A systematic analysis of commonly used antibodies in cancer diagnostics

Histopathology. 2014 Jan;64(2):293-305. doi: 10.1111/his.12255. Epub 2013 Nov 5.


Aims: Immunohistochemistry plays a pivotal role in cancer differential diagnostics. To identify the primary tumour from a metastasis specimen remains a significant challenge, despite the availability of an increasing number of antibodies. The aim of the present study was to provide evidence-based data on the diagnostic power of antibodies used frequently for clinical differential diagnostics.

Methods and results: A tissue microarray cohort comprising 940 tumour samples, of which 502 were metastatic lesions, representing tumours from 18 different organs and four non-localized cancer types, was analysed using immunohistochemistry with 27 well-established antibodies used in clinical differential diagnostics. Few antibodies, e.g. prostate-specific antigen and thyroglobulin, showed a cancer type-related sensitivity and specificity of more than 95%. A majority of the antibodies showed a low degree of sensitivity and specificity for defined cancer types. Combinations of antibodies provided limited added value for differential diagnostics of cancer types.

Conclusions: The results from analysing 27 diagnostic antibodies on consecutive sections of 940 defined tumours provide a unique repository of data that can empower a more optimal use of clinical immunohistochemistry. Our results highlight the benefit of immunohistochemistry and the unmet need for novel markers to improve differential diagnostics of cancer.

Keywords: biological tumour markers; differential diagnosis; immunohistochemistry; surgical pathology; tissue microarray analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies*
  • Biomarkers, Tumor / analysis*
  • Humans
  • Immunohistochemistry
  • Neoplasms / diagnosis*
  • Sensitivity and Specificity


  • Antibodies
  • Biomarkers, Tumor