Abstract

Identifying genetic alterations in tumors is critical for molecular targeting of therapy. In the clinical setting, formalin‐fixed paraffin‐embedded (FFPE) tissue is usually employed for genetic analysis. However, DNA extracted from FFPE tissue is often not suitable for analysis because of its low levels and poor quality. Additionally, FFPE sample preparation is time‐consuming. To provide early treatment for cancer patients, a more rapid and robust method is required for precision medicine. We present a simple method for genetic analysis, called touch imprint cytology combined with massively paralleled sequencing (touch imprint cytology [TIC]‐seq), to detect somatic mutations in tumors. We prepared FFPE tissues and TIC specimens from tumors in nine lung cancer patients and one patient with breast cancer. We found that the quality and quantity of TIC DNA was higher than that of FFPE DNA, which requires microdissection to enrich DNA from target tissues. Targeted sequencing using a next‐generation sequencer obtained sufficient sequence data using TIC DNA. Most (92%) somatic mutations in lung primary tumors were found to be consistent between TIC and FFPE DNA. We also applied TIC DNA to primary and metastatic tumor tissues to analyze tumor heterogeneity in a breast cancer patient, and showed that common and distinct mutations among primary and metastatic sites could be classified into two distinct histological subtypes. TIC‐seq is an alternative and feasible method to analyze genomic alterations in tumors by simply touching the cut surface of specimens to slides.

Highlights

  • In the clinical setting, formalin-f­ixed paraffin-­embedded (FFPE) tumor specimens are commonly used for pathological diagnosis

  • We compared the high confident somatic mutations in touch imprint cytology (TIC) and FFPE DNA to estimate the specificity for detecting somatic mutations in tumors

  • epidermal growth factor receptor gene (EGFR) mutations in six lung adenocarcinomas were 100% concordant according to data from TIC-­seq and the PCR-­Invader assay (Table S4)

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Summary

Introduction

Formalin-f­ixed paraffin-­embedded (FFPE) tumor specimens are commonly used for pathological diagnosis. Recent advances in sequencing technology have led to the identification of genetic alterations in several tumor types using FFPE specimens. Formalin fixation-­induced DNA-­ protein cross-­linking and DNA fragmentation hinders the ability to detect all genetic aberrations [4,5,6]. DNA derived from FFPE tissue is often extensively fragmented during preparation by approaches such as xylene treatment, paraffin embedding, and heat incubation; so, such DNA samples may not be suitable for genetic analysis. It takes several days to prepare these DNA samples from FFPE tissue; it is necessary to improve the technical method for rapidly obtaining accurate genetic results to aid bench–to-­bedside decisions

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