Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study

K Dufraing, J H van Krieken, G De Hertogh, G Hoefler, A Oniscu, T P Kuhlmann, W Weichert, C Marchiò, A Ristimäki, A Ryska, J Y Scoazec, E Dequeker

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Abstract Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. Since molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity - colorectal carcinoma - that can be adapted for other cancer types. A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was a priori defined as an agreement of >80%. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second survey, respectively. Remaining issues were sorted out during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should do the morphological evaluation, nevertheless molecular biologists/technicians may estimate the NCP, if a specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. We believe these recommendations may lead to more accurate NCP estimates ensuring a correct interpretation of test results and might help in validating digital algorithms in the future. This article is protected by copyright. All rights reserved.
Original languageEnglish
JournalHistopathology
Volume0
Issue numberja
ISSN0309-0167
DOIs
Publication statusPublished - 4 May 2019
MoE publication typeA1 Journal article-refereed

Fields of Science

  • Neoplastic cell percentage
  • Recommendations
  • Molecular biomarker testing
  • 3122 Cancers

Cite this

Dufraing, K., van Krieken, J. H., De Hertogh, G., Hoefler, G., Oniscu, A., Kuhlmann, T. P., ... Dequeker, E. (2019). Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study. Histopathology, 0(ja). https://doi.org/10.1111/his.13891
Dufraing, K ; van Krieken, J H ; De Hertogh, G ; Hoefler, G ; Oniscu, A ; Kuhlmann, T P ; Weichert, W ; Marchiò, C ; Ristimäki, A ; Ryska, A ; Scoazec, J Y ; Dequeker, E. / Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study. In: Histopathology. 2019 ; Vol. 0, No. ja.
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abstract = "Abstract Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. Since molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity - colorectal carcinoma - that can be adapted for other cancer types. A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was a priori defined as an agreement of >80{\%}. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second survey, respectively. Remaining issues were sorted out during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should do the morphological evaluation, nevertheless molecular biologists/technicians may estimate the NCP, if a specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. We believe these recommendations may lead to more accurate NCP estimates ensuring a correct interpretation of test results and might help in validating digital algorithms in the future. This article is protected by copyright. All rights reserved.",
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author = "K Dufraing and {van Krieken}, {J H} and {De Hertogh}, G and G Hoefler and A Oniscu and Kuhlmann, {T P} and W Weichert and C Marchi{\`o} and A Ristim{\"a}ki and A Ryska and Scoazec, {J Y} and E Dequeker",
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Dufraing, K, van Krieken, JH, De Hertogh, G, Hoefler, G, Oniscu, A, Kuhlmann, TP, Weichert, W, Marchiò, C, Ristimäki, A, Ryska, A, Scoazec, JY & Dequeker, E 2019, 'Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study' Histopathology, vol. 0, no. ja. https://doi.org/10.1111/his.13891

Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study. / Dufraing, K; van Krieken, J H; De Hertogh, G; Hoefler, G; Oniscu, A; Kuhlmann, T P; Weichert, W; Marchiò, C; Ristimäki, A; Ryska, A; Scoazec, J Y; Dequeker, E.

In: Histopathology, Vol. 0, No. ja, 04.05.2019.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Neoplastic cell percentage estimation in tissue samples for molecular oncology: recommendations from a modified Delphi study

AU - Dufraing, K

AU - van Krieken, J H

AU - De Hertogh, G

AU - Hoefler, G

AU - Oniscu, A

AU - Kuhlmann, T P

AU - Weichert, W

AU - Marchiò, C

AU - Ristimäki, A

AU - Ryska, A

AU - Scoazec, J Y

AU - Dequeker, E

PY - 2019/5/4

Y1 - 2019/5/4

N2 - Abstract Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. Since molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity - colorectal carcinoma - that can be adapted for other cancer types. A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was a priori defined as an agreement of >80%. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second survey, respectively. Remaining issues were sorted out during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should do the morphological evaluation, nevertheless molecular biologists/technicians may estimate the NCP, if a specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. We believe these recommendations may lead to more accurate NCP estimates ensuring a correct interpretation of test results and might help in validating digital algorithms in the future. This article is protected by copyright. All rights reserved.

AB - Abstract Results from external quality assessment revealed considerable variation in neoplastic cell percentages (NCP) estimation in samples for biomarker testing. Since molecular biology tests require a minimal NCP, overestimations may lead to false negative test results. We aimed to develop recommendations to improve the NCP determination in a prototypical entity - colorectal carcinoma - that can be adapted for other cancer types. A modified Delphi study was conducted to reach consensus by 10 pathologists from 10 countries with experience in determining the NCP for colorectal adenocarcinoma. This study included two online surveys and a decision-making meeting. Consensus was a priori defined as an agreement of >80%. All pathologists completed both surveys. Consensus was reached for 8 out of 19 and 2 out of 13 questions in the first and second survey, respectively. Remaining issues were sorted out during the meeting. Twenty-four recommendations were formulated. Major recommendations resulted as follows: only pathologists should do the morphological evaluation, nevertheless molecular biologists/technicians may estimate the NCP, if a specific training has been performed and a pathologist is available for feedback. The estimation should be determined in the area with the highest density of viable neoplastic cells and lowest density of inflammatory cells. Other recommendations concerned: the determination protocol itself, needs for micro- and macro-dissection, reporting and interpreting, referral practices and applicability to other cancer types. We believe these recommendations may lead to more accurate NCP estimates ensuring a correct interpretation of test results and might help in validating digital algorithms in the future. This article is protected by copyright. All rights reserved.

KW - Neoplastic cell percentage

KW - Recommendations

KW - Molecular biomarker testing

KW - 3122 Cancers

U2 - 10.1111/his.13891

DO - 10.1111/his.13891

M3 - Article

VL - 0

JO - Histopathology

JF - Histopathology

SN - 0309-0167

IS - ja

ER -