2004 Summer Meeting - Amsterdam - The Pathological Society of ...

1
Validation of Tissue Microarray Technology using Cervical
Adenocarcinoma and its Precursors as a Model System
MMT EL-Mansi , DJ Harrison , ARW Williams
Edinburgh Medical school, Edinburgh, United Kingdom
The recent development of tissue microarray (TMA) technology has potentiated
large-scale retrospective cohort studies using archival formalin-fixed, paraffinembedded
tissues. One obstacle to broad acceptance of TMAs is that they
reduce the amount of tissue analyzed from a whole tissue section to a disk of
0.6mm diameter. In this study, we used a large series of cervical adenocarcinomas
to investigate TMA technology in assessment of
immunohistochemical staining. A TMA was constructed using 273 archival
paraffin blocks from a series of 139 patients with 119 invasive and 20
preinvasive cervical adenocarcinomas, and 16 normal controls. Two cores were
obtained from specific regions of donor blocks selected at histological review,
and subsequently were arrayed into a recipient block. The novel array blocks
and some whole donor blocks were sectioned and used for immunohistochemical
analysis for CEA, CK7 and CK20. We compared staining in the
microarray disks with the whole tissue sections. The TMA was found to yield
good immunohistochemical staining which was concordant with that of the
whole section from which it originated. Two TMA cores achieved
representation of the whole section in immunohistochemical studies in over
95% of cases. Our results suggest that TMAs can be successfully used for
immunohistochemical studies of cervical adenocarcinomas. The TMA
technique is a rapid, cost effective, and tissue-saving method for highthroughput
immunohistochemical studies. The areas sampled from donor
blocks must be selected by careful review of sections from the original blocks,
and we have shown the cores to accurately represent the morphology of the
tumour in all cases. Two cores will provide representative
immunohistochemical results in over 95% of cases.
2
BMD In hrHPV Positive Women Is Age Dependent And Is
Probably A Cytopathological Effect Of A Primary HrHPV
Infection
NWJ Bulkmans 1 , L Rozendaal 1 , PJF Snijders 1 , FJ Voorhorst
1 , AJP Boeke 1 , GRJ Zandwijken 1 , FJ van Kemenade 1 , RHM
Verheijen 1 , K van Groningen 2 , ME Boon 3 , HJF Keuning 4 , M
van Ballegooijen 5 , AJC van den Brule 1 , CJLM Meijer 1
1 VU Universtity Medical Centre, Amsterdam, Netherlands, 2
Spaarneziekenhuis, Heemstede, Netherlands, 3 Leiden Cytology and
Pathology Laborotory, Leiden, Netherlands, 4 Stichting PA Laboratorium
Kenemmerland, Haarlem, Netherlands, 5 Erasmus Medical Centre,
Rotterdam, Netherlands
POBASCAM is a population-based randomised-controlled trial to implement
hrHPV-testing in cervical screening, comparing hrHPV-testing & cytology with
cytology & hrHPV-blinded. Here, we present the baseline data.
Between January 1999 and September 2002, 44,102 women, mean age 42.8
years, were included. The presence of hrHPV was age-dependent, decreasing
from 12.0% at 29-33 years to 2.4% at 59-61 years. In the intervention group the
distribution of cytology hrHPV by cytology class was normal cytology 96.6%
(3.6% hrHPV-positive), borderline and mild dyskaryosis (BMD) 2.5% (34.6%
hrHPV-positive), and moderate dyskaryosis or worse (>BMD) 0.8% (88.3%
hrHPV-positive). In the control group, 96.5% normal cytology, 2.4% BMD and
0.8% >BMD. When stratified to hrHPV-status, in hrHPV-negative women the
prevalence of BMD or >BMD were low and independent of age. In hrHPVpositive
women, the prevalence of >BMD (13.7%) was also independent of age,
i.e., women with an hrHPV-infection have a flat risk of having severe cervical
lesions. In contrast, in women with a positive hrHPV-test the prevalence of
BMD was age-dependent, (p for trend