOM

(+)
MO BAO

(+)
THAN KINH
8/19/2011

XAC NH NGUON GOC CARCINOM

CARCINOM
CK8/18 CK10/13

THYROGLOBULIN

EMA

CEA

CK 7

PSA

(+) (+)

(+)
TUYEN GIAP TE BAO GAI

(+) (+) (+) (+)

TLT

(+)

(+)

TUYEN

TE BAO CHUYEN TIEP

8/19/2011

XAC NH NGUON GOC SARCOM

SARCOM
DESMIN ACTIN

MYOSIN

FIBRONECTIN

CD31

CD34

FVIII

(+) (+)

(+)
C TRN

(+) (+)

(+)

(+)

(+)

C VAN

SI

MACH MAU

8/19/2011

XAC NH NGUON GOC U THUOC HE TAO HUYET

U
PAN B-CELL PAN T-CELL S100 CD15

CD30

CD68

MYELOPEROXIDASE

(+) (+)
LYMPHOM T

(+) (+)

(+)

(+)

(+)

TB REED STERNBERG

(+) BENH BACH CAU

LYMPHOM B

MO BAO

8/19/2011

XAC NH YEU TO TIEN LNG

8/19/2011

Khang nguyen cua s tang sinh TB:

  

Ki67: (+) trong nhan, hien dien trong te bao pha G1, G2, S tr pha G0 PCNA (proliferating cell nuclear antigen, cyclin) Nhng benh nhan co thi gian song them ngan thng co t le Ki67, PCNA cao

Xac nh xam nhap hay gia xam nhap cua TB ung th:
  

KT khang mang ay- laminin (collagen IV) KT khang actin e xac nh TB c bieu mo(vu) Cytokeratin trong lng phan t cao e xac nh te bao ay (mo tuyen tien liet)
8/19/2011

 

Xac nh o di can nho tuy xng hay hach Khang nguyen U:  Khang nguyen ac hieu u : protein p53  Gen sinh ung, yeu to phat trien, thu the:  Her-2/neu  EGFR  bcl-2  Gen e nen u va san pham gen:  Rb 8/19/2011  P53

CHAN OAN PHAN BIET LANH-AC

8/19/2011

CHAN OAN PHAN BIET LANH- AC



Khang nguyen cua s tang sinh TB:

 

Ki67: (+) trong nhan -> dng tnh nhieu ac tnh PCNA

Chan oan phan biet phan ng lanh tnh cua mo limpho : Nhuom ong thi B,T> ca hai dng la lanh tnh, 1 trong hai dng hay ca hai am la limphom CEA hien dien mang te bao tuyen ac tnh ( trong khi te bao bnh thng khong hien dien hoac rat t) -> chan oan carcinom giai oan sm
8/19/2011

 

ER, PR (+): ap ng ieu tr hocmon trong ung th Vu, ung th noi mac t cung Androgen receptor: giup ieu tr ung th tien liet tuyen bang thuoc c che androgen Phat hien khang thuoc:
  

D OAN AP NG IEU TR

Her-2/neu (++): Ung th vu khang vi hoa tr N-myc : Ung th phoi te bao nho va u nguyen bao than kinh khang vi hoa tr P-glycoprotein (P-170) : bieu hien nhieu mo ung th, th benh nhan ap ng kem Nguon Anderson vi hoa tr
8/19/2011

PHAT HIEN TE BAO NHIEM KHUAN



Phat hien sm, nhanh chong va chnh xac cac vi sinh vat kho phat hien trong moi trng cay nh Helicobacter Pylori, Histoplasma capsulatum, Pneumocystic carinii, Phat hien khoang hn 60 loai vi khuan va virus
     

Cytomegalovirus HPV (human papilloma virus) Virus viem gan SV A,B,C Epstein barr virus Toxoplasma gondii HSV (Herpes simplex virus) ,

8/19/2011

SPIROCHETES OF LEPTOSPIRA SP.

8/19/2011

HELICOBACTER PYLORI
8/19/2011

MOT SO DAU AN THONG DUNG TRONG CHAN OAN MO BENH HOC

8/19/2011

CHON LA KHANG NGUYEN

stt 1 2 3 4 5 6 7 8 9 10 11 Keratin Vimentin Desmin Neurofilament Glial fibrillary acidic protein ( GAFB) Actin + myosin Maker ac trng Bieu mo Tb trung mo C trn-c van Co tb than kinh Tb than kinh em Mo c

