Abstract:
:An ideal immunohistochemical screening panel would be one in which each antibody is 100% sensitive and specific for the target cell type (e.g., markers for epithelial neoplasms, lymphomas, sarcomas, etc.). Anyone who has practiced immunochemistry is well aware that this situation does not exist. High sensitivity is hindered by the loss of key antigens through formalin fixation and routine tissue processing. Although sensitivity can be improved by dealing with fresh-frozen, lyophilized, or plastic-embedded specimens, these procedures are often perceived as inconvenient by pathologists. Specificity is a more insidious problem. With the advent of monoclonal antibody technology, many individuals equated the monospecificity (e.g., marking one antigen a determinant) with tissue specificity. This, of course, is not the case as determinants recognized by one monoclonal antibody may be expressed on cells of different lineage. High sensitivity and high specificity are important for different reasons. By definition, an undifferentiated neoplasm lacks morphologic features to unequivocally substantiate sarcoma, lymphoma, carcinoma, or melanoma. Thus, antibodies with low sensitivity that fail to mark a significant percent of cases will provide inconclusive or erroneous information. The failure of an antibody to stain a particular tissue could be a true-negative (valuable information) or a false-negative (misleading information) result. Obviously, when antibodies have a sufficiently low sensitivity, their use is a liability rather than an advantage. Specificity is obviously important. When an undifferentiated neoplasm is found to be "positive" for a particular marker, there is a tendency to immediately categorize the neoplasm. In this setting, when histologic features of cellular differentiation are totally lacking, an extreme degree of trust is being placed on the immunohistochemical technique. From our earlier discussion it is apparent that perfect sensitivity and specificity do not exist among most immunohistochemical reagents. Accordingly, the safest approach is to use a panel of antibodies that will disclose anomalous immunohistochemical reactions (e.g., a neoplasm positive for both keratin and LCA). Specimens from such cases should be carefully evaluated with additional monoclonal antibodies and scrutinized by light microscopy. Furthermore, while immunohistochemistry provides for rapid and cost-effective diagnosis, electron microscopy may still contribute valuable information. Despite our best intentions and desires, it is also clear that a small percentage of "undifferentiated" neoplasms will remain undifferentiated. Quality control and quality assurance are two final, but important, issues to address. An extraordinary large number of variables in tissue selection, fixation, and processing can skew results.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Clin Lab Medjournal_title
Clinics in laboratory medicineauthors
Linder Jsubject
Has Abstractpub_date
1990-03-01 00:00:00pages
59-76issue
1eissn
0272-2712issn
1557-9832journal_volume
10pub_type
杂志文章,评审abstract::From the inception of TBS in 1988, it has been well received by the pathology and clinical communities. The need for a unifying system of nomenclature was so great that most of the laboratories in the United States, as well as in numerous countries worldwide, quickly adopted TBS. By 1991, only 2 years after the initia...
journal_title:Clinics in laboratory medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.1016/s0272-2712(03)00053-2
更新日期:2003-09-01 00:00:00
abstract::Severe adverse drug reactions are a common cause of morbidity and mortality. Some of the most severe reactions are immunologically mediated and have been linked to specific HLA alleles. The mechanisms underlying HLA-associated drug hypersensitivity are complex and not fully understood. Recent findings have provided in...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2018.08.002
更新日期:2018-12-01 00:00:00
abstract::Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasosep...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2016.07.012
更新日期:2016-12-01 00:00:00
abstract::Nephropathy progressing to end-stage renal failure is a common complication of diabetes mellitus. The development of diabetic nephropathy is preceded for many years by minor increases in urine albumin excretion (microalbuminuria), and some diabetologists believe that by reducing or reversing this early abnormality, po...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Advances in molecular genetics have had a major impact on our understanding of the pathogenesis of neurologic disorders. This article discusses molecular genetic contributions to our knowledge of Huntington's disease, amyotrophic lateral sclerosis, and Alzheimer's disease, as well as their implications for diagnosis a...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-01 00:00:00
abstract::The antiphospholipid syndrome (APS) is an autoimmune disorder presenting with tissue injury in various organs attributed to large or small vessel thrombosis or, in some instances, possible nonthrombotic inflammatory mechanisms, associated with in vitro evidence of antibodies to certain proteins, or proteinphospholipid...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2009.06.001
更新日期:2009-06-01 00:00:00
abstract::Laboratory information systems (LISs) supply mission-critical capabilities for the vast array of information-processing needs of modern laboratories. LIS architectures include mainframe, client-server, and thin client configurations. The LIS database software manages a laboratory's data. LIS dictionaries are database ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2015.09.002
更新日期:2016-03-01 00:00:00
abstract::Lipoprotein-associated phospholipase A2 (LP-PLA2) is an emerging inflammatory marker that is used to assess the risk for cardiovascular disease (CVD) and associated events. Several epidemiologic studies have demonstrated an independent association between plasma Lp-PLA2 concentration and risk for cardiovascular events...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2006.06.003
更新日期:2006-09-01 00:00:00
abstract::India is a global leader in diabetes, currently with second largest pool of diabetes in the world. Asian Indian phenotype is uniquely predisposed to develop type 2 diabetes because of strong familial aggregation as well lifestyle factors of imprudent diet and sedentary physical habit. The typical Asian Indian phenotyp...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2012.04.012
更新日期:2012-06-01 00:00:00
abstract::Direct-to-consumer genetic testing came on the scene 2 decades ago as a means for allowing consumers to access their genetic information without the involvement of a physician or genetic counselor. Results are delivered directly to the consumer, often leading to misinterpretation and needless medical interventions or ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2019.11.003
更新日期:2020-03-01 00:00:00
abstract::The primary product of the laboratory is information. Greater attention should be devoted to how laboratory reports are presented to ensure that information is being conveyed effectively to the clinician. Different reporting techniques, including test-by-test, interim, cumulative, and completed accession reports, are ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
