AUTHOR=Koonmee Supinda , Sangkhamanon Sakkarn , Intarawichian Piyapharom , Aphivatanasiri Chaiwat , Kunprom Waritta , Sa-ngiamwibool Prakasit , Balthaisong Suwit , Phuyao Chitsakul , Prajumwongs Piya , Alaghehbandan Reza , Thanee Malinee 

TITLE=The Impact of Pre-analytical Quality Initiatives on Cholangiocarcinoma Diagnostics in Thailand

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.792847

DOI=10.3389/fpubh.2022.792847

ISSN=2296-2565

ABSTRACT=Cholangiocarcinoma (CCA) is the most prevalent malignancy in Thailand, with unfortunate late diagnosis and frequent metastatic disease outcome. An accurate tissue diagnosis is the first and most important step in treatment of CCA. Tissue quality and preservation during pre-analytical phase play a major role in proper histological evaluation and potential biomarker testing. This study evaluated the impact of using “Cholangiocarcinoma Screening and Care Program (CASCAP)” container, as an innovative tool to address pre-analytical challenges pathology laboratories face in Thailand. This is a comparative study examining the quality of CCA specimens between utilizing CASCAP container versus conventional method, using H&E and immunohistochemistry. CCA tissue quality using CASCAP container significantly reduced artifact deposition, while improved cellular structure, nuclear and cytoplasmic morphologies. The immunohistochemical expression of CK19, a prognostic marker in CCA, significantly improved in the CASCAP container group compared with the conventional method. This innovation is proven to significantly enhance the CCA tissue quality diagnostics and prognostic biomarker testing, hence improving overall cancer care diagnosis and treatment in Thailand.