Re: [Histonet] IHC QC's

From:"Joe Nocito"

Re: [Histonet] IHC QC's
I've always run one positive control for each antibody and a negative control for each paraffin block. When I was the immuno supervisor at AFIP (during another life) we would anywhere from 25-100 cases of the same antibody, i.e. we would run 1 CD45 control and 50 patient slides, but each patient slide would have 1 negative.  I haven't had a problem yet, including both the CAP and CLIA inspections I went through this year.
    I have to agree with Patti, since I work in a reference lab, we don't receive the good cases that a hospital would so we have to make do with what we can get.
Joe Nocito BS, HT (ASCP) QIHC
Histology Manager
Pathology Reference Lab
San Antonio, Texas
----- Original Message -----
From: Patti Loykasek
To: Horn, Hazel V ; histonet
Sent: Monday, October 13, 2003 2:18 PM
Subject: Re: [Histonet] IHC QC's

There was in fact, a post from Nick Kirk on running a positive control with each case. I do realize the CAP requirements and am familiar with the checklist.

Patti Loykasek
Phenopath Laboratories
Seattle, WA

I don't think anyone said a POSTIVE control should be run with each slide.    We were talking about negative controls, I believe.
I just copied and pasted from the latest CAP survey in another email.

Hazel Horn, HT/HTL (ASCP)
Histology Supervisor
Arkansas Children's Hospital

Phone - 501.364.4240
Fax - 501.364.3912

-----Original Message-----
From: Patti Loykasek []
Sent: Monday, October 13, 2003 10:52 AM
To: histonet
Subject: [Histonet] IHC QC's

I'm glad that everyone is so concerned with both negative and positive IHC controls. There is certainly more than one side to this issue. I will say that I don't think a positive QC on every slide is absolutely necessary, for many reasons. If the QC is rare & precious, then it is a waste of resources. As is running a negative control for every possible technique permutation on small amounts of tumor. I would rather have slides with tumor left for additional studies than have wasted tumor sections on 4-6 negative controls. You can always evaluate non-specific staining on slides that have had an antibody applied & that are negative with that antibody. The CAP is specific that positive controls be used for each antibody - see  CAP checklist ANP.22550. They do not specify for each slide. Since positive QC's should be kept filed for the same number of years as the patient slide & records, it should be possible to pull a QC slide from the IHC run for a particular slide. In the CAP comment on ANP.22550, the use of internal QC's is also mentioned. Although there are many ways of dealing with the issue of QC's, I'm sure we all want to do what is prudent, abide by the regulations, and increase the level of patient care.
Just my 2 cents worth.

Patti Loykasek
Phenopath Laboratories
Seattle, WA

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