Continuous specimen cooling during slicing and thickness measurement contributes to improved accuracy in image analysis of pathologic specimens

Abstract

We measured section thickness (ST) after slicing using a film thickness meter and investigated the relationship between ST and the percent area of positive staining using computer-assisted image analysis. Methods: Sections were prepared from a paraffin-only block and formalin-fixed paraffin-embedded (FFPE) blocks containing fish sausage and human liver specimens. The ST was compared between the sections prepared with cooling using an ice pack (IP) or a continuous cooling device (CCD) paired with a sliding microtome set at an ST of 4 μm. The sections were stained with eosin or aniline blue, and the association between the percent area of positive staining and ST was determined using computer-aided analysis of images captured with a whole slide scanner. Results: The average STs of the paraffin-only block sections measured by four practitioners were 5.01-5.41 and 4.09-4.33 μm in samples prepared using an IP and a CCD, respectively. Therefore, subsequent analyses included sections prepared using the CCD. The ST of the tissue surface was significantly thinner than that of the paraffin surrounding the tissue section. Furthermore, the percent areas of positive staining for eosin and aniline blue were significantly correlated with ST in both the fish sausage and liver sections. The analysis of the ST and percent area of positive staining in 60 sections of the same block, which were categorized into quantiles based on ST, revealed a significant difference in the percent area of positive staining between the thicker and thinner sections. Discussion: Specimen sectioning should be performed with a CCD, ST should be measured before the staining of pathologic specimens prepared for quantitative analysis, and histologic examination should be performed using specimens with uniform ST.