JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Special Issue "Pathology", March, 2023
Pages: 1149-1149
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Pre-analytical performance in surgical pathology: improvement of the fixation technique at the Ibn Rochd University Hospital of Casablanca Morocco.
Author: N Anibat, M. Belcaid, A Mellouki, O. Aazzane, A. Rezzaki, M. Keballi, L. Zoubir, N Khlil, M Karkouri
Category: JMSR Pathology
Abstract:
Background: Pathologists play a crucial role in the management of patients, especially in case of tumor diseases. In order to achieve these missions, adequate course of the pre-analytical phase with all its steps is critical. Fixation is a fundamental part of the pre-analytical process and it is used to protect tissue from decay, making the morphological analysis of tissue and cells possible.
Objective: To improve the fixation process in a central Department of Pathology, serving 4 University hospitals, and to discuss the benefits and drawbacks of each protocol.
Methods: We carried out a prospective study in the Department of Pathology of the Ibn-Rochd University Hospital, Casablanca, Morocco. We evaluated the quality of fixation by buffered formalin compared to unbuffered formalin on surgical breast specimens collected from the Oncology-gynecology Department over a period of 3 months. We evaluated slides reading and current recommendations.
Results & Conclusions: A total of 145 specimens were examined and 5 pathologists participated in this study. Each case was analyzed by two pathologists. We summarized our results in the table 1, below.
Keywords: : Preanalytic, Quality, Fixation Process, Buffered Formalin
Full Text:
Pre-analytical performance in surgical pathology: improvement of the fixation technique at the Ibn Rochd University Hospital of Casablanca Morocco.
N Anibat1,2, M. Belcaid1, A Mellouki2, O. Aazzane1, A. Rezzaki2, M. Keballi2, L. Zoubir2, N Khlil3, M Karkouri1,2,
1Laboratory of Cellular and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco
2Pathology Department, Ibn Rochd University Hospital of Casablanca, Morocco
3Laboratory of Chemistry-Biochemistry, Environment, Nutrition and Health "LC-BENS" Faculty of Medicine and Pharmacy, Casablanca, Morocco.
Background: Pathologists play a crucial role in the management of patients, especially in case of tumor diseases. In order to achieve these missions, adequate course of the pre-analytical phase with all its steps is critical. Fixation is a fundamental part of the pre-analytical process and it is used to protect tissue from decay, making the morphological analysis of tissue and cells possible.
Objective: To improve the fixation process in a central Department of Pathology, serving 4 University hospitals, and to discuss the benefits and drawbacks of each protocol.
Methods: We carried out a prospective study in the Department of Pathology of the Ibn-Rochd University Hospital, Casablanca, Morocco. We evaluated the quality of fixation by buffered formalin compared to unbuffered formalin on surgical breast specimens collected from the Oncology-gynecology Department over a period of 3 months. We evaluated slides reading and current recommendations.
Results & Conclusions: A total of 145 specimens were examined and 5 pathologists participated in this study. Each case was analyzed by two pathologists. We summarized our results in the table 1, below.
Table.1 – Summary of the main findings
|
Specific process
|
Specific criteria
|
Fixers used
|
|
Unbuffered formalin
|
Buffered formalin
(ph=7.1)
|
|
Quality of cuts
|
Adequate thickness
|
B
|
A
|
|
Presence/absence of tears, creases, streaks, dye stains, delaminations
|
C
|
B
|
|
Presence/absence of contamination
|
B
|
A
|
|
Montage
|
B
|
A
|
|
Quality of routine staining
|
Nuclear components
|
Clear and blue/purple chromatin
|
B
|
A
|
|
Well identified nucleolus
|
B
|
A
|
|
Well defined nuclear membrane
|
B
|
A
|
|
Cytoplasmic features
|
Well delimited cytoplasm
|
B
|
A
|
|
Well defined cytoplasmic granules
|
B
|
A
|
|
Well defined mucus
|
B
|
A
|
|
Extracellular matrix components
|
Bright red hematies
|
B
|
A
|
|
Quality of fibers
|
B
|
A
|
The use of buffered formalin allowed a stable and reproducible fixation, a better preservation tissue, a relatively short period of fixation and better morphological analysis.
Keywords: Preanalytic, Quality, Fixation Process, Buffered Formalin
Conflicts of interest: None
References:
- ISO NF15189 version 2012
- ISO 20166-4:2021(fr), Analyses de diagnostic moléculaire in vitro
- Directives de qualité SGPath –Cancer sein Version 2017
- William J. Howat , Beverley A. Wilson(2014). Tissue fixation and the effect of molecular fixatives on downstream” .“Staining procedures”.doi: 10.1016/j.ymeth.2014.01.022.