IHC Marker - NKX 2.2 Test
About IHC Marker - NKX 2.2 Test
| Field | Value |
|---|---|
| Also Known As | NKX2.2 IHC, NKX2-2 Immunohistochemistry, NKX2.2 Marker Test, NK2 Homeobox 2 IHC |
| Sample Type | FFPE tissue block (formalin-fixed, paraffin-embedded tissue) |
| Fasting Required | No |
| Report Time | 3 days |
| Recommended For | All ages and genders; primarily children, adolescents, and young adults with suspected bone or soft tissue tumours |
| Price | Starting at ₹1,920 |
What Is an IHC Marker - NKX 2.2 Test?
The IHC marker - NKX 2.2 test is a specialised tissue-based test that detects the presence of the NKX2.2 protein in a biopsy or surgical specimen. NKX2.2 is a transcription factor, meaning it is a protein involved in converting genetic information from DNA into functional molecules. This test is commonly ordered by oncologists and pathologists when certain bone, soft tissue, or neuroendocrine tumours are suspected. It is also referred to as NKX2.2 IHC or NKX2-2 Immunohistochemistry.
What Does an IHC Marker - NKX 2.2 Test Measure?
This test uses the immunohistochemistry (IHC) method, which applies a targeted antibody to a tissue section to reveal whether a specific protein is present. The table below summarises what the test assesses.
| Component | What It Tells Us |
|---|---|
| NKX2.2 Protein Expression | Whether the NKX2.2 protein is present or absent in the tissue sample |
| Staining Pattern | The intensity and distribution of staining within the tumour cells |
| Nuclear Staining | NKX2.2 is a nuclear transcription factor; positive staining is expected in the cell nuclei |
| Diagnostic Significance | Helps identify tumours with NKX2.2 expression, particularly certain small round cell tumours such as Ewing Sarcoma |
Unlike routine tests, this is a qualitative test. It does not produce a number. Instead, it reports whether the protein is detected, guiding the pathologist toward a tumour classification.
Why Is an IHC Marker - NKX 2.2 Test Done?
Doctors order this test to help classify tumours and narrow down a diagnosis when tissue examination alone is not sufficient.
Common Symptoms That May Require This Test
A doctor may request this test when a patient presents with the following signs:
- Persistent bone pain, particularly at night
- Swelling or tenderness near a bone or joint
- A palpable lump in soft tissue
- Unexplained fever without an obvious cause
- Unintended weight loss
- Bone fractures that occur without significant injury
Conditions This Test Can Help Detect
This test is used to identify or support the diagnosis of several tumour types:
- Ewing sarcoma, a rare cancer of bone and surrounding soft tissue
- Primitive neuroectodermal tumour (PNET)
- Gastrointestinal and pancreatic neuroendocrine tumours
- Olfactory neuroblastoma (a tumour arising in the nasal cavity)
- A subset of small-cell carcinoma
- Synovial sarcoma and melanoma (where NKX2.2 expression has been noted)
How to Prepare and What to Expect
The IHC marker - NKX 2.2 test procedure requires a tissue sample obtained by a clinician. There is nothing specific the patient needs to do in terms of physical preparation before the biopsy.
Do You Need to Fast?
No fasting is required for this test. Dietary restrictions do not apply, as the sample is tissue rather than blood or urine.
Practical Tips Before Your Test
Being well prepared before submitting a tissue sample helps ensure accurate results. Keep the following points in mind:
- Bring a detailed clinical history, including your symptoms, previous test results, and family history, as this is required for the test.
- Carry your doctor's referral letter, which should state the biopsy site and a summary of your clinical situation.
- Bring any existing histopathology reports if you are submitting a previously prepared paraffin block.
- Include relevant imaging reports such as CT scans, MRI, PET scans, or X-rays.
- Inform your doctor about all medications you are currently taking.
- Ensure the tissue sample has been properly preserved; inform the laboratory of the biopsy date and the fixation method used.
Step-by-Step Procedure
The steps below describe how the tissue sample is collected and processed for the IHC marker - NKX 2.2 test.
- A qualified healthcare provider collects the tissue sample during a biopsy or surgical procedure at a clinical setting.
- The tissue is placed in formalin, a preserving liquid, to stabilise it, then embedded in a paraffin wax block for transport and storage.
- In the laboratory, very thin sections are cut from the block using a precision instrument called a microtome.
- The sections are treated with a specific antibody that binds to the NKX2.2 protein, making it visible under a microscope. A heating step called epitope retrieval is used to restore the protein to a detectable form.
