Limits...
Length of prostate biopsies is not necessarily compromised by pooling multiple cores in one paraffin block: an observational study.

Tolonen TT, Isola J, Kaipia A, Riikonen J, Koivusalo L, Huovinen S, Laurila M, Porre S, Tirkkonen M, Kujala P - BMC Clin Pathol (2015)

Bottom Line: For individual site-designated cores, the median length was 11 mm (range 7 mm -15 mm).The core length was not correlated with the number of cores embedded into one paraffin block (r = 0.015).We conclude that carefully embedded multiple (three to nine) cores per block may yield cores of equal quality in a more cost-efficient way and that current guidelines favoring individually submitted cores may be too strict.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland ; Department of Cancer Biology, Institute of Biomedical Technology, University of Tampere, Tampere, Finland.

ABSTRACT

Background: Individually submitted prostatic needle biopsies are recommended by most guidelines because of their potential advantage in terms of core quality. However, unspecified bilateral biopsies are commonly submitted in many centers. The length of the core is the key quality indicator of prostate biopsies. Because there are few recent publications comparing the quality of 12 site-designated biopsies versus pooled biopsies, we compared the lengths of the biopsies obtained by both methods.

Methods: The material was obtained from 471 consecutive subjects who underwent prostatic needle biopsy in the Tampere University Hospital district between January and June 2013. Biopsies from 344 subjects fulfilled the inclusion criteria. The total number of cores obtained was 4047. The core lengths were measured on microscope slides. Extraprostatic tissue was subtracted from the core length.

Results: The aggregate lengths observed were 129.5 ± 21.8 mm (mean ± SD) for site-designated cores and 136.9 ± 26.4 mm for pooled cores (p = 0.09). The length of the core was 10.8 ± 1.8 mm for site-designated cores and 11.4 ± 2.2 mm for pooled cores (p = 0.87). The median length for pooled cores was 11 mm (range 5 mm - 18 mm). For individual site-designated cores, the median length was 11 mm (range 7 mm -15 mm). The core length was not correlated with the number of cores embedded into one paraffin block (r = 0.015). There was no significant difference in cancer detection rate (p = 0.62).

Conclusions: Our results suggest that unspecified bilateral biopsies do not automatically lead to reduced core length. We conclude that carefully embedded multiple (three to nine) cores per block may yield cores of equal quality in a more cost-efficient way and that current guidelines favoring individually submitted cores may be too strict.

No MeSH data available.


Related in: MedlinePlus

Two complete slide sets illustrating the different workload of site-designated and pooled biopsies. Individual biopsy cores yield twelve slides per subject whereas pooled biopsies yield only four slides.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4373419&req=5

Fig4: Two complete slide sets illustrating the different workload of site-designated and pooled biopsies. Individual biopsy cores yield twelve slides per subject whereas pooled biopsies yield only four slides.

Mentions: It is likely that the most important advantage of individually embedded biopsies is not the biopsy core quality but rather the spared locus information. This is an important issue in selected cases, and site-designated biopsies should be encouraged. On the other hand, the use of multiple biopsies per vial (and paraffin block) is supported by less extensive laboratory loading and better facilities for immunohistochemistry. Our medium-sized laboratory receives biopsies from approximately 1000 patients per year. Widespread use of site-designated biopsies would annually increase the number of paraffin blocks by approximately 10,000, which increases the workload for the pathology laboratory throughout various steps including processing, embedding, sectioning and analyzing. Roughly estimated this would take approximately 80 working days for sectioning only and would increase the time pathologists spend analyzing and reporting prostate biopsies (Figure 4).Figure 4


Length of prostate biopsies is not necessarily compromised by pooling multiple cores in one paraffin block: an observational study.

Tolonen TT, Isola J, Kaipia A, Riikonen J, Koivusalo L, Huovinen S, Laurila M, Porre S, Tirkkonen M, Kujala P - BMC Clin Pathol (2015)

Two complete slide sets illustrating the different workload of site-designated and pooled biopsies. Individual biopsy cores yield twelve slides per subject whereas pooled biopsies yield only four slides.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4373419&req=5

Fig4: Two complete slide sets illustrating the different workload of site-designated and pooled biopsies. Individual biopsy cores yield twelve slides per subject whereas pooled biopsies yield only four slides.
Mentions: It is likely that the most important advantage of individually embedded biopsies is not the biopsy core quality but rather the spared locus information. This is an important issue in selected cases, and site-designated biopsies should be encouraged. On the other hand, the use of multiple biopsies per vial (and paraffin block) is supported by less extensive laboratory loading and better facilities for immunohistochemistry. Our medium-sized laboratory receives biopsies from approximately 1000 patients per year. Widespread use of site-designated biopsies would annually increase the number of paraffin blocks by approximately 10,000, which increases the workload for the pathology laboratory throughout various steps including processing, embedding, sectioning and analyzing. Roughly estimated this would take approximately 80 working days for sectioning only and would increase the time pathologists spend analyzing and reporting prostate biopsies (Figure 4).Figure 4

Bottom Line: For individual site-designated cores, the median length was 11 mm (range 7 mm -15 mm).The core length was not correlated with the number of cores embedded into one paraffin block (r = 0.015).We conclude that carefully embedded multiple (three to nine) cores per block may yield cores of equal quality in a more cost-efficient way and that current guidelines favoring individually submitted cores may be too strict.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland ; Department of Cancer Biology, Institute of Biomedical Technology, University of Tampere, Tampere, Finland.

ABSTRACT

Background: Individually submitted prostatic needle biopsies are recommended by most guidelines because of their potential advantage in terms of core quality. However, unspecified bilateral biopsies are commonly submitted in many centers. The length of the core is the key quality indicator of prostate biopsies. Because there are few recent publications comparing the quality of 12 site-designated biopsies versus pooled biopsies, we compared the lengths of the biopsies obtained by both methods.

Methods: The material was obtained from 471 consecutive subjects who underwent prostatic needle biopsy in the Tampere University Hospital district between January and June 2013. Biopsies from 344 subjects fulfilled the inclusion criteria. The total number of cores obtained was 4047. The core lengths were measured on microscope slides. Extraprostatic tissue was subtracted from the core length.

Results: The aggregate lengths observed were 129.5 ± 21.8 mm (mean ± SD) for site-designated cores and 136.9 ± 26.4 mm for pooled cores (p = 0.09). The length of the core was 10.8 ± 1.8 mm for site-designated cores and 11.4 ± 2.2 mm for pooled cores (p = 0.87). The median length for pooled cores was 11 mm (range 5 mm - 18 mm). For individual site-designated cores, the median length was 11 mm (range 7 mm -15 mm). The core length was not correlated with the number of cores embedded into one paraffin block (r = 0.015). There was no significant difference in cancer detection rate (p = 0.62).

Conclusions: Our results suggest that unspecified bilateral biopsies do not automatically lead to reduced core length. We conclude that carefully embedded multiple (three to nine) cores per block may yield cores of equal quality in a more cost-efficient way and that current guidelines favoring individually submitted cores may be too strict.

No MeSH data available.


Related in: MedlinePlus