Classifications

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  • G01N21/62—Systems in which the material investigated is excited whereby it emits light or causes a change in wavelength of the incident light
  • G01N21/63—Systems in which the material investigated is excited whereby it emits light or causes a change in wavelength of the incident light optically excited
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Definitions

• Tissue microarray technology offers the opportunity for high throughput analysis of tissue samples (Konen, J. et al., Nat. Med. 4:844-7 (1998); Kallioniemi, O.P. et al., Hum. Mol. Genet. 10:657-62 (2001); Rimm, D.L. et al., Cancer J. 7:24-31 (2001)).
• tissue microarrays can provide critical information for identifying and validating drug targets/ prognostic markers (e.g. estrogen receptor (ER) and HER2/neu) and candidate therapeutics.
• prognostic markers e.g. estrogen receptor (ER) and HER2/neu
• the protocol must not only be able to select the region of interest but also normalize it, so that the expression level read from any given area can be compared with that of other areas. Subcellular localization presents similar challenges. Comparisons of nuclear or membranous staining, for example, are quite different from those in total cytoplasmic staining.
• H-score where the percent of positively stained cells (0 to 100) is multiplied by the staining intensity (e.g. 0 to 3) to make a theoretically continuous scale (0 to 300).
• staining intensity e.g. 0 to 3
• the invention features systems and methods for rapidly analyzing cell containing samples to localize and quantitate particular biomarkers within cells.
• the method is implemented by a computer and superimposes an image of the biomarker against an image of a user defined area within the cell to determine whether the biomarker is within the user defined area.
• the invention features an algorithm that facilitates the optical analysis of an array of biological samples, despite image irregularities, distortions, varying topologies, and the absence of one or more elements.
• Analysis of patient samples according to the systems and processes described herein can be useful diagnostically (e.g. to identify patients who have a particular disease, have been exposed to a particular toxin or are responding well to a particular therapeutic or organ transplant) and prognostically (e.g. to identify patients who are likely to develop a particular disease, respond well to a particular therapeutic or be accepting of a particular organ transplant).
• diagnostically e.g. to identify patients who have a particular disease, have been exposed to a particular toxin or are responding well to a particular therapeutic or organ transplant
• prognostically e.g. to identify patients who are likely to develop a particular disease, respond well to a particular therapeutic or be accepting of a particular organ transplant.
• the instant described processes which not only quantitate the markers, but also determine their relative location within a cell, will increase in applicability.
• Automated analysis of cell containing preparations, as described herein can provide a rapid assessment of the prognostic benefit of biomarkers.
• these automated techniques can identify associations that are typically not revealed using manual techniques. Also, automated analysis can better discern subtle differences in staining intensity, particularly at the upper and lower extremes. The ability to detect low level expression and distinguish it from no expression can provide important prognostic information. Furthermore, analysis of the sub-cellular distribution of certain biomarkers may elucidate previously unrecognized associations with patient survival.
• FIG. l(A-D) shows separate monochromatic images of a colon carcinoma taken after staining with fluorescently-tagged markers and combined into a single color image as follows: DAPI (to visualize nuclei, blue), anti-cytokeratin (to distinguish tumor from non- tumor elements, green), and anti-alpha-catenin (to visualize cell membranes, red).
• DAPI to visualize nuclei, blue
• anti-cytokeratin to distinguish tumor from non- tumor elements, green
• anti-alpha-catenin to visualize cell membranes, red.
• FIG. 2(A-D) shows a regression comparison of automated and pathologist-based scoring of estrogen receptor levels.
• FIG. 3 is a flowchart of a method for identifying and accounting for the relative location of spots within an array.
• FIG. 4 is a flowchart of a process for localizing a signal (e.g. a biomarker) within a locale.
• FIG. 5 shows a tissue microarray.
• FIG. 6 shows an optical microscope station
• a technique to identify the location of spots within an image The technique, termed "spotfinder", can flexibly identify such locations despite image irregularities, distortions, varying topologies, and the absence of one or more elements.
• spotfinder can flexibly identify such locations despite image irregularities, distortions, varying topologies, and the absence of one or more elements.
• the process is described for locating the position of histospots and identifying missing histospots within tissue microarray images, the technique has broader application. More specifically it can be used to locate elements and identify missing elements in any collection of elements. Moreover, the process can be used on arrays of virtually any dimension and comprising a variety of elements.
• the specimens are not limited by size or shape, nor must they be regularly spaced.
• a technique that can be used alone or in conjunction with spotfinder to optically localize and quantitate a biomarker within a cell.
• an image of a cellular preparation typically features two dimensions, cellular preparations feature depth. For example, one cellular feature may rest atop another. This overlap can potentially confuse image analysis software.
• a technique described herein, dubbed RESA (Rapid Exponential Subtraction Algorithm), can approximate a three dimensional image by subtracting out-of-focus image elements. Thus, the impact of background features on an image can be reduced, permitting better image analysis.
