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Polymerase chain reaction based human leucocyte antigen genotyping for the investigation of suspected gastrointestinal biopsy contamination
  1. A C Batemana,
  2. S J Turnerb,
  3. J M Theakera,
  4. B F Warrenc,
  5. W M Howellb
  1. aDepartment of Histopathology, Southampton General Hospital, Southampton, UK, bHistocompatibility and Immunogenetics Laboratory, Southampton General Hospital, Southampton, UK, cDepartment of Cellular Pathology, John Radcliffe Hospital, Oxford, UK
  1. Dr A C Bateman, Department of Histopathology, Level E, South Block, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.

Abstract

BACKGROUND Mislabelling or contamination of surgical specimens may lead to diagnostic inaccuracy, particularly within gastrointestinal pathology when multiple small mucosal biopsy specimens are commonly taken, and where a tiny fragment of foreign tissue may be indistinguishable from true biopsy material using histological assessment alone.

AIMS To assess the utility of polymerase chain reaction (PCR) based human leucocyte antigen (HLA) genotyping techniques for the investigation of potentially mislabelled or contaminated gastrointestinal biopsy specimens.

PATIENTS Ten cases (28 samples) in which mislabelling or contamination was suspected, comprising four upper gastrointestinal tract biopsies and six colonoscopic biopsy series.

METHODS Direct and nested PCR-sequence specific primer (SSP) based HLA class II genotyping was performed on DNA extracted from formalin fixed and paraffin wax embedded tissue (23 samples) or peripheral blood leucocytes (five samples).

RESULTS A full HLA-DRB1 genotype was determined in all 28 samples. In seven cases the HLA-DRB1 genotype of the putative contaminant was different to that of the corresponding reference tissue, confirming different individual origins for the contaminant and reference material. In one case the contaminant tissue was shown to possess the same HLA-DRB1 alleles as a second patient (probable source). In the remaining three cases the same HLA-DRB1 alleles were detected within the potential contaminant and reference tissues.

CONCLUSIONS PCR based HLA class II genotyping is a valuable tool for investigating potential contamination or mislabelling within gastrointestinal biopsy specimens and this report has confirmed contamination in seven of ten cases studied.

  • polymerase chain reaction
  • human leucocyte antigen
  • tissue typing
  • contamination
  • mislabelling
  • Abbreviations used in this paper

    HLA
    human leucocyte antigen
    PCR
    polymerase chain reaction
    SSP
    sequence specific primer
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  • Abbreviations used in this paper

    HLA
    human leucocyte antigen
    PCR
    polymerase chain reaction
    SSP
    sequence specific primer
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