1. Evaluation of a worldwide EQA scheme for complex clonality analysis of clinical lymphoproliferative cases demonstrates a learning effect
- Author
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Elke Boone, Elisabeth Dequeker, Véronique Tack, Markus Möbs, Monika Brüggemann, María Eugenia Sarasquete, Patricia J. T. A. Groenen, Paula Gameiro, Elizabeth Hodges, Ian Carter, Hongxiang Liu, Paul Evans, Cleo Keppens, Dido Lenze, Elisabeth Moreau, Keppens, Cleo [0000-0002-4498-8386], Gameiro, Paula [0000-0002-3761-7050], Tack, Véronique [0000-0001-8464-9541], Evans, Paul [0000-0002-7915-0946], Sarasquete, Maria Eugenia [0000-0001-7335-3657], Möbs, Markus [0000-0002-1502-3032], Groenen, Patricia JTA [0000-0003-4314-228X], and Apollo - University of Cambridge Repository
- Subjects
0301 basic medicine ,Quality Control ,medicine.medical_specialty ,Laboratory Proficiency Testing ,Quality Assurance, Health Care ,Routine practice ,Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] ,Polymerase Chain Reaction ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,External quality assessment ,Pathology ,medicine ,Humans ,IG rearrangements ,Overall performance ,Molecular Biology ,Protocol (science) ,Gene Rearrangement ,Observer Variation ,Clonality Analysis ,Science & Technology ,Genes, Immunoglobulin ,business.industry ,Reproducibility of Results ,Cell Biology ,General Medicine ,Lymphoproliferative Disorders ,Genes, T-Cell Receptor ,030104 developmental biology ,Molecular Diagnostic Techniques ,030220 oncology & carcinogenesis ,Clinical diagnosis ,Clonality analysis ,Original Article ,business ,Life Sciences & Biomedicine ,TCR rearrangements - Abstract
Clonality analysis of immunoglobulin (IG) or T-cell receptor (TR) gene rearrangements is routine practice to assist diagnosis of lymphoid malignancies. Participation in external quality assessment (EQA) aids laboratories in identifying systematic shortcomings. The aim of this study was to evaluate laboratories’ improvement in IG/TR analysis and interpretation during five EQA rounds between 2014 and 2018. Each year, participants received a total of five cases for IG and five cases for TR testing. Paper-based cases were included for analysis of the final molecular conclusion that should be interpreted based on the integration of the individual PCR results. Wet cases were distributed for analysis of their routine protocol as well as evaluation of the final molecular conclusion. In total, 94.9% (506/533) of wet tests and 97.9% (829/847) of paper tests were correctly analyzed for IG, and 96.8% (507/524) wet tests and 93.2% (765/821) paper tests were correctly analyzed for TR. Analysis scores significantly improved when laboratories participated to more EQA rounds (p=0.001). Overall performance was significantly lower (p=0.008) for non-EuroClonality laboratories (95% for IG and 93% for TR) compared to EuroClonality laboratories (99% for IG and 97% for TR). The difference was not related to the EQA scheme year, anatomic origin of the sample, or final clinical diagnosis. This evaluation showed that repeated EQA participation helps to reduce performance differences between laboratories (EuroClonality versus non-EuroClonality) and between sample types (paper versus wet). The difficulties in interpreting oligoclonal cases highlighted the need for continued education by meetings and EQA schemes. Supplementary Information The online version contains supplementary material available at 10.1007/s00428-021-03046-0.
- Published
- 2021