Handling and Processing of Prostate Needle Biopsies (PNBx) in Europe: A Web-Based Survey by the European Network of Uropathology (ENUP)
Murali Varma, Ferran Algaba, Daniel M Berney, Philippe Camparo, Eva Comperat, David FR Griffiths, Glen Kristiansen, Antonio Lopez-Beltran, Rodolfo Montironi, Lars Egevad. University Hospital of Wales, Cardiff, United Kingdom; Fundación Puigvert-University Autonomous, Barcelona, Spain; St Bartholomew's Hospital, London, United Kingdom; Hopital Foch, Paris, France; UPMC Paris VI la Pitié, Paris, France; University Hospital Bonn, Bonn, Germany; Cordoba University Medical School, Cordoba, Spain; Polytechnic University of the Marche Region, Ancona, Italy; Karolinska Institutet, Stockholm, Sweden
Background: Little information is available regarding the handling and processing of PNBx in laboratories across Europe.
Design: A web based survey of 23 questions related to the procuring, handling and processing PNBx was emailed to members of ENUP and British Association of Urological Pathologists.
Results: Responses were received from 241 laboratories in 17 countries in Europe, including 151 from continental Europe (CE) and 90 from UK/Ireland(UK/I). A few routines were almost universally adopted; buffered formalin (96.5% of centers) and right vs. left side identification (100%).
PNBx were most commonly taken by urologists (93.8%) or radiologists (23.7%) but in 8.7% were also taken by non-medical persons such as radiographer, nurse or biomedical assistant. The latter was more common in UK/I [21.1% (nurse 15.6%)] compared to CE (2%). The most common PNBx protocol was 12 cores per patient (42.3%).
PNBx were received loose in fixative (55.6%), attached to paper (22.4%) or between sponges (21.2%). Cores were most commonly received in separate containers (40.8%) and processed 1 core/block (42.3%) with 3 levels/block (54.2%), 1 H&E section/level (49.4%) and retention of unstained spare sections for possible immunohistochemistry (56.1%). Unstained spares were most commonly retained for over a year (40.9%) but 36.2% discarded spares within 1 month of reporting. Only 2 (0.8%) respondents routinely performed immunohistochemistry on all PNBx. Special techniques for flattening cores were employed during embedding by 12.4%, most commonly use of metal tampers.
As compared to UK/I, laboratories in CE more commonly receive each core in a separate container (CE: 55.3% vs. UK/I: 15.9%), process one core/block (57.6% vs. 16.7%), examine fewer levels/block (<3 levels: 42.9% CE, 6.7% UK/I), examine more H&E sections/level (>1 section: 61.1% vs. 19.3%), less often retain unstained spares (38% vs. 86.5%) and more often discard spares within a month of reporting (48.2% vs. 26.8%).
Conclusions: There are significant differences in procurement, handling and processing of PNBx in laboratories across Europe. This data can help development of best practice guidelines.
Category: Genitourinary (including renal tumors)
Tuesday, March 20, 2012 2:00 PM
Platform Session: Section A, Tuesday Afternoon