Chromoganin, neuron specific enolase ( NSE) Mo than kinh noi tiet HMB45 + S 100 protein LCA Placectal alkalin phosphatase (PLAP) Human chorionic gonadotropin (hCG) Melanocytes Hematolymphoid cells Te bao mam T bo nui
8/19/2011

stt 12 13 14

Maker Carcinoembryonic antigen ( CEA) CD15 , CD 30 Alpha fetoprotein

c tr ng Ung th tuyen Benh Hodgkin Yolk sac tumors, carcinom te bao gan GIST Ung th TLT Lymphom B Lymphom T

15 16 17 18

CD117 Prostate specific antigen (PSA) CD20 CD3

8/19/2011

DAU AN BIEU MO

8/19/2011

KERATIN
 

La dau an cua te bao bieu mo Cac keratin trong lng phan t cao thng phan bo te bao bieu mo lat tang (sng hoa va khong sng hoa) Cac keratin trong lng phan t thap thng phan bo cac bieu mo n va bieu mo tuyen Keratin trong te bao la cytokeratin
  

CK 7: UT bieu mo BT, dau an biet hoa nguyen bao nuoi trong u TB mam CK 10,11: (+) Ung th te bao gai, (-) ung th tuyen CK 18,8 : sarcom te bao hnh thoi

8/19/2011

8/19/2011

8/19/2011

CEA (Carcinoembryonic antigen)



La glycoprotein, la dau an ac hieu cua ung th bieu mo ai trang

8/19/2011

Adenoid cystic vu
8/19/2011

EMA(epithelial membrane antigen)

 

La carbohydrate Bieu hien bieu mo tuyen vu, nhieu tuyen ngoai tiet va cac loai bieu mo khac nhau Ngoai ra con bieu hien cac u nh sarcom dang bieu mo, sarcom bao hoat dch, u day song
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DAU AN KHONG PHAI BIEU MO

8/19/2011

DESMIN, ACTIN, MYOSIN



Desmin : tm thay trong cac te bao c , la dau an cho s biet hoa c cua te bao u -> bieu hien sarcom c van, sarcom c trn Actin, myosin: la dau an cho s biet hoa c

8/19/2011

ACTIN
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DESMIN
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VIMENTIN
 

Bieu hien cac te bao trung mo Ngoai ra con bieu hien 1 so te bao bieu mo nhat nh ( TB bieu mo cau than)

8/19/2011

Vimentin (+)/ melanom

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DAU AN THAN KINH

8/19/2011

NSE , CHROMOGRANIN


NSE: La khang the khang cac neuron, la dau an cho s biet hoa than kinh noi tiet. Chromogranin: La protein co mat trong hat che tiet than kinh noi tiet v the no la dau an co o nhay va o ac hieu cao cho s biet hoa than kinh noi tiet
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S100


La protein, phan bo rong rai trong c the nh mo nao (TB than kinh em, Tb schwann), mo sun, mo m, te bao hac to, TB langerhans Con bieu hien 1 so te bao bieu mo ( TB c bieu mo

8/19/2011

Melanocyte

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FACTOR VIII


Xac nh cac u biet hoa noi mo mach mau nhng khong thc s hu ch trong chan oan u te bao noi mo mach mau biet hoa thap

8/19/2011

SARCOM MACH MAU/ VU

8/19/2011

CAC KHANG NGUYEN BACH CAU

8/19/2011

   

LCA( leucocyte common antigen) : La khang nguyen mang, rat nhay vi te bao limpho va u limpho va khoang 10% am tnh vi u limpho te bao ln CD 20: xac nh te bao B CD3, CD43, CD45 RO: xac nh te bao T CD15, CD30: xac nh te bao Reed Sternberg Bcl-2:

8/19/2011

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HER-2/NEU
  

La 1 proto- oncogene tren chromosome 17q21 La thanh vien cua gia nh HER (Human epithelial receptor). Ma hoa 1 glycoprotein xuyen mang te bao 185kD con goi la p185HER2 con co ten la C-erB-2 hay Her 2 S khuech ai gen HER2 (nhan) Bieu hien qua mc protein HER2 (mang bao tng)
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Cach tnh iem

0 (negative)

1+ (negative)

2+ (equivocal)

3+ (positive)
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Estrogen Receptor Progesteron Receptor

TONG IEM = ER, PR ER, PR ER, PR ER, PR (-): (+): (++): (+++): iem t le% + iem cng o 2 3-4 5-6 7-8

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ESTROGEN

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PROGESTERON
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(+): 1+2 = 3

(++): 2+2 = 4

(+++): 5+3 = 8
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HMB45

8/19/2011

HMB45/ melanoma

8/19/2011

KET LUAN
    

HMMD la ky thuat hien ai Giup chan oan nguon goc u Xac nh u lanh hay ac Giup tien lng at tien, ky thuat phc tap

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