Automated Hematoxylin and Eosin Staining with Leica AutoStainer XL v1

PURPOSE: To stain formalin fixed paraffin tissue for microscopic evaluation. Hematoxylin will stain the nuclei of the tissue blue/purple and Eosin will stain cytoplasmic elements a spectrum of brilliant pink. QUALITY CONTROL: Fixation: 10% Neutral Buffered Formalin Technique: Paraffin sections at 5 microns Control: PCRL PROCEDURE: Station #Time in StationExact Time?Solution Name185:00NoXylene175:00NoXylene165:00NoXylene150:20No100% Alcohol140:20No100% Alcohol130:20No95% Alcohol120:20No70% AlcoholWash 11:20NoWater83:30YesHematoxylinWash 20:30YesWaterWash 30:30YesWater90:10YesAcid AlcoholWash 40:30YesWater100:10YesAmmonia WaterWash 50:30YesWater112:00Yes95%70:20YesEosin60:30Yes95%50:30Yes100%40:30Yes100%30:30NoXylene21:00NoXylene11:00NoXylene RESULTS: Nuclei……………………………………………..……………Blue/Purple Cytoplasmic Elements………………………………….Shades of brilliant pink For digital storage and possible pathology review slides are scanned on the Leica Aperio slide scanner. The file output is .svs and can be viewed by downloading freely available software from Leica.

Methods for restoration of ki67 antigenicity in aged paraffin tissue blocks

Pathology archives are a treasure trove of paraffin embedded tissue spanning many years and covering a wide variety of tissues and diseases. The possibility of using old archival formalin fixed paraffin embedded (FFPE) tissues for diagnostic updates and research projects is a widespread need and it requires archives of stable, well-preserved samples. Immunohistochemistry performed on old archival paraffin blocks may give unreliable results, in particular for some antigens, such as Ki67. In consideration of this phenomenon, our aim is to comprehensively test and identify methods which may be used to obtain Ki67 immunohistochemical reactions of good quality from old archival FFPE blocks. Various methods were tested in order to evaluate their possible efficacy in increasing Ki67 immunointensity in a collection of 40-year-old, archival blocks including re-embedding, with deeper sectioning of tissue from the block and increasing heat-based pretreatment times (20 cases) and re-processing (20 cases). All reactions were performed using an automated immunostainer and Ki67 stained immunosections compared using a visual colour-based scale (the first immunostained section was considered as baseline). The combination of deep sectioning (1000 µM) and prolonged heat-based pretreatment (64 min) markedly increased immunoreactivity for Ki67. Re-embedding and reprocessing did not have a significant effect. Large tissue samples showed heterogeneity of Ki67 immunoexpression between the periphery of the sample and the central area. In conclusion, the study defines a useful protocol to increase antigen retrieval applicable to dated archival tissues.

Piezoelectric Ultrasonic Biological Microdissection Device Based on a Novel Flexure Mechanism for Suppressing Vibration

Biological microdissection has a wide range of applications in the field of molecular pathology. The current laser-assisted dissection technology is expensive. As an economical microdissection method, piezoelectric ultrasonic microdissection has broad application prospects. However, the performance of the current piezoelectric ultrasonic microdissection technology is unsatisfactory. This paper aims to solve the problems of the low dissecting precision and excessive wear of the dissecting needle caused by the harmful lateral vibration of the present piezoelectric ultrasonic microdissection device. A piezoelectric ultrasonic microdissection device based on a novel flexure mechanism is proposed. By analyzing the flexure hinge flexibility, the type of flexure beam and the optimal design parameters are determined. Through harmonic response simulation analysis, the newly designed microdissection device with a vibration-suppressing mechanism achieves the best vibration effect when the driving frequency is 28 kHz. Under this driving frequency, the lateral vibration suppression effect is improved by 68% compared to the traditional effect without vibration suppression. Then, based on 3D printing technology, a prototype of a novel microdissection device is produced, and its performance is tested. Experiments on dissecting needle vibration tests show that the flexure mechanism does indeed suppress the lateral vibration of the needle tip. We conducted various tissue dissection experiments on paraffin tissue sections. First, we determine the optimal dissecting parameters (driving voltage, frequency, feed speed, cutting angle) of the new equipment through various parameter dissecting experiments. Then, we adopt these optimal dissecting parameters to perform three kinds of dissecting experiments on mouse tissue paraffin section (liver, lung, bone), dissecting experiments on tissue sections of different thicknesses (3 μm, 4 μm, 5 μm), sampling and extraction experiments on complete tissue. The new device has a better dissecting performance for paraffin tissue sections below a 5 μm thickness and can complete various dissecting tasks. Finally, we compare the wear of the dissecting needles of the new and old devices after the same dissecting tasks. The results prove that the suppression of harmful lateral vibration not only significantly improves the dissecting effect but also increases the service life and durability of the dissecting needle, which is beneficial for reducing the equipment costs.