- A trained pathologist examines the stained slides under a microscope and assesses the degree of protein expression.
- Results are interpreted alongside other clinical findings, imaging data, and additional IHC markers before a final report is issued.
Factors That Can Affect Accuracy
- Delay in placing the tissue into fixative solution after biopsy (ideally within 6 hours)
- Over-fixation or under-fixation of the tissue block
- Chemical decalcification of bone specimens may reduce the staining quality
- Prior chemotherapy or radiation therapy, which can alter protein expression in tissue
- Antibody quality and laboratory equipment calibration
- Pathologist's experience in interpreting IHC staining patterns
Understanding Your IHC Marker - NKX 2.2 Test Results
Results from this test are qualitative and must always be reviewed by a pathologist or oncologist in context with other findings.
| Result | Interpretation |
|---|---|
| Negative | NKX2.2 protein not detected; generally argues against Ewing sarcoma but does not exclude all tumour types |
| Positive | NKX2.2 protein detected; supports a diagnosis of Ewing sarcoma in the appropriate clinical and pathological context, but can also be seen in some neuroendocrine and other tumour types |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
A result is considered positive when moderate to high protein staining is seen in the nuclei of at least 5% of cells. NKX2.2 shows a sensitivity of 93% and a specificity of 89% for Ewing sarcoma diagnosis. However, positive results can also appear in a subset of other neuroendocrine and neuroectodermal tumours. This is why the test is used as part of a panel alongside markers such as CD99 and PAX7, rather than in isolation.
Results During Special Conditions
Certain circumstances can affect the quality or accuracy of the test result:
- Tissue left without fixation for more than 6 hours may show reduced staining intensity, making results harder to interpret.
- Over-fixation beyond 48 hours can make tissue samples unsuitable for IHC testing altogether.
- Bone specimens that have undergone decalcification may yield weaker staining signals.
- Patients who have received chemotherapy or radiation before biopsy may show altered protein expression that affects interpretation.
How to Maintain Healthy Levels
This test is a diagnostic marker for tumour classification, not a wellness indicator, so "maintaining levels" does not apply in the usual sense. The following general points apply after receiving results:
- Attend all follow-up appointments recommended by your oncologist or pathologist.
- Keep all previous biopsy reports, imaging records, and clinical documents organised for future consultations.
- Discuss any concerns about your results openly with your treating specialist.
Lupin Diagnostics IHC Marker - NKX 2.2 Test Price
The IHC marker - NKX 2.2 test cost at Lupin Diagnostics starts at ₹1,920. This test requires a visit to a Lupin Diagnostics centre or submission of a prepared FFPE tissue block; home collection is not available for this test.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 1920 |
| CHENNAI | 1920 |
| HYDERABAD | 1920 |
| KOLKATA | 1920 |
| NAVI MUMBAI | 1920 |
| PUNE | 1920 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book your IHC marker - NKX 2.2 test online or at a centre:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time to submit your tissue block or biopsy specimen.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
This test helps classify tumours by detecting the NKX2.2 protein in tissue samples. It is predominantly used in the diagnosis of Ewing sarcoma and certain neuroendocrine tumours. Doctors order it when the initial tissue examination is not sufficient to confirm a diagnosis.
The tissue sample is obtained through a biopsy or surgical procedure performed by a qualified healthcare provider. It cannot be collected at home. Once collected, the tissue is preserved in formalin and embedded in a paraffin block before being sent to the laboratory.
No. Because the sample is a tissue block obtained during a biopsy or surgery, home collection is not possible. The specimen must be collected by a trained clinical professional in a healthcare setting.
The test shows a sensitivity of 93% and a specificity of 89% for Ewing sarcoma. In cytological material specifically, sensitivity has been reported as high as 100% with moderate specificity. However, it should always be used alongside other markers such as CD99 for a more reliable diagnosis.
Pathologists commonly use NKX2.2 as part of a panel that includes CD99 and PAX7. The combination of strong CD99 staining along with positive NKX2.2 and PAX7 nuclear staining is considered highly reliable for Ewing sarcoma when supported by clinical and imaging findings.
A positive result should be reviewed by an oncologist, preferably one specialising in bone or soft tissue tumours. They will assess the result alongside your imaging studies, clinical history, and other IHC markers before advising on next steps.
Not necessarily. While a positive result strongly suggests certain tumour types, it can also appear in some non-Ewing neuroendocrine or neuroectodermal tumours. A positive finding always requires further evaluation by a specialist before any conclusions can be drawn.
IHC Marker - NKX 2.2 Test
