Newswise — NORTHFIELD, ILL. — Patients battling lung disease are frequently diagnosed through minimally invasive procedures that allow clinicians to perform vital ancillary tests on increasingly small specimens. But how small is too small? What is considered adequate for ancillary testing? And what are the essential steps to ensure that an adequate specimen is collected so that patients receive the best diagnostic testing?

A new evidence-based guideline from the College of American Pathologists (CAP) has the answers. Published today as an early online release in Archives of Pathology and Laboratory Medicine, “Collection and Handling of Thoracic Small Biopsy and Cytology Specimens for Ancillary Studies” clarifies procedures and methods to optimize test outcomes.  

Often times, people give little thought to how specimens are collected, but as our guideline demonstrates, pathologists and clinical teams are always focused on improving procedures to ensure we get the best results for patients,” explains Sinchita Roy-Chowdhuri, MD, PhD, FCAP, the pathologist leading the guideline development.

In personalized medicine, especially in context of lung cancer, small specimens need to be tested for multiple biomarkers that guide care and determine if a patient is eligible for treatment. If a sample size is inadequate, patient management is hampered and sometimes a repeat biopsy is required. The solution: an evidence-based guideline to guide collection and handling of adequate tissue to optimize biomarker testing.

Dr. Roy-Chowdhuri and Christopher R. Gilbert, DO, MS, FCCP, a member of the American Thoracic Society, co-chaired an interdisciplinary panel of pathologists, thoracic specialists, and other experts that reviewed more than 3,100 articles to develop the guideline’s 16 recommendations. Members of the expert panel represented eight collaborating medical societies.

“Because a diverse group of clinicians was involved in evaluating a broad range of evidence, the guideline recommendations give care providers a new level of confidence when making decisions for vital procedures,” Dr. Gilbert explains. “And patients benefit as we work together to minimize the need for repeat biopsies due to specimen issues.”

The guideline divides the recommendations into six main categories of procedures and considerations for the diagnosis of lung cancer or infectious diseases such as tuberculosis. The CAP and the collaborating medical societies encourage their members to adopt the guideline recommendations. Pathologists and their clinical colleagues should discuss the recommendations to coordinate efforts and determine how best to implement them. Resources to support guideline adoption are published on as part of guideline launch.  

The CAP develops evidence-based guidelines and consensus statements related to the practice of pathology and laboratory medicine. Through this work, the CAP and its members continually improve the quality of diagnostic medicine and patient outcomes.

About the College of American Pathologists

As the world's largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the College of American Pathologists (CAP) serves patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. For more information, READ THE CAP ANNUAL REPORT at CAP.ORG.

Journal Link: Archives of Pathology and Laboratory Medicine