When an immunohistochemical stain is used as a surrogate for a molecular alteration, check its published sensitivity as well as its specificity. A positive result may be reliable while a negative one leaves the question open.
If the clinical or morphological picture points to the alteration, say in the report that a negative stain does not exclude it and recommend confirmatory molecular testing.
- Know the sensitivity of any surrogate stain before relying on a negative result.
- Write in the report when a negative stain does not exclude the alteration.
- Recommend molecular testing when morphology or clinical context suggests it.
- Record the clone and protocol used, as performance depends on them.
Why it matters
A confident negative report can end a work-up that should have continued.
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