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Diagnostic immunohistochemistry use in Belgian laboratories
Christophe de Meester1, Elena Costa1, Claudia Schönborn1
1Belgian Health Care Knowledge Centre, Brussels, Belgium.
Insights
Diagnostic immunohistochemistry (IHC) use in Belgium surged 63.8% from 2012 to 2019. H. pylori, Ki-67, and CK stains were most common, particularly in gastrointestinal biopsies, indicating a need for clearer diagnostic indications.
Area of Science:
- Medical diagnostics
- Pathology
- Biotechnology
Background:
- Immunohistochemistry (IHC) testing has seen increased utilization in Belgium over the past decade.
- Information regarding specific reimbursed indications for IHC testing remains limited.
- Trends in diagnostic IHC usage require comprehensive analysis.
Purpose of the Study:
- To provide an overview of diagnostic IHC testing in Belgium.
- To analyze recent trends in IHC test utilization and reimbursement.
- To identify the most frequent indications for diagnostic IHC staining.
Main Methods:
- Analysis focused on reimbursed IHC testing in Belgium.
- Data sourced from compulsory health insurance and pathology reports from 2019.
- Study limited to a maximum of 4 IHC stains per sampling session for diagnostic purposes.
Main Results:
- IHC use increased by 63.8% from 2012 to 2019, outpacing general histological/cytological examination growth (13.3%).
- Top stains in 2019 included H. pylori, Ki-67, and broad-spectrum cytokeratin (CK), used across various body sites.
- The gastrointestinal tract accounted for 38.2% of all IHC stains, with H. pylori being the most frequent stain in biopsies (43.1%).
Conclusions:
- The study presents frequent indications for diagnostic IHC staining in Belgium.
- Findings highlight the dynamic nature of IHC applications in diagnostics.
- There is a clear need to enhance clarity and improve data collection for IHC testing indications.
Objectives:
In Belgium, the use of IHC testing has grown in the last decade. However, there is a lack of information on the specific indications for which it is reimbursed. The aim of the study is to offer an overview on the use of diagnostic inmunohistochemistry (IHC) testing and its recent trends.
Methods:
Our analysis is limited to reimbursed use, which in Belgium is restricted to a maximum of 4 different IHC stains per sampling session for diagnostic IHC. Consulted sources included data from the compulsory health insurance, and data extracted from a sample of pathology reports gathered from Belgian laboratories for the year 2019.
Results:
Over the last 10 years, the use of IHC in Belgium grew from 729 030 stains in 2012 to 1,194,331 in 2019, an increase of 63.8 % while the increase in the number of histological or cytological examinations was 13.3 %. The main stains used in 2019 were H. pylori, Ki-67 and broad spectrum CK, which were used in multiple body sites, reflecting the difficulties to identify specific indications. The gastro-intestinal tract is the body site with the highest number of IHC stains (38.2 % of all stains performed), and the most frequently used stain in gastro intestinal biopsies were H. pylori (43.1 %), and CD3 (6.8 %).
Conclusion:
This study offers an overview of the most frequent indications for which diagnostic IHC staining is used in Belgium, and reflects the evolving nature of this field, highlighting the importance to increase clarity and improve data collection.
