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43 protocols using benchmark ultra autostainer

1

Histological Analysis of Human Granulation Tissue

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Our experiments were performed on two samples of human granulation tissue. The first sample was a set of eight consecutively sliced tissue sections of H&E-stained granulation tissue. The second one was a set of ten consecutive tissue sections of a CD31-stained granulation tissue. The thickness of the sections was 4 µm for the H&E and 3 µm for the CD31 samples. For both staining methods, the fresh tissue was first fixed in 5% formalin and then embedded in paraffin. The formalin-fixed paraffin-embedded (FFPE) tissue blocks were cut into consecutive sections and mounted onto glass slides. For the H&E staining, the tissue was deparaffinized, rehydrated and then stained in Mayer’s hematoxylin and eosin. The immunohistochemical staining of CD31 was performed with the help of a BenchMark Ultra autostainer (Ventana Medical Systems, Oro Valley, AZ, USA) employing a mouse anti-CD31 antibody (1:40; clone JC70A; Dako, Glostrup, Denmark). After staining both the H&E and CD31, the slides were covered with glass cover slips and were scanned as whole slide images (WSI) via the PreciPoint M8 slide scanner (PreciPoint GmbH, Freising, Germany) with a 20× objective (Olympus UPlan FLN 20×, Olympus, Tokyo, Japan). The resolution observed at maximum zoom was 0.28 µm per pixel.
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2

Immunohistochemical Staining of HLA-DR

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IHC staining for HLA-DR was performed as previously described3 (link). Briefly, 4 µm FFPE sections were stained using an HLA-DR antibody (Santa Cruz Biotechnology (sc-53319) in a Ventana BenchMark™ ULTRA autostainer. Sections were de-paraffinized and subject to antigen retrieval using Cell Conditioning 1 (CC1, pH 8.5) for 64 minutes at 95 °C. The primary antibody was applied at a concentration of 1:1000. Interpretation was performed as previously described3 (link).
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3

Immunohistochemical Analysis of Serpins

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Sections of 3 µm-thick, formalin-fixed, paraffin-embedded tissue were cut and placed on Superfrost Plus microscope slides. The slides were heated for one hour at 60 °C in a dry oven to enhance tissue attachment and soften the paraffin. The immunohistochemistry procedure was performed on a Ventana BenchMark ULTRA autostainer using the standard protocol. In summary, the sections underwent deparaffinization, rehydration, and antigen retrieval using CC1 (prediluted, PH 8.0) antigen retrieval solution (Ventana). The primary antibodies were added and incubated with the sections at a dilution suggested by the manufacturer. The following primary antibodies were used: mouse monoclonal anti-human SerpinB3/SCCA [clone OTI1A5] (ab180396, Abcam, Cambridge, MA, USA, 1:100 dilution) and rabbit monoclonal anti-human α 1 Antitrypsin (Serpina1) [clone EPR17087-50] (ab207303, Abcam, Cambridge, MA, USA, 1:400 dilution). The visualization process was performed using the Ultraview universal DAB IHC detection kit, and it was afterwards counterstained using hematoxylin and bluing solution. The slides were gently cleaned, dehydrated in graded ethanol and xylene, and then mounted using mounting media on a microscope slide.
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4

Detecting MCPyV and HPV in OCC

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A tissue microarray was constructed using JHH OCC samples with available formalin-fixed, paraffin-embedded (FFPE) tissue blocks. Antigen retrieval was performed on deparaffinized, 4 micron sections using 10 mM citrate buffer at 92°C for 30 minutes. A mouse monoclonal antibody for MCPyV Large T-antigen (Santa Cruz Biotechnology, Dallas, TX; clone CM2B4; 1:500 dilution) was applied using a BenchMark Ultra autostainer (Ventana Medical Systems, Tucson, AZ). Signals were visualized using the UltraView polymer detection kit (Ventana). Staining was performed according to manufacturer’s instructions with a known positive case of Merkel cell carcinoma as a positive control and benign tonsillar tissue as a negative control. The presence of staining was assessed by a head and neck pathologist (LR).
Human papillomavirus (HPV) testing was performed on evaluable whole-slide specimens from all sites using p16 immunohistochemistry and HPV RNA in situ hybridization (ISH) for high-risk types as described elsewhere9 (link).
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5

Immunohistochemistry of c-Met in Formalin-Fixed Paraffin-Embedded Tumors

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After ex vivo imaging, the specimen was formalin-fixed, sectioned and then paraffin-embedded. IHC of the formalin-fixed paraffin-embedded tumor samples was performed on a BenchMark Ultra autostainer (Ventana Medical Systems, Oro Valley, AZ, USA). In brief, 3 µm paraffin sections were deparaffinized with the EZ prep solution (Ventana Medical Systems), and heat-induced antigen retrieval was carried out using Cell Conditioning 1 (Ventana Medical Systems). Hereafter, sections were incubated with an anti-c-MET antibody (clone SP44; Roche Diagnostics, Rotkreuz, Switserland), and an UltraView Universal DAB Detection Kit (Ventana Medical Systems) was used to visualize the c-Met expression. Slides were counterstained with Hematoxylin and Bluing Reagent (Ventana Medical Systems). Due to the lack of a quantitively read-out in routine immunohistochemistry, the c-Met expression levels were visually scored by a dedicated pathologist. Scoring was based on the intensity of the UltraView signal (four classifications were used: no staining, weak, moderate and strong, respectively −, +, ++, +++). Both membrane and cytoplasmic staining were noted. Since c-Met is considered a membrane-bound biomarker [9 (link)], membranous staining was leading in the scoring.
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6

