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Validation of tissue microarray immunohistochemistry staining and interpretation in diffuse large B-cell lymphoma.
Youli Zu1, Seth M Steinberg, Elias Campo
1Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland 20892-1500, USA.
Leukemia & Lymphoma
|July 16, 2005
Summary
Tissue microarrays (TMAs) demonstrate good agreement for most diffuse large B-cell lymphoma (DLBCL) markers across institutions and observers. However, p53 and MUM-1 markers show significant inter-institutional variability, highlighting the need for standardized staining and interpretation protocols.
Area of Science:
- Oncology
- Pathology
- Immunohistochemistry
Background:
- Tissue microarrays (TMAs) are efficient for evaluating tumor cells via immunohistochemistry.
- Inter-institutional variability in observer interpretation and staining methods for TMAs requires investigation.
Purpose of the Study:
- To assess inter-observer and inter-institutional variability in immunohistochemical staining of diffuse large B-cell lymphoma (DLBCL) using TMAs.
- To evaluate the concordance of TMA results with whole tissue sections.
Main Methods:
- 21 DLBCL cases were processed into TMAs.
- Immunohistochemical stains were performed in 3 laboratories and independently reviewed by 3 hematopathologists.
- Statistical analyses assessed scoring variation among observers and institutions.
Main Results:
- High agreement was observed for CD3, CD10, CD20, BCL-2, BCL-6, MIB-1, and FOX-P1.
- MUM-1 and p53 staining showed significant inter-observer and inter-institutional variability.
- p53 agreement was higher in self-review compared to non-self review (58% vs. 10.5%, P < 0.01).
Conclusions:
- TMAs are reliable for most DLBCL phenotypic markers, including CD3, CD20, CD10, BCL-2, BCL-6, MIB-1, and FOX-P1.
- p53 and MUM-1 require standardized protocols to mitigate inter-institutional variation.
- Self-adjustment in interpretation can partially overcome variability, but standardization is crucial for new markers.