• RESA Rapid Exponential Subtraction Algorithm
• the technique can determine the location of subcellular compartments within individual cells.
• a computer implementing this technique can, for instance, measure the relative intensities of images derived from compartment-specific stains on a pixel-by-pixel basis.
• the computer determines for individual pixels within an image, the likelihood that the pixel corresponds to a particular locale or user defined area within the cell.
• Such analysis permits the computer to assign signals to a sub-cellular compartment with an established degree of accuracy (e.g., 95%).
• the technique can co- localize signals associated with particular biomarkers with images of defined locales within cells.
• Figure 1 shows separate monochromatic images of a colon carcinoma taken after staining with fluorescently-tagged markers and combined into a single color image as follows: DAPI (to visualize nuclei, blue), anti-cytokeratin (to distinguish tumor from non-tumor elements, green), and anti-alpha-catenin (to visualize cell membranes, red) (panel A). Note the significant degree of overlap between the subcellular compartments.
• Panel A shows a composite of the exponentially subtracted images of DAPI and anti-alpha-catenin (blue and red, respectively), shown on a mask derived from the anti-cytokeratin mask (green pixels). Pixels with too much overlap between channels are negated ( ⁇ 5%), as are non-tumor areas, as defined by a mask generated from the anti-cytokeratin image.
• the signal intensity from an exponentially subtracted image of the biomarker ( ⁇ -catenin, inset) is then redistributed according to the compartments defined in panel C. This results in more accurate assignment of the biomarker to the membrane compartment, which can have important prognostic significance.
• membrane-associated beta-catenin stabilizes cadherin-mediated adhesion by facilitating the cytoskeletal attachment of adhesion complexes
• nuclear-associated beta-catenin acts as a transcription factor, which up- regulates several genes important in cell proliferation and invasion and is considered an oncogene in this capacity
• expression of beta-catenin alone does not provide prognostic information. However its localization in the nucleus can be an important indicator of carcinogenesis.
• the computer removes BI any atypically sized spots from the image.
• Atypically sized spots may include, for example, images of fused spots and/or debris.
• the computer performs the process automatically, though in other embodiments it may allow use of user input to facilitate the process.
• the computer then creates or accesses an opaque virtual mask that is the size and shape of a typical spot.
• the computer scans B2 the image to determine B3 where the mask first covers an area with the highest average pixel intensity.
• the computer monitors the total intensity of the image during the scan and, because the mask is opaque, identifies the position of the mask when the total image intensity is minimized.
• the computer identifies this area as the first spot and sets B4 the pixels within this area to have zero intensity.
• the computer also sets additional pixels within a predefined area around this area to have zero intensity. This helps to differentiate between overlapping spots.
• the computer again scans B2 the image using the mask to find the next area with the highest average pixel intensity.
• the computer When the next area is found, the computer identifies it as the second spot and sets the pixels in and surrounding this area to have zero intensity. The computer repeats this process until it can no longer find areas of the image with sufficient intensity to qualify as spots. The computer then identifies B5 a reference point (e.g., the center) in each spot, and draws a line connecting the reference point of each spot to each nearest neighboring spot reference point, above, below, to the left, and to the right. If the computer cannot identify a nearest neighbor in any of these directions (i.e., the spot is on the edge of the array), the computer draws a line from the center of the spot to the nearest edge of the image.
• a reference point e.g., the center
• an optical microscope can obtain a high resolution image at an appropriate wavelength to identify cellular features of interest.
• These features include the biomarker, also referred to as the "signal”, the cells of interest within the tissue section (referred to as the "cell mask”), or a user defined location within the cell mask, also referred to as the "locale”.
• the signal, the cell mask, and the locale are referred to as "channels”.
• a process 50 determines the region of interest in the images by developing a mask from the cell mask channel (step CI). Next, the process applies this mask to the locale and signal channels (step C2). The process then removes out-of-focus information from the masked images, for example, in a process of pseudo-deconvolution (step C3).
• step C3 the process identifies subcellular features in the image, assigning pixels in the image to the locales (step C4). Once the pixels are assigned, the computer maps the locales onto the signal image (step C5), and quantifies the amount of biomarker in each locale. This phase is referred to as "signal assignment".
• the software identifies a region of interest in the image of the stained cells of interest (i.e., the cell mask channel).
• the software masks the locale and signal channels avoiding unnecessary analyses of areas outside the region of interest.
• the computer determines a threshold intensity for the cell mask channel. Once determined, the computer redistributes the pixel intensities in a binary redistribution. In other words, the computer sets the intensity of each pixel below the threshold to zero, and sets the remaining pixels to have the maximum intensity (e.g., for an 8-bit image the maximum intensity is 255).
• the set of pixel locations set to maximum intensity are referred to as the mask. Subsequent procedures on the other images in the image stack are performed on the pixel locations corresponding to the mask.
• the threshold intensity is related to the intensity of the background in the image, which the computer determines by first binning each pixel according to its intensity (e.g., in an 8-bit image each pixel will have an intensity from 0 to 255).
