A multi-site cutting device implements efficiently the divide-and-conquer strategy in tumor sampling

Area of Science:

• Pathology
• Oncology
• Surgical Pathology

Background:

• Intra-tumor heterogeneity detection is crucial for accurate cancer diagnosis and treatment.
• Current routine tumor sampling protocols may not adequately capture this heterogeneity.
• The Divide-and-Conquer (DAC) strategy has shown promise in improving heterogeneity detection.

Purpose of the Study:

• To describe a practical laboratory implementation of the Divide-and-Conquer (DAC) strategy for tumor sampling.
• To present a novel, time-efficient method for processing large surgical specimens in pathology.
• To enhance the detection of intra-tumor heterogeneity in clear cell renal cell carcinomas.

Main Methods:

• A novel method utilizing a cutting grid device for uniform tissue sampling.
• Thin slicing of tumor specimens followed by grid-based sectioning into tissue cubes.
• Systematic selection and processing of tissue cubes for histological analysis.

Main Results:

• The described method ensures thorough sampling of large surgical specimens.
• It significantly facilitates the demonstration of intra-tumor heterogeneity.
• The protocol saves considerable time for pathologists in daily practice, processing 80 fragments in 10 cassettes for a 10 cm tumor.

Conclusions:

• The implemented DAC strategy offers a superior approach to routine tumor sampling for detecting heterogeneity.
• This method is practical, efficient, and enhances diagnostic accuracy for renal cell carcinomas.
• Adoption of this technique can improve the pathological assessment of intra-tumor heterogeneity.