Pitfalls in diagnostic molecular pathology - significance of sampling error

Heinmoeller, Ernst and Renke, Birgit and Beyser, Kurt and Dietmaier, Wolfgang and Langner, Cord and Rueschoff, Josef (2001) Pitfalls in diagnostic molecular pathology - significance of sampling error. VIRCHOWS ARCHIV-AN INTERNATIONAL JOURNAL OF PATHOLOGY, 439 (4). pp. 504-511. ISSN 0945-6317

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Abstract

Today, molecular diagnostic tests are widely used in clinical medicine with polymerase chain reaction (PCR)-based techniques being of particular interest. In tissue specimens, however, false-positive and false-negative results can be obtained if pathomorphological and processing aspects are not considered. We therefore studied the impact of tissue sampling in three widely used diagnostic tests: (1) assessment of clonality in B-cell non-Hodgkin's lymphoma, (2) analysis of microsatellite instability (MSI) in colorectal neoplasia, and (3) demonstration of mycobacterium tuberculosis. Tissue sections of routinely formalin-fixed and paraffin-embedded diagnostic specimens were taken, and the significance of sampling was systematically investigated using laser microdissection or processing of the entire section. PCR analyses were done according to standard protocols. False-positive pseudo-monoclonality was obtained in small gastrointestinal biopsies and in laser microdissected lymph follicles of non-neoplastic tonsils. False negativity (pseudo-stability) could be demonstrated in a case with hereditary rectal adenoma if whole tissue sections were taken without microdissection of the most dysplastic subareas. Demonstration of mycobacteria failed in tissue sections of a formalin-fixed lymph node that was positive after complete digestion or in fresh frozen material of the same patient. In diagnostic molecular pathology, sampling error is an important source of false-positive and false-negative results, particularly if disease- and tissue-specific morphological features, such as sample size, type of fixation, and intralesional heterogeneity, are ignored.

Item Type: Article
Uncontrolled Keywords: POLYMERASE-CHAIN-REACTION; NONPOLYPOSIS COLORECTAL-CANCER; B-CELL CLONALITY; MICROSATELLITE INSTABILITY; GENE REARRANGEMENTS; PCR ANALYSIS; BIOPSY SPECIMENS; ADENOMAS; TUBERCULOSIS; CARCINOMAS; molecular pathology; sampling error; B-cell clonality; microsatellite instability; tuberculosis
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Pathologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 07 Dec 2021 07:08
Last Modified: 07 Dec 2021 07:08
URI: https://pred.uni-regensburg.de/id/eprint/41085

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