• the background corresponds to the largest bin (i.e., the most common pixel intensity).
• the background corresponds to the second largest bin. This occurs in some cases when the tissues autofluoresce and the largest bin corresponds to an area of fluorescing tissue instead of the fluorescing histochemical stains. In either case, the computer assumes that the background intensity is lower than a certain fraction of the maximum intensity (e.g., less than half the maximum intensity).
• Bin size is plotted versus intensity to yield a histogram.
• the maximum peak in the histogram corresponds to the largest bin.
• the computer assigns the maximum peak intensity as the background intensity.
• the histogram has a second peak at a lower intensity than the maximum peak. So, if the second peak is at least a certain fraction of the size of the maximum peak (e.g., at least five percent), then the computer assigns the second peak intensity as the background intensity of the image.
• the computer adds an additional factor to the background intensity to determine the threshold intensity. For an 8-bit image, this factor equals D (l/5)/10 multiplied by a user defined input (usually 0.5).
• E>( ) is the quintile distribution of the binned pixels, which is determined as
• DvA ⁇ J ) top 20 ⁇ V /b ttom20 '
• (/) is the mean pixel intensity of the pixels within the top 20 th percentile
• Pixels with intensity at or above the threshold intensity are assigned to the mask.
• the mask is then further modified according to user-defined parameters and image processing techniques.
• the mask can be dilated or eroded so that the mask area matches a user-defined value, or have holes of a particular (user-defined) size within it filled.
• the user-defined parameters for creating the mask may be adjusted after analyzing a small number of sample histospot images, prior to running the entire array.
• the computer After developing the mask, the computer applies the mask to the images in the image stack, identifying the region of interest in each of these images as the pixel locations corresponding to the mask pixel locations.
• the process 50 reduces C3 the impact of the out-of-focus information from the image.
• the process 50 may use a pseudo deconvolution technique. While the pixels of the remaining image are reduced in intensity, the image information represents a thinner virtual slice through the top of the tissue. Furthermore, pseudo- deconvolution enhances the interfacial areas between the higher stain intensity and lower stain intensity areas of the image by increasing the contrast between these areas.
• the computer performs pseudo-deconvolution on the locale (cellular compartments) and signal (i.e., cellular components) channels.
• the computer first masks the images of these channels, reducing the number of pixels to be analyzed.
• the computer analyzes two images of each channel.
• the first image is an in- focus image (i.e., an image of the top of the histospot).
• the second image is a slightly out-of-focus image, produced by placing the focal plane slightly below the bottom of the tissue (e.g., for a five micron thick histospot, the focal plane of this image is located about eight microns below the top of the histospot).
• the computer For each pixel location, the computer subtracts a percentage of the out-of-focus image pixel intensity, / out - o f- f o cus , from the corresponding in-focus image pixel intensity, I m . focus - The computer determines the adjusted pixel intensity, 7 n e pixel, using the quartile distribution, D ⁇ / 4 ) , of the in-focus image as follows:
• J nax is the maximum pixel intensity (e.g., 255 for an 8-bit image)
• ⁇ is calculated from which was developed from an empiric assessment of a library of images Optical deconvolutions were judged visually and the ⁇ ox each was plotted versus the quartile distribution for the in-focus image. Regression analysis of the empiric data yielded values for the fitting-parameters (i.e., ⁇ is about 80 and ⁇ is about 1.19). The quartile distribution is determined from
• (/) _ 5 is the mean pixel intensity of the pixels within the top 25 th percentile
• (-/ ⁇ . 25 is the mean pixel intensity of pixels in the bottom 25 th percentile.
• low intensity pixels in images with a low D(/ 4 ) i.e. a low signal to noise ratio
• the value of ⁇ may be refined by determining the percent of signal intensity remaining after pseudo-deconvolution within the masked area and comparing it to a predefined value for that channel. If the percent is, for example, greater than the predefined value then the pseudo-deconvolution stops. Otherwise, the computer iteratively increases the value of ⁇ until the predefined percent of signal intensity is reached.
• the predefined value is the expected percentage of the mask covered by a channel.
• each pixel of the resulting images is assigned to a locale in a process referred to as pixel assignment.
• the computer assigns an identity based on the relative intensity of that pixel location in each of the locale channel images (i.e., the images of the stained locales). For example, during this phase the computer decides for each pixel location in the image whether it belongs to the nucleus, the membrane, or the cytoplasm. The computer does not make an assignment to pixels that it cannot assign within a user-defined degree of confidence (e.g., 95%). Higher levels of confidence eliminate more pixels from the analysis. In general, for each pixel location in two locale images the computer reads a pixel intensity and compares each intensity value to a predetermined threshold intensity value.
