Torlakovic E E, Naresh K, Kremer M, van der Walt J, Hyjek E, Porwit A
Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
J Clin Pathol. 2009 Jun;62(6):547-51. doi: 10.1136/jcp.2008.063446.
In diagnostic immunohistochemistry (IHC), daily quality control/quality assurance measures (QC/QA) and participation in external quality assurance programmes (EQA) are important in ensuring good laboratory practice and patient care. Bone marrow trephine biopsies (BMTB) have been generally excluded from EQA programmes for diagnostic IHC due to a lack of standards for tissue processing. The European Bone Marrow Working Group (EBMWG) has set up an EBMWG IHC Committee with the task of exploring the plausibility of an EQA programme for BMTB IHC in Europe.
28 laboratories participated in a web-based anonymous survey; 19 laboratories submitted a total of 109 slides stained for CD34, CD117, CD20, CD3, Ki-67 and a megakaryocyte marker of choice.
Eight different fixatives and nine different decalcification methods were used. While 93% of participants believed that they produced excellent results in BMTB IHC, only 4/19 (21%) laboratories did not have any poor results. CD117 and Ki-67, with 53% and 50% poor results, respectively, were the most problematic immunostains, while CD20 was the least problematic, with only 11% poor results.
The EBMWG IHC Committee calls for a reduction in the tissue processing methods for BMTB and establishment of an EQA programme for BMTB IHC to help diagnostic IHC laboratories calibrate their tests according to expert recommendations. This is especially necessary in the light of recent introduction of predictive IHC tests in BMTB.
在诊断性免疫组织化学（IHC）中，日常质量控制/质量保证措施（QC/QA）以及参与外部质量保证计划（EQA）对于确保良好的实验室规范和患者护理至关重要。由于缺乏组织处理标准，骨髓活检组织切片（BMTB）通常被排除在诊断性IHC的EQA计划之外。欧洲骨髓工作组（EBMWG）已成立了一个EBMWG IHC委员会，其任务是探讨在欧洲开展BMTB IHC的EQA计划的可行性。
28个实验室参与了一项基于网络的匿名调查；19个实验室共提交了109张分别用CD34、CD117、CD20、CD3、Ki-67以及一种所选巨核细胞标志物染色的切片。
使用了8种不同的固定剂和9种不同的脱钙方法。虽然93%的参与者认为他们在BMTB IHC中取得了优异的结果，但只有4/19（21%）的实验室没有任何不佳的结果。CD117和Ki-67是问题最大的免疫染色指标，不佳结果分别占53%和50%，而CD20问题最小，不佳结果仅占11%。
EBMWG IHC委员会呼吁减少BMTB的组织处理方法，并为BMTB IHC建立一个EQA计划，以帮助诊断性IHC实验室根据专家建议校准其检测。鉴于最近在BMTB中引入了预测性IHC检测，这一点尤为必要。
