Diagnostic Protocol

We provide comprehensive cancer diagnostic services from our state of the art histo-pathology and molecular diagnostic laboratory based in Thapathali, Kathmandu. Our histo-pathological and immunohistochemical methods offer better and more reliable well rounded diagnostics than most labs in Nepal.

The following Immuno-histopathology based cancer diagnostic services are immediately available.

IHC Cancer Markers currently available are:

  1. 34βE12: This high molecular weighted protein is a potential marker for prostate and breast cancer, also for carcinoma (cancer) of the lung. (Dako, 2013)
  2. BCL2: The outer mitochondrial membrane protein encoded by BCL2 is responsible for preventing apoptosis (cell death) of lymphocytes (White Blood Cells). This antibody could be vital in classifying various types of lymphomas as well as lymph proliferative diseases. (Dako, 2013)
  3. CD3: CD3 is expressed by most outer T cells and natural killer cells (part of immune response). It is a useful immunohistochemical marker for T-cells in tissue sections. (Dako, 2013)
  4. CD5: CD5 is mainly expressed on the surfaces of B and T cells and is thus associated with cancers of B and T cells. Its absence in T-cell lymphoma is a major indicator of this particular type of malignancy. CD5 is a suitable immunohistochemical marker of T cells. (Dako, 2013)
  5. CD10: CD10 is usually expressed on immature B cells in the bone marrow. Studies have shown its close association for tumour progression of malignant melanomas. CD10 is also useful for the identification of various conditions of lymphoma and leukemia. (Dako, 2013)
  6. CD15: CD15 combines with carbohydrates and is expressed on Reed-Steenberg and myeloid cells (not lymphoid cells), it has been expressed previously in acute myeloid leukemia and chronic myelogenous leukemia. It is critical in identifying Hodgkin's disease. (Dako, 2013)
  7. CD20: Mainly used as a marker for normal and neoplastic B cells (abnormal B cells associated with B cell lymphoma), CD20 can also be useful for the identification of Hodgkin's Lymphoma. (Dako, 2013)
  8. CD23: CD23 is mainly used for the differentiation of various B cell lymphomas (B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma) Mantle cell lymphoma is generally negative for CD23. (Dako, 2013)
  9. CD30: CD30 is particularly useful in the identification of large cell lymphoma and Hodgkin's Lymphoma as it is expressed on Hodgkin's cells as well as embryonal cancer cells. (Dako, 2013)
  10. CD31: CD31 is particularly useful to identify endothelial cells (cells lining the interior layer of blood and lymph vessels) also to identify disorders associated with cancerous blood vessels. (Dako, 2013)
  11. CD34: CD34 is essential for the identification and classification of vascular cancers. (Dako, 2013)
  12. CD45: CD45 markers are mainly used in the identification of cancers that have been recognized in the lymphoid region. (Dako, 2013)
  13. CD56: CD56 marker is mainly expressed in Small Cell Lung Cancer (SCLC) and since it combines with natural killer (NK cells) and is a part of T cells, is also an identifier of NK and T cells. . (Dako, 2013)
  14. CD68: CD68 mainly is mainly associated with monocytes (part of our innate immune system) as it identifies macrophages (cells produced by differentiation of monocytes) and a case of acute myeloid leukemia. (Accumulation of abnormal white blood cells in the bone marrow) (Dako, 2013)
  15. CD99: Seen on the cell membrane of lymphocytes, islet cells in the pancreas. CD99 is used to detect tumour of the islet cells, Ewing's sarcoma. (A form of cancer of the soft tissue and the bone mostly in the femur, humerus and the pelvis) (Dako, 2013)
  16. CD138: CD138 is mainly used in the detection of myeloma cells, cancerous and terminally differentiated plasma cells and used to sub-classify B cell lymphomas as it is linked to the latter stages of B cell differentiation. (Dako, 2013)
  17. CK 7: Expressed in normal and abnormal epithelial cells, Cytokeratin7 are identifying markers of lung, breast, edometrium cancers and have potential in the differential diagnosis of prostate cancer. (Dako, 2013)
  18. CK20: CK20 is expressed in cancers relating to the colon, ovarian cancers, also carcinomas of the stomach and pancreas. (Dako, 2013)
  19. CK PAN: CK-PAN is used in the differential diagnosis of carcinomas from the majority of non epithelial malignant tumours.
  20. Calret: Calret is mainly used for the differential diagnosis of lung/ovarian cancer; it is also a useful identification marker for malignant mesothelial cells. (Dako, 2013)
  21. Cycline D1: Cyclin D1 is useful in the identification of tumours, mostly as the antibodies to Cycline D1 are used in the identification of Mantle cell lymphoma. (type of B-cell Lmyphoma) (Dako, 2013)
  22. Desmine: This marker is expressed on smooth and striated muscles and on any reactive mesothelial cells. It is used for the identification of tumours of muscle origin like leiomyoma. (A tumour of the smooth muscles) (Dako, 2013)
  23. ER: ER (Estrogen Receptor) present in the mammary gland is identifying marker for breast cancer. (Lee et al, 2002)
  24. MELAN-A: Mainly used as an identifying marker for Melanoma, this marker is also used for identifying adrenocortical carcinomas. (Cancer of the cortex tissues of the adrenal gland) (Dako, 2013)
  25. Pax5: Pax 5 is mainly used as a significant IHC marker for the differential diagnosis of lymphoid neoplasms. They are also expressed significantly in B lymphocytes and B cell lymphomas. (Fieldman & Dogan, 2007)
  26. PR: Progesterone Receptors are IHC markers may help in the differential diagnosis of breast cancer and adrenal carcinomas. (Lee et al, 2002)
  27. PSA (Prostate Specific Antigen): PSA is mainly used in the immunohistochemical identification of tumours of prostate origin. (Dako, 2013)
  28. SMA: SMA mainly are used to relate to disease progression, Specific Membrane Antigens are location specific, for example Prostate SMA's are expressed in both normal and cancerous prostatic epithelium. (Dako, 2013)
  29. Synapt: This antibody is useful in the identification of neuroendocrine neoplasms (abnormal tissue mass) and tumours. (Dako, 2013)
  30. TTF1: TTF1 is mainly used in the expression of cancers in the lungs and thyroid. It is also used in the differential diagnosis of primary and metastatic cancers. (Dako, 2013)
  31. TDT: For identification of precursor B- and T-cell lymphoma/leukemia, and for identification of thymoma. (Dako, 2013)
  32. Her2: Her2 protein is expressed at a significantly high amount in primary human invasive breast cancer; therefore it is a major identifying marker of breast carcinoma. (Dako, 2013)
  33. S100: Very essential for melanoma testing, also regularly identified in neuroectodermal tumours (tumours of the central or peripheral nervous system) such as neurofibroma (a benign nerve sheath tumour of the peripheral nervous system) (Dako, 2013)
  34. CD79: CD79 is expressed at all stages of B cell differentiation also in B cell neoplasms. Also, CD79 is used for the differential diagnosis of Hodgkin's disease. (Dako, 2013)
  35. CK 5: CK 5 is used for the detection and differential diagnosis of various types of carcinoma, squamous carcinoma vs. adrenocarcinoma, and prostate carcinoma vs. its benign mimics. (Dako, 2013)
  36. Cam 5.2: Cam 5.2 is mainly expressed and used in the diagnosis of adrenocarcinoma, squamous cell carcinoma, renal cell carcinoma, hepatocellular carcinoma, a few breast carcinomas amongst others.(Dako, 2013)