• the computer assigns the pixel location to that locale. If both the intensity values are greater than their respective thresholds, the computer compares the intensity values from each locale, and assigns the identity of the locale having the greater intensity to that pixel location. If both the pixel intensities are below their threshold values, the computer assigns the pixel to a third locale. After repeating the above for pixel locations in the images, the computer calculates the area of each locale, and compares the result to a predetermined (expected) coverage fraction. If the calculated coverage fraction (e.g., number of nuclear locale pixels/number of masked pixels) is greater than the predetermined coverage fraction, then the computer removes the pixels having the lowest intensity from the locale. The computer continues to remove the lowest intensity pixels until the coverage fraction is reduced to about the predetermined coverage fraction.
• a predetermined coverage fraction e.g., number of nuclear locale pixels/number of masked pixels
• the membrane locale and the nucleus locale images are selected for assignment analysis performed at 95% confidence interval. Pixel locations are assigned to the cytoplasm locale by exclusion.
• the computer reads pixel intensities at each pixel location in the membrane and nucleus locale images, and compares them to threshold values. If neither of the intensity values are greater than the threshold values, the pixel location is assigned to the cytoplasm locale. If only the nuclear intensity or membrane intensity is greater than the threshold value, the computer assigns the pixel location to the above-threshold locale. If both intensities are higher than the thresholds, computer compares the ratio of the intensity values to one, and makes an assignment as follows: nuclear intensity , . . . . i , ,
• pixel location nuclear locale membrane intensity nuclear intensity
• the computer assigns the pixel location to the nuclear locale. If the membrane intensity is greater than the nuclear intensity, the computer assigns the pixel location to the membrane locale. If the membrane intensity is equal to the nuclear intensity, the pixel location is unassigned. This repeats for the pixel locations.
• the computer determines the amount of nuclear intensity incorrectly assigned to the membrane locale (i.e., nuclear to membrane spill-over), and vice versa. If the amount of nuclear intensity incorrectly assigned to the membrane channel is >5% of the total nuclear intensity, then the computer weights the nuclear intensity by a factor, w, and recalculates the ratio of weighted nuclear intensity to membrane intensity. This ratio is compared to one, and pixel locations are reassigned as follows: wx nuclear intensity
• the computer also calculates the area of the cytoplasmic (exclusion) locale and compares it to a predetermined value. By iterating the assignment process, the computer ensures that there is ⁇ 5% cytoplasmic-to-nuclear or cytoplasmic-to-membrane, as determined based on the biology.
• the computer then evaluates the amount of signal in each locale during a "signal assignment" process.
• the computer sums the signal in each locale.
• the computer reads the pixel intensity of the signal image (i.e., the image of the stain that selectively labels the cellular component), and adds together the signal intensity for pixel locations assigned to like subcellular compartments.
• the computer calculates a pixel intensity sum of a locale by the direct addition of the signal intensity of each pixel location assigned to that locale.
• the computer also calculates a sum of pixel intensity ratios by adding together the ratio of the signal intensity and the locale intensity for each pixel location.
• the pixel intensity sum and pixel intensity ratio sum is then used in calculating one or more parameters.
• the computer determines the relative percentage of signal falling within each of the compartments (e.g. 30% of the total signal is membranous, 20% is cytoplasmic, and 50% is nuclear).
• the computer expresses the amount of signal present relative to the size of a particular compartment (e.g. the signal intensity of pixels assigned to the membrane channel divided by the number of pixels assigned to the membrane channel).
• the user may select to have the computer evaluate other parameters of interest. For example, how much of the image area is covered by the mask, how much of the mask is covered by each locale, etc.
• the computer By implementing the pseudo-deconvolution algorithm (which limits the majority of extraneous pixel intensity) together with intensity area measurements (which further define the area of a particular sub-cellular locale), the computer is able to make highly accurate assignments of pixel locations sub-cellular locations.
• the computer performs additional steps to better utilize the dynamic range of the camera. This is achieved by redistributing the pixel intensities in an image across the dynamic range of the detector based on their relative intensities.
• redistribution is normalized redistribution, whereby the lower threshold
• Double-logarithmic redistribution sets all pixels in an image above 50% of the image's upper threshold (i.e., the value which only 50% of the pixels in the image have greater intensity) to the maximum intensity value (e.g., 255 for an 8-bit image). All pixels with intensity values below the lower threshold are set to 0, and all pixels with intensity values between the upper and lower thresholds are reassigned according to the formula: iog(/ old -zr)
• the spotfinder algorithm may be used for identifying the location of any element comprising a collection and the RES A and PLACE algorithms may be used to localize and quantitate a biomarker within any imageable, cell containing sample, including tissue biopsies and cell containing fluid samples, such as blood, urine, spinal fluid, saliva, lymph, pleural fluid, peritoneal fluid and pericardial fluid.
• any optical or non-optical imaging device can be used, such as for example, upright or inverted optical microscopes, scanning confocal microscopes, cameras, scanning or tunneling electron microscopes, scanning probe microscopes, and imaging infrared detectors etc.
• the computer can include hardware, software, or a combination of both to control the other components of the system and to analyze the images to extract the desired information about the histospots and tissue microarrays.
