Characterizing the Tumor Immune Microenvironment with Tyramide-Based Multiplex Immunofluorescence

Hidetoshi Mori, Jennifer Bolen, Louis Schuetter, Pierre Massion, Clifford C. Hoyt, Scott VandenBerg, Laura Esserman, Alexander D. Borowsky, Michael J. Campbell

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Multiplex immunofluorescence (mIF) allows simultaneous antibody-based detection of multiple markers with a nuclear counterstain on a single tissue section. Recent studies have demonstrated that mIF is becoming an important tool for immune profiling the tumor microenvironment, further advancing our understanding of the interplay between cancer and the immune system, and identifying predictive biomarkers of response to immunotherapy. Expediting mIF discoveries is leading to improved diagnostic panels, whereas it is important that mIF protocols be standardized to facilitate their transition into clinical use. Manual processing of sections for mIF is time consuming and a potential source of variability across numerous samples. To increase reproducibility and throughput we demonstrate the use of an automated slide stainer for mIF incorporating tyramide signal amplification (TSA). We describe two panels aimed at characterizing the tumor immune microenvironment. Panel 1 included CD3, CD20, CD117, FOXP3, Ki67, pancytokeratins (CK), and DAPI, and Panel 2 included CD3, CD8, CD68, PD-1, PD-L1, CK, and DAPI. Primary antibodies were first tested by standard immunohistochemistry and single-plex IF, then multiplex panels were developed and images were obtained using a Vectra 3.0 multispectral imaging system. Various methods for image analysis (identifying cell types, determining cell densities, characterizing cell-cell associations) are outlined. These mIF protocols will be invaluable tools for immune profiling the tumor microenvironment.

Original languageEnglish (US)
Pages (from-to)417-432
Number of pages16
JournalJournal of Mammary Gland Biology and Neoplasia
Issue number4
StatePublished - Dec 2020


  • Breast cancer
  • Immune cells
  • Immunohistochemistry
  • Multiplex

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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