Articles UK NEQAS-ICC & ISH: Historical perspective, current role, future directions Andy Dodson, M. Phil. CSci, FIMBS Started his career in medical science at St. Georges Hospital London in 1981. After qualifying, he went on to work in research for the British Heart Foundation for four years. Following a move to Liverpool in 1990, he returned to clinical laboratory work, and has managed the diagnostic immunocytochemistry and molecular pathology services in the Pathology Department at the Royal Liverpool University Hospital for a number of years, as well as contributing to its research activities. He is also the departments Quality Manager. In 1996, Andy became an assessor with UK NEQAS-ICC, and in 2001 he was invited to become the editor of its journal for participants, Immunocytochemistry. The early years The United Kingdom National External Quality Assessment Scheme for Immunocytochemistry and in- situ hybridisation (UK NEQAS-ICC & ISH) had its origins in the ideas first put forward by Gerry Reynolds in 1984 [1]. Gerry was a London-based biomedical scientist who had worked and lectured in the area of immunocytochemistry (ICC) since its earliest introductions into clinical cellular pathology. He was widely recognised as an expert and held in high regard by colleagues and students alike [2]. It was at a London Histology Discussion Group meeting that Gerry first invited interested members of the audience, mainly comprising scientific staff from histopathology departments in and around London, to participate in a trial of a fledgling scheme in which they would stain the sections provided for immunoglobulin kappa light chains by an immunocytochemical method of their choice. The stained sections were then returned to Gerry for central independent assessment by a panel whose members had an interest and some expertise in the field of ICC; and thus the Scheme was born. I am proud to say that I was amongst the audience for that meeting, and I collected slides from Gerry along with about 15 colleagues (obviously, at that time I was a mere callow youth ­ a neophyte, keen to learn all that I could from my elders and betters). Thus the hospital I was working in at that time, St. Georges in Tooting, had one of the lowest participant numbers in the Scheme ­ and still does as far as I am aware. The original panel of assessors consisted of Gerry, Keith Miller, Brian Mepham, Mike Bennett and Ken McLennan [1] with Keith and Brian still serving as members to this day. They marked on a scale of 1-5, with a score of 3 being acceptable [3]. At that time, kappa light chains were considered the `gold standard with staining of that antigen being assessed at every run. In addition, a second pair of sections was provided to participants in order for them to be able to demonstrate another antigen which varied from run to run. The stated aim of the Scheme was: `Independent evaluation of participants results so that laboratories, which were producing poor results, might improve [3]. The Scheme quickly gathered momentum as people realised its worth, so that on run eight there were 95 returns representing a growth of more than 500% in the first two years of its life. It is interesting to compare the Scheme in those early years with its present incarnation, and when doing so, we find that much of the original framework is still recognisable today having stood the test of time for more than 20 years. For example, in the majority of modules, the scoring is still done on a scale of 1-5 by four assessors. There are still four runs per year, and each module has a `gold standard antibody. (Please refer to Figure 1 for a complete list of features of the original Scheme which are still used today as well as a guide to the scoring system). In 1988, the Scheme was given official recognition by the UK Department of Health when it was admitted to the UK National External Quality Assessment Service (UK NEQAS) organisation. UK NEQAS-ICC continued to flourish over the next few years, but suffered a severe setback in April of 1991 with the sudden and untimely death of Gerry Reynolds. The Scheme was