• the analysis described above is implemented in computer programs using standard programming techniques. Such programs are designed to execute on programmable computers each comprising a processor, a data storage system (including memory and/or storage elements), at least one input device, at least one output device, such as a display or printer.
• the program code is applied to input data (e.g., stitched together images or image stacks) to perform the functions described herein and generate information (e.g., localization of signal), which is applied to one or more output devices.
• a tissue microarray 100 includes multiple samples of histospots 120 prepared from histocores embedded typically in a thin (e.g., about five microns) block of paraffin 130 at regular intervals, forming a series of rows and columns.
• Histospots (thin sections of histocores) 120 may be substantially disk-like in shape and will typically have the same thickness as the paraffin block 130 (i.e., about five microns) and a diameter of about 0.6 millimeters. Typically the centers of the histospots are spaced about a few tenths of a millimeter apart. Paraffin block 130 and histospots 120 may be mounted on a microscope slide 110.
• a tissue microarray 100 may include any number of histospots, typically on the order of several hundred to a few thousand.
• Microscopy station 200 includes an inverted optical microscope 201 for imaging the tissue, and a computer 290 for analyzing the images.
• Optical microscope 201 includes a mount 210, housing a light source 220, a sample stage 240, an objective lens 250 and a CCD camera 270.
• a frame grabber in computer 290 acquires the images through CCD camera 270.
• Optical microscope 201 also includes filter wheels 230 and 260, which house a series of dichroic filters.
• the filters in wheel 230 allow selection of the appropriate illumination spectra for standard or fluorescent microscopy.
• Filters in wheel 260 filter the transmitted light for isolation of spectral signatures in fluorescent microscopy.
• Sample stage 240 supports and appropriately positions tissue microarray 100. Sample stage 240 can be linearly translated in the x, y, and z directions (axes are shown). Sample stage 240 includes motors to enable automated translation. Computer 290 controls sample stage 240 translation by servo control of the motors.
• a tissue microarray 100 can be imaged as follows: a user places the microarray on a sample stage 240. The user adjusts sample stage 240 so that the first (i.e., top-left) histospot is at the center of the field of view and focused on CCD camera 270.
• the objective lens 250 should be adjusted to the appropriate resolution, for example, a 0.6 millimeter histospot can be viewed at 10X magnification.
• the histospots correspond to areas of higher light intensity than the surrounding paraffin, as assessed through various means including signals derived from the visible light scattering of stained tissues, tissue autofluorescence or from a fluorescent tag.
• Computer 290 can acquire a low- resolution image (e.g.
• Computer 290 automatically translates sample stage 240 by an amount approximately equal to a field of view. The computer then acquires a second low-resolution image. This process is repeated until the computer has acquired images of the entire tissue microarray. Then, using commercially available software, the computer generates a composite image of the entire tissue microarray by stitching together the sequence of images like a patchwork.
• Biological markers which may be detected in accordance with the present invention include, but are not limited to any nucleic acids, proteins, peptides, lipids, carbohydrates or other components of a cell.
• markers are characteristic of particular cells, while other markers have been identified as being associated with a particular disease or condition.
• prognostic markers include enzymatic markers such as galactosyl transferase II, neuron specific enolase, proton ATPase-2, and acid phosphatase.
• Hormone or hormone receptor markers include human chorionic gonadotropin (HCG), adrenocorticotropic hormone, carcinoembryonic antigen (CEA), prostate-specific antigen (PSA), estrogen receptor, progesterone receptor, androgen receptor, gClq-R/p33 complement receptor, IL-2 receptor, p75 neurotrophin receptor, PTH receptor, thyroid hormone receptor, and insulin receptor.
• Lymphoid markers include alpha- 1 -antichymotrypsin, alpha- 1-antitrypsin, B cell marker, bcl-2, bcl-6, B lymphocyte antigen 36kD, BM1 (myeloid marker), BM2 (myeloid marker), galectin-3, granzyme B, HLA class I Antigen, HLA class II (DP) antigen, HLA class II (DQ) antigen, HLA class II (DR) antigen, human neutrophil defensins, immunoglobulin A, immunoglobulin D, immunoglobulin G, immunoglobulin M, kappa light chain, kappa light chain, lambda light chain, lymphocyte/histocyte antigen, macrophage marker, muramidase (lysozyme), p80 anaplastic lymphoma kinase, plasma cell marker, secretory leukocyte protease inhibitor, T cell antigen receptor (JOVI 1), T cell antigen receptor (JOVI 3),
• Tumour markers include alpha fetoprotein, apolipoprotein D, BAG-1 (RAP46 protein), CA19-9 (sialyl lewisa), CA50 (carcinoma associated mucin antigen), CA125 (ovarian cancer antigen), CA242 (tumour associated mucin antigen), chromogranin A, clusterin (apolipoprotein J), epithelial membrane antigen, epithelial-related antigen, epithelial specific antigen, gross cystic disease fluid protein-15, hepatocyte specific antigen, heregulin, human gastric mucin, human milk fat globule, MAGE-1, matrix metalloproteinases, melan A, melanoma marker (HMB45), mesothelin, metallothionein, microphthalmia transcription factor (MITF), Muc-1 core glycoprotein.
