Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens

ABSTRACT Background Multiplex genetic testing is recommended when treating nonsmall cell lung cancer. A certain percentage of test failures in RNA assays owing to poor surgical specimen quality have been documented, and fixation failure is a possible cause. At our institution, sheet‐like fixation is...

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Main Authors: Takashi Teishikata, Manabu Itoh, Yusuke Okamoto, Naofumi Miyahara, Chiho Nakashima, Koichiro Takahashi, Masafumi Hiratsuka, Keita Kai, Keiji Kamohara
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.70005
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author Takashi Teishikata
Manabu Itoh
Yusuke Okamoto
Naofumi Miyahara
Chiho Nakashima
Koichiro Takahashi
Masafumi Hiratsuka
Keita Kai
Keiji Kamohara
author_facet Takashi Teishikata
Manabu Itoh
Yusuke Okamoto
Naofumi Miyahara
Chiho Nakashima
Koichiro Takahashi
Masafumi Hiratsuka
Keita Kai
Keiji Kamohara
author_sort Takashi Teishikata
collection DOAJ
description ABSTRACT Background Multiplex genetic testing is recommended when treating nonsmall cell lung cancer. A certain percentage of test failures in RNA assays owing to poor surgical specimen quality have been documented, and fixation failure is a possible cause. At our institution, sheet‐like fixation is performed to reduce fixation time. This study aimed to compare the quality of RNA from resected lung cancer specimens following different fixation methods. Methods Sheet‐like fixation specimens (n = 15), conventional fixation specimens of the same resected lungs (n = 15), and other lung cancer specimens collected for conventional fixation and subjected to multiplex gene‐panel testing (n = 22) were retrospectively examined. RNA was extracted from each specimen. RNA quality and quantity were compared, and the success rate of multiplex gene‐panel testing was determined. Results The DV200 value was significantly higher in RNA extracted from sheet‐like fixation samples (median 47.5%, interquartile range [IQR]:40.3–51.5) compared with RNA extracted from conventionally fixed samples or conventionally fixed samples of other patient specimens (median 21%, IQR:5.3–29.8 and median 16.3%, IQR:9.5–27.1, respectively). No significant difference was observed in nucleic acid concentration. The multiplex genetic analysis success rate was 95% with conventional methods (one failure); however, it was 100% with the sheet‐like fixation method. Conclusion Sheet‐like fixation preserved RNA extracted from lung cancer specimens, resulting in lesser degradation than with conventional fixation.
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publishDate 2025-01-01
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series Thoracic Cancer
spelling doaj-art-cbe0ca926d53400bbd7ef596682862252025-01-30T22:40:34ZengWileyThoracic Cancer1759-77061759-77142025-01-01162n/an/a10.1111/1759-7714.70005Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung SpecimensTakashi Teishikata0Manabu Itoh1Yusuke Okamoto2Naofumi Miyahara3Chiho Nakashima4Koichiro Takahashi5Masafumi Hiratsuka6Keita Kai7Keiji Kamohara8Department of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanDepartment of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanDepartment of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanDepartment of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine Faculty of Medicine, Saga University Saga JapanDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine Faculty of Medicine, Saga University Saga JapanDepartment of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanDepartment of Pathology Faculty of Medicine, Saga University Saga JapanDepartment of Thoracic and Cardiovascular Surgery Faculty of Medicine, Saga University Saga JapanABSTRACT Background Multiplex genetic testing is recommended when treating nonsmall cell lung cancer. A certain percentage of test failures in RNA assays owing to poor surgical specimen quality have been documented, and fixation failure is a possible cause. At our institution, sheet‐like fixation is performed to reduce fixation time. This study aimed to compare the quality of RNA from resected lung cancer specimens following different fixation methods. Methods Sheet‐like fixation specimens (n = 15), conventional fixation specimens of the same resected lungs (n = 15), and other lung cancer specimens collected for conventional fixation and subjected to multiplex gene‐panel testing (n = 22) were retrospectively examined. RNA was extracted from each specimen. RNA quality and quantity were compared, and the success rate of multiplex gene‐panel testing was determined. Results The DV200 value was significantly higher in RNA extracted from sheet‐like fixation samples (median 47.5%, interquartile range [IQR]:40.3–51.5) compared with RNA extracted from conventionally fixed samples or conventionally fixed samples of other patient specimens (median 21%, IQR:5.3–29.8 and median 16.3%, IQR:9.5–27.1, respectively). No significant difference was observed in nucleic acid concentration. The multiplex genetic analysis success rate was 95% with conventional methods (one failure); however, it was 100% with the sheet‐like fixation method. Conclusion Sheet‐like fixation preserved RNA extracted from lung cancer specimens, resulting in lesser degradation than with conventional fixation.https://doi.org/10.1111/1759-7714.70005lung cancermultiplex gene‐panel testingRNA preservation
spellingShingle Takashi Teishikata
Manabu Itoh
Yusuke Okamoto
Naofumi Miyahara
Chiho Nakashima
Koichiro Takahashi
Masafumi Hiratsuka
Keita Kai
Keiji Kamohara
Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
Thoracic Cancer
lung cancer
multiplex gene‐panel testing
RNA preservation
title Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
title_full Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
title_fullStr Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
title_full_unstemmed Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
title_short Examining the Formalin Fixation Method for Maintaining High RNA Quality in Surgical Lung Specimens
title_sort examining the formalin fixation method for maintaining high rna quality in surgical lung specimens
topic lung cancer
multiplex gene‐panel testing
RNA preservation
url https://doi.org/10.1111/1759-7714.70005
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