Immunohistological markers for tumour prognostication

Traditionally, cancer prognostication has been based on the histological typing and clinical staging of the tumour. However, these parameters do not adequately identify subsets of patients who are likely to relapse and those likely to benefit from contemporary forms of therapy including chemotherapy, hormonal therapy, antibody treatment and radiotherapy. The paradigm shift in management strategies for cancer has necessitated a search for biological markers that are of prognostic relevance and predict outcome to treatment. Such markers include those that allow assessment of microscopic invasion of basal lamina, micrometastasis to sentinel and regional nodes, and bone marrow, hormone receptors, tumour growth fraction, angiogenesis, a number of tumour-associated genes including p53, growth factor receptors and anti-metastasis genes and markers that predict response to therapy such as p -glycoprotein and c- erbB -2. Immunohistology remains the most convenient method of assessment of these biological markers and many are now required in the routine assessment of some cancers.