Organization

The field of immunohistochemistry is like a double-edged sword. When the staining fails, interpretation gets skewed resulting in disastrous outcomes in terms of misdiagnosis, loss of critical time and money. Importantly, interpretative skills come in picture only when staining is optimum. Process of IHC staining is a multistep, multi-factorial process where many variables play a role. It becomes, at times, difficult to judge where the things have gone wrong. It could be wrong selection of retrieval methods or pH of buffer or type of buffer or antibodies themselves. In an internal set-up many such questions remain unanswered if not unknown.

We faced this trouble when we started doing immunoshistochemistry in the year 2006. Unfortunately, very few laboratories in entire India were into immunohistochemistry at that time. Many of them restricted to only few antibodies. We could overcome those difficulties by having informal opinions about stains from experts. Till date the things have remained same, though number of laboratories using IHC has increased along with the number of markers. Many laboratories are acquiring accreditation and have sound external quality assessment schemes for practically all the areas of laboratory medicine. Unfortunately, no such program exists in India at present. The avenues to us are only few, in form of Australian, Nordic, UK and CAP assessment schemes. They are prohibitively expensive and logistically cumbersome. They enroll limited number of participants from abroad (not without logic as tissues are generally not sufficient for allowing many participants).

We, therefore, thought to make use of our experience in the field and put forward a scheme that could address the quality issues in immunohistochemistry. It may not be possible for us to cover all the available markers in one year. We therefore decided to have a breast module where we test ER, PR and Her-2 neu markers (three runs a year); and a general module that could have assorted markers (16 per scheme year in total three runs). We would like to expand this scope in future.

The aim of QC mark is to promote the quality of immunohistochemistry and expand its clinical use by arranging schemes for immunohistochemical staining and providing examples of good protocols and other information including descriptions of epitopes and technical solutions. The organization shall try to review the recent advances in the epitopes and put forth interesting cases.

QC mark is a professionally run scheme to promote quality of immunohistochemistry. All laboratories actively involved in immunohistochemistry techniques are invited to participate in the scheme. At present, the participation is open to laboratories in India only. The enrolment fees are just sufficient to take care of the incidental expenses involved in the process.

Participation is strictly voluntary and the findings expressed in the report are consultant’s (Assessor’s) view on the provided stains. The results of this program are not valid for any legal purpose.

The laboratories enroll by following instructions in the participation.

The QC mark work is primarily based on routine immunostaining of slides from standard processed human histological specimens with varying expression of antigens. The stains presented at the web-site originates from cases worked up at Baroda Clinical Laboratory. The laboratory standardizes the stains with its internal quality control mechanisms as well as referring cases to other reputed laboaratories.

Important immunohistochemical markers are described with illustrations of optimal staining results. The origin of these stains and the associated protocols are given, encouraging technicians and pathologists to communicate directly when needed.

If a participating laboratory wish to remain anonymous, QC mark should be informed by e-mail.

Further details are described in Assessment method.

Payment and banking details, see Subscription

The scheme itself is not accredited. Many of the participants in the run are accredited for the IHC services.

Separate accreditation is either not available for such scheme or not possible at the present moment.