New double embedding technique for specimens of endoscopic submucosal dissection using agarose: comparison with other media

Zozumi, Masataka; Nakai, Mayumi; Ito, Takashi; Matsuda, Ikuo; Hao, Hiroyuki; Tsukamoto, Yoshitane; Hirota, Seiichi

doi:10.1136/jcp.2010.078980

Cited by 6 publications

(9 citation statements)

References 12 publications

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“…In the next few decades, many types of media were used to wrap larger ESD specimens to hold the tissues in place 30 31. In other studies,20 double embedding technique was carried out for larger tissues obtained by the ESD procedure. In the first-step embedding, agarose, agar and gelatin were all applied as embedding medium for covering ESD specimens and cutting the tissues with medium, so as to avoid tissue shrinking and hold the specimens in place without moving in the cassette during processing.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens

Jiang

Wen

et al. 2022

J Clin Pathol

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AimsAccurate histopathological evaluation of the endoscopic submucosal dissection (ESD) specimens is essential for clinicians to guide further triage and management. This study aimed to report a novel processing technique for large ESD (≥4 cm) specimens.Methods92 patients with colorectal neoplasms who had undergone ESD were included. 46 ESD specimens were treated with conventional handling process, while the rest 46 cases were given the optimised method. Macrobiocassettes and L-shaped embedding moulds were applied in the optimised method. We evaluated the efficacy of this improved procedure in terms of the number of paraffin blocks, storage space and time consumption of pathological assessment.ResultsThe average diameter of ESD specimens was 4.5±0.4 cm and 4.7±0.5 cm in the control and test group (p=0.023), respectively. In control group, 398 paraffin blocks of 46 cases were obtained. With the same cases number and larger lesion size, only 276 blocks were achieved in test group (p<0.001). As for the storage space, the total volume of paraffin blocks and slides (4554.0 cm3 and 1207.5 cm3) of optimised method was significantly reduced compared with the control group (6208.8 cm3 and 1741.3 cm3) (p=0.001, p<0.001). In addition, the optimised method was superior to the conventional one in shortening time consumption of pathological assessment (164.5 min and 269.0 min, p<0.001).ConclusionsThe optimised technique not only reduced the workload and storage space, but also facilitated accurate pathological assessment.

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Section: Discussionmentioning

confidence: 99%

“…Ten pathology technicians/pathologists involved in this study. The design of this questionnaire borrowed the contents of the previous study 20…”

Section: Methodsmentioning

confidence: 99%

Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens

Jiang

Wen

et al. 2022

J Clin Pathol

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“…The older literature from the 1960s, 1970s and 1980s proposed a pre-embedding technique in agar to maintain the precise orientation of tissue specimens before paraffin embedding 1–4. Advantages in microtome section preparation have been well documented in small tissue biopsies,7–9 ocular biopsies,10 skin samples11 12 and large dissection specimens 13. Unfortunately, even though often used in cytology14 and biology/botany,15 this technique is by no means widespread in routine pathology laboratories as it requires instrumentation, all be it simple, and lengthens cut up time.…”

Section: Discussionmentioning

confidence: 99%

Agar pre-embedding of small skin biopsies: real-life benefits and challenges in high throughput pathology laboratories

et al. 2019

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Paraffin embedding of small, thin tissue samples requires specific expertise for optimal orientation before tissue sectioning. This study evaluates the real-life utility of the agar pre-embedding technique for small skin biopsies with regards to lengthening of work times, problems in orientation (re-embedding) and ancillary techniques (immunohistochemistry and in situ hybridisation) between two high work flow pathology laboratories, one of which routinely uses the agar pre-embedding technique and one which does not. The mean time required for pre-embedding in agar was 30.4 s, but time for paraffin embedding for agar pre-embedded samples was shorter than the traditional method (177 vs 296 s; p<0.005). The number of skin samples requiring re-embedding was significantly higher with the traditional embedding method (p<0.005). No problems in immunoreactivity were observed in all 1900 reactions performed with 17 different antibodies. Fluorescence in situ hybridisation analysis was optimised with a prolonged protease K incubation time (21 vs 18 min).

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“…All specimens were completely dissected into 2- to 3-mm thick slices. Then, 3-μm sections from each slice were examined with hematoxylin and eosin (HE) or Elastica van Gieson staining [ 13 ]. Immunohistochemistry for desmin and D2-40 was performed to visualize muscularis mucosae and lymphatic vessels, respectively [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

The eCura system as a novel indicator for the necessity of salvage surgery after non-curative ESD for gastric cancer: A case-control study

et al. 2018

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Endoscopic submucosal dissection (ESD) for early gastric cancer does not always lead to complete cancer resection. The aim of this study was to determine indicators for cancer residue (CR) status in cases of non-curative ESD. We analyzed 47 cases of non-curative ESD followed by salvage surgery and collected data regarding the rates of CR, which included both local CR and lymph node metastasis (LNM). To elucidate the risk factors for CR status, we compared the CR positive and the CR negative groups among surgical specimens according to the following variables obtained from ESD findings: tumor location, tumor size, depth of invasion, lympho-vascular invasion, histological margin, and histological diagnosis. The eCura system, which is an LNM risk scoring system, was also applied and scores were calculated in each case as follows: 3 points for lymphatic invasion and 1 point each for tumor size >30 mm, positive vertical margin, venous invasion, and submucosal invasion ≥500 μm. There were 9 (19%) CR positive cases, which included 6 cases of local CR and 4 cases of LNM; no cancer was detected in over 80% of the patients. The eCura scoring system was the only significant factor for CR status: the higher the eCura score, the greater the CR positivity (p = 0.0128). In particular, all patients in the low-risk group (score = 0–1 point) had no CR. Although no cancer recurrence was observed during a median follow-up of 4 years, 2 patients died of pneumonia. In conclusion, the eCura system might make it possible to select appropriate cases for salvage surgery.

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New double embedding technique for specimens of endoscopic submucosal dissection using agarose: comparison with other media

Abstract: The present new double embedding technique using agarose provides not only an easy and reliable embedding procedure for technicians but also accurate and exact diagnosis for pathologists.

Cited by 6 publications

References 12 publications

Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens

Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens

Agar pre-embedding of small skin biopsies: real-life benefits and challenges in high throughput pathology laboratories

The eCura system as a novel indicator for the necessity of salvage surgery after non-curative ESD for gastric cancer: A case-control study

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