Academic and Non-Academic Laboratories Perform Equally on CIQC Immunohistochemistry External Quality Assessment
Z Will Chen, Heather Neufeld, Maria A Copete, John Garratt, Blake C Gilks, Emina E Torlakovic. University Health Network, University of Toronto, Toronto, Canada; University of Saskatchewan, Saskatoon, Canada; Lions Gate Hospital, Vancouver, Canada; University of British Columbia, Vancouver, Canada
Background: Expertise in medicine tends to concentrate in academic institutions in larger cities. Quality of laboratory testing may be expected to follow this trend. We hypothesize that academic centers (AC) are more successful than non-academic centers (NAC) in immunohistochemistry (IHC) external quality assessment (EQA) challenges in the Canadian IHC Quality Control (CIQC) program, an EQA program supported by the Canadian Partnership Against Cancer.
Design: Results of 9 CIQC challenges for ER, PR, Her2, CD45, CD20, CD3, cyclin D1, Bcl-2, Bcl-6, Ki-67, pankeratin, LMWK, HMWK, CK7, CK20 and CK5 were examined. Performance on breast marker tests (BT) was assessed based on concordance to reference values. Performance on other tests was assigned a 3 or 4-tier score ranging from optimal to poor by expert assessors based on preestablished criteria for each test. For this study, these results were converted to a binary result (poor/good) as follows: for BT, <90% concordance=poor, ≥90%=good; for non-BT, lowest tier score=poor, all other scores=good. AC were compared to NAC, and labs located in a small city (pop. <300,000) were compared to those located in a large city (pop. ≥300,000).
Results: A total of 66 Canadian and 8 foreign labs, of which 33 (45%) were AC and 48 (65%) in large cities, participated in at least one CIQC test. The number of participants in each test ranged from 17 to 53. There was no difference in performance on any test compared to AC/NAC nature or city size. However, overall performance on BT was significantly better (p<0.0001, Student's t-test) than on non-BT regardless of AC/NAC nature or city size, with the mean value of poor results on non-BT being approximately twice that of BT.
Conclusions: AC and NAC irrespective of city size were equally successful in CIQC EQA challenges, suggesting that expertise in IHC can be achieved in many types of labs. However, performance on BT was significantly higher than on non-BT in every category, suggesting that emphasis on breast hormone IHC quality assurance in recent years has led to improved results.
Category: Quality Assurance
Monday, March 19, 2012 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 300, Monday Morning