Optimizing Immunohistochemistry Reporting in Endometrial Cancer.

Area of Science:

• Oncology
• Pathology
• Genetics

Background:

• Endometrial cancer management relies on a multidisciplinary team (MDT) approach.
• Immunohistochemistry (IHC) markers like estrogen receptor (ER), progesterone receptor (PR), p53, and mismatch repair (MMR) proteins are crucial for prognosis.
• Polymerase epsilon (POLE) mutations predict favorable treatment response and prognosis.

Purpose of the Study:

• To enhance IHC reporting accuracy and introduce POLE testing for endometrial cancer at Royal Cornwall Hospitals Trust (RCHT).
• To achieve sustainable, long-term improvements in endometrial cancer management through standardized diagnostic processes.

Main Methods:

• Initial analysis of 53 endometrial cancer cases from 2022 to assess baseline IHC reporting quality and delays.
• Implementation of an IHC proforma, introduction of POLE testing, and departmental educational presentations in February 2023.
• Re-collection of data from March to September 2023 to evaluate the impact of interventions.

Main Results:

• Prior to interventions, 15.5% of cases had incomplete reporting for key IHC markers (p53, ER, PR, MMR).
• Post-intervention, a 100% correct reporting rate for IHC was achieved.
• POLE testing was successfully integrated into departmental practice, and the IHC proforma became standard.

Conclusions:

• The implemented interventions led to a significant improvement in the quality and completeness of endometrial cancer biomarker reporting.
• Standardization of IHC reporting and the incorporation of POLE testing enhance diagnostic accuracy and support optimal patient management.
• The developed proforma is now integral to endometrial cancer case reporting and MDT discussions at RCHT.