A Tissue Processing Technique for Improving Slide Preparation Quality of ESD Specimens

The efficacy of endoscopic submucosal dissection (ESD) procedures and subsequent treatment is predominantly reliant on precise pathologic evaluation, intricately linked to specimen sampling and paraffin sectioning. Despite established guidelines in China for ESD specimen processing, the postsampling process remains intricate and error-prone. This study investigates the impact of various placement and labeling methods following ESD sampling on the quality of paraffin slides and the precision of pathologic diagnoses, with the ultimate goal of identifying the most effective approach.

We selected 45 ESD specimens and used 3 distinct postsampling placement and labeling methods: the conventional method, the sponge sandwich placement method, and the sponge interstitial vertical embedding method. Routine HE, IHC, and specific staining were performed to evaluate the effect.

Our findings demonstrated that both the sponge sandwich placement and sponge interstitial vertical embedding methods resulted in superior HE preparation quality compared with the conventional method, with no discernible difference in HE preparation quality between the sponge sandwich and sponge interstitial vertical embedding methods. It was also verified by IHC and special staining. Nevertheless, the sponge sandwich placement method resulted in irregular marking of the dehydration box, making it challenging for technicians to determine the embedding direction of the specimens without a bulge or without remembering the embedding phenomenon. In contrast, the sponge interstitial vertical placement and labeling embedding method obviates the need to recognize the embedding direction of the specimen and tissues to be embedded; embedding is guided solely by the morphology and direction of the doctor-placed sponge.

Based on our laboratory experience, we advocate for the sponge interstitial vertical embedding method.