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Indication of intraoperative immunohistochemistry for accurate pathological diagnosis of brain tumors

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Abstract

Immunohistochemical staining is important for histological diagnosis of brain tumors; however, its intraoperative application has rarely been reported. Herein, we describe our methods and four successfully diagnosed cases. Between January 2008 and April 2010, intraoperative immunohistochemical analysis was performed in 43 patients undergoing brain tumor surgery at our institute. The time for rapid histological diagnosis was 70 min. MIB-1 immunostaining was performed; staining index (SI) was 0.8–76.2% (median, 2.5%) in rapid diagnoses and 0.6–83.9% (median, 7.7%) in permanent diagnoses. There was no discrepancy in low- or high-grade tumors between intraoperative and final pathological diagnosis. The antibodies used for staining were MIB-1 in all cases, L26 in 8 cases, UCHL-1 in 6 cases, GFAP in 4 cases, AFP in 3 cases, and PLAP in 5 cases. The staining patterns were similar between rapid and permanent diagnoses. We think that immunohistochemical examination is indicated under the following conditions: (1) preoperative radiologic differential diagnosis includes both high- and low-grade tumors, (2) intraoperative assessment is necessary to determine the extent of excision, and (3) quick and accurate pathological diagnosis is necessary for early initiation of treatment after surgery.

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Acknowledgments

We wish to express our appreciation to C. Tanda, J. Takasaki, H. Saito, and T. Fujita for their technical assistance.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this article.

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Authors and Affiliations

  1. Department of Neurosurgery, Brain Research Institute, University of Niigata, 1-757 Asahimachi, Niigata, 951-8585, Japan

    Takeo Uzuka, Hiroshi Aoki, Manabu Natsumeda & Yukihiko Fujii

  2. Department of Pathology Neuroscience (Resource Branch for Brain Disease Research CBBR), Brain Research Institute, University of Niigata, Niigata, Japan

    Akiyoshi Kakita

  3. Department of Pathology, Brain Research Institute, University of Niigata, Niigata, Japan

    Akiyoshi Kakita & Hitoshi Takahashi

Authors
  1. Takeo Uzuka
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  2. Hiroshi Aoki
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  3. Manabu Natsumeda
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  4. Akiyoshi Kakita
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  5. Hitoshi Takahashi
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  6. Yukihiko Fujii
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Correspondence to Takeo Uzuka.

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Uzuka, T., Aoki, H., Natsumeda, M. et al. Indication of intraoperative immunohistochemistry for accurate pathological diagnosis of brain tumors. Brain Tumor Pathol 28, 239–246 (2011). https://doi.org/10.1007/s10014-011-0026-4

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  • DOI: https://doi.org/10.1007/s10014-011-0026-4

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