细胞病理学实验室的免疫组织化学实践：对美国病理学家学会非妇科细胞病理学教育项目参与者的一项调查。
Immunohistochemistry practices of cytopathology laboratories: a survey of participants in the College of American Pathologists Nongynecologic Cytopathology Education Program.
作者信息
Fischer Andrew H, Schwartz Mary R, Moriarty Ann T, Wilbur David C, Souers Rhona, Fatheree Lisa, Booth Christine N, Clayton Amy C, Kurtyz Daniel F I, Padmanabhan Vijayalakshmi, Crothers Barbara A
机构信息
From the Department of Pathology, University of Massachusetts Memorial Health Care, Worcester (Dr Fischer); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Schwartz); the Department of Pathology, AmeriPath Indiana, Indianapolis (Dr Moriarty); the Department of Pathology, Massachusetts General Hospital, Boston (Dr Wilbur); the Departments of Statistics/Biostatistics (Ms Souers) and Cytology Surveys (Ms Fatheree), College of American Pathologists, Northfield, Illinois; the Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio (Dr Booth); the Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota (Dr Clayton); the Department of Cytology, Wisconsin State Laboratory of Hygiene, Madison (Dr Kurtyz); the Department of Pathology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (Dr Padmanabhan); and the Department of Pathology and Area Laboratory Services, Walter Reed Army Medical Center, Washington, District of Columbia (Dr Crothers).
出版信息
Arch Pathol Lab Med. 2014 Sep;138(9):1167-72. doi: 10.5858/arpa.2013-0259-CP. Epub 2014 May 19.
CONTEXT
Immunohistochemistry (IHC) is important for cytology but poses special challenges because preanalytic conditions may differ from the conditions of IHC-positive controls.
OBJECTIVE
To broadly survey cytology laboratories to quantify preanalytic platforms for cytology IHC and identify problems with particular platforms or antigens. To discover how validation guidelines for HER2 testing have affected cytology.
DESIGN
A voluntary survey of cytology IHC practices was sent to 1899 cytology laboratories participating in the College of American Pathologists Nongynecologic Cytopathology Education Program in the fall of 2009.
RESULTS
A total of 818 laboratories (43%) responded to the survey by April 2010. Three hundred fourty-five of 791 respondents (44%) performed IHC on cytology specimens. Seventeen different fixation and processing platforms prior to antibody reaction were reported. A total of 59.2% of laboratories reported differences between the platforms for cytology specimens and positive controls, but most (155 of 184; 84%) did not alter antibody dilutions or antigen retrieval for cytology IHC. When asked to name 2 antibodies for which staining conditions differed between cytology and surgical samples, there were 18 responses listing 14 antibodies. A total of 30.6% of laboratories performing IHC offered HER2 testing before publication of the 2007 College of American Pathologists/American Society of Clinical Oncologists guidelines, compared with 33.6% afterward, with increased performance of testing by reference laboratories. Three laboratories validated a nonformalin HER2 platform.
CONCLUSIONS
The platforms for cytology IHC and positive controls differ for most laboratories, yet conditions are uncommonly adjusted for cytology specimens. Except for the unsuitability of air-dried smears for HER2 testing, the survey did not reveal evidence of systematic problems with any antibody or platform.
背景
免疫组织化学（IHC）对细胞学很重要，但由于分析前条件可能与IHC阳性对照的条件不同，因此带来了特殊挑战。
目的
广泛调查细胞学实验室，以量化细胞学IHC的分析前平台，并识别特定平台或抗原存在的问题。了解HER2检测的验证指南如何影响细胞学。
设计
2009年秋季，向1899个参与美国病理学家学会非妇科细胞病理学教育项目的细胞学实验室发送了一份关于细胞学IHC实践的自愿调查问卷。
结果
截至2010年4月，共有818个实验室（43%）回复了调查。791名受访者中有345名（44%）对细胞学标本进行了IHC检测。报告了抗体反应前17种不同的固定和处理平台。共有59.2%的实验室报告细胞学标本平台与阳性对照之间存在差异，但大多数（184个中的155个；84%）在细胞学IHC中未改变抗体稀释度或抗原修复。当被要求说出2种在细胞学和手术样本中染色条件不同的抗体时，有18份回复列出了14种抗体。在2007年美国病理学家学会/美国临床肿瘤学会指南发布之前，进行IHC检测的实验室中有30.6%提供HER2检测，之后这一比例为33.6%，参考实验室的检测性能有所提高。3个实验室验证了一种非福尔马林HER2平台。
结论
大多数实验室的细胞学IHC平台与阳性对照不同，但很少针对细胞学标本调整条件。除了空气干燥涂片不适用于HER2检测外，调查未发现任何抗体或平台存在系统性问题的证据。
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