• HMB45 melanoma marker
• MITF microphthalmia transcription factor
• Cell cycle associated markers include apoptosis protease activating factor- 1, bcl-w , bcl-x, bromodeoxyuridine, CAK (cdk-activating kinase), cellular apoptosis susceptibility protein (CAS), caspase 2, caspase 8, CPP32 (caspase-3), CPP32 (caspase-3), cyclin dependent kinases, cyclin A, cyclin BI, cyclin Dl, cyclin D2, cyclin D3, cyclin E, cyclin G, DNA fragmentation factor (N-terminus), Fas (CD95), Fas-associated death domain protein, Fas ligand, Fen-1, IPO-38, Mcl-l, minichromosome maintenance proteins, mismatch repair protein (MSH2), poly (ADP-Ribose) polymerase, proliferating cell nuclear antigen, pl6 protein, p27 protein, p34cdc2, p57 protein (Kip2),
• Neural tissue and tumour markers include alpha B crystallin, alpha-intemexin, alpha synuclein, amyloid precursor protein, beta amyloid, calbindin, choline acetyltransferase, excitatory amino acid transporter 1, GAP43, glial fibrillary acidic protein, glutamate receptor 2, myelin basic protein, nerve growth factor receptor (gp75), neuroblastoma marker, neurofilament 68kD, neurofilament 160kD, neurofilament 200kD, neuron specific enolase, nicotinic acetylcholine receptor alpha4, nicotinic acetylcholine receptor beta2, peripherin, protein gene product 9, S-100 protein, serotonin, SNAP-25, synapsin I, synaptophysin, tau, tryptophan hydroxylase, tyrosine hydroxylase, ubiquitin.
• Cluster differentiation markers include CD la, CD lb, CDlc, CD Id, CDle, CD2, CD3delta, CD3epsilon, CD3gamma, CD4, CD5, CD6, CD7, CD8alpha, CD ⁇ beta, CD9, CD10, CDl la, CDl lb, CDl lc, CDwl2, CD13, CD14, CD15, CD15s, CD16a, CD16b, CDwl7, CD18, CD19, CD20, CD21,CD22, CD23, CD24, CD25, CD26, CD27, CD28, CD29, CD30, CD31, CD32, CD33, CD34, CD35, CD36, CD37, CD38, CD39, CD40, CD41, CD42a, CD42b, CD42c, CD42d, CD43, CD44, CD44R, CD45, CD46, CD47, CD48, CD49a, CD49b, CD49c, CD49d, CD49e, CD49f, CD50, CD
• centromere protein-F CENP-F
• giantin involucrin
• LAP-70 LAP-70
• mucin nuclear pore complex proteins
• pi 80 lamellar body protein ran, r
• cathepsin D Ps2 protein
• Her2-neu P53
• SI 00 epithelial marker antigen
• EMA epithelial marker antigen
• Cell containing samples may be stained using dyes or stains, or histochemicals, that directly react with the specific biomarkers or with various types of cells or subcellular compartments. Not all stains are compatible. Therefore the type of stains employed and their sequence of application should be well considered, but can be readily determined by one of skill in the art.
• Histochemicals may be chromophores detectable by transmittance microscopy or fluorophores detectable by fluorescence microscopy.
• a cell containing samples may be incubated with a solution comprising at least one histochemical, which will directly react with or bind to chemical groups of the target. Some histochemicals must be co-incubated with a mordant, or metal, in order to allow staining.
• a cell containing sample may be incubated with a mixture of at least one histochemical that stains a component of interest and another histochemical that acts as a counterstain and binds a region outside the component of interest.
• mixtures of multiple probes may be used in the staining, and provide a way to identify the positions of specific probes.
• chromophores that may be used as histological stains or counterstains and their target cells, subcellular compartments, or cellular components: Eosin (alkaline cellular components, cytoplasm), Hematoxylin (nucleic acids), Orange G (red blood, pancreas, and pituitary cells), Light Green SF
• DAPI 4',6- diamidino-2-phenylindole
• Eosin alkaline cellular components, cytoplasm
• Hoechst 33258 and Hoechst 33342 two bisbenzimides
• Propidium Iodide (nucleic acids)
• Spectrum Orange (nucleic acids)
• Spectrum Green (nucleic acids)
• Quinacrine (nucleic acids)
• Fluorescein-phalloidin actin fibers
• Chromomycin A 3 nucleic acids
• Acriflavine-Feulgen reaction nucleic acid
• Auramine O-Feulgen reaction Ethidium Bromide (nucleic acids).
• Nissl stains 4',6- diamidino-2-phenylindole (DAPI)
• Eosin alkaline cellular components, cytoplasm
• Hoechst 33258 and Hoechst 33342 two bisbenzimides
• DNA binding protein such as histones, ACMA, Quinacrine and Acridine Orange.
