Was soll der Chirurg vom histopathologischen Präparate-Processing wissen?

Zusammenfassung

Zahlreiche Einflussfaktoren beeinflussen den Zustand des Gewebes auf dem Weg von der Entnahme aus dem Körper bis unter das Mikroskop des Pathologen. Diese Faktoren lassen sich unterteilen in solche, die der Chirurg beeinflussen kann, und solche, die sich in der Pathologie abspielen, deren mögliche Fehlerquellen und Einflüsse auf die Diagnose er kennen sollte. Die Faktoren können die Diagnosen an konventionellen Färbungen verändern, besonders aber die Diagnosen an immunhistochemisch oder molekularpathologisch untersuchten Geweben. Deswegen ist eine Standardisierung der Gewebebearbeitung zu fordern. Diese ist extrem wichtig für Biobankproben, insbesondere für Biobankgewebeproben, für die ein Protokoll der Gewebebehandlung zu fordern ist.

Abstract

A multitude of factors influence the state of tissue samples on their way from the biopsy site in the body to the pathologistʼs microscope. Some of these factors can be influenced by surgeons, while others are dealt with in pathology departments, but surgeons should know potential pitfalls and caveats and their influence on the pathohistological diagnosis. These factors influence diagnoses made on conventional stains, but even more so the results of immunohistochemical stains and molecular pathology examinations. Therefore, the work-up of tissue samples should be standardised. This is of utmost importance for biobank tissue samples, especially those for which a tissue treatment protocol is recommended.

