Tissue microarray
Tissue micro arrays (TMAs) was introduced by Kononen et al. in 1998 157. This technique is based on the assembly of separate tissue cores on a paraffin block, which may contain up to 1000 cores. TMA can be used for several purposes, in which the detection of protein is the most common. In this thesis, prognosis/outcome based arrays was applied to evaluate the prognostic value of various proliferation markers.
Several advantages and disadvantages are associated with TMA compared to the classic single sample microscope slide. Advantages associated with this technique include rapid and high-throughput validation of biomarkers, less reagent consumption, less expensive, decreased technical time, decreased assessment time, decreased variability of results, standardization and the possibility of digitizing and quantifying results 155,158-162. However, TMA is not better than the classic microscope slide in every are. Several disadvantages are also associated with this technique, including the preparation that requires more careful planning and high technical skills, sample selection is also critical due to
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In the first study, 581 patients were retrospectively analyzed and associations between numerous parameters and RFS were made 217. The study demonstrated that a mitotic index of 4 or more or the presence of three of the following four histological features: sheeting, prominent nuclei, hypercellularity and small cells were highly predictive of recurrence. Tumors presenting these criteria showed a significantly greater recurrence rate compared with other tumors. In the second study, the researchers demonstrated an association between survival and both anaplasia (defined as loss of meningothelial features) and an even higher mitotic index (20 or more) 216. Meningioma patients harboring one of these features had a significantly shorter
higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III
Provider-performed microscopy (PPM) procedures are a part of moderately complex testing in which a microscope is used as the main instrument for testing [4]. PPM is performed by a physician, mid-level provider, or a dentist and is performed during the patients’ exam [3,4]. Examples of PPM testing include KOH preparations, wet mounts, post-vasectomy specimens, and urine sedimentation exams [4].
We studied the correlation between the micro-vascular density and pathological tumor staging that revealed high positive correlation between MVD and tumor stage was observed (r = 0.606, p = 0.001). From the ROC curve, by applying the cut off value =37.63 MVD, the higher MVD above the cut off
Aziz, N., Qin, Z., Bry, L., Driscoll, D. K., Funke, B., Gibson, J. S., & ... Voelkerding, K. V. (2015). College of American Pathologists' Laboratory Standards for Next-Generation Sequencing Clinical Tests. Archives Of Pathology & Laboratory Medicine, 139(4), 481-493 13p.
30). According to Brunstein (2016), individual tests can be moved to a patient’s bedside or in other less formal settings to provide faster diagnosis, allowing for quicker response times when medical interventions are needed (p. 30). Bedside testing uses a method called point-of-care testing (POCT) and presents both new possibilities as well as challenges (Brunstein, 2016, p. 30). Brunstein (2016) points out some of the challenges are decreased sensitivity, specificity, or sometimes both, especially when compared to the testing that is done in the core lab (p.30). However, POCT can prove to be advantageous because of reduced response times for medical interventions. POCT with moderate sensitivity and high specificity have proven to be convenient, cost effective first-line screening tools (Brunstein, 2016, p. 30). Molecular POCT has positive implications for the future but there are some limitations. POCT used for molecular diagnosis (Madix) are limited to only
Neuro-Oncology is the study of cancer in the brain, skull base, or spinal cord. They can also treat genetic disorders of a certain type such as Neurofibromatosis. Neurofibromatosis is tumors that grow in the nervous system that is caused by a genetic disorder. The main purpose of the research was to gain information on Neuro- oncology, general information on brain tumors, and general information on specific tumor types. Central nervous system tumors include various gliomas such as glioblastoma multiforme, astrocytoma, brainstem glioma, ependymoma, and oligodendroglioma. Furthermore, meningioma and vestibular schwannomas. Other conditions neuro-oncologist can treat are central nervous system lymphoma, metastic disease to the spine
TNM system is based on the size of the tumor (T), whether lymph nodes are involved (N) and whether the tumor has metastasized (M) and spread to another part of the body(Dighe et al., 2015). TNM system can classify the cancer into 5 stages ranging from Stage 0 (carcinoma in situ (DCIS) or (LCIS) up to Stage IV where cancer has already metastasized to other organs(Moussa and Yones 2015). Larger size, nodal spread and metastasis lead to larger stage number and worse prognosis(Dighe et al.,
Various investigators have found cellular pleomorphic, stromal elements or the combination of histologous stromal elements or the combination of histological features to be prognostically useful [1,8,10,11]. According to Hawkins et al. Four features-high mitotic count, stromal overgrowth, severe nuclear pleomorphism and infiltrating margins were useful predictors for the development of metastases [8]. They also showed that the most reliable predictor for metastasis was the presence of stromal overgrowth, and a primary tumor with stromal overgrowth had a 72% risk of metastatic spread [8]. Here patients need a close follow up with a CT scan of the bones and lungs.
One of the important markers of tumor grade and invasiveness is vascular proliferation, which was mainly identified by invasive biopsy now they found a noninvasive surrogate by which can be non-invasively measured using MRI.
Tumour markers are detectable cancer cells that are found in the spinal fluid, urine or blood (Craft, Gordon & Tiziani, 2011). They can include enzymes, hormones, antigens or genes (Craft, Gordon & Tiziani, 2011).Tumour markers are beneficial, in that they are able to identify high risk cancers in individuals (Craft, Gordon & Tiziani, 2011). They also help by diagnosing different cancer types (Craft, Gordon & Tiziani, 2011).There are different markers that are able to identify different cancer types (Craft, Gordon & Tiziani, 2011). For example, Prostrate-specific antigen (PSA) identifies prostate cancer cells and a-fetoprotein (AFP) identifies Hepatic cancer cells (Craft, Gordon & Tiziani, 2011). There is a disadvantage of using tumour markers, and that is that some non-cancerous tissues produce markers (Craft, Gordon & Tiziani, 2011). Therefore, to determine whether a patient has cancer, additional tests are necessary (Craft, Gordon & Tiziani, 2011).
Their analysis showed out of 240 cases 93.67% cases were non neoplastic 8.62% cases were neoplastic lesions and malignant lesions were
The evaluation looks at these factors in relationship to the cancer’s invasion of other organs, metastases to lymph nodes or beyond and the persistence or recurrence of the cancer
In order for efficient fixation and processing times to occur, all tissues should be no thicker than 3mm (Washington School of Medicine, 2016). When a tissue sample is thicker than the recommended thickness, penetration and crosslinking of the sample tissue proteins will take an increased amount of time for this to occur. The centre of the tissue may undergo autolysis as the proteins located within the centre of the sample will not be reached at an optimum time. Additionally, the sample may be prevented from undergoing complete fixation by the chosen fixative. However when careful cutting techniques are utilised and the care is taken to cut optimally sized tissue samples, the desired fixation efficiency can be achieved. There are a few processes
In modern day medicine, the use of tissue biopsies is a well-established method for diagnosing cancer and other diseases. However, such procedures are often accompanied by technical limitations that can make obtaining the necessary amount of sample material from patients
Tumors are one of the most feared diseases of our time. Many people upon hearing the word “tumor” immediately resonate to the conclusion of it being cancer, which is not necessarily true. Tumors fall into to two main types, benign and malignant. Although they are considerably different in tissue invasion, their nature that makes them distinct and symptoms, they are also quite similar in the way they recur in the same location, growth size and their health risks.