• Each cell containing sample may be co-incubated with appropriate substrates for an enzyme that is a cellular component of interest and appropriate reagents that yield colored precipitates at the sites of enzyme activity.
• enzyme histochemical stains are specific for the particular target enzyme. Staining with enzyme histochemical stains may be used to define a subcellular component or a particular type of cell. Alternatively, enzyme histochemical stains may be used diagnostically to quantitate the amount of enzyme activity in cells.
• Acid phosphatases may be detected through several methods.
• Gomori method for acid phophatase a cell preparation is incubated with glycerophosphate and lead nitrate. The enzyme liberates phosphate, which combines with lead to produce lead phosphate, a colorless precipitate. The tissue is then immersed in a solution of ammonium sulfide, which reacts with lead phosphate to form lead sulfide, a black precipitate.
• cells may be incubated with a solution comprising pararosanilin-HCl, sodium nitrite, napthol ASB1 phosphate (substrate), and veronal acetate buffer.
• This method produces a red precipitate in the areas of acid phosphatase activity. Owing to their characteristic content of acid phosphatase, lysosomes can be distinguished from other cytoplasmic granules and organelles through the use of this assay.
• Dehydrogenases may be localized by incubating cells with an appropriate substrate for the species of dehydrogenase and tetrazole.
• the enzyme transfers hydrogen ions from the substrate to tetrazole, reducing tetrazole to formazan, a dark precipitate.
• NADH dehydrogenase is a component of complex I of the respiratory chain and is localized predominantly to the mitochondria.
• ATPases muscle fibers
• succinate dehydrogenases mitochondrial dehydrogenases
• mitochondriachrome c oxidases mitochondrial dehydrogenases
• phosphorylases mitochondrial dehydrogenases
• phosphofructokinases mitochondrial cholinesterases
• acetyl cholinesterases nerve cells
• lactases small intestine
• leucine aminopeptidases liver cells
• myodenylate deaminases muscle cells
• NADH diaphorases erythrocytes
• sucrases small intestine
• Immunohistochemistry is among the most sensitive and specific histochemical techniques. Each histospot may be combined with a labeled binding composition comprising a specifically binding probe.
• Various labels may be employed, such as fluorophores, or enzymes which produce a product which absorbs light or fluoresces.
• a wide variety of labels are known which provide for strong signals in relation to a single binding event.
• Multiple probes used in the staining may be labeled with more than one distinguishable fluorescent label. These color differences provide a way to identify the positions of specific probes.
• the method of preparing conjugates of fluorophores and proteins, such as antibodies, is extensively described in the literature and does not require exemplification here.
• Anti-estrogen receptor antibody (breast cancer), anti-progesterone receptor antibody (breast cancer), anti-p53 antibody (multiple cancers), anti-Her-2/neu antibody (multiple cancers), anti-EGFR antibody (epidermal growth factor, multiple cancers), anti-cathepsin D antibody (breast and other cancers), anti-Bcl-2 antibody (apoptotic cells), anti- E-cadherin antibody, anti-CA125 antibody (ovarian and other cancers), anti-CA15-3 antibody (breast cancer), anti-CA19-9 antibody (colon cancer), anti-c-erbB-2 antibody, anti-P-glycoprotein antibody (MDR, multi- drug resistance), anti-CEA antibody (carcinoembryonic antigen), anti-retin
• Fluorophores that may be conjugated to a primary antibody include but are not limited to Fluorescein, Rhodamine, Texas Red, Cy2, Cy3, Cy5, VECTOR Red, ELF.TM. (Enzyme-Labeled Fluorescence), CyO, Cy0.5, Cyl, Cyl.5, Cy3, Cy3.5, Cy5, Cy7, FluorX, Calcein, Calcein-AM, CRYPTOFLUOR.TM.'S, Orange (42 kDa), Tangerine (35 kDa), Gold (31 kDa), Red (42 kDa), Crimson (40 kDa), BHMP, BHDMAP, Br-Oregon, Lucifer Yellow, Alexa dye family, N-[6-(7-nitrobenz-2-oxa-l, 3-diazol-4-yl)amino]caproyl] (NBD), BODIPYTM., boron dipyrromethene difluoride, Oregon Green, MITOTRACKER.TM.
• Further amplification of the signal can be achieved by using combinations of specific binding members, such as antibodies and anti-antibodies, where the anti-antibodies bind to a conserved region of the target antibody probe, particularly where the antibodies are from different species.
• specific binding ligand-receptor pairs such as biotin-streptavidin, may be used, where the primary antibody is conjugated to one member of the pair and the other member is labeled with a detectable probe.
• the first binding member binds to the cellular component and serves to provide for secondary binding, where the secondary binding member may or may not include a label, which may further provide for tertiary binding where the tertiary binding member will provide a label.
