Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study
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Neoplastic cell percentage estimation in tissue samples for molecular oncology : recommendations from a modified Delphi study. / Dufraing, Kelly; van Krieken, J. Henricus; De Hertogh, Gert; Hoefler, Gerald; Oniscu, Anca; Kuhlmann, Tine P.; Weichert, Wilko; Marchiò, Caterina; Ristimäki, Ari; Ryška, Aleš; Scoazec, Jean Yves; Dequeker, Elisabeth.
I: Histopathology, Bind 75, Nr. 3, 2019, s. 312-319.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Neoplastic cell percentage estimation in tissue samples for molecular oncology
T2 - recommendations from a modified Delphi study
AU - Dufraing, Kelly
AU - van Krieken, J. Henricus
AU - De Hertogh, Gert
AU - Hoefler, Gerald
AU - Oniscu, Anca
AU - Kuhlmann, Tine P.
AU - Weichert, Wilko
AU - Marchiò, Caterina
AU - Ristimäki, Ari
AU - Ryška, Aleš
AU - Scoazec, Jean Yves
AU - Dequeker, Elisabeth
PY - 2019
Y1 - 2019
N2 - Aims: Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. As molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity – colorectal carcinoma – that can be adapted for other cancer types. Methods and results: A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was defined a priori as an agreement of > 80%. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second surveys, respectively. Remaining issues were resolved during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should conduct the morphological evaluation; nevertheless molecular biologists/technicians may estimate the NCP, if specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. Conclusion: We believe these recommendations may lead to more accurate NCP estimates, ensuring the correct interpretation of test results, and might help in validating digital algorithms in the future.
AB - Aims: Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. As molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity – colorectal carcinoma – that can be adapted for other cancer types. Methods and results: A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was defined a priori as an agreement of > 80%. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second surveys, respectively. Remaining issues were resolved during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should conduct the morphological evaluation; nevertheless molecular biologists/technicians may estimate the NCP, if specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. Conclusion: We believe these recommendations may lead to more accurate NCP estimates, ensuring the correct interpretation of test results, and might help in validating digital algorithms in the future.
KW - molecular biomarker testing
KW - neoplastic cell percentage
KW - recommendations
U2 - 10.1111/his.13891
DO - 10.1111/his.13891
M3 - Journal article
C2 - 31054167
AN - SCOPUS:85070664393
VL - 75
SP - 312
EP - 319
JO - Histopathology
JF - Histopathology
SN - 0309-0167
IS - 3
ER -
ID: 241432372