Schlüsselwörter

präanalytische Phase - Standardisierung - Biobanken

Key words

pre-analytical phase - biobanking - standardisation

• Literatur

• 1 Bussolati G, Annaratone L, Maletta F. The Pre-analytical Phase in Surgical Pathology. In: Dietel M, Wittekind C, Bussolati G, von Winterfeld M, eds. Pre-analytics of Pathology Specimens in Oncology. Cham, Heidelberg, New York, Dordrecht, London: Springer; 1-13
• 2 Ruijter E, van de Kaa C, Aalders T et al. Heterogeneous expression of E-cadherin and p 53 in prostate cancer: clinical implications. BIOMED-II markers for prostate cancer study group. Mod Pathol 1998; 11: 276-281
• 3 Medeiros F, Rigl CT, Anderson CG et al. Tissue handling for genome-wide expression analysis: a review of the issues, evidence, and opportunities. Arch Pathol Lab Med 2007; 131: 1805-1816
• 4 Bray SE, Paulin FE, Fong SC et al. Gene expression in colorectal neoplasia: modifications induced by tissue ischaemic time and tissue handling protocol. Histopathology 2010; 56: 240-250
• 5 Wolff AC, Hammond ME, Hicks DG et al. American Society of Clinical Oncology and College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2013; 31: 3997-4013
• 6 Portier BP, Wang Z, Downs-Kelly E et al. Delay to formalin fixation “cold ischemia time”: effect on ERBB2 detection by in-situ hybridization and immunohistochemistry. Mod Pathol 2013; 26: 1-9
• 7 Groenen PJ, Blokx WA, Diepenbroek C et al. Preparing pathology for personalized medicine: possibilities for improvement of the pre-analytical phase. Histopathology 2011; 59: 1-7
• 8 Goldstein NS, Hewitt SM, Taylor CR et al. Recommendation for improved standardization of immunohistochemistry. Appl Immunohistochem Mol Morphol 2007; 15: 124-133
• 9 Dabbs DJ. Immunohistochemical protocols: back to the future. Am J Clin Pathol 2008; 129: 355-356
• 10 Hammond MEH, Hayes DF, Dowsett M et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010; 28: 2784-2795
• 11 Chung JY, Braunschweig T, Williams R et al. Factors in tissue handling and processing that impact RNA obtained from formalin-fixed, paraffin-embedded tissues. J Histochem Cytochem 2008; 56: 1033-1042
• 12 Helander KG. Kinetic studies of formaldehyde binding in tissue. Biotech Histochem 1994; 69: 177-179
• 13 Hewitt SM, Lewis FA, Cao Y et al. Tissue handling and specimen preparation in surgical pathology: issues concerning the recovery of nucleic acids from formalin-fixed, paraffin-embedded tissue. Arch Pathol Lab Med 2008; 132: 1929-1935
• 14 Dotti I, Bonin S, Basili G et al. Effects of formalin, methacarn, and fineFIX fixatives on RNA preservation. Diagn Mol Pathol 2010; 19: 112-122
• 15 Van Maldegem F, de Wit M, Morsink F et al. Effects of processing delay, formalin fixation, and immunohistochemistry on RNA recovery from formalin-fixed, paraffin-embedded tissue. Diagn Mol Pathol 2008; 17: 51-58
• 16 Páska C, Bögi K, Szilák L et al. Effects of formalin, acetone, and RNAlater fixatives on tissue preservation and different size amplicons by real-time PCR from paraffin-embedded tissue sections. Diagn Mol Pathol 2004; 13: 234-240
• 17 Masuda N, Ohnishi T, Kawamoto S et al. Analysis of chemical modification of RNA from formalin-fixed samples and organization of molecular biology applications for such samples. Nucleic Acid Res 1999; 27: 4436-4443
• 18 Bussolati G, Annaratone L, Medico E et al. Formalin fixation at low temperature better preserves nucleic acid integrity. PLoS One 2011; 6: e21043
• 19 Anonym Verordnung 2008/1272/EG, Anhang VI der Europäischen Chemikalienagentur (ECHA) über die Einstufung, Kennzeichnung und Verpackung von Stoffen und Gemischen.
• 20 Bundesverband Deutscher Pathologen e.V.. S1-Leitlinien zur pathologisch-anatomischen Bearbeitung von verschiedenen Tumoren. Im Internet: http://www.pathologie.de/fachinfos/nachschlagewerke-handbuchreihe/handbuch-leitlinien-pathologie/ Stand: 30.10.2015
• 21 Fricain JC, Rouais F, Dupuy B. A two-step embedding process for better preservation of soft tissue surrounding coral implants. J Biomed Mater Res 1996; 33: 23-27
• 22 Fergenbaum JH, Garcia-Closas M, Hewitt SM et al. Loss of antigenicity in stored sections of breast cancer tissue microarrays. Cancer Epidemiol Biomarkers Prev 2004; 13: 667-672
• 23 NCCLS (National Committee for Clinical Laboratory Standards). Quality assurance for immunohistochemistry. Approved guideline. Wayne Pa: NCCLS; 1999. NCCLS document MM4-AC
• 24 Cronin M, Pho M, Dutta D et al. Measurement of gene expression in archival paraffin-embedded tissues: development and performance of a 92-gene reverse transcriptase polymerase chain reaction assay. Am J Pathol 2004; 164: 35-42
• 25 Bernsen MR, Dijkman HB, de Vries E et al. Identification of multiple mRNA and DNA sequences from small tissue samples isolated by laser assisted microdissection. Lab Invest 1998; 78: 1267-1273
• 26 Hale MD, Gotoda T, Hayden JD et al. Endoscopic biopsies from gastrointestinal carcinomas and their suitability for molecular analysis: a review of the literature and recommendations for clinical practice. Histopathology 2015; 67: 147-157
• 27 Vaught JB, Henderson MK, Compton CC. Biospecimens and biorepositories: from afterthought to science. Cancer Epidemiol Biomarkers Prev 2012; 21: 253-255
• 28 Baker M. Building better biobanks. Nature 2012; 486: 141-146
• 29 Robb JA, Gulley ML, Fitzgibbons PL et al. A call to standardize preanalytic data elements for biospecimens, part I. Arch Pathol Lab Med 2014; 138: 526-537
• 30 Robb JA, Bry L, Sluss PM et al. A call to standardize preanalytic data elements for biospecimens, part II. Arch Pathol Lab Med 2015; 139: 1125-1128