Winter Meeting 2011 - The Pathological Society of Great Britain ...

P1
The Retention and Storage of Post-mortem Tissue
P CVL Randall; D Hilton
Derriford Hospital, Plymouth, United Kingdom
Following increased public and media awareness the Human Tissue Act 2004 was
implemented to protect families from unnecessary distress by providing a clear
legal framework for the correct retention and storage of post-mortem tissues. In our
department post-mortem tissue is taken with the coroner’s permission and retained under
their authority until released. The family then has 3 months to give their consent for
either storage, disposal or return of the tissue. If consent is not returned, there is a legal
obligation to dispose of the tissue.
The aim of the study was to ensure that our Trust was achieving the correct standards
in tissue retention and storage, in relation to the HTAct, and to highlight areas for
improvement.
We reviewed 194 post-mortems from April to June 2008. The post-mortem reports, the
post-mortem histology forms and returned relatives consent forms were reviewed and
compared with the laboratory files of slides, blocks and wet tissue.
We found that 26% of cases had histology taken, approximately 600 blocks of tissue. One
case (2%) indicated that 4 lung blocks were taken when in fact only 3 were taken. Six cases
(12%) had some inaccuracies of exactly which samples were retained stated on the consent
form sent to the relatives by the Coroner. All returned consent instructions were followed
correctly. More than 50% requested storage in the hospital. 3 cases (6%) were misfiled due
to mislabelling. There were no slides, blocks or wet tissue in file that should have been
disposed of or returned to families.
In a busy department where many people are involved in a complicated multi-step
process errors are likely to occur. However our study showed a high level of performance
with only minor errors requiring improvement in filing, coding and correct form details.
Several of these areas have already been addressed with alterations to the forms for
recording post-mortem histology and relative’s consent.
P3
Contribution of Stroma to Breast Cancer Outcome
P SA Simpkins; AM Hanby; D Treanor; V Speirs; DL Holliday
Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United
Kingdom
Cancer associated fibroblasts (CAFs) form a major component of breast cancer stroma.
Altered protein expression in CAFs can alter tumour cell behaviour and impact on
tumour progression and patient prognosis. Recently a role for caveolin-1 (cav-1) in
predicting breast cancer progression was identified with loss of expression associated
with increased metastasis and poor prognosis. Activation of fibroblasts demonstrated by
α-smooth muscle actin (α-SMA) expression is linked to the cancer invasion-promoting
phenotype. In addition the presence of more stroma (hence more CAFs), determined by
measuring the stroma-tumour ratio has been associated with poor prognosis in breast
cancer. The aim of this study was to test the hypothesis that CAF phenotype and their
proportional relationship to tumour epithelial cells predict breast cancer progression
and prognosis. With ethical approval, immunohistochemistry for cav-1 and α-SMA was
performed on 140 cases of breast cancer with known clinico-pathological data and follow
up (mean follow up: 91 months). Using α-SMA staining to identify CAFs cav-1 staining
was scored as strong, weak or absent. Stromal content was assessed by point counting on
virtual tissue sections and tumour-stroma ratio calculated using an in-house computer
algorithm. Cases with >50% stroma were classed as stroma-rich; those with