abstract::Image processing has traveled to the lunar surface and back, finding its way into the clinical laboratory. Advances in digital computers have improved the technology of image analysis, resulting in a wide variety of medical applications. Offering improvements in turnaround time, standardized systems, increased precisi...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-12-01 00:00:00
abstract::An exciting era exists as a result of the introduction of novel markers of myocardial damage. The prognostic implications of troponins, even in the setting of "minor myocardial damage," are potentially of immense value to patient care. We need to take the next step and assess the outcomes of interventions in these set...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1997-12-01 00:00:00
abstract::Fine needle aspiration biopsy (FNAB) is the diagnostic procedure of choice for evaluation of liver lesions. Although primarily applied to malignant disease, it is also used in the evaluation of benign conditions. Improvements in imaging techniques and advances in cytologic interpretations, as well as production of new...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::Cyclosporine (CsA) monitoring has remained controversial since the advent of the use of CsA in organ transplantation in the early 1980s. This article attempts to clarify for the clinical laboratory worker many of the vagaries associated with CsA monitoring by considering choice of sample matrix, the nature of metaboli...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::The combination of requirements for decreased turnaround time for hematology laboratory results and advances in technology have driven testing closer to the point of patient contact. This article provides an overview of the technologies available to measure hemoglobin, white blood cell counts, differentials, and CD4+ ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2014.10.009
更新日期:2015-03-01 00:00:00
abstract::At the start of the twenty-first century, a dramatic change occurred in the clinical laboratory community. Concepts from Metrology, the science of measurement, began to be formally applied to clinical laboratory field methods, resulting in a new appreciation of metrological calibrator traceability. It is a change beca...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2016.09.010
更新日期:2017-03-01 00:00:00
abstract::Antiretroviral drugs against HIV infection have been developed that inhibit various stages of the HIV replication cycle. Agents other than reverse transcriptase inhibitors are reviewed with particular attention to those under study in clinical trials, including inhibitors of the virus-encoded protease enzyme. In addit...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract::As aerobic creatures, normal living requires that not only are human beings exposed to oxygen but are dependent on oxygen. Humans have evolved mechanisms to cope with living in an aerobic environment; however, modern humans may be more exposed to oxidant stresses. Much indirect evidence implicates reactive oxygen spec...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::Automation of AST has come quite some way and is here to stay. In particular, fully automated, "hands off" instruments have great appeal to laboratories with a limited number of well-trained and experienced clinical microbiology personnel. None of the evaluated instruments is perfect, but then neither are the standard...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract::Mechanisms of immunologic injury causing glomerulonephritis are based on immune complex or autoantibody deposition with activation of complement. Circulating immune complex disease can be diagnosed and monitored with improved assays for immune complexes, DNA antibodies, complement levels, and complement activation pro...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::Cannabis, or marijuana, has been known and used as a drug for many thousands of years. Recent interest in drug abuse and detection has spurred the development of several methodologies for cannabinoid detection. These methods include immunoassays and chromatography. Laboratories routinely performing cannabinoid testing...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-09-01 00:00:00
abstract::It is necessary to determine the safety of polymeric materials through laboratory and animal testing before biomedical use can become more widespread. This article describes many of the methods used in analyzing the toxicology and biocompatibility of potentially important biomedical polymers. The study method used in ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::The most efficacious and practical means of diagnosing human schistosomiasis is based on the detection of infection-specific antibodies. Because of their high sensitivity, antibody assays remain the most practical assays for epidemiologic studies and patient management. Initial screening may be performed in the field ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-12-01 00:00:00
abstract::Diagnosis of invasive fungal pneumonias by conventional culture methods is difficult to assess and often delayed. Nonmolecular fungal markers have emerged as an important adjunctive tool to support their diagnosis in combination with other clinical, radiologic, and microbiological criteria of invasive fungal diseases....
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2014.02.006
更新日期:2014-06-01 00:00:00
abstract::Vertical auto profile (VAP) method is a direct single test for measuring comprehensive lipoprotein cholesterol profile. It is based on a well-established method of ultracentrifugation that uses vertical rotor and single density gradient spin. VAP provides cholesterol concentrations of total lipoprotein, high-density l...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2006.07.004
更新日期:2006-12-01 00:00:00
abstract::In marked contrast to their historical classification as relatively harmless, common cold-causing, respiratory pathogens, human coronaviruses (HCoVs) are associated with more severe clinical complications, as emphasized by the discovery of severe acute respiratory syndrome-associated CoV (SARS-CoV) in 2003. Still, the...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2009.07.007
更新日期:2009-12-01 00:00:00
abstract::Osteoporosis (low bone mass) depends on the peak bone mass attained and bone loss after the peak. Sex steroids (estrogens and androgens) have an impact on both processes. In this article the roles and mechanisms of estrogens and androgens are discussed in relation to clinical osteoporosis. Other hormones and hormone-l...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::The classic workup of a patient for possible PA is revisited in light of the vanishing Schilling test. The vagaries of testing for B12 and blocking antibodies are reexamined. The advantages and disadvantages of newer tests such as MMA and serum gastrin levels are catalogued. At this juncture in the evolution of new te...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-2712(01)00003-8
更新日期:2002-06-01 00:00:00
abstract::Adenocarcinoma of the small intestine is relatively rare in comparison to colorectal carcinoma. Adenocarcinoma of the small intestine arises through the adenoma-carcinoma sequence in the colon. However, adenocarcinomas arising in the background of inflammatory bowel disease develop through the dysplasia-carcinoma sequ...
journal_title:Clinics in laboratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.cll.2013.08.007
更新日期:2013-12-01 00:00:00