Application of microsatellite PCR techniques in the identification of mixed up tissue specimens in surgical pathology

Gras, Esther; Matías‐Guiu, Xavier; Catasús, Lluis; Argüelles, Rosmary; Cardona, Dolors; Prat, Jaime

doi:10.1136/jcp.53.3.238

Cited by 13 publications

(7 citation statements)

References 10 publications

(14 reference statements)

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“…These include immunolabeling of blood group antigens [22], sex chromosome targeting using fluorescence in situ hybridization [21] and microsatellite analysis. According to some authors, microsatellite analysis is the gold standard for investigating tissue identity [1, 10, 23, 28, 31]. …”

Section: Discussionmentioning

confidence: 99%

Search for residual prostate cancer on pT0 radical prostatectomy after positive biopsy

et al. 2007

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Reported incidence of no residual prostate cancer (i.e. pathological stage pT0) on radical prostatectomy ranges from 0.07 to 4.2%. The incidence is higher after neoadjuvant endocrine treatment. The aim of this study was to search for residual cancer on radical prostatectomy (RP) specimens when an initial sampling failed to find the cancer in patients with positive biopsy. Our database of 1,328 consecutive patients whose biopsies and RP specimen were both examined at the Polytechnic University-United Hospitals of the Marche Region between March 1995 and June 2006 was reviewed. The radical prostatectomies were grossly completely sampled and examined with the whole mount technique. We identified eight patients (i.e. 0.6%; three untreated and five hormonally treated preoperatively, i.e. 0.3 and 0.8%, respectively, of the total number of RPs included in the study) with positive biopsy and with no residual cancer in the initial routine histological examination of the RP. The RP of this group of eight was subjected to additional sectioning and evaluation of the paraffin blocks of the prostatectomy, also after block-flipping, immunostaining with an antibody against CAM 5.2, p63, PSA, and alpha-methylacyl-CoA racemase, and DNA specimen identity analysis. There were no cases with a false positive biopsy diagnosis, and cancer was not overlooked or missed in the initial routine histological examination of any of the 8 pT0 RPs. A minute focus of cancer (the diameter was always below 2.0 mm) was found on the additional sections in five. In particular, cancer was found after block-flipping in one of them. In an additional case, cancer was eventually discovered after immunostaining tissue sections for cytokeratin CAM 5.2, for p63 and PSA. In the remaining two cases (one untreated and the other hormonally treated), cancer was not found (0.15% of the 1,328 RPs included in the study); the review of the description of the macroscopic appearance of the RP and of its slides revealed that part of the peripheral zone corresponding to the site of the positive biopsy was missing, i.e. not removed from the patient at the time of the operation at least in one of the two. DNA specimen analysis confirmed the identity of the biopsy and prostatectomy in both. An extensive search for residual cancer reduces the number of pT0 RPs after a positive biopsy from 0.6 to 0.15%. It is recommended to have the needle biopsy reviewed, carefully look again at the radical prostatectomy, do deeper sections and then flip certain paraffin blocks. In addition, atypical foci should be stained for basal cell markers and often AMACR, especially in hormone-treated cases. If a block is missing part of the peripheral zone (capsular incision), this should be commented on. DNA analysis for tissue identity should be performed when the other steps have been taken without finding cancer.

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Section: Discussionmentioning

confidence: 99%

Search for residual prostate cancer on pT0 radical prostatectomy after positive biopsy

et al. 2007

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“…The pathologist must be alert to the possibility of any identity mismatch, any discrepancy between the macroscopic examination and the available microscopic slide, and any potential histology laboratory contamination (Bpickups[ and Bfloaters[). Isolated fragments of carcinoma with a histological appearance out of keeping with the remainder of the slide (17) and the satellite fragments of carcinoma on the biopsy slide should be regarded with suspicion. Background findings of endometrial hyperplasia or endometrial intraepithelial carcinoma may provide some reassurance that small malignant fragments are indeed native to the biopsy.…”

Section: Discussionmentioning

confidence: 99%

Vanishing Endometrial Carcinoma

Dubé

Macdonald²,

Allingham-Hawkins³

et al. 2007

International Journal of Gynecological Pathology

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Three cases of histologically proven endometrial carcinoma (EmCa) demonstrated no residual carcinoma or biopsy site on the subsequent hysterectomy specimen. The shared identity of both endometrial biopsy and hysterectomy specimen was proven, and specimen misidentification was excluded in all 3 cases through successful DNA profiling. Just as vanishing cancer in prostatic carcinoma has recently been defined and accepted, it is suggested that vanishing EmCa can also be defined using specific pathological and clinical criteria. DNA profiling may serve to confirm the diagnosis. Vanishing EmCa is only a small subset within hysterectomy specimens that show no EmCa after a histological diagnosis of EmCa. The concept of vanishing EmCa may be useful in both clinical and medicolegal practice.

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“…Others have reported on the use of microsatellite markers in establishing patient identity [10][11][12][13], and Hunt et al [14] proved its success in microdissected samples using a panel of 10 polymorphic microsatellite markers. Other means of identifying the derivation of extraneous tissue include fluorescence in situ hybridization [13] using DNA probes for regions on the X and Y chromosomes in a case in which a female specimen is believed to be contaminated by a male tissue.…”

Section: Discussionmentioning

confidence: 99%

A simple and rapid approach to the problem of tissue contamination and patient identity in histopathologic specimens

et al. 2006

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Application of microsatellite PCR techniques in the identification of mixed up tissue specimens in surgical pathology

Cited by 13 publications

References 10 publications

Search for residual prostate cancer on pT0 radical prostatectomy after positive biopsy

Search for residual prostate cancer on pT0 radical prostatectomy after positive biopsy

Vanishing Endometrial Carcinoma

A simple and rapid approach to the problem of tissue contamination and patient identity in histopathologic specimens

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