H & E SLIDES • Stained tissue on glass slide. • Required for every case entered on a protocol for central review.
RESOLUTION Re-cuts Must have adequate tissue to show tumor. PROBLEM Pathology departments tend to be possessive of H&E slides. H&E SLIDES
PARAFFIN BLOCKS • The manner in which biopsies are preserved. • Verify the block/blocks submitted includes a portion of the tumor used for diagnosis. • Required on most protocols.
PARAFFINBLOCKS • PROBLEM • Pathology departments tend to be possessive of paraffin blocks.
PLUGSAMPLES • method uses derm needle to remove selected tumor area from paraffin block.
PLUGSAMPLES • Request a Specimen Plug Kit. • Kit contains shipping tube and derm needle.
PLUGSAMPLES • Ask pathologist to select tumor area. • Use the derm needle to punch the selected area from the specimen block.
PLUGSAMPLES • Label needle with specimen ID. • Place derm needle into specimen shipping tube, without removing specimen from needle.
PLUGSAMPLES • Allows your pathology department to keep their original block, while submitting a tissue sample to us for banking.
DISADVANTAGES OF UNSTAINED SLIDES • Easily broken during shipment • Slides become negative for antibody detection in a short time • Difficult to store • Limited amount for staining • Cannot make tissue arrays from slides
ADVANTAGES OF PARAFFIN BLOCKS • Easy to store, no freezer necessary • Hundreds of samples are possible • Not broken in shipping • Antibodies are preserved • Tissue Microarrays are made from paraffin blocks
TISSUEARRAYS • Allows a pathologist to look at many different tumor sections at once. • Helpful in finding common markers in hundreds of patients using only 1 slide, instead of hundreds of slides.
TISSUEARRAYS • Core sample removed from specimen block. • Inserted into blank paraffin block. • Repeated until block is filled with rows of specimens, each representing a different case.
TISSUEARRAYS • Grid chart used for documenting the specific location of each specimen.
TISSUEARRAYS • Sections are cut from array block, and placed on glass slides. • Slides stained for pathologist review.
Share letter written by Dr. Hammond to announce the funding of the tissue repository by the NCI. Explain that patient is participating in research study and has given written permission. PATHOLOGY
REIMBURSEMENT Only offered for submissions which can be used for more than current study. • $200 Block / blocks submitted with tumor. • $200 Plug sample from the block, must contain tumor • $300 Blood, Serum, complex materials. • No reimbursement for H&E only submissions.
SUBMISSION REQUIREMENTS • TISSUE (H&E, blocks, plug samples). One or all may be required per protocol. • Pathology Report. Always required. • RTOG Pathology Submission Form. Always required when tissue is being submitted.
PATHOLOGYSUBMISSIONFORM • MUST check appropriate box on submission form to specify level of patient consent. • Do not send me copy of patients consent.
OUTSIDE HOSPITALS AND LABORATORIES • Make sure they understand importance of including paperwork with the pathology material.
PLEASE GO OUT OF YOUR WAY TO MAKE SURE THAT I RECEIVE EVERYTHING NECESSARY TO PROCESS YOUR PATHOLOGY MATERIAL!
WHAT HAPPENS TO TISSUE SUBMISSIONS • Every piece of paper, every slide and every block is marked with protocol and case number. • Logged on sheet faxed to RTOG Headquarters. • Receipt information entered on calendar. • Send copies of paperwork which is put in patients file. • Tissue is filed until sent to pathologist or for future study.
SENDING TISSUE TO PATHOLOGIST • Periodically or when requested, material is sent to pathologist for central review or for a research study. • I am responsible to collect and send the following material: • Slides • Pathology report • Review form
DATABASE • Our database allows us to account for disclosure of all information.
RTOG TISSUE REPOSITORY • A great resource for even more studies in the future. • To date the tissue bank has currently collected: • 17,251 Cases • 51,410 H & E’s • 16,360 Blocks
RTOG TISSUE REPOSITORY Holly Goold LDS Hospital (801)408-5626 Holly.firstname.lastname@example.org