title: Multi-site tumor sampling (MSTS) improves the performance of histological detection of intratumor heterogeneity in clear cell renal cell carcinoma (CCRCC).
abstract: Current standard-of-care tumor sampling protocols for CCRCC (and other cancers) are not efficient at detecting intratumoural heterogeneity (ITH). We have demonstratedin silicothat an alternative protocol, multi-site tumor sampling (MSTS) based upon the divide and conquer (DAC) algorithm, can significantly increase the efficiency of ITH detection without extra costs. Now we test this protocol on routine hematoxylin-eosin (HE) sections in a series of 38 CCRCC cases. MSTS was found to outperform traditional sampling when detecting either high grade (p=0.0136) or granular/eosinophilic cells (p=0.0114). We therefore propose that MSTS should be used in routine clinical practice.
authors.affiliation: Department of Pathology, Complejo Hospitalario B de Navarra, Pamplona, Navarra, 31008, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Guarch
authors.affiliation: Quantitative Biomedicine Unit, Biocruces Research Institute, Barakaldo, 48903, Spain; Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Cortés
authors.affiliation: Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain; Molecular Oncology Group, Biodonostia Research Institute, San Sebastian, 20014, Spain; Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Lawrie
authors.affiliation: Department of Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, 48903, Spain; Biomarkers in Cancer Unit, Biocruces Research Institute, Barakaldo, 48903, Spain.
authors.forename: José I
authors.initials: JI
authors.lastname: López
keywords: Intratumor heterogeneity; clear cell renal cell carcinoma; multi-site tumor sampling grade; pathology; tumor sampling