First Belgian national EQA for special stains in histopathology

<p>In 2014, the first national survey for special stains in histopathology was organized by the Belgian ScientificInstitute of Public Health, in collaboration with the Commission of anatomic pathology. EQA programs havebecome imperative to give confidence in the quality of laboratory testing and to ensure delivery of consistentand accurate results that, ultimately, impact a patient diagnosis. They enable laboratories to evaluate theirperformance and methods compared with that of their peers or with the whole laboratory community.Participation is mandatory for Belgian licensed pathology laboratories and the goal of our programs is to beeducational rather than to be repressive. This abstract provides an insight into the first (2014) and the secondsurvey (2015) for special stains in histopathology.Aim:The two surveys aimed at assessing laboratory and method performance of the Belgian licensed pathologylaboratories. General quality of the slides (sectioning and coverslipping), of the hematoxylin and eosin (HE)stain and of four special stains (PAS, reticulin, trichrome and Perls), as submitted by the participants, wasevaluated. All laboratories were encouraged to process the samples within the laboratory's regular workloadof patient specimens, using their routine methods.Methods:A panel of two formalin-fixed and paraffin-embedded tissue samples, liver and kidney, was provided to eachparticipant, along with a request for sectioning and staining (HE, PAS and reticulin in 2014 and HE, PAS,reticulin, trichrome and Perls in 2015). Participants were surveyed for methodology and were instructed toreturn the stained slides within a two-week time frame. An expert panel of two pathologists evaluated thesubmitted slides for histologic technique using pre-established criteria. General quality of the slides andquality of each stain was assessed as optimal, good, borderline or poor. For each survey, an overall assessmentscore was generated which allowed us to compare all laboratories' performances. Since not all participantsroutinely perform all requested special stains, this overall assessment score was based upon slide quality andHE stain only. A general report including the encrypted results of all participants, individual comments,recommendations and assessment marks for staining methods was published. Following the first survey andprior to the next, follow-up on poor performing laboratories was conducted by the program organizers.Results:Ninety-one laboratories participated in the 2014 survey of which 73% achieved an excellent overall score.Eighty-eight laboratories participated in the 2015 survey of which 80% achieved an excellent overall score. In2014, the percentage of participants that achieved a satisfactory mark (optimal or good) for slide quality was80%, for the HE stain 90%, for the PAS stain 76% and for the reticulin stain 81%. In 2015, the percentage ofparticipants that achieved a satisfactory mark (optimal or good) for slide quality was 82%, for the HE stain97%, for the PAS stain 82%, for the reticulin stain 76%, for the trichrome stain 72% and for the Perls stain92%. A statistically significant difference between results obtained with manual vs. automated stainingmethods was observed.Conclusions:These surveys assessed the laboratory and method performance of the Belgian pathology laboratoriescurrently licensed for routinely performing histopathological stains. The results suggest that the vast majorityof the Belgian laboratories are able to provide good quality histopathological stains. Moreover, differencesbetween staining methods were observed. By providing a general report with individual comments and followupon poor performances, the program aims at stimulating the participants to adopt proper practices forhistopathological stains and hence improving their quality.</p>