• the secondary antibody, avidin, strepavidin or biotin are each independently labeled with a detectable moiety, which can be an enzyme directing a colorimetric reaction of a substrate having a substantially non-soluble color reaction product, a fluorescent dye (stain), a luminescent dye or a non- fluorescent dye. Examples concerning each of these options are listed below.
• any enzyme that (i) can be conjugated to or bind indirectly to (e.g., via conjugated avidin, strepavidin, biotin, secondary antibody) a primary antibody, and (ii) uses a soluble substrate to provide an insoluble product (precipitate) could be used.
• the enzyme employed can be, for example, alkaline phosphatase, horseradish peroxidase, beta-galactosidase and/or glucose oxidase; and the substrate can respectively be an alkaline phosphatase, horseradish peroxidase, beta.-galactosidase or glucose oxidase substrate.
• Alkaline phosphatase (AP) substrates include, but are not limited to, AP-Blue substrate (blue precipitate, Zymed catalog p.
• AP-Orange substrate range, precipitate, Zymed
• AP-Red substrate red, red precipitate, Zymed
• 5-bromo, 4-chloro, 3- indolyphosphate BCIP substrate, turquoise precipitate
• 5-bromo, 4-chloro, 3-indolyl phosphate/nitroblue tetrazolium/ iodonitrotetrazolium BCIP/iNT substrate, yellow-brown precipitate, Biomeda
• 5-bromo, 4-chloro, 3-indolyl phosphate/nitroblue tetrazolium/iodonitrotetrazolium BCIP/NBT/iNT, brown precipitate, DAKO, Fast Red (Red), Magenta-phos (magenta), Naphthol AS-BI-phosphate (NABP)/Fast Red
• Horseradish Peroxidase (HRP, sometimes abbreviated PO) substrates include, but are not limited to, 2,2' Azino-di-3-ethylbenz-thiazoline sulfonate (ABTS, green, water soluble), aminoethyl carbazole, 3-amino, 9-ethylcarbazole AEC (3A9EC, red).
• ABTS 2,2' Azino-di-3-ethylbenz-thiazoline sulfonate
• aminoethyl carbazole aminoethyl carbazole
• 3-amino 9-ethylcarbazole AEC (3A9EC, red).
• Alpha- naphthol pyronin (red), 4-chloro- 1 -naphthol (4C1N, blue, blue-black), 3,3'- diaminobenzidine tetrahydrochloride (DAB, brown), ortho-dianisidine (green), o-phenylene diamine (OPD, brown, water soluble), TACS Blue (blue), TACS Red (red), 3,3',5,5'Tetramethylbenzidine (TMB, green or green/blue), TRUE BLUE.TM. (blue), VECTOR.TM. VIP (purple), VECTOR.TM. SG (smoky blue-gray), and Zymed Blue HRP substrate (vivid blue).
• Glucose oxidase (GO) substrates include, but are not limited to, nitroblue tetrazolium (NBT, purple precipitate), tetranitroblue tetrazolium (TNBT, black precipitate), 2-(4-iodophenyl)-5-(4-nitorphenyl)-3-phenyltetrazolium chloride (INT, red or orange precipitate), Tetrazolium blue (blue), Nitrotetrazolium violet (violet), and 3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT, purple). All tetrazolium substrates require glucose as a co-substrate. The glucose gets oxidized and the tetrazolium salt gets reduced and forms an insoluble formazan which forms the color precipitate.
• Beta-galactosidase substrates include, but are not limited to, 5-bromo-4-chloro-3- indoyl beta-D-galactopyranoside (X-gal, blue precipitate).
• X-gal 5-bromo-4-chloro-3- indoyl beta-D-galactopyranoside
• the precipitates associated with each of the substrates listed have unique detectable spectral signatures (components).
• the enzyme can also be directed at catalyzing a luminescence reaction of a substrate, such as, but not limited to, luciferase and aequorin, having a substantially non- soluble reaction product capable of luminescencing or of directing a second reaction of a second substrate, such as but not limited to, luciferine and ATP or coelenterazine and Ca.sup.++, having a luminescencing product.
• a substrate such as, but not limited to, luciferase and aequorin
• a substantially non- soluble reaction product capable of luminescencing capable of luminescencing
• a second reaction of a second substrate such as but not limited to, luciferine and ATP or coelenterazine and Ca.sup.++
• ISH in-situ hybridization
• a nucleic acid sequence probe is synthesized and labeled with either a fluorescent probe or one member of a ligand:receptor pair, such as biotin/avidin, labeled with a detectable moiety. Exemplary probes and moieties are described in the preceding section.
• the sequence probe is complementary to a target nucleotide sequence in the cell. Each cell or cellular compartment containing the target nucleotide sequence may bind the labeled probe.
• Probes used in the analysis may be either DNA or RNA oligonucleofides or polynucleotides and may contain not only naturally occurring nucleotides but their analogs such as dioxygenin dCTP, biotin dcTP 7-azaguanosine, azidothymidine, indsine, or uridine.
• Other useful probes include peptide probes and analogues thereof, branched gene DNA, peptidomimetics, peptide nucleic