title: The Symphony protocol for H&E staining of prostatic adenocarcinoma on needle biopsy: a multicentre analysis of 120 cases.
abstract: OBJECTIVE
  The diagnosis of prostate carcinoma is based on a constellation of architectural, nuclear, cytoplasmic, and ancillary features. The aim of this study was to determine if the Ventana Symphony H&E protocol can improve on the detection of prominent nucleoli in foci of prostate cancer.
  
  
  METHODS
  One hundred and twenty cases of Gleason score 3 + 3 = 6 cancers involving 10-30% of one core were retrieved from four academic institutions and two large laboratories (20 cases per institution). The routine H&E and Symphony H&E protocol stained slides from the same case were reviewed centrally in a blinded fashion at the Johns Hopkins Hospital. The mean percentages of prominent nucleoli in malignant and benign glands by visual estimation were recorded for each case. After unblinding, the routine H&E slides were compared in a pair-wise t-test with the corresponding Symphony stained slide.
  
  
  RESULTS
  Within all sites, the Symphony slides showed statistically significantly more prominent nucleoli in the malignant glands than the routine slides.
  
  
  CONCLUSIONS
  The Symphony H&E staining protocol consistently highlights nucleoli in cancer to a greater extent than routine H&E stains and may increase the likelihood of making a diagnosis of limited adenocarcinoma of the prostate in challenging cases.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Adeboye O
authors.initials: AO
authors.lastname: Osunkoya
authors.forename: Donna E
authors.initials: DE
authors.lastname: Hansel
authors.forename: Anil V
authors.initials: AV
authors.lastname: Parwani
authors.forename: Tehmina Z
authors.initials: TZ
authors.lastname: Ali
authors.forename: Ecaterina F
authors.initials: EF
authors.lastname: Tamas
authors.forename: Vasundhara G
authors.initials: VG
authors.lastname: Untawale
authors.forename: Hillel
authors.initials: H
authors.lastname: Kahane
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D001707:Biopsy, Needle; D002466:Cell Nucleolus / Q000473:pathology; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D004801:Eosine Yellowish-(YS); D006416:Hematoxylin