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Sun T, Xu L, Yao H, Zhao J, Chen Z, Chen Z, Wang B, Ding W. A set of pretreatment reagents including improved formula fixation and decalcification facilitating immunohistochemistry and DNA analyses of formalin-fixed paraffin-embedded bone marrow trephine biopsy. Acta Histochem 2024; 126:152188. [PMID: 39243590 DOI: 10.1016/j.acthis.2024.152188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 08/03/2024] [Accepted: 08/12/2024] [Indexed: 09/09/2024]
Abstract
Bone marrow biopsy depends on tissue morphology, immunohistochemical staining, and moleculardetection. Tissue pretreatment is required for bone marrow samples, from clinical specimen acquisition to pathological reporting, but during the process, proteins and nucleic acids are often altered because of the acid in fixation and decalcification solutions. In our study, we present an easy and effective pretreatment protocol and compared this novel pretreatment protocol (Set 2) with an existing traditional pretreatment process (Set 1) using tissue morphology, IHC staining, and molecular pathological analyses. Granulocytic IHC markers showed more intensive staining in samples of Set 2 than in those of Set 1. The Set 2 protocol provided a higher DNA yield and less fragmentation; moreover, samples processed with the Set 2 protocol could be subsequently used in FISH and DNA sequencing assays. Our optimized novel pretreatment protocol could better protect proteins and DNA molecules while maintaining good cell morphology compared to traditional pretreatment The novel pretreatment reagents could role as a reference by more laboratories for pretreating bone marrow biopsy samples and scientific research.
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Affiliation(s)
- Ting Sun
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Liming Xu
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongtian Yao
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jing Zhao
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhen Chen
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zexin Chen
- Department of Science and Development, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Wang
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Ding
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Differential Characteristics of TP53 Alterations in Pure Erythroid Leukemia Arising after Exposure to Cytotoxic Therapy. Leuk Res 2022; 118:106860. [DOI: 10.1016/j.leukres.2022.106860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
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Abstract
OBJECTIVES The pathology report serves as a crucial communication tool among a number of stakeholders. It can sometimes be challenging to understand. A communication barrier exists among pathologists, other clinicians, and patients when interpreting the pathology report, leaving both clinicians and patients less empowered when making treatment decisions. Miscommunication can lead to delays in treatment or other costly medical interventions. METHODS In this review, we highlight miscommunication in pathology reporting and provide potential solutions to improve communication. RESULTS Up to one-third of clinicians do not always understand pathology reports. Several causes of report misinterpretation include the use of pathology-specific jargon, different versions of staging or grading systems, and expressions indicative of uncertainty in the pathologist's report. Active communication has proven to be crucial between the clinician and the pathologist to clarify different aspects of the pathology report. Direct communication between pathologists and patients is evolving, with promising success in proof-of-principle studies. Special attention needs to be paid to avoiding inaccuracy while trying to simplify the pathology report. CONCLUSIONS There is a need for active and adequate communication among pathologists, other clinicians, and patients. Clarity and consistency in reporting, quantifying the level of confidence in diagnosis, and avoiding misnomers are key steps toward improving communications.
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Affiliation(s)
- Lorna Mirham
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Department of Laboratory Medicine, North York General Hospital, Toronto, Canada
| | - Jessica Hanna
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
| | - George M Yousef
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Department of Paediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, Canada
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Riley RS, Gandhi P, Harley SE, Garcia P, Dalton JB, Chesney A. A Synoptic Reporting System to Monitor Bone Marrow Aspirate and Biopsy Quality. J Pathol Inform 2021; 12:23. [PMID: 34447603 PMCID: PMC8356705 DOI: 10.4103/jpi.jpi_53_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 08/13/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives: Bone marrow evaluation plays a critical role in the diagnosis, staging, and monitoring of many diseases. Although there are standardized guidelines for assessing bone marrow specimen quality, there is a lack of evidence-based tools to perform such assessments. The objective was to monitor bone marrow sample quality in real time by standardizing the basic components of a synoptic report and incorporating it into a bone marrow report template. Materials and Methods: A relational database of bone marrow quality parameters was developed and incorporated into our laboratory information system bone marrow report template, with data entry completed during specimen sign out. Data from multiple reports created within a date range were extracted by Structured Query Language query, and summarized in tabular form. Reports generated from these data were utilized in quality improvement efforts. Results: The synoptic reporting system was routinely used to record the quality of bone marrow specimens from adult patients. Data from 3189 bone marrow aspirates, 3302 biopsies, and 3183 biopsy touch imprints identified hemodilution as the principal issue affecting bone marrow aspirate quality, whereas aspiration artifact and fragmentation affected bone marrow biopsy quality. Conclusions: The bone marrow synoptic reporting process was easy to use, readily adaptable, and has proved a useful component of the overall quality assurance process to optimize bone marrow quality.
