The
slide to be stained for CD3 comprised:
1. Colon, 2. Tonsil, 3. Precursor T-cell lymphoma, 4-5. Peripheral
T-cell lymphomas.
All tissues were fixed in 10% neutral buffered formalin.
Criteria for assessing a CD3 staining as optimal
included:
- A strong and distinct predominantly
membranous reaction of the majority of neoplastic T-cells in all
3 T-cell lymphomas.
- A strong and distinct predominantly
membranous staining of all the T-cells in the tonsil and in the
colon.
- No staining in other cells. Especially
B-cells in the tonsil should be negative.
119 laboratories submitted stains. At the
assessment 64 achieved optimal marks (54 %), 35 good (30 %), 16
borderline (13 %) and 4 poor marks (3 %).
The following Abs were used:
mAb clone PS1 (Novocastra, n=26; BioCare Medical, n=2; Monosan,
n=1; Vector, n=1)
mAb clone F7.2.38 (Dako, n=28)
mAb clone LN10 (Novocastra, n=6)
rmAb clone SP7 (NeoMarkers, n=17; DCS, n=1; Master Diagnostica,
n=1)
rmAb clone 2GV6 (Ventana, n=7)
rmAb clone E272 (BioCare Medical, n=1)
pAb A0452 (Dako, n=20)
pAb 760-2613 (Ventana, n=5)
pAb NCL-CD3p (Novocastra, n=2)
pAb RB-360 (NeoMarkers, n=1)
Optimal staining for CD3 in this assessment
was obtained with the mAbs clone PS1 (19/30)*, clone F7.2.38 (15/28), the mAb clone LN10 (4/6), the rmAb clone SP7 (7/19), the rmAb clone
2GV6 (7/7) and the pAb A0452 (12/20).
* (number of optimal results/number of
laboratories using this Ab).
PS1: the protocols
giving an optimal result were all based on heat induced epitope
retrieval (HIER) using Tris-EDTA/EGTA pH 9 (14/17)**, Cell
Conditioning1 (BenchMark, Ventana) (2/7), Bond Epitope Retrieval
Solution 2 (Bond, Vision Biosystems)(2/3) or EDTA/EGTA pH 8 (1/1).
The mAb was typically diluted in the range of 1:20 – 1:200 depending
on the total sensitivity of the protocol employed. Using these
protocol settings 24 out of 28 (86 %) laboratories produced a
sufficient staining (i.e., optimal or good).
** (number of optimal results/number of
laboratories using this buffer).
F7.2.38: the
protocols giving an optimal result were all based on heat induced
epitope retrieval (HIER) using Tris-EDTA/EGTA pH 9 (15/21). The mAb
was diluted in the range of 1:50 – 1:400 depending on the total
sensitivity of the protocol employed or as a Ready-To-Use antibody.
Using these protocol settings 19 out of 19 (100 %) laboratories
produced a sufficient staining.
LN10: the protocols
giving an optimal result were all based on heat induced epitope
retrieval (HIER) using Tris-EDTA/EGTA pH 9 (2/2) or Bond Epitope
Retrieval Solution 2 (Bond, Vision Biosystems) (2/2). The mAb was
typically diluted in the range of 1:100 – 1:200 depending on the
total sensitivity of the protocol employed. Using these protocol
settings 4 out of 4 (100 %) laboratories produced a sufficient
staining.
SP7: the protocols
giving an optimal result were all based on heat induced epitope
retrieval (HIER) using Tris-EDTA/EGTA pH 9 (5/6), Cell
Conditioning1 (BenchMark, Ventana) (1/6) or Bond Epitope Retrieval
Solution 2 (Bond, Vision Biosystems)(1/1). The rmAb was typically
diluted in the range of 1:40 – 1:400 depending on the total
sensitivity of the protocol employed. Using these protocol settings
9 out of 10 (90 %) laboratories produced a sufficient staining.
2GV6: the protocols
giving an optimal result were all based on heat induced epitope
retrieval (HIER) using Cell Conditioning1 (BenchMark, Ventana)
(6/6) or EDTA/EGTA pH8 (1/1). The rmAb was used as a Ready-To-Use
antibody. Using these protocol settings 7 out of 7 (100 %)
laboratories produced a sufficient staining (all marked as optimal).
A0452: the protocols
giving an optimal result was all based on HIER using Tris-EDTA/EGTA
pH 9 (5/10), Cell Conditioning1 (BenchMark, Ventana) (3/3), Target
Retrieval Solution pH 9 (FLEX TRS high pH, Dako) (3/3) or EDTA/EGTA
pH8 (1/1). The pAb was diluted in the range of 1:50– 1:500
depending on the total sensitivity of the protocol employed or
applied as a Ready-To-Use antibody. Using
these protocol settings 15 out of 16 (94 %) laboratories produced a
sufficient staining.
The most frequent causes of insufficient
staining were:
- Too low concentration of the primary antibody
- Insufficient HIER (espc. non-alkaline buffer as Citrate pH
6.0)
- Less successful primary antibody.
In this assessment the prevalent feature of an
insufficient result was a too weak or false negative staining reaction in both the
normal and neoplastic T-cells. Virtually all laboratories
could sufficiently demonstrate CD3 in the interfollicular T-cells in the tonsil, whereas a generally too weak
or false negative reaction was seen in the dispersed germinal centre T-cells and the intraepithelial T-cells in
the colon.
It was not possible to differentiate between the cytoplasmic CD3
expression in the precursor T-cell lymphoma and the membranous CD3
expression in the peripheral T-cell lymphomas, irrespective of the
Ab or protocol used.
Tonsil is a recommendable control for CD3: The dispersed germinal
centre and mantle zone T-cells must show a strong and distinct staining without
reaction of the B-cells.
This was the third assessment of CD3. A constant increase in the proportion of sufficient results has been
seen, as shown in table:
The
availability of several robust Abs for CD3 combined with efficient
HIER seems to be the main reason for the high pass rate. HIER in
Citrate pH 6,0 was found to be inferior to an alkaline HIER buffer
irrespective of the antibody applied, as an optimal result could not
be obtained using Citrate and 4 out of the 10 protocols based on
HIER in Citrate gave an insufficient result. The increase in the proportion of sufficient
results has been accomplished despite a large number of new
participants. The tailored recommendations to the laboratories with insufficient
staining results seem to be useful: In run 14, 22
laboratories obtaining an insufficient mark were given a specific
recommendation to adjust their protocol for CD3 and submitted a new
stain in run 22. 15 laboratories followed the recommendation and 14
of these (93%) improved their result. 3 did not follow the
recommendations and 1 of these (33%) improved. 4 laboratories
changed their entire system obtaining a sufficient result.
Conclusion
The mAbs clones PS1, F7.2.38, LN10, the rmAbs SP7, 2GV6 and the pAb
A0452 are all useful markers for CD3. HIER in an alkaline buffer
seems to be mandatory for an optimal CD3 staining. |