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(Timisoara) An insight into modern digital pathology diagnosis using Immunohistochemistry techniques.
Romania (FASMR) - University of Medicine and Pharmacy "Victor Babes", Timisoara
Prof. dr. DemaAlis, MD, PhD
Dr. Codruța Lăzureanu and Dr. Remus Cornea
Type of Research Project
- Basic science
What is the background of the project?
Immunohistochemistry (IHC) is a tool used to improve the accuracy of the diagnosis and provide information regarding the therapeutic targets in various cancers. Chemotherapy for breast cancer relies on the status of the hormonal receptors and proliferation rate, therefore the proper examination and quantification of immunohistochemical reactions on biopsy and resection specimens is crucial for the outcome of the patient. Recent developments in digital pathology allow rapid computer driven IHC (immunohistochemistry) quantifications on both selected still images and whole slide images obtained on slide-scanners. Our research project aims to study the impact on diagnostic improvement brought by the addition of digital pathology techniques in the pathology lab of the Emergency County Hospital “Pius Branzeu” from Timisoara.
What is the aim of the project?
The aim of the current project is to teach the students about IHC techniques and how to quantify the nuclear staining for several antibodies. This quantification is to be performed using optical microscopy on a regular microscope and digital pathology, on still images and scanned virtual slides (whole slide imaging).
What techniques and methods are used?
Formalin fixed – paraffin embedded tissue samples (mostly breast tumors, but not excluding other) will be stained using IHC (immunohistochemistry) techniques on an automated IHC stainer (Leica Bond). The following primary antibodies will be used: ER (estrogen receptor, PR (progesterone receptor), and Ki67 (cellular marker for proliferation). The resulting slides will then be scanned, along with the corresponding H&E (hematoxylin & eosin morphological staining) slides on an automated slide scanner (Leica Aperio AT2) and stored on the local slide server, which allows remote access for slide examination. For each IHC stained slide, hotspots will be identified and staining quantification will be performed on 10 microscopic fields at x40 objective. Every case will be examined by the student on a regular microscope, on a projection microscope (Leica DMD 108) and the corresponding scanned slide.
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The tasks expected to be accomplished by the student: - Observe the IHC staining techniques – the student will learn the steps required for efficient staining of the cells - Observe and learn the scanning technique, in order to obtain the virtual slides from which the student is to quantify in order to get the final diagnosis. The student will be taught the scanning technique by the tutor - Learn to identify positive and negative nuclear staining (whether the observed cells are positive –thus they have the antigens required for the staining antibodies to bind or not) and also aberrant staining - Learn to identify hotspots – select the areas from the slide which are of importance for the final diagnosis. Then the student will then quantify the result from the observed virtual images. - The student will then create quantification reports about the findings from the overall virtual slide diagnosis. This is for student’s self-evaluation (by following the steps of the work protocol… the results are as follows… and the diagnosis is this one…) - Optionally: Prepare a poster regarding what the student has learnt: the steps, the methods and the results of the IHC virtual diagnosis.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes, there will be theoretical teaching which will introduce the student into the used techniques. The teaching is done using books from which the student can learn. These books will be lent by the department during the internship.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- No specific outcome is expected
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
The candidate needs to be at least a 3rd year medical school student, with good computer skills and know basic microscopy techniques. Previous experience with: microscopy techniques, computer handling.
Are there any legal limitations in the student’s involvement
The student has to sign a patient data confidentiality agreement upon arrival.
Type of students accepted
This project accepts: - Medical students
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