You are right but, your point is?Regardless, the pathologist is the responsible
for his/her diagnosis/interpretation and the liability is his/hers.Remember
that for us histotechs, our "client" is the pathologist (always remembering the
patient behind the whole process) and our essential duty is to provide the
pathologist what s/he needs to being able to make the best and more accurate
diagnosis.Follow his/her instructions and your life will be much simpler and
less stressful.René
On Tuesday, November 21, 2017 4:21 PM, "Lindrud, Scott via Histonet"
<histonet@lists.utsouthwestern.edu> wrote:
Hi All,
We are having an internal debate regarding Her2 IHC control tissue in our lab.
We run a MTA (multi tissue array) consisting of 0+, 1+, 2+, and 3+ Her2
staining tissue taken from lumpectomy/resection cases. I'm in the process of
searching for more tissue to use in future control blocks and it can be
difficult to find tissue that is 0+ and 3+.
I've discussed this with our pathologist in charge of Histology and he says
that we don't need to run all 4 of the cores as controls. He says all we need
to run is a positive control and a negative control. He says the positive
control could be a 2+ or 3+ and the negative control could be either a 0+ OR a
1+.
I respectfully disagreed with him and said the negative control is not meant
for accessing staining interpretation but to verify the sensitivity and
specificity of the actual antibody-antigen reaction. I said a 1+ is still
staining the tissue where there is no staining in a 0+ reaction. The 1+ is not
a negative staining reaction, but a negative interpretation. The pathologist
says I'm wrong.
The CAP in its checklist says "It is also important to assess the specificity
of each antibody by a negative tissue control, which must show no staining of
tissues known to lack the antigen". To me, a 1+ Her2 staining reaction shows
that that tissue has antigen and should not be used as a negative control.
So, after saying all that, can/should 1+ Her2 breast tissue be used as a
negative tissue control? Seems pretty straight forward to me, but I'm just a
Cytotechnologist/Histotech.
Thanks for any input!
Scott
Scott A. Lindrud, MLS(ASCP)CM CTCM
Histopathology Technical Specialist/Cytotechnologist
Rice Memorial Hospital
301 Becker Ave SW
Willmar, MN 56201
WP(320)231-4406
Fax(320)231-4861
scott.lind...@rice.willmar.mn.us
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