title: Evaluation of colon cancer histomorphology: a comparison between formalin and PAXgene tissue fixation by an international ring trial.
abstract: The aim of our study was to evaluate the quality of histo- and cytomorphological features of PAXgene-fixed specimens and their suitability for histomorphological classification in comparison to standard formalin fixation. Fifteen colon cancer tissues were collected, divided into two mirrored samples and either formalin fixed (FFPE) or PAXgene fixed (PFPE) before paraffin embedding. HE- and PAS-stained sections were scanned and evaluated in a blinded, randomised ring trial by 20 pathologists from Europe and the USA using virtual microscopy. The pathologists evaluated histological grading, histological subtype, presence of adenoma, presence of lymphovascular invasion, quality of histomorphology and quality of nuclear features. Statistical analysis revealed that the reproducibility with regard to grading between both fixation methods was rather satisfactory (weighted kappa statistic (k w) = 0.73 (95 % confidence interval (CI), 0.41-0.94)), with a higher agreement between the reference evaluation and the PFPE samples (k w = 0.86 (95 % CI, 0.67-1.00)). Independent from preservation method, inter-observer reproducibility was not completely satisfactory (k w = 0.60). Histomorphological quality parameters were scored equal or better for PFPE than for FFPE samples. For example, overall quality and nuclear features, especially the detection of mitosis, were judged significantly better for PFPE cases. By contrast, significant retraction artefacts were observed more frequently in PFPE samples. In conclusion, our findings suggest that the PAXgene Tissue System leads to excellent preservation of histomorphology and nuclear features of colon cancer tissue and allows routine morphological diagnosis.
authors.affiliation: Institute of Pathology, Technische Universität München, Trogerstr. 18, 81675, Munich, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Gündisch
authors.forename: Julia
authors.initials: J
authors.lastname: Slotta-Huspenina
authors.forename: Paolo
authors.initials: P
authors.lastname: Verderio
authors.forename: Chiara Maura
authors.initials: CM
authors.lastname: Ciniselli
authors.forename: Sara
authors.initials: S
authors.lastname: Pizzamiglio
authors.forename: Christina
authors.initials: C
authors.lastname: Schott
authors.forename: Enken
authors.initials: E
authors.lastname: Drecoll
authors.forename: Christian
authors.initials: C
authors.lastname: Viertler
authors.forename: Kurt
authors.initials: K
authors.lastname: Zatloukal
authors.forename: Marcel
authors.initials: M
authors.lastname: Kap
authors.forename: Peter
authors.initials: P
authors.lastname: Riegman
authors.forename: Irene
authors.initials: I
authors.lastname: Esposito
authors.forename: Katja
authors.initials: K
authors.lastname: Specht
authors.forename: Gregor
authors.initials: G
authors.lastname: Babaryka
authors.forename: Martin
authors.initials: M
authors.lastname: Asslaber
authors.forename: Koppany
authors.initials: K
authors.lastname: Bodó
authors.forename: Michael
authors.initials: M
authors.lastname: den Bakker
authors.forename: Jan
authors.initials: J
authors.lastname: den Hollander
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.forename: Jens
authors.initials: J
authors.lastname: Neumann
authors.forename: Simone
authors.initials: S
authors.lastname: Reu
authors.forename: Aurel
authors.initials: A
authors.lastname: Perren
authors.forename: Rupert
authors.initials: R
authors.lastname: Langer
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lugli
authors.forename: Ingrid
authors.initials: I
authors.lastname: Becker
authors.forename: Thomas
authors.initials: T
authors.lastname: Richter
authors.forename: Gian
authors.initials: G
authors.lastname: Kayser
authors.forename: Annette M
authors.initials: AM
authors.lastname: May
authors.forename: Fatima
authors.initials: F
authors.lastname: Carneiro
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Lopes
authors.forename: Leslie
authors.initials: L
authors.lastname: Sobin
authors.forename: Heinz
authors.initials: H
authors.lastname: Höfler
authors.forename: Karl-Friedrich
authors.initials: KF
authors.lastname: Becker
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology; D003110:Colonic Neoplasms / Q000473:pathology*; D005557:Formaldehyde; D006801:Humans; D015588:Observer Variation; D016612:Paraffin Embedding; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D016707:Tissue Fixation / Q000379:methods*; D014584:User-Computer Interface
chemical_list: D011933:Reagent Kits, Diagnostic; D005557:Formaldehyde
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