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1

Automated Cell and Tissue Segmentation for TMA

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For automatic image acquisition, we used the Vectra platform (Perkin Elmer, Waltham, MA) and InForm™ 1.4 software, (Perkin Elmer, Waltham, MA) for image analysis 23 (link). Using InForm™ 1.4 software (Perkin Elmer, Waltham, MA), 18% of the total images (rendering approximately 97% accuracy) were trained by a genitourinary pathologist (WH) to segment nucleus from cytoplasm, and epithelium from stroma. This created an algorithm enabling automated cell and tissue segmentation for each tissue compartment within each core sample. The same algorithm and threshold was then applied to the entire TMA.
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Quantifying Cellular Proliferation via Ki-67

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The Ki-67 immunohistochemical staining method of estimating cell proliferation was evaluated in 16 samples. This procedure evaluates the percentage of crypt cells that stain positive for Ki-67 protein, which is a specific nuclear marker of cell proliferation. Ki-67 staining was performed in OCT-embedded colon tissue to obtain a commonly used metric of cell proliferation. Slides were visualized at ×20 magnification on a Zeiss Axioskop 2 MOT microscope (Carl Zeiss Microscopy GmbH; Jena, Germany) equipped with a Nuance FX Multispectral Imaging System camera (Cambridge Research and Instrumentation; Woburn, MA). To obtain a more robust estimate of Ki-67 labeling, four representative images were taken for each tissue sample by using Nuance 2.10 software, and positive and negative crypt nuclei were counted by using inForm 1.4 software (Caliper Life Sciences; Hopkinton, MA); on average, 3239 ± 787 cells were counted for each tissue sample.
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Quantifying Cellular Proliferation via Ki-67

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The Ki-67 immunohistochemical staining method of estimating cell proliferation was evaluated in 16 samples. This procedure evaluates the percentage of crypt cells that stain positive for Ki-67 protein, which is a specific nuclear marker of cell proliferation. Ki-67 staining was performed in OCT-embedded colon tissue to obtain a commonly used metric of cell proliferation. Slides were visualized at ×20 magnification on a Zeiss Axioskop 2 MOT microscope (Carl Zeiss Microscopy GmbH; Jena, Germany) equipped with a Nuance FX Multispectral Imaging System camera (Cambridge Research and Instrumentation; Woburn, MA). To obtain a more robust estimate of Ki-67 labeling, four representative images were taken for each tissue sample by using Nuance 2.10 software, and positive and negative crypt nuclei were counted by using inForm 1.4 software (Caliper Life Sciences; Hopkinton, MA); on average, 3239 ± 787 cells were counted for each tissue sample.
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Immunohistochemical Analysis of Breast Cancer

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K5 and K8 expression were examined in a human breast cancer tissue microarray (TMA) containing patient tumors and normal breast samples (University of Wisconsin Carbone Cancer Center BioBank) (30 (link)). In brief, slides were deparaffinized, hydrated and permeabilized, then incubated with anti-K8 (Developmental Studies Hybridoma Bank, University of Iowa, TROMA-1), 1:50 in antibody diluent, (Da Vinci Green-BioCare Medical), followed by goat anti-rat IgG biotinylated secondary antibody (BioCare Medical), Streptavidin-HRP (BioCare Medical), and Deep Space Black chromogen (BioCare Medical). This was followed by anti-K5 (Covance Antibody Products, cat#PRB-160P), 1:4000, Mach 2 rabbit AP polymer (BioCare Medical) and Warp Red chromogen (BioCare Medical). Slides were counterstained with CAT hematoxylin (BioCare Medical), scanned using the Vectra imaging system (PerkinElmer Life Sciences), and analyzed using InForm 1.4 software (PerkinElmer Life Sciences), as described (30 (link)). Cytokeratin and hematoxylin signals were resolved using Nuance 3.0.2 (PerkinElmer Life Sciences), pseudocolored and merged to generate the images shown.
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