Biopsy Specimen Handling, Processing, and Quality Assurance Program
With widespread use of prostate-specific antigen (PSA) screening, a greater number of prostate biopsies are performed. It is estimated that more than one million prostate biopsies are performed in the United States annually, with each biopsy consisting of an average of eight to ten sample cores, creating an estimated ten million tissue samples. This trend has created a challenge for effective and timely handling and processing of prostate biopsies in histology laboratories, in addition to their accurate interpretation and quality assurance by surgical pathologists. Various laboratory-controlled factors influence the prostate cancer detection rate in contemporary prostate biopsy practice.
In addition, genomic testing is increasingly utilized following prostate biopsy for potential treatment decisions. This practice requires that laboratory adequately control various pre-, intra-, and post-analytic factors that can potentially affect outcome of genomic testing. This chapter addresses ideal practices for the submission, handling, and processing of prostate biopsies, as well as commonly applied quality assurance programs known to improve overall practice.
KeywordsBiopsy specimen handling Processing Quality assurance program Prostate-specific antigen PSA Hematoxylin-and-eosin stain H&E stain High-grade prostatic intraepithelial neoplasia HGPIN Atypia Error reduction Transurethral resection of prostate TURP Interobserver reproducibility Disease-focused review Consensus diagnosis Second opinion
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