Importance of immunohistochemistry and targeted therapy in lymphoma

The article was professionally consulted with Master, Doctor Phan Truc - Internal Oncologist - Vinmec Cancer Center - Vinmec Times City International Hospital.

Immunohistochemistry is one of the medical advances in the diagnosis of cancer, by using chemicals to detect immune markers on the surface of cells. Accurate diagnosis of cancer cell type makes treatment more effective, especially in the application of targeted therapy.

Cluster Distinguished (Cluster Distinguished) markers are also known as CD antigens. These are antigens found on the surface of cells that help differentiate different types of cells.
Immunomarkers are used very widely in the diagnosis of immunopathology, infection and cancer diagnosis. In addition, it is also used in the treatment of cancer.
Watch now: Differential diagnosis of malignant tumor - benign tumor by immunohistochemistry

Lymphoma is a type of lymphoma, it can be divided into malignant and benign lymphoma. In particular, non-Hodgkin's lymphoma is a lymphocytic leukemia, which is one of the 10 most common types of cancer. It can be seen in all ages, according to histology, it is mainly found in B lymphocytes (accounting for more than 85%) and the rest are T lymphocytes and NK cells.
In fact, in diagnosing lymphoid tissue lesions, relying on routine histopathology alone is difficult and can still be confusing. The application of immunomarkers is necessary to help confirm whether the lesion is benign or malignant as well as the origin of the malignancy.
Although biopsied tumors have a relatively similar pathology, when studying it and determining the immune markers, it can be very different. From there, it gives the doctor more specificity about the disease, as well as determining whether it is benign or malignant.
In a study of people with confirmed or suspected malignancy. It was then diagnosed by immunohistochemistry with 6 major immunological markers including LCA, CD3, CD20, Bcl2, CD30 and AE1/3.
Results after immunohistochemical staining showed: Immunomarkers LCA, CD3, CD20, Bcl2 and CD30 were 100% positive for malignant lymphoma depending on type. 100% positive type AE1/3 is seen in poorly differentiated carcinoma. The rate of true malignant lymphoma accounted for 59.3%, inflammatory or benign lymphoid hyperplasia 35.8% and poorly or undifferentiated carcinoma accounted for 4.9%.
CD30 is positive in more than 95% of classical Hodgkin lymphomas, 100% of ALK(+) regressive large cell lymphomas, and about 50% of peripheral T-cell lymphomas.
In summary, the use of these 6 immunological markers is very important in helping to diagnose and classify benign or malignant tumors, and can identify the origin of cancer as lymphoma or poorly differentiated carcinoma. for lesions that have been diagnosed as malignant lymphoma or suspected malignant lymphoma.
Not only that, the identification of immune markers is very useful in treating with monoclonal antibodies or so-called targeted therapy.

What is targeted therapy? This is something that a lot of people care about. Targeted therapy is the use of monoclonal antibodies to destroy antigens on the surface of cancer cells.
Mechanism of targeted therapy:
Immunohistochemically determined immunohistochemical markers (CDs) help diagnose certain cell types. The researchers then created a defense protein, or monoclonal antibody (mAb), that matches a specific CD antigen. These monoclonal antibodies work similarly to the body's own antibodies to kill cancer cells. When introduced into the body, these monoclonal antibodies act in different ways, depending on the structure of each substance:
Bind to CD-marked sites and destroy these cells. These substances can bind to the CD marker on cancer cells and block their ability to replicate, slowing their growth. It may increase the body's natural defenses against cancer. Therefore, once the immune marker has been identified in the lymphoma, the patient is given appropriate monoclonal antibodies, also known as targeted therapy. The advantage of this method is that it is targeted at cancer cells and does not cause damage to other healthy cells in the body. Meanwhile, chemotherapy targets fast-replicating cells, both cancerous and healthy. Some of the active ingredients approved for use in lymphoma immunotherapy such as: Brentuximab vedotin, a targeted therapy targeting the CD30 receptor, has been shown to be highly effective in the treatment of regressing large cell lymphoma. dysplasia, T-cell cutaneous lymphoma, peripheral T-cell lymphoma; rituximab is used to treat non-hodgkin' lymphoma ...
Hopefully, through the article you have understood the importance of immune markers and the mechanism of action of targeted therapy. Malignant lymphoma is a dangerous disease, which can be encountered in many different subjects and early identification and treatment will bring high efficiency. Therefore, when there are abnormal signs, you should see a doctor for diagnosis and treatment.
Document supported by Takeda company.