# Immunohistochemistry effect on diagnostic reliability for paediatric cancer at Mwanza region, Tanzania: a laboratory descriptive study

## TL;DR

This study shows that immunohistochemistry improves pediatric cancer diagnosis accuracy in Tanzania, where nearly a third of diagnoses change after testing.

## Contribution

The study identifies key biomarkers and demonstrates the significant impact of IHC on diagnostic reliability in a low-resource setting.

## Key findings

- IHC changed 31.4% of pediatric cancer diagnoses in Mwanza, Tanzania.
- Burkitt lymphoma and NHL-DLBCL were the most common diagnoses.
- A 51% correlation was found between H&E and IHC histology results.

## Abstract

In nations with poor and intermediate incomes, cancer is one of the main causes of mortality. Immunohistochemistry (IHC) is crucial for an accurate cancer evaluation, prognosis and treatment decision-making. To use IHC, a significant amount of facilities and capacity growth are needed. Because of this, it is crucial to comprehend the potential effects of IHC and identify the most essential reagents required to distinguish between typical diagnoses in our environment.

Employing IHC, this study aims to assess how well paediatric cancer diagnoses in Tanzania can be made and to identify the most widely used biomarkers for diagnostic distinction.

Pathology samples from kids who were given cancer diagnoses in 2018 at the Bugando Medical Centre in Mwanza, Tanzania, were examined using H&E staining. Basic demographic information from the histology form was gathered in addition to the reported histopathology results from Bugando Medical Centre, including patient age, sex and sample collection. Muhimbili National Hospital received tissue from the histology block for the IHC examination. It was determined which reagents/biomarkers were required for diagnostic confirmation by comparing the histopathology data for diagnostic agreement, variations in diagnosis and other factors.

The examinations included 105 (105) patients with paediatric cancer. 55.2% of the population, who had a median age of 6 years (IQR 3–9), were female. Burkitt and NHL-DLBCL were the paediatric diagnoses with the greatest pathology. The correlation between H&E and IHC histology was 51.0%. 17.6% (n = 18) of diagnoses had enhanced diagnostic specificity (e.g., NHL to diffuse large B cell lymphoma), and 31.4% of diagnoses were altered as a result of IHC.

Considering that the diagnosis of juvenile cancer changes in about 30% of cases, IHC is crucial for accurate diagnosis. IHC retraining is crucial, and developing nations can successfully adopt a modest shared biomarker panel to improve therapy allocation.