Jornal Brasileiro de Patologia e Medicina Laboratorial
On-line version ISSN 1678-4774
NONOGAKI, Suely et al. Analysis of internal and external factors potentially relevant to the diagnosis in immunohistochemistry in a public reference laboratory. J. Bras. Patol. Med. Lab. [online]. 2007, vol.43, n.4, pp. 297-304. ISSN 1678-4774. http://dx.doi.org/10.1590/S1676-24442007000400012.
OBJECTIVES: The aim of this study was to evaluate the resolutivity of immunohistochemical (IHC) assays on neoplastic samples in a public health laboratory and to assess the influence of communication between the requiring institution and reference one on the quality of the IHC diagnosis. MATERIAL AND METHODS: One thousand oncological samples from eight public hospitals were submitted to IHC assay: 500 immediately before and 500 after an intervention demanding further information from the requiring pathologist. Antigen retrieval was performed in a pressure cooker and the detection system was LSAB plus System. The results were expressed as positive, negative or inconclusive. Information about paraffin blocks, fixatives, official requiring form, the attachment of original anatomopathological report, topography of the lesion, age and gender of the patients was collected. RESULTS AND CONCLUSION: From 989 samples, 5,719 slides were stained by IHC, leading to a resolutivity for 919/989 (92.9%). The number of antigen tested ranged from one to 22 - average of 5.8 for case. Panels with up to five antigens per case resolved 534 samples, whereas up to 10 markers were necessary to resolve 919 samples. Even nowadays, basic information, such as anatomopathological reports, age, gender, representative and technically superior paraffin block are not always available to the reference laboratory. The improvement of such communication is essential to rationalize the flux of immunohistochemical tests and to enhance the quality of diagnostic conclusions.
Keywords : Immunohistochemistry; Quality assurance; Communication.