IHC markers in summary

We have a comprehensive Immunohistochemical (IHC) marker library which helps identify various cancers at different stages of development.

Some of the most frequent cases are:

Cancer Type
Identifying marker
Breast cancer
34βE12, CK7, ER, PR, HER2
Lymphoma
BCL12, CD3, CD5, CD10
B/T cell Lymphoma
CD5, CD138, TDT
Leukemia
CD10, CD15
Acute Myeloid Leukemia
CD15
Hodgkin's Lymphoma
CD15, CD20, CD30, CD79
Vascular Cancers
CD31, CD34
Small Cell Lung Cancer
CD56
Ewing's Sarcoma
CD68
Lung Cancer
CK7, CALRET, TTF1
Ovarian Cancer
CK20, CALRET
Stomach Cancer
CK20
Mantle Cell Lymphoma
CYCLINE D1
Muscle Related Cancer
DESMINE
Melanoma
MELAN-A
Prostate Cancer
PSA, SMA
Hepatocellular Cancers
CAM 5.2
References:

Dako North America Inc., 2013, 'Product Group', Viewed on 14th May 2013 http://www.dako.com/us/ar38/psg38719000/baseproducts.htm

Fieldman AL & Dogan A, 2007, 'Diagnostic uses of PAX5 Immunohistochemistry', Advances in Anatomic Pathology, vol. 5, pp. 323-334, viewed on 14th May 2013 http://www.ncbi.nlm.nih.gov/pubmed/17717432

Lee BH, Hecht JL, Pinkus JL, Pinkus GS, 2002, 'WT1Estrogen Receptor, and Progesterone Receptor as Markers for Breast and Ovarian Primary sites in Metastatic Adrenosarcoma to Body Fluids', Anatomic Pathology, vol. 117, pp. 745-750 viewed on 14th May 2013 http://ajcp.ascpjournals.org/content/117/5/745.full.pdf

Nordic Immunohistochemical Quality Control 2012, 'Cytokeratin', viewed on 14th May 2013 http://www.nordiqc.org/Epitopes/Cytokeratins/cytokeratins.htm