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Updated: Jan 23, 2026

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Is the Mirror Image Method Really Useful in Tumor Tissue Bank Quality Control?

Oriane Dudez1, Véronique Dalstein1,2,3, Lukshe Kanagaratnam4

  • 1Pathology Department, Academic Hospital, Reims, France.

Biopreservation and Biobanking
|June 25, 2019
PubMed

Insights

The mirror image method is not reliable for quality control of frozen colon cancer samples. Microscopic and molecular analysis showed poor concordance, failing to ensure sample integrity for oncology research.

Area of Science:

  • Oncology
  • Pathology
  • Biobanking

Background:

  • High-quality tumor samples are crucial for oncology research.
  • Microscopic examination ensures frozen sample integrity, including tumor cell content.
  • Biobanks store valuable tumor samples for future studies.

Purpose of the Study:

  • To assess the effectiveness of the mirror image method for quality control of frozen colonic adenocarcinoma samples.
  • To compare microscopic and molecular concordance between frozen samples and their formalin-fixed, paraffin-embedded mirror images.
  • To determine if the mirror image method is a suitable alternative for quality assurance in tumor banking.

Main Methods:

  • 82 colon adenocarcinoma samples and paired mirror image controls were analyzed.
  • Microscopic concordance was evaluated for differentiation grade, cell percentages, necrosis, mucinous component, and ulceration.
  • Molecular concordance for KRAS mutation status was assessed in 76 samples.

Main Results:

  • Morphological concordance was good for mucinous component (ICC=0.81) but poor for ulceration (k=0.08) and necrosis (ICC=0.13).
  • Molecular concordance for KRAS status was almost perfect (95% correspondence, k=0.88).
  • Despite good KRAS concordance, overall microscopic concordance was insufficient.

Conclusions:

  • The mirror image method is not a reliable substitute for microscopic quality control of frozen colonic adenocarcinoma samples.
  • While molecular concordance for KRAS was high, it does not compensate for poor morphological assessment.
  • This method is unsuitable for ensuring the quality and integrity of banked tumor samples for research.
Keywords:
RNA qualitybiobankingcolorectal cancermirror samplepathology

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