IHC Service in Low- and Middle-Income Countries
IHC service is a powerful diagnostic tool used to identify specific proteins in tissues and cells. The procedure relies on the binding of antigen-specific antibodies to the target molecules, followed by the detection of the resulting immunochemical reaction using a colorimetric or fluorescent method (brown precipitating HRP substrate is common).
Immunohistochemistry can be performed on fresh frozen tissue or on formalin fixed paraffin embedded tissue (FFPE). Advances in technology such as heat-induced epitope retrieval, which restores antigens to their native state, have made IHC feasible on archival FFPE tissue specimens.
IHC Service: The Benefits of Immunohistochemistry in Diagnostics
The development of IHC laboratories in low- and middle-income countries is essential to provide cancer care services to address the growing burden of malignancy in these regions. This paper describes the experience of a tertiary-care hospital in western Kenya that built an IHC laboratory to support its oncology service. The building blocks for the IHC laboratory included physical housing, coordination of equipment and supplies, the organisation of the service, training of personnel and ongoing quality assessment.
Four pathology technicians and two graduate students were trained in IHC through short group workshops led by an IHC expert from AMPATH, as well as representatives of the company that provides the IHC reagents (DAKO, Nairobi, Kenya). These were supplemented by one-on-one instruction delivered by visiting pathologists from a consortium of North American universities. This allowed for a sustainable IHC laboratory with a modest investment of infrastructure, personnel and supplies. Continual quality assessments ensured that the service was of sufficient standards to deliver clinically meaningful results to patients.…