left in limbo for several months while a person with the necessary experience and expertise was sought to continue what Gerry had so excellently begun. The appointment at the end of 1991 of Keith Miller (University College Hospital, London) as Scheme Organiser was surely the best thing that could happen under the circumstances. At the time, Keith was already a well-known and respected member of his scientific community with considerable experience in the field of ICC, and as an assessor of the Scheme he was very familiar with its workings. Moreover, Keith shared Gerrys profound enthusiasm for the subject and for assisting others in improving by teaching and advising them. Connection 2008 | 36 April 2008, VOL 11 Connection IHC STANDARDIZATION AROUND THE WORLD In this issue Q&A with Patho Contents APRIL 2008, VOL 11 2 3 4 Editorial George L. Kumar, PhD Featured Laboratory The Osamura Editorial Immunohistochemistry (IHC) Standardization Around the World George L. Kumar, PhD Managing Featured Laboratory The Osamura Laboratory Laboratory headed by Prof. Robert Yoshiyuki Osamura, MD, Q&A Ask the Experts: On Immunohistochemistry (IHC) Standardization Professor Leong is Medical Di time interval between removal of tissue and immersion in fixative, the temperature of tissue storage Connection: How would you like to standardize IHC in Australia? As discussed above, standardization Connection: Antigen retrieval is essential in immunohistochemistry (IHC) in order to restore epitope Connection: Is a universal image analysis system feasible? No, not until we standardize the all impo Q&A Fernando Soares, MD, PhD University of São Paulo, São Paulo, Brazil Dr. Fernando Soares is F Connection: In your opinion, what is the biggest hurdle for standardization? Probably education in l There are no standards in Latin America. We always follow the manufacturers protocol during our firs Q&A Bryan R. Hewlett, ART, MLT Consultant Technologist to the Anatomic Pathology EQA program of There is no standardization of AR steps circumstances, it would be impossible toand, undera the pre Connection: How would you rate European (UK NEQAS, NordiQC) and US IHC standards to Canadian IHC sta Q&A Prof. Chen Jie Prof. Cui Quancai Peking Union Mediacl College Hospital, Beijing, China Prof. Connection: According to Goldstein et al. Appl Immunohistochem Mol Morphol 2007;15:124­133 Immunohis Connection: Is it true that a particular histology feature may be better demonstrated by other fixat Connection: What constitutes standardization of image analysis as applied to immunohistochemistry (I Q&A Dr. Tanuja Manjanath Shet Dr. Vani Parmar Tata Memorial Hospital, Mumbai, India Tanuja Manj ... the biggest hurdle in India is suboptimal fixation and processing of tissues. Though I agree th Connection: Is it true that a particular histology feature may be better demonstrated by other fixat Connection: Can you comment on the internal and external quality control (EQC) procedures followed i Q&A Prof. Robert Yoshiyuki Osamura Department of Pathology, Tokai University School of Medicine Connection: In your opinion, what is the biggest hurdle for standardization? The biggest hurdle for the standardization of image ... appropriate for pre-screeninganalysis is of the staining quality. Connection: Why is standardization of image analysis in diagnostic pathology important? Because the Q&A James F. Happel, DLM (ASCP), HTL Technical Director of Surgical Pathology, Research and Deve Connection: United Kingdom National External Quality Assessment Service (UK NEQAS) helps to ensure t Connection: The American Society of Clinical Oncology (ASCO) and the College of American Pathologist would recommend that standardization Ibegin with identifying a reliable and trustworthy source ... Interview Immunohistochemistry for Oestrogen and Progesterone Receptors Dr. Andrew Lee Consultant H Connection: What is the difference between the H score and the Allred score? Which is better? What d Connection: Can you comment on the burden in the laboratory, if one changes from a current ER/PR ass Opinion & Interview IHC Standardization: A Dako