Derivation of a list of priority antibodies from the analysis of a cohort of cases sent from Nigeria for external consultation

Introduction: The major obstacle to developing sustainable services in a resource-limited setting, which hitherto has not had routine availability of diagnostic immunohistochemistry (IHC), is choosing from a large array of over 200 antibodies that are currently in use in the Western world. Materials and Methods: By critically analyzing the use of diagnostic IHC in a cohort of 360 cases sent for consultation from Nigeria to the UK between January 2014 and May 2016, we have derived a list of antibodies that could meet over 85% of current diagnostic IHC needs in Nigeria. Results: From our analysis, a starter list of only two antibodies could immediately meet over 30% of the IHC needs. Having mastered this starter list, the service could move to the next step by adding 23 other antibodies which could meet another 85% of diagnostic IHC needs. Conclusions: Testing with these 25 antibodies can be done at least twice weekly to address the 3 areas mentioned above and greatly increase the chances of success in establishing a sustainable service. We recommend this list to the various groups working with diagnostic IHC in Nigeria and look forward to reports of their efforts.