Immunohistochemical Analysis of PD-L1 Expression

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Immunohistochemistry of the FFPE tumor samples was performed on a BenchMark Ultra autostainer (Ventana Medical Systems). Briefly, paraffin sections were cut at 3 µm, heated at 75°C for 28 min, and deparaffinized in the instrument with EZ prep solution (Ventana Medical Systems). Heat-induced antigen retrieval was carried out using Cell Conditioning 1 (CC1; Ventana Medical Systems) for 48 min at 95°C. PD-L1 clone 22C3 (DAKO) was detected using 1:40 dilution. Bound antibody was visualized using the OptiView DAB Detection Kit (Ventana Medical Systems). Slides were counterstained with hematoxylin II and bluing reagent (Ventana Medical Systems). After staining, slides were scanned with the P1000 (Sysmex). An experienced pathologist determined the tumor proportion score (TPS; the percentage of tumor cells with complete or partial membranous staining at any intensity) using Slide Score (https://www.slidescore.com). The TPS was classified as being <1%, 1–50%, >50%, or not evaluable (due to pigmentation or little to no tumor cells).
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7

Fused-USgFNAC Cytology and Immunohistochemistry for Head and Neck Tumors

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Cytological results in nodes for which Fused-USgFNAC was performed were refereed as reference standard. Part of the FNAC material was processed in smears, air-dried and stained with Giemsa stain. Another portion of every aspirate was fixed in 10 mL 4% formalin and embedded in paraffin for further immunohistochemistry examination if deemed necessary, according to routine diagnostic workup. All samples were evaluated by experienced head and neck pathologists in a clinical setting and the cytological results were used retrospectively. HPV status was assessed immunohistochemically on formalin-fixed paraffin-embedded tissue samples from tumor biopsies or resections during standard routine diagnostic procedures. Antibodies for p53 (DO-7, 1/7000, DAKO) and p16 (E6H4; ready to use, Ventana Medical systems/Roche/Arizona, USA) were used in a Benchmark ULTRA autostainer (Ventana Medical systems). Reactions were detected using the OptiView DAB Detection kit (#760-700; Roche) for visualization of p16 and p53. Finally, the slides were counterstained with Hematoxylin II and Bluing Reagent (Ventana Medical Systems).
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8

Immunohistochemical Staining of Tissue Arrays

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Immunohistochemical staining of the tissue arrays was performed according to standard protocols.[19 (link)] In brief, slides were deparaffinized and, after heat-induced antigen retrieval and blocking, incubated with the primary antibody. The primary antibodies and staining conditions were as follows: TGF-Δ1: Acris, #DM1047, dilution 1:100, pretreatment in EDTA-buffer for 36 min.; TGF-Δ2: Acris, #AP15815PU-S, 1:25, EDTA-buffer for 36 min.; Santa Cruz, #sc-90, 1:25, citrate-buffer for 30 min.; p-Smad2/3: Cell Signaling, #3101, 1:200, citrate-buffer for 20 min. Immunoreactivity was detected using 3,3′-diaminobenzidine tetrahydrochloride (DAB) as a chromogen. Stainings for p-Smad2/3 and TGF-Δ2 (for the Santa Cruz antibody) were performed manually using the EnVisionTM Detection System (Dako, # K406511-2). Stainings for TGF-Δ1 and TGF-Δ2 (Acris antibody) were performed on the Benchmark Ultra Autostainer (Ventana/Roche, Mannheim, Germany) using the reagents and detection systems supplied by the vendor. As positive controls we used human placenta tissue for both TGF-Δ2 antibodies, human tonsil tissue for TGF-Δ1 staining and cirrhotic liver tissue for p-Smad2/3 detection.
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9

Immunohistochemical Evaluation of MET

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MET immunohistochemical staining (MET-IHC) was evaluated using a Benchmark Ultra Autostainer (Ventana, Tucson, AZ) with anti-total c-MET (SP44) rabbit monoclonal primary antibody (Ventana, Tucson, AZ), following the manufacturer’s instructions. Staining was scored by determining the percentage of cells showing weak (1+), moderate (2+), or strong (3+) membranous staining. MET overexpression was considered as positive if ≥ 50% of tumor cells showing cellular membrane staining at an intensity of “2+” or “3+” [37 (link)]. Scoring was performed independently by two individuals and any discrepant cases were re-evaluated for the final interpretation.
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10

Immunohistochemical Analysis of Formalin-Fixed Paraffin-Embedded Tissue

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Formalin-fixed paraffin-embedded tissue was collected from the archives of the pathology division of our hospital. Hematoxylin–eosin archival slides were revised by an expert pathologist and the diagnosis was confirmed in all cases. The most representative slide of each sample was selected for IHC in cases with available material. Specifically, three-micron-thick serial paraffin sections of each case were processed by IHC using an automated immunostainer (Ventana BenchMark Ultra AutoStainer, Ventana Medical Systems, Tucson, AZ, USA) with antibodies against p53 (clone DO-7, catalogue number 7800-2912,Ventana Medical Systems, Tucson, AZ, USA), ER (clone SP1, catalogue number 790-4324, Ventana Medical Systems, Tucson, AZ, USA), PgR (clone 1E2, catalogue number 790-2223, Ventana Medical Systems, Tucson, AZ, USA), and the MMR status, evaluating the protein expression of MLH1 (clone M1, catalogue number 760-5091, Ventana Medical Systems, Tucson, AZ, USA), PMS2 (clone EPR3947, catalogue number 760-5094, Ventana Medical Systems, Tucson, AZ, USA), MSH2 (clone G219-1129, catalogue number 760-5093, Ventana Medical Systems, Tucson, AZ, USA), MSH6 (clone 44, catalogue number 760-5092, Ventana Medical Systems, Tucson, AZ, USA). Appropriate positive controls were included for each IHC run.
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