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Affiliation(s)
- Roger S Riley
- Department of Pathology, VCU School of Medicine, MCV Campus of Virginia Commonwealth University, Richmond, VA, USA
| | | | - Susan E Harley
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AK, USA
| | | | - Justin B Dalton
- Department of Pathology, VCU School of Medicine, MCV Campus of Virginia Commonwealth University, Richmond, VA, USA
| | - Alden Chesney
- Department of Pathology, VCU School of Medicine, MCV Campus of Virginia Commonwealth University, Richmond, VA, USA
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Arber DA, Erba HP. Diagnosis and Treatment of Patients With Acute Myeloid Leukemia With Myelodysplasia-Related Changes (AML-MRC). Am J Clin Pathol 2020; 154:731-741. [PMID: 32864703 PMCID: PMC7610263 DOI: 10.1093/ajcp/aqaa107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives Acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC) represents a high-risk and somewhat diverse subtype of AML, and substantial confusion exists about the pathologic evaluation needed for diagnosis, which can include the patient’s clinical history, cytogenetic analysis, mutational analysis, and/or morphologic evaluation. Treatment decisions based on incomplete or untimely pathology reports may result in the suboptimal treatment of patients with AML-MRC. Methods Using a PubMed search, diagnosis of and treatment options for AML-MRC were investigated. Results This article reviews the current diagnostic criteria for AML-MRC, provides guidance on assessments necessary for an AML-MRC diagnosis, summarizes clinical and prognostic features of AML-MRC, and discusses potential therapies for patients with AML-MRC. In addition to conventional chemotherapy, treatment options include CPX-351, a liposomal encapsulation of daunorubicin/cytarabine approved for treatment of adults with AML-MRC; targeted agents for patients with certain mutations/disease characteristics; and lower-intensity therapies for less fit patients. Conclusions Given the evolving and complex treatment landscape and the high-risk nature of the AML-MRC population, a clear understanding of the pathology information necessary for AML-MRC diagnosis has become increasingly important to help guide treatment decisions and thereby improve patient outcomes.
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Affiliation(s)
- Daniel A Arber
- Department of Pathology, University of Chicago, Chicago, IL
| | - Harry P Erba
- Department of Medicine, Duke University School of Medicine, Durham, NC
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Wang Z, Li Y, Zhou F, Piao Z, Hao J. β-elemene enhances anticancer bone neoplasms efficacy of paclitaxel through regulation of GPR124 in bone neoplasms cells. Oncol Lett 2018; 16:2143-2150. [PMID: 30008912 PMCID: PMC6036473 DOI: 10.3892/ol.2018.8909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/24/2018] [Indexed: 12/19/2022] Open
Abstract
The purpose of the present study was to investigate the anticancer effects of β-elemene and paclitaxel for bone neoplasms. MTT assay, reverse transcription-quantitative polymerase chain reaction, western blotting, flow cytometry and immunostaining were used to analyze the combined effects of β-elemene and paclitaxel both in vitro and in vivo. The results demonstrated that combined treatment of β-elemene and paclitaxel (β-elemene-paclitaxel) significantly inhibited growth and aggressiveness of U-2OS cells compared with either β-elemene or paclitaxel treatment alone. It was demonstrated that β-elemene promoted paclitaxel-induced apoptosis of U-2OS cells. Anti-apoptosis B-cell lymphoma (Bcl)-2 and Bcl-w genes were downregulated and pro-apoptotic Bcl-2-associated agonist of cell death and caspase-3 genes were upregulated in U-2OS cells following treatment with β-elemene-paclitaxel. Treatment of β-elemene-paclitaxel arrested the cell cycle and decreased cyclin-dependent kinase, cyclin-B1, P21 and P27 expression levels and decreased resistant genes alterations of ATP binding cassette subfamily B member 1, LDL receptor related protein and TS in U-2OS cells. Results demonstrated that β-elemene-paclitaxel decreased G-protein coupled receptor 124 (GPR124), vascular endothelial growth factor receptor, matrix metallopeptidase (MMP)-3, MMP-9 expression levels and increased endostatin, TIMP metallopeptidase inhibitor (TIMP)-1, TIMP-2 expression in U-2OS cells. In vivo assay demonstrated that β-elemene-paclitaxel treatment inhibited tumor growth of BALB/c-nu/nu nude mice and prolonged survival rate of tumor-bearing mice. Immunostaining demonstrated that β-elemene-paclitaxel treatment increased apoptotic bodies, GPR124 and increased endostatin, TIMP-1 and TIMP-2 expression in tumor tissues. In conclusion, these results suggest that the combined treatment of β-elemene-paclitaxel is more effective at inhibiting bone neoplasm growth than β-elemene or paclitaxel single treatment GPR124.
