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    Diagnostic Patterns and Immunohistochemical Stain Usage in Extended Core Prostate Biopsies: Comparisons Between Genitourinary and Non-Genitourinary Pathologists

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    Authors
    Plourde, Anna
    Jiang, Zhong
    Owens, Christopher L.
    Faculty Advisor
    Christopher L. Owens
    UMass Chan Affiliations
    Department of Pathology
    Document Type
    Poster
    Publication Date
    2012-05-02
    Keywords
    Prostate
    Biopsy
    Needle
    Pathology
    Clinical
    Staining and Labeling
    Immunohistochemistry
    Life Sciences
    Medicine and Health Sciences
    Pathology
    
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    Abstract
    Background: Ancillary immunohistochemical (IPOX) stains are useful in clarifying diagnostically challenging pathologic specimens. In diagnostic workup of prostate needle biopsies, stains for basal cells and α-methylacyl coenzyme A racemase are routinely used to support or refute the diagnosis of prostate cancer. Although useful, these stains add cost and must be used judiciously. There is a lack of firm guidelines establishing the proper utilization of IPOX studies in prostate pathology. Therefore, differences in patterns of stain use and diagnoses may exist, related to expertise of the pathologist. Objectives: The purpose of this study was to compare patterns of diagnoses and IPOX stain use in extended core prostate biopsies between genitourinary (GU) and non-genitourinary (NGU) pathologists in the University of Massachusetts Medical Center Pathology department. Methods: By computer search of medical records, consecutive extended core prostate biopsies (6+ cores) from years 2006-2011 were identified. Using Current Procedural Terminology (CPT) billing data, the number of cores and number of IPOX stains were retrieved. Diagnoses were recorded. Pathologists were divided into two groups based on expertise: genitourinary and non-genitourinary. Differences in the patterns of IPOX use and diagnoses between the two groups were analyzed. Results: GU pathologists diagnose significantly higher rates of prostate cancer (43.8% vs. 35.8%, p Conclusion: Significant differences exist in patterns of IPOX usage between GU and NGU pathologists in extended core prostate biopsy in this single institution study. This suggests the need for guidelines and continuing education focused on this issue to standardize practice, an intervention likely to improve quality of diagnoses and to reduce unnecessary costs.
    DOI
    10.13028/q3jb-3636
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49184
    Notes

    Medical student Anna Plourde participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

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    Copyright is held by the author(s), with all rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.13028/q3jb-3636
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