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Analysis of immunohistochemical stain usage in different pathology practice settings

Akeesha A Shah1, Henry F Frierson, Helen P Cathro

  • 1Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908, USA.

American Journal of Clinical Pathology
|November 20, 2012
PubMed

Insights

This study found that diagnostic agreement for carcinoma using immunohistochemistry (IHC) was high across different practice settings. However, IHC use varied, with commercial labs employing it more frequently than academic or private practices.

Area of Science:

  • Pathology
  • Oncology
  • Diagnostic Medicine

Background:

  • Immunohistochemistry (IHC) is a valuable tool in diagnosing carcinoma.
  • Variations in IHC utilization exist across different pathology practice settings.

Purpose of the Study:

  • To compare the utilization of IHC in diagnosing carcinoma between academic centers and private/commercial practice settings.
  • To assess diagnostic agreement among pathologists in various settings.

Main Methods:

  • Review of H&E-stained slides and available IHC stains for 200 recently diagnosed carcinomas.
  • Evaluation by academic pathologists (resident, mid-level, senior) and referral pathologists.
  • Analysis of IHC usage rates and diagnostic agreement.

Main Results:

  • High diagnostic agreement (98%) between academic and referral pathologists.
  • Significantly higher IHC utilization in commercial laboratories (38%) compared to private/community (24%) and academic (11%) settings.
  • Similar average number of IHC stains ordered per case across all groups.

Conclusions:

  • The use of immunohistochemistry in carcinoma diagnosis varies by practice setting.
  • Pathologist experience and practice environment may influence IHC utilization.
  • High diagnostic agreement suggests consistent diagnostic quality despite differing IHC usage patterns.

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