Seropositive PLA2R-associated membranous nephropathy but biopsy-negative PLA2R staining

Background Serum phospholipase A2 receptor (PLA2R) antibody (SAb) and glomerular deposits of PLA2R antigen (GAg) have been tested widely in idiopathic membranous nephropathy (MN). Recently, we noticed a special form of PLA2R-associated MN with positive circulating PLA2R antibody but negative PLA2R deposits in the glomeruli by immunofluorescence on frozen tissue (IF-F). The significance of this form of PLA2R-associated MN is yet to be elucidated. This study aimed to explore the clinicopathological features of these PLA2R-associated MN patients. Methods This study enrolled 229 biopsy-proven PLA2R-associated MN patients with SAb+. SAb was measured by enzyme-linked immunosorbent assay, and GAg was detected by IF-F. These patients were divided into SAb+/GAg+ and SAb+/GAg− groups. Clinicopathological characteristics of SAb+/GAg+ and SAb+/GAg− PLA2R-associated MN patients were compared. PLA2R antigens of 19 SAb+/GAg− PLA2R-associated MN patients were verified by immunohistochemistry on paraffin tissue (IHC-P). Results Among 229 SAb+ PLA2R-associated MN patients, 210 (91.70%) were GAg+ and 19 (8.3%) were GAg−. These 19 SAb+/GAg− PLA2R-associated MN patients presented positive PLA2R deposits by IHC-P. Compared with SAb+/GAg+ PLA2R-associated MN patients, SAb+/GAg- PLA2R-associated MN patients had higher levels of serum PLA2R antibody (P = 0.004), increased proteinuria (P = 0.008), lower serum albumin (P = 0.019), more prominent chronic pathological lesions in terms of glomerulosclerosis score (P = 0.025), interstitial fibrosis score (P = 0.016), tubular atrophy score (P = 0.010) and total renal chronicity score (P = 0.010), and were more likely to be accompanied by focal segmental glomerulosclerosis (P = 0.014). Higher SAb level was associated with the total renal chronicity score (odds ratio per 100 RU/mL, 1.16; 95% confidence interval 1.01–1.33; P = 0.033). Conclusions PLA2R-associated MN patients with seropositive PLA2R antibody but negative PLA2R deposits in the glomeruli by IF-F have higher levels of SAb and worse clinicopathological manifestations compared with their double-positive counterparts. IHC-P can be an alternative technique to reveal PLA2R glomerular deposits.

Frequency of IL-10+CD19+ B cells in patients with prostate cancer compared to patients with benign prostatic hyperplasia

Background: The function of the immune system in prostate cancer (PC) might promote carcinogenesis. PC is a common cancer in men. Regulatory B cells (Bregs) are a new subtype of B cells that have suppressive roles in the immune system. Inter- leukin-10 (IL-10) is a dominant mediator of immune suppression released by Bregs. Objective: The purpose of this research was to examine the frequency of CD19+IL10+ B cells and IL-10 mRNA expression in patients with PC compared to patients with benign prostatic hyperplasia (BPH). Methods: Forty paraffin tissue samples from patients with PC and 32 paraffin tissue samples from patients with BPH were en- tered in this study. The immunohistochemistry staining was used to evaluate the pattern expression of CD19 and IL-10 markers. IL-10 mRNA expression in fresh tissue was determined by real time-polymerase chain reaction (RT-PCR). Results: The frequency of CD19+IL-10+ B cells and IL-10 mRNA expression in PC patients were significantly higher than patients with BPH. Also, there was no meaningful relationship between the frequency of IL-10+CD19+ B cells and gleason scores in patients with PC. Conclusions: Our findings suggested that frequency of IL-10+CD19+ B cells correlates with progressive stage of PC. Keywords: Prostate cancer; benign prostatic hyperplasia; IL-10+CD19+ B cells.