Perspective Dr. Ole Rasmussen R&D Director, Connection: Dako has developed Readyto-Use Antibodies for in vitro diagnostic applications. How is t Articles UK NEQAS-ICC & ISH: Historical perspective, current role, future directions Andy Dodso UK NEQAS-ICC in the 1990s In his first year as Scheme Organiser, Keith oversaw the transition to sub The application could be argued to represent a field change in terms of the rigour with which the an Assessment teams consist of four assessors, who view slides around a multi-headed microscope and sco The archive which UK NEQAS holds, both in terms of stained slides and methodological data, must sure For Immunocytochemistry and FISH RESULT: RUN 80L SLIDE: NEQAS Laboratory No: XXX Mr. A. Scientist De Figure 6. Feedback on results has always been given high priority, and for many years this has been a b c d Figure 7. The antigen chosen by Gerry Reynolds for his very first assessment run was kap Bibliography Selected UK NEQAS-ICC & ISH papers. Ibrahim M, Dodson AR, Barnett S, Fish D, Jasani Articles Nordic Immunohistochemical Quality Control (NordiQC) An Organization for External Quality A parameters (i.e. results interpretation and reporting) (4, 5). In an EQA setting, by circulating ser CD79a (Fig. 2) Among 112 laboratories submitting stains in the latest run, most used mAb clone JCB11 References 1. Rhodes A, Jasani B, Barnes DM, Bobrow LG, Miller KD. Reliability of immuno-histochemic Fig. 2. CD79a A. Optimal CD79a staining of the tonsil using the monoclonal antibody (mAb) clone JCB Standardization of Ki-67 Immunohistochemical Staining for Diagnosing Grade of Gastrointestinal Strom was conducted in 49 GIST cases. The concordance rate for the evaluation results at three laboratorie CB pH6 a b c d TE pH9 e f g h Autoclave 121° C/10 min Water bath 95° C/40 min Microwave 50 Table 1. Correlation between NCC and STD methods R2=0.9483 Categories of proportion NCC Method 3 Opinions Importance of Standardization for Predictive Prognosis David J. Dabbs, MD Chief of Pathol is documented and serves as a surrogate marker for the initial exposure to formalin. Since the first Opinions The New Era for ER and PRIts time to Standardize! Dr. Ian Ellis, B.Med.Sci. BM, MS, FRCpa et al 2001). The main reason for false-negative results is due to inefficient heat-induced epitope ( Standardization of HER2 TestingInconsistency Raises Questions Opinions Sunil S. Badve, MD, FRCPath rence seen in these trials is in the order of 50%. This is the major reason for all the excitement a which now requires expression of HER2 by at least 30% of tumor cells (instead of 10%). It has also r IHC CONSENSUS MEETING, JANUARY 27 2008, SANTA BARBARA, CA, USA , IHC CONSENSUS MEETING, JANUARY 27, Richard Cartun, PhD, Sunil Badve, MD Jon Askaa, PhD Søren Nielsen, HT, CT, Mogens Vyberg, MD Elizab Dako Abstracts Abstracts presented at the 30th Annual San Antonio Breast Cancer Symposium December Dako Abstracts Amplification of ESR1 may predict resistance to adjuvant tamoxifen in postmenopausal Dako Abstracts Abstracts presented at the United States and Canadian Academy of Pathology (USCAP) A Dako Abstracts Metastatic Pancreatic Endocrine Tumors in the Liver Express KOC Briones AJ, Bourne P Dako Abstracts Merkel Cell Carcinomas Express K Homology Domain Containing Protein Overexpressed in Dako Abstracts Immunohistochemical Analysis of KOC/IMP3 in Malignant Pleural Mesothelioma Xu H, Sim Dako Abstracts KOC, TTF-1 and CDX2 Discriminate Small-Cell Carcinoma from Carcinoid and Pancreatic Dako Publications Publications Co-authored by Dako: In Press Li L, Xu H, Spaulding B, Cheng L, Si Dako Meetings 2007 - National Society for Histotechnology Meeting. Denver, CO NSH workshop attend New Premium Quality Concentrated Antibodies New Products Your current and future needs drive the c Targeting Colorectal Adenocarcinomas, Anti-TIMP-1 and Anti-Villin Monoclonal Mouse Anti-Human Tissue Dakos FLEX Ready-to-Use Concept Enhance performance of your laboratory by running FLEX Ready-to-Use 2008 Product Catalog Available Now! The catalog features more than 170 new products, including the A