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Quality control by tissue microarray in immunohistochemistry
Sergio Antonio Tripodi1, Bruno Jim Rocca, Lizart Hako
1Department of Pathology, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Insights
This study introduces a novel internal control method for immunohistochemistry, significantly reducing costs and improving efficiency in bone marrow diagnostics. The technique streamlines workflow and enhances slide interpretation for pathologists.
Area of Science:
- Histopathology
- Immunohistochemistry
- Diagnostic Pathology
Background:
- External positive controls are standard in immunohistochemistry but are time-consuming and costly.
- Internal controls offer a cost-effective alternative but are limited to specific diagnoses.
- Standardizing immunohistochemical results is crucial for accurate diagnosis.
Purpose of the Study:
- To present a new method for incorporating internal controls in bone marrow immunohistochemistry.
- To demonstrate how this technique improves interpretation and reduces costs.
- To validate the feasibility and benefits of the proposed internal control method.
Main Methods:
- A paraffin-embedded tonsil tissue cylinder was used as an internal control, processed in the same block as the bone marrow biopsy.
- This approach eliminated the need for separate external tonsil tissue controls.
- The technique was validated by comparing quality, workload, and costs against routine external controls in 50 bone marrow biopsies.
Main Results:
- The simultaneous processing of samples and internal controls spared 60 external positive control tests.
- Preparation of recipient blocks required minimal time and technical skill.
- Significant savings in disposable materials, reduced technician workload, and decreased interpretation time for pathologists were observed.
- Potential technical bias was also minimized.
Conclusions:
- The developed internal control method is feasible, cost-effective, and enhances quality in immunohistochemical analysis.
- This technique is applicable beyond haematopathology, with potential for broader use in various pathology fields.
- The method offers a practical solution for standardizing immunohistochemical results while optimizing resource utilization.
Aims:
An external positive control section is included in each immunohistochemical analysis as a well recognised and validated technique for standardising results. The method is time-consuming and expensive. On the contrary, internal controls are warranted and inexpensive, but their use is only feasible in selected diagnoses. The aim of this work is to show how the method of the authors allows improving the interpretation and cuts costs in the immunohistochemical analysis of bone marrow specimens.
Methods:
A paraffin-embedded tonsil tissue cylinder was sampled from a donor block using an automated sampler and included as an 'internal control' together with a bone marrow biopsy in a recipient block, avoiding the use of external tonsil tissue control. To validate this technique, the authors compared the quality of immunohistochemistry, the workload and costs with routine external control in 50 consecutive bone marrow biopsies.
Results:
Processing simultaneously the sample and the tissue control in the same block, 60 external positive control tests were spared. Only a few minutes were taken for the preparation of the recipient blocks, and no particular technical skill was required. Considering that the volume of antibodies used for the analysis of each sample was not increased, a considerable amount of the disposable material was saved. The workload of technicians was decreased and some potential technical bias was avoided. The time required for pathologists to interpret the slides was also reduced.
Conclusions:
In conclusion, this seems to be a feasible, cost-cutting and quality-improving technique, not limited to haematopathology but potentially extensible to other fields of pathology.