Multiplex enzyme activity imaging by MALDI-IMS of substrate library conversions

Enzymes are fundamental to biological processes and involved in most pathologies. Here we demonstrate the concept of simultaneously mapping multiple enzyme activities (EA) by applying enzyme substrate libraries to tissue sections and analyzing their conversion by matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS). To that end, we spray-applied a solution of 20 naturally derived peptides that are known substrates for proteases, kinases, and phosphatases to zinc-fixed paraffin tissue sections of mouse kidneys. After enzyme conversion for 5 to 120 min at 37 °C and matrix application, the tissue sections were imaged by MALDI-IMS. We could image incubation time-dependently 16 of the applied substrates with differing signal intensities and 12 masses of expected products. Utilizing inherent enzyme amplification, EA-IMS can become a powerful tool to locally study multiple, potentially even lowly expressed, enzyme activities, networks, and their pharmaceutical modulation. Differences in the substrate detectability highlight the need for future optimizations.

Positivity for SATB2 distinguishes Islet1 positive rectal neuroendocrine tumours from pancreaticoduodenal neuroendocrine tumours

AimsDetermining the site of origin of a metastatic neuroendocrine tumour (NET) can be challenging and has important prognostic and therapeutic implications. An immunohistochemical (IHC) panel consisting of TTF1, CDX2, PAX8/PAX6 and Islet1 is often employed. However, there can be a significant IHC overlap among different primary sites. Herein, we sought to determine the utility of including Special AT-rich sequence binding protein-2 (SATB2) in the IHC panel that is used for determining the site of origin of a metastatic NET.MethodsParaffin tissue microarrays consisting of 137 primary NETs (26 lung, 22 jejunoileal, 8 appendix, 5 stomach, 4 duodenum, 17 rectum and 55 pancreas) were stained for SATB2, in addition to the well-described lineage-associated markers, such as TTF1, CDX2, PAX6 and Islet1. Additionally, a tissue microarray consisting of 21 metastatic NETs (1 lung, 1 stomach, 8 jejunoileal and 11 pancreas) was stained for TTF1, CDX2, SATB2 and Islet1. The results were recorded as no staining, weak staining and moderate to strong staining.ResultsAll appendiceal NETs and majority (88%) of the rectal NETs were positive for SATB2. All primary foregut NETs (stomach, pancreas, duodenum and lung) were negative for SATB2, except for one pulmonary NET with weak staining. However, among the metastatic tumours, 5 of 11 pancreatic NETs, 1 stomach NET, 1 lung NET and 2 of 8 jejunoileal NETs showed weak staining. Receiver operating characteristic analysis incorporating sensitivity and specificity data of IHC panel, considering moderate to strong staining as truly positive cases, showed that inclusion of SATB2 to the previously described NET IHC panel outperformed the panel without SATB2, raising the specificity for pancreaticoduodenal NETs from 81.2% to 100%, with a positive predictive value (PPV) of 100% and negative predictive value (NPV) of 82.22% (p<0.0001); for appendiceal NETs the specificity changed from 99.1% to 98.5% and sensitivity increased from 11.8% to 80%, with a PPV and NPV of 66.67% and 99.26%, respectively (p<0.0001); and for rectal NETs the specificity increased from 97.6% to 99.3% and sensitivity raised from 7.1% to 66.7%, with a PPV and NPV of 80% and 98.53%, respectively (p<0.0001).ConclusionsSATB2 stain is useful in differentiatingIslet1/PAX6 positive pancreatic and rectal NETs, as rectal NETs are typically moderately to strongly positive for SATB2 and pancreatic NETs are usually negative or weakly positive for SATB2. Moderate to strong staining for SATB2 is suggestive of an appendiceal or a rectal primary. SATB2 may complement the panel of CDX2, TTF1 and Islet1 in determining the site of origin of an NET in a metastatic setting.