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Affiliation(s)
- Zongze Wang
- Department of Orthopedics, Nankai Hospital of Tianjin, Tianjin 300100, P.R. China
| | - Ying Li
- Renal Department of Internal Medicine, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Fengxin Zhou
- Department of Orthopedics, Nankai Hospital of Tianjin, Tianjin 300100, P.R. China
| | - Zhe Piao
- Department of Orthopedics, Nankai Hospital of Tianjin, Tianjin 300100, P.R. China
| | - Jian Hao
- Department of Orthopedics, Nankai Hospital of Tianjin, Tianjin 300100, P.R. China
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Yan B, Wubuli A, Liu Y, Wang X. Long non-coding RNA phosphatase and tensin homolog pseudogene 1 suppresses osteosarcoma cell growth via the phosphoinositide 3-kinase/protein kinase B signaling pathway. Exp Ther Med 2018; 15:4829-4837. [PMID: 29805503 PMCID: PMC5952087 DOI: 10.3892/etm.2018.6021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 12/06/2017] [Indexed: 12/15/2022] Open
Abstract
Osteosarcoma is a common type of human carcinoma, which exhibits a high metastasis and recurrence rate. Previous studies have indicated that long non-coding RNA phosphatase and tensin homolog pseudogene 1 (lnPTENP1) has tumor suppressive action by modulating PTEN expression in different types of tumor cells. However, the potential mechanism by which lnPTENP1 has an effect in osteosarcoma cells remains elusive. In the present study, the role of lnPTENP1 in osteosarcoma cells was investigated and the possible mechanisms by which it functions were explored. It was revealed that lnPTENP1 transfection significantly inhibited osteosarcoma cell growth, proliferation, migration and invasion. LnPTENP1 transfection also significantly promoted apoptosis in Mg63 cells treated with tunicamycin. Further analysis revealed that lnPTENP1 transfection regulated osteosarcoma cell growth via the PI3K/AKT signaling pathway. In vivo assays revealed that lnPTENP1 transfection significantly inhibited osteosarcoma tumor growth and significantly increased the protein expression and phosphorylation levels of PI3K and AKT. In conclusion, the results of the present study indicated that lnPTENP1 may inhibit osteosarcoma cell growth via the PI3K/AKT signaling pathway, which may be a potential novel target for human osteosarcoma therapy.
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Affiliation(s)
- Bin Yan
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830028, P.R. China
| | - Aikepaer Wubuli
- Department of Orthopaedics, North Hospital of People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, Xinjiang 830011, P.R. China
| | - Yidong Liu
- Department of Orthopaedics, Altai People's Hospital, Urumchi, Xinjiang 836500, P.R. China
| | - Xin Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830028, P.R. China
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Yang RK, Nazeef M, Patel SS, Mattison R, Yang DT, Ranheim EA, Leith CP. Improving bone marrow biopsy quality through peer discussion and data comparisons: A single institution experience. Int J Lab Hematol 2018; 40:419-426. [PMID: 29575638 DOI: 10.1111/ijlh.12804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/07/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Bone marrow biopsy (BMB) is crucial for the diagnosis, staging, and monitoring of a variety of hematologic diseases. Obtaining an adequate BMB can be challenging given the need to balance patient comfort with acquisition of high quality specimens. We had observed variable BMB quality at our institution with poor quality specimens sometimes affecting diagnosis. We thus undertook this quality improvement (QI) project to improve the quality of diagnostic BMB specimens. METHODS We used an A3 QI process to identify factors possibly influencing BMB quality. We collected baseline data on 211 BMB, with short and long-term follow-up data on a further 382 cases. We used clinical conferences to discuss data, perform peer comparisons and identify strategies to create a sustainable improvement in BMB quality. RESULTS Baseline data showed that BMB length was influenced most by the individual performer, with some influence of needle gauge. Other factors such as sedation, BMB indication were noncontributory. BMB lengths improved following performer education and individual performer data comparisons (15.2 mm post vs 12.8 mm baseline, P < .0001) and with use of an 8- rather than 11-gauge needle (18.3 mm 8-gauge vs 13.3 mm 11-gauge P < .0001), and were sustained over the long term. CONCLUSIONS Education on BMB standards, sharing of performer data, and changing needle gauge are relatively straightforward methods to improve BMB quality, leading to easier pathology diagnosis.
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Affiliation(s)
- R K Yang
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M Nazeef
- Division of Hematology and Medical Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - S S Patel
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R Mattison
- Division of Hematology and Medical Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - D T Yang
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - E A Ranheim
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C P Leith
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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