Multi-site tumor sampling (MSTS) improves the performance of histological detection of intratumor heterogeneity in clear cell renal cell carcinoma (CCRCC)

Rosa Guarch; Jesús M Cortés; Charles H Lawrie; José I López

doi:10.12688/f1000research.9419.2

Multi-site tumor sampling (MSTS) improves the performance of histological detection of intratumor heterogeneity in clear cell renal cell carcinoma (CCRCC)

F1000Res. 2016 Aug 17:5:2020. doi: 10.12688/f1000research.9419.2. eCollection 2016.

Authors

Rosa Guarch¹, Jesús M Cortés², Charles H Lawrie³, José I López⁴

Affiliations

¹ Department of Pathology, Complejo Hospitalario B de Navarra, Pamplona, Navarra, 31008, Spain.
² Quantitative Biomedicine Unit, Biocruces Research Institute, Barakaldo, 48903, Spain; Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.
³ Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain; Molecular Oncology Group, Biodonostia Research Institute, San Sebastian, 20014, Spain; Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Radcliffe Department of Medicine, University of Oxford, Oxford, OX3 9DU, UK.
⁴ Department of Pathology, Cruces University Hospital, University of the Basque Country (UPV/EHU), Barakaldo, 48903, Spain; Biomarkers in Cancer Unit, Biocruces Research Institute, Barakaldo, 48903, Spain.

Abstract

Current standard-of-care tumor sampling protocols for CCRCC (and other cancers) are not efficient at detecting intratumoural heterogeneity (ITH). We have demonstrated in silico that an alternative protocol, multi-site tumor sampling (MSTS) based upon the divide and conquer (DAC) algorithm, can significantly increase the efficiency of ITH detection without extra costs. Now we test this protocol on routine hematoxylin-eosin (HE) sections in a series of 38 CCRCC cases. MSTS was found to outperform traditional sampling when detecting either high grade (p=0.0136) or granular/eosinophilic cells (p=0.0114). We therefore propose that MSTS should be used in routine clinical practice.

Keywords: Intratumor heterogeneity; clear cell renal cell carcinoma; multi-site tumor sampling grade; pathology; tumor sampling.

Grants and funding

CHL and JMC acknowledge financial support from Ikerbasque: The Basque Foundation for Science. This work was partially funded by grant SAF2013-48812-R from Ministerio de Economía y Competitividad (Spain).