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Srebotnik Kirbiš I, Rodrigues Roque R, Bongiovanni M, Strojan Fležar M, Cochand-Priollet B. Immunocytochemistry practices in European cytopathology laboratories-Review of European Federation of Cytology Societies (EFCS) online survey results with best practice recommendations. Cancer Cytopathol 2020; 128:757-766. [PMID: 32598103 DOI: 10.1002/cncy.22311] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/19/2020] [Accepted: 05/21/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Variability in preanalytical and analytical steps for immunocytochemistry (ICC) on cytology samples is poorly defined. The objective of this study was to evaluate current practices for ICC on cytology samples in European laboratories. METHODS A link to an online survey with 19 questions about ICC practices was distributed to cytology laboratories through national representatives in the European Federation of Cytology Societies. RESULTS In total, 245 laboratories responded to the survey by January 30, 2019. Cell blocks, cytospins, liquid-based cytology (LBC) preparations, and smears alone or in combination with other preparations were used for ICC in 38%, 22%, 21%, and 19% of laboratories, respectively. In general, various combinations of preparations were used for ICC in greater than one-half of laboratories (147 of 245; 60%), whereas only 1 specific type of cytology preparation was used in the remaining 98 of 245 laboratories (40%) laboratories. The majority of laboratories (217 of 226; 96%) performed ICC on automated platforms using protocols that were the same as those used for formalin-fixed, paraffin-embedded samples (238 of 527 laboratories; 45%), either optimized (138 of 527 laboratories; 26%) or optimized and validated (151 of 527 laboratories; 29%) for cytology preparations. Positive control slides, negative control slides, and external quality control were used in 174 of 223 (78%), 112 of 223 (50%), and 111 of 120 (50%) laboratories, respectively. Greater than 1000 ICC tests were performed yearly in 34% of laboratories (65 of 191; average, 1477 tests; median, 500 tests). CONCLUSIONS ICC is extensively performed in European laboratories using variously prepared cytology preparations on automated platforms, mostly without quality-assurance measures.
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Affiliation(s)
| | - Rúben Rodrigues Roque
- Anatomic Pathology Service, Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal
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Raskin RE, Vickers J, Ward JG, Toland A, Torrance AG. Optimized immunocytochemistry using leukocyte and tissue markers on Romanowsky-stained slides from dogs and cats. Vet Clin Pathol 2019; 48 Suppl 1:88-97. [PMID: 31347181 DOI: 10.1111/vcp.12759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/05/2018] [Accepted: 01/16/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Romanowsky staining is often the initial method used to stain hematologic and cytologic materials. While immunocytochemistry (ICC) is a well-established method on air-dried smears, there are rare veterinary reports of ICC involving Romanowsky-stained slides. OBJECTIVES This study aimed to compare immunoreactivity of unstained vs Romanowsky-stained specimens, evaluate reactions over time, and assess ICC associations with confirmatory tests of 50 lymphoma cases. Another goal aimed to optimize manual ICC protocols with cellular and tissue immunomarkers to detect CD3ε, CD20, Pax5, MHCII, lysozyme, MUM1, vimentin, cytokeratin, and Melan-A antigens on Romanowsky-stained specimens. MATERIALS AND METHODS Cytologic specimens from cases of lymphoid and nonlymphoid neoplasms were stained with a methanolic Romanowsky method. Additional unstained slides from these cases were used for comparison with the stained materials. Antigen retrieval involved a citrate buffer pH6 or Tris/EDTA pH9 at 95°C for 25 minutes in a decloaking chamber. Immunocytochemistry used known positive and secondary antibody-only negative cytologic controls. Immunoreactivity of unstained and prestained lymphoma slides was graded by the intensity and percent of stained cells. Signal grading was monitored over time for diagnostic differences. RESULTS Unstained and Romanowsky-stained slides had similar membrane/cytoplasm graded reactions, but unstained slides produced stronger signals. Romanowsky-stained blood films from B-cell and T-cell leukemias showed minimal loss of signal when monitored over 20 weeks. Signal differences did not change the diagnosis. There was a significant association between ICC and confirmatory tests. Optimization involved antibody dilution and antigen retrieval methodology for each antibody tested. CONCLUSIONS Immunocytochemistry of Romanowsky-stained material can be successfully performed using antibodies against CD3ε, CD20, cytokeratin, lysozyme, Melan-A, MHCII, MUM1, Pax5, and vimentin.
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Affiliation(s)
| | - Julie Vickers
- VGP, formerly TDDS, a member of SYNLAB, Exeter, Devon, UK
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Dörfelt S, Matiasek LA, Felten S, Sangl L, Hartmann K, Matiasek K. Antigens under cover-The preservation and demasking of selected antigens for successful poststaining immunocytochemistry of effusion, brain smears, and lymph node aspirates. Vet Clin Pathol 2019; 48 Suppl 1:98-107. [PMID: 30802342 PMCID: PMC7169317 DOI: 10.1111/vcp.12702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 07/06/2018] [Accepted: 08/09/2018] [Indexed: 11/29/2022]
Abstract
Background In clinical cytology, the applicability of an ancillary test such as immunocytochemistry is too often limited by low sample volume, poor cell representation, and sample preservation. Diagnosticians often read Romanowsky‐stained cytology, although specific techniques such as immunocytochemistry are often essential for a definitive diagnosis. Objectives The goal of the present study aimed to investigate if immunocytochemistry on previously‐stained cytologic specimens was possible. Different pretreatments were examined to determine which treatment preserved antigenicity best. Methods One hundred and twenty‐two impression smears and 64 fine‐needle aspirate preparations of brain and lymph nodes were processed and evaluated microscopically. The impact of staining cytologic preparations with a modified Wright's stain, using a destaining method, performing a coverslipping and decoverslipping process, and subjecting smears to a microwave treatment (MWT) were examined for the immunolabeling of selected nuclear, cytoplasmic, and plasmalemmal antigens, as well as intracellular feline coronavirus (FCoV). Biotinylated secondary antibodies were used, and the bound primary antibody was visualized using an ABC amplification kit. Results Cellular antigens were reliably detected with immunocytochemistry after smears were stained with a Romansky stain and were coverslipped early after staining and stayed coverslipped until immediately before immunolabeling. The staining intensity reached the same levels as that of the controls if the films underwent MWT in citrate buffer. In contrast, FCoV antigen detection was abolished after any physicochemical interference. Conclusions Poststaining immunocytochemistry represents a practical tool for additional investigations on prestained cytologic specimens when searching for cellular antigens. Paired untreated samples should be kept in case the workup requires testing for more vulnerable viral antigens.
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Affiliation(s)
- Stefanie Dörfelt
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany
| | - Lara A Matiasek
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany.,Anicura Small Animal Clinic, Babenhausen, Germany
| | - Sandra Felten
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany
| | - Laura Sangl
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximillians-Universitaet, Munich, Germany
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Abstract
Background: The role played by cytology in primary diagnosis is undeniable. With improved management protocols and targeted therapy, the need for accurate diagnosis has become mandatory. Immunochemistry and molecular techniques are increasingly being used on limited tissue samples. Aims: This study was conducted to find out the impact of immunocytochemistry (ICC) on cytology material in cytology practice. Materials and Methods: Immunochemistry was done on alcohol-fixed smears and cell-block preparations. It was done with i6000 BioGenex autostainer using BioGenex reagents. Results: A total of 148 cases occurring over a period of 3 years (September 2010-June 2013) were analyzed. Staining was done on cytology smears in 77 cases and on cell-block sections in 71 cases. ICC helped in diagnosis in 8 cases, confirmed the diagnosis in 26 cases, helped in subtyping in 60 cases, and helped in prognostication in 6 cases. ICC has altered the diagnosis in two cases. It was noncontributory in 43 cases, and the material was inadequate in three cases. Conclusion: In 102 cases (69%), ICC proved to be a useful adjunct in the diagnosis and prognostication; hence, its use is recommended in practice to aid in cytology services.
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Affiliation(s)
- Pooja Chavali
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Aruna Kumari Prayaga
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Ashwani Tandon
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
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Cozzolino I, Varone V, Picardi M, Baldi C, Memoli D, Ciancia G, Selleri C, De Rosa G, Vetrani A, Zeppa P. CD10, BCL6, and MUM1 expression in diffuse large B-cell lymphoma on FNA samples. Cancer Cytopathol 2015; 124:135-43. [PMID: 26414904 DOI: 10.1002/cncy.21626] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 09/02/2015] [Accepted: 09/02/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gene expression profiling has divided diffuse large B-cell lymphoma (DLBCL) into 2 main subgroups: germinal center B (GCB) and non-GCB type. This classification is reproducible by immunohistochemistry using specific antibodies such as CD10, B-cell lymphoma 6 (BCL6), and multiple myeloma oncogene 1 (MUM1). Fine-needle aspiration (FNA) plays an important role in the diagnosis of non-Hodgkin lymphoma, and in some cases FNA may be the only available pathological specimen. The objectives of the current study were to evaluate CD10, BCL6, and MUM1 immunostaining on FNA samples by testing the CD10, BCL6, and MUM1 algorithm on both FNA cell blocks (CB) and conventional smears (CS), evaluating differences in CB and CS immunocytochemical (ICC) performance, and comparing results with histological data. METHODS Thirty-eight consecutive DLBCL cases diagnosed by FNA were studied. Additional passes were used to prepare CB in 22 cases and CS in 16 cases; the corresponding sections and smears were immunostained using CD10, BCL6, and MUM1 in all cases. The data obtained were compared with histological immunostaining in 24 cases. RESULTS ICC was successful in 33 cases (18 CB and 15 CS) and not evaluable in 5 cases (4 CB and 1 CS). The CD10-BCL6-MUM1 algorithm subclassified DLBCL as GCB (9 cases) and non-GCB (24 cases). ICC data were confirmed on histologic staining in 24 cases. CONCLUSIONS CD10, BCL6, and MUM1 ICC staining can be performed on FNA samples. The results herein prove it is reliable both on CB and CS, and is equally effective and comparable to immunohistochemistry data.
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Affiliation(s)
| | - Valeria Varone
- Department of Advanced Biomedical Sciences, University of Naples "Federico II, " Naples, Italy
| | - Marco Picardi
- Department of Medicine and Surgery, University of Naples "Federico II, " Naples, Italy
| | - Carlo Baldi
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Domenico Memoli
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Giuseppe Ciancia
- Department of Advanced Biomedical Sciences, University of Naples "Federico II, " Naples, Italy
| | - Carmine Selleri
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Gaetano De Rosa
- Department of Advanced Biomedical Sciences, University of Naples "Federico II, " Naples, Italy
| | - Antonio Vetrani
- Department of Public Health, University of Naples "Federico II, " Naples, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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Hartman AK, Gorman BK, Chakraborty S, Mody DR, Schwartz MR. Determination of HER2/neu status: a pilot study comparing HER2/neu dual in situ hybridization DNA probe cocktail assay performed on cell blocks to immunohistochemisty and fluorescence in situ hybridization performed on histologic specimens. Arch Pathol Lab Med 2014; 138:553-8. [PMID: 24678687 DOI: 10.5858/arpa.2013-0314-sa] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Validation of new methodologies for determining human epidermal growth factor receptor 2 gene (HER2/neu) amplification status is crucial for advancing the standard of care and determining treatment for patients with primary and/or metastatic breast carcinoma. OBJECTIVE To compare results of HER2/neu gene amplification status by 2-color chromogenic in situ hybridization (ISH) on cell block material to HER2/neu status by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH) in the corresponding resection specimen or previous biopsy specimen. DESIGN Formalin, thrombin, and Cellient cell blocks were prepared from cytologic samples obtained from resection specimens from 27 patients with invasive breast carcinoma. In situ hybridization was performed on cell block sections from 18 of the collected cases, on both the Ventana BenchMark ULTRA and the Ventana BenchMark XT, and the HER2/neu gene amplification status was determined. This was then compared to the HER2/neu status by IHC and/or FISH in the resection specimen or previous biopsy specimen. RESULTS Comparison of HER2/neu status by ISH on the quantifiable cell block sections showed 100% correlation with the HER2/neu status determined by IHC or FISH in the corresponding histologic specimens. The results from thrombin and formalin cell blocks were statistically superior to the results from Cellient cell blocks on both Ventana instruments. CONCLUSIONS While further validation and study are needed, preliminary results show that the HER2/neu gene amplification status of breast carcinomas can reliably be determined on thrombin and formalin cell block material by using ISH. More consistent staining and better signal integrity was obtained with the Ventana BenchMark ULTRA than the BenchMark XT.
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Affiliation(s)
- Adria K Hartman
- From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas, and Weill Medical College of Cornell University, New York, New York
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Shidham VB, DeMay RM. Thank you CytoJournal reviewers for your 2012 and 2013 services! Cytojournal 2014. [PMCID: PMC4007383 DOI: 10.4103/1742-6413.129186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Vinod B. Shidham
- Address: Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Detroit, MI 48201, USA
| | - Richard M. DeMay
- Department of Pathology, University of Chicago, Chicago, IL, USA
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Li J, Zhou Y, Gu J. Stain-Decolorize-Stain (SDS): a new technique for multiple staining. Histochem Cell Biol 2014; 141:251-62. [PMID: 24390593 DOI: 10.1007/s00418-013-1177-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2013] [Indexed: 02/05/2023]
Abstract
Multiple staining of more than one gene/antigen on a single tissue section is an indispensable tool in cell and tissue research. However, most of the available multiple staining techniques have limitations, and there has been no technique to simultaneously visualize and distinguish tissue antigens, nucleotide sequences and other chemical compounds on the same slide. Here, we present a practical and economic multiple stain technique, with which multiple cellular components including mRNA (with in situ hybridization), antigen epitope (with immunohistochemistry) and chemical molecules (with histochemistry) can be stained on a single tissue section to study their relationship. In addition, this technique also offers the possibility to evaluate morphology with an H&E staining on the same sections. We used the placenta, pancreas, breast ductal carcinoma, colon adenocarcinoma, cerebellum, tonsil and heart tissue sections to evaluate the applicability of this new technique. The sensitivity and specificity of the technique have been tested, and an optimal protocol is recommended. Its applications in surgical pathology and research are discussed. This technique offers a novel tool to evaluate the relationship among multiple components at the same or adjacent locations to meet the needs of pathology diagnosis and research.
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Affiliation(s)
- Jing Li
- Department of Pathology, Shantou University Medical College, Shantou, China
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Shidham VB, Demay RM. Announcement of first time Cytojournal impact factor for 2012 coincides with Cytojournal decade celebration (2004-2013). Cytojournal 2013; 10:18. [PMID: 24082914 PMCID: PMC3779425 DOI: 10.4103/1742-6413.117359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 07/29/2013] [Indexed: 12/25/2022] Open
Affiliation(s)
- Vinod B Shidham
- Address: Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
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