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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:

  1. ISO NF15189 version 2012
  2. ISO 20166-4:2021(fr), Analyses de diagnostic moléculaire in vitro
  3. Directives de qualité SGPath –Cancer sein Version 2017
  4. 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.