For Immunocytochemistry and FISH RESULT: RUN 80L SLIDE: NEQAS Laboratory No: XXX Mr. A. Scientist Department of Histopathology Anytown Hospital Anytown SCHEME: Lymphoma August 2007 Scheme Assessor Assessor1 Assessor2 Assessor3 Assessor4 Lymphoma Mark 3 3 2 3 Assessment Code 80L Comment 2 Antibody Cyclin D1 Comment 1 Staining could be stronger Weak demonstration of cyclin D1 Staining could be stronger Staining could be stronger Individual Comment 4. An example of a report sheet supplied to a participant. In addition to an overall score, a breakdown of the individual assessors score is given. Comments made by assessors on staining constitute an important educational aspect of the report, especially so, if the staining is suboptimal. This guidance is a good starting point for participants wishing to improve their immunocytochemical staining results. Another important element of the assessment exercise is self-assessment. The technologist and pathologist are invited to assess their own slides and to submit a mark out of 20, allowing them to compare their opinions with those of the expert panel. Counterstain is weak Mantle cell preferred control Assessors Total Mark: 11 SELF-ASSESSMENT The marks which the participating laboratory considered the quality of staining to be worth. The laboratorys technologist and pathologist are each asked to award marks out of 20, prior to the submission of slides. Technologists 12 Mark: Pathologists Mark: 14 Guidelines Used at Assessment and for Interpretation of Scores The TOTAL MARK out of 20 is derived from the four individual assessors scores, each assessor awarding marks out of 5 using the following guidelines: SCORE 0 1 2 3 4 5 No return Little or no staining Very weak demonstration of cyclin D1 with many of the cells expected to stain, not demonstrated Weak demonstration of most of the cyclin D1 expected to stain Good demonstration of the cyclin D1 expected to stain Excellent demonstration of the cyclin D1 expected to stain, with no background NB: NO RETURNS Please note that a score of 0 indicate that slides have not been returned for the assessment. If a valid reason is given for a `no submission such as antibody not stocked, then you will not be penalised in the end of year report. However, participants not sending in slide for assessment without a valid reason or slides which have arrived too late for assessment will be penalised in the end of year report. UK NEQAS-ICC & FISH Room 3/02, Hamilton Place Mabledon Place London WC1H 9BB Tel: 02075548679 Fax: 02075548685 © Copyright UK NEQAS-ICC & FISH Dr Merdol Ibrahim Not for publication without written permission Printed at 10:08 on Wednesday, 7 November, 2007 HER-2 ICC Module Results: UK-based participants 100 90 80 70 60 % 50 40 30 20 10 0 64 65 66 67 68 69 70 71 72 73 74 75 76 Assessment Run Pass Borderline Fail HER-2 ICC Module Results: All participants 100 90 80 70 60 % 50 40 30 20 10 0 64 65 66 67 68 69 70 71 72 73 74 75 76 Assessment Run Pass Borderline Fail Figure 5. Comparative data for UK and non-UK based participants in the HER-2 ICC Module. The left-hand chart shows that UK laboratories have demonstrated a sustained significant improvement in performance between Run 64 (conducted in 2003) and Run 76 (conducted in 2007). Results from the most recent runs indicate that this high standard of performance has continued (data for Runs 77-79 is not included here). The right-hand chart shows data for the same timeframe drawn for all participants (36 countries in total, including the UK). Here an analysis of the results indicates that there has been an improvement in performance, but the improvements are significantly smaller in magnitude for this group. One hypothesis that could explain this disparity is the requirement for UK laboratories to demonstrate continued acceptable performance in order to maintain their accreditation status with the relevant clinical pathology authorities. This is not a requirement for overseas laboratories. 41 | Connection 2008 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. 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