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Updated: Aug 10, 2026
Quality-Controlled Sputum Analysis by Flow Cytometry
Published on: August 9, 2021
Immunocytochemical staining of effusions; an external quality control study in The Netherlands
V Kuenen-Boumeester1, E M De Bruijn, S C Henzen-Logmans
1Department of Pathology, dr Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
Insights
External quality control for immunocytochemical (IC) staining of effusions showed that control specimens yielded better results than in-house preparations. This highlights the need for robust staining procedures and quality control systems in diagnostic laboratories.
Area of Science:
- Cytopathology
- Immunohistochemistry
- Laboratory Quality Control
Background:
- Immunocytochemical (IC) staining is crucial for diagnosing effusions.
- Variability in laboratory protocols can impact diagnostic accuracy.
- External quality assessment is vital for maintaining high standards.
Purpose of the Study:
- To evaluate the quality of immunocytochemical staining for effusions through an external quality control study.
- To compare the performance of 'in-house' prepared specimens versus standardized control specimens.
- To identify factors influencing the quality of IC staining in participating laboratories.
Main Methods:
- A three-round external quality control study involving 12 laboratories.
- Distribution of malignant effusion samples and unstained control specimens.
- Laboratories used their own protocols for sample preparation and staining.
- Standardized scoring criteria were applied to evaluate slides based on cell characteristics, background, and specificity.
Main Results:
- Control specimens demonstrated superior scoring results compared to 'in-house' specimens.
- Significant cell loss was observed in 'in-house' prepared specimens, impacting scoring.
- The study identified processing and staining procedures as critical factors for IC quality.
Conclusions:
- Well-organized processing and staining procedures are essential for high-quality immunocytochemical staining.
- External quality control systems are necessary to ensure reliable diagnostic accuracy in cytopathology.
- Standardized control specimens can effectively highlight deficiencies in laboratory protocols.
Abstract:
In The Netherlands an external quality control study of immunocytochemical (IC) staining of effusions was initiated, consisting of three test rounds. The 12 participating laboratories received samples of malignant effusions (runs 1, 2 and 3), and five unstained control specimens prepared from the same material in runs 2 and 3. The laboratories used their own protocols to prepare and stain the samples ('in-house' specimens). Two persons viewed and scored the slides following preset criteria concerning number and morphology of diagnostic cells, background staining and staining specificity. Better scoring results were found for control specimens, compared with 'in-house' specimens, primarily caused by cell loss in the latter. This finding underlines the view that high quality IC needs well organized processing and staining procedures, and warrants external quality control systems.
