Comparison of three cell block techniques for detection of low frequency abnormal cells

Steven A Hecht, Matthew McCormackHologic Inc, Marlborough, MA, USABackground: The Cellient Automated Cell Block System rapidly creates paraffin-embedded cell blocks by using vacuum filtration to deposit a layer of cells on a filter and infiltrate those cells with reagents and paraffin. This study used a “tracer” cell model to mimic low frequency abnormal cells and compare detection and representative sampling with simple sedimentation, Richard-Allan HistoGel , and Cellient cell block techniques.Methods: Tracer cells were a cultured cell line (CaSki) fixed in methanol, prestained in solution with hematoxylin, and quantified using a hemacytometer. Tracer cells were diluted in a 10-fold dilution series ranging from 100 to 0.1 tracer/mL in a background of pooled clinical serous effusion specimens. Ten replicates of each dilution were processed using each cell block method, and the resulting blocks were cut to produce two slides from each block. The slides were deparaffinized, counterstained with eosin, cover-slipped, and screened for the presence of tracer cells. Blocks were considered to be representative of the specimen if tracer cells were detected on either of the slides. If no tracer cells were observed on either slide, the block was recut to generate a third slide. If tracer cells were seen on the third slide, the block was considered representative of the specimen.Results: Tracer cells were identified on the initial slides for 20 of 40 (50.0%) simple sedimentation, 21 of 40 (52.5%) of HistoGel, and 25 of 40 (62.5%) of Cellient cell blocks. Representative sampling of the 1 tracer/mL specimen was 10.0% for simple sedimentation and 30.0% for HistoGel and Cellient. Only Cellient showed representative sampling of the 0.1 tracer/mL specimen.Conclusion: The Cellient System blocks demonstrated representative sampling at the lowest tracer cell concentration compared with simple sedimentation and HistoGel.Keywords: Cellient , HistoGel , simple sedimentation, CaSki, microtomy