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dc.contributor.advisorChristopher Owens
dc.contributor.authorPlourde, Anna
dc.contributor.authorGross, Alden
dc.contributor.authorJiang, Zhong
dc.contributor.authorOwens, Christopher L.
dc.date2022-08-11T08:10:55.000
dc.date.accessioned2022-08-23T17:24:44Z
dc.date.available2022-08-23T17:24:44Z
dc.date.issued2013-11-01
dc.date.submitted2015-10-07
dc.identifier.citation<p>Arch Pathol Lab Med. 2013 Nov;137(11):1630-4. doi: 10.5858/arpa.2012-0517-OA. <a href="http://dx.doi.org/10.5858/arpa.2012-0517-OA">Link to article on publisher's site</a></p>
dc.identifier.issn0003-9985 (Linking)
dc.identifier.doi10.5858/arpa.2012-0517-OA
dc.identifier.pmid24168501
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49256
dc.description<p>Medical student Anna Plourde participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.</p>
dc.description.abstractCONTEXT: Immunohistochemical (IHC) stains have known utility in prostate biopsies and are widely used to augment routine staining in difficult cases. Patterns in IHC utilization and differences based on pathologist training and experience is understudied in the peer-reviewed literature. OBJECTIVES: To compare the rates of IHC usage between specialized (genitourinary; [GU]) and nonspecialized (non-GU) pathologists in extended core prostate biopsies (ECPBs) and the effects of diagnosis; and in cancer cases Gleason grade, disease extent, and perineural invasion on the rate. DESIGN: Consecutive ECPBs from 2009-2011 were identified and billing data were used to determine the number of biopsies and IHC stains per case. Diagnoses were mapped and in cancer cases, Gleason grade, extent of disease, and perineural invasion were recorded. Pathologists were classified as GU or non-GU on the basis of training and experience. RESULTS: A total of 618 ECPBs were included in the study. Genitourinary pathologists ordered significantly fewer IHC tests per case and per biopsy than non-GU pathologists. The rate of ordering was most disparate for biopsies of cancerous and benign lesions. For biopsies of cancerous lesions, high-grade cancer, bilateral disease, and perineural invasion decreased the rate of ordering in both groups. In cancer cases, GU pathologists ordered significantly fewer stain tests for highest Gleason grade of 3 + 3 = 6, for patients with focal disease and for patients with multiple positive bilateral cores. The effect of the various predictors on IHC ordering rates was similar in both groups. CONCLUSIONS: Genitourinary pathologists ordered significantly fewer IHC stain tests than non-GU pathologists in ECPBs. Guidelines to define when IHC workup is necessary and not necessary may be helpful to guide workups.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=24168501&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.5858/arpa.2012-0517-OA
dc.subjectBiopsy, Large-Core Needle
dc.subjectHumans
dc.subjectImmunohistochemistry
dc.subjectMale
dc.subjectPathology, Clinical
dc.subjectProstate
dc.subjectProstatic Neoplasms
dc.subjectStaining and Labeling
dc.subjectDiagnosis
dc.subjectHealth Services Administration
dc.subjectInvestigative Techniques
dc.subjectMale Urogenital Diseases
dc.subjectNeoplasms
dc.subjectOther Analytical, Diagnostic and Therapeutic Techniques and Equipment
dc.subjectPathology
dc.subjectSurgical Procedures, Operative
dc.subjectUrogenital System
dc.titlePatterns in immunohistochemical usage in extended core prostate biopsies: comparisons among genitourinary pathologists and nongenitourinary pathologists
dc.typeJournal Article
dc.source.journaltitleArchives of pathology and laboratory medicine
dc.source.volume137
dc.source.issue11
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ssp/200
dc.legacy.embargo2019-01-01T00:00:00-08:00
dc.identifier.contextkey7688601
html.description.abstract<p>CONTEXT: Immunohistochemical (IHC) stains have known utility in prostate biopsies and are widely used to augment routine staining in difficult cases. Patterns in IHC utilization and differences based on pathologist training and experience is understudied in the peer-reviewed literature.</p> <p>OBJECTIVES: To compare the rates of IHC usage between specialized (genitourinary; [GU]) and nonspecialized (non-GU) pathologists in extended core prostate biopsies (ECPBs) and the effects of diagnosis; and in cancer cases Gleason grade, disease extent, and perineural invasion on the rate.</p> <p>DESIGN: Consecutive ECPBs from 2009-2011 were identified and billing data were used to determine the number of biopsies and IHC stains per case. Diagnoses were mapped and in cancer cases, Gleason grade, extent of disease, and perineural invasion were recorded. Pathologists were classified as GU or non-GU on the basis of training and experience.</p> <p>RESULTS: A total of 618 ECPBs were included in the study. Genitourinary pathologists ordered significantly fewer IHC tests per case and per biopsy than non-GU pathologists. The rate of ordering was most disparate for biopsies of cancerous and benign lesions. For biopsies of cancerous lesions, high-grade cancer, bilateral disease, and perineural invasion decreased the rate of ordering in both groups. In cancer cases, GU pathologists ordered significantly fewer stain tests for highest Gleason grade of 3 + 3 = 6, for patients with focal disease and for patients with multiple positive bilateral cores. The effect of the various predictors on IHC ordering rates was similar in both groups.</p> <p>CONCLUSIONS: Genitourinary pathologists ordered significantly fewer IHC stain tests than non-GU pathologists in ECPBs. Guidelines to define when IHC workup is necessary and not necessary may be helpful to guide workups.</p>
dc.identifier.submissionpathssp/200
dc.contributor.departmentDepartment of Pathology
dc.source.pages1630-4


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