Molecular-friendly histopathology: Validation of a robust platform

The rapidly expanding fields of pharmacogenomics and pharmacodiagnostics have presented pathology laboratories with many challenges and opportunities. As custodians of patient tissues, these laboratories are in the logical position to perform biomolecular testing for proper management of patients. To meet these challenges, the histopathology laboratories of the twenty-first century should strive to design and execute a biomarker-friendly, standardized tissue handling, including fixation and processing, to ensure uniform protection of macromolecules for clinically useful molecular assays. This important preanalytical phase cannot be successful if tissues are handled in the traditional manner that includes the use of conventional fixation and processing. In fact, the newly developed alternative fixation and processing methods are rapidly replacing the time-honored routine formalin fixation and overnight processing. In this article, we describe our experience with such a new platform that not only produces good histomorphology but also preserves high-quality RNA, DNA, and proteins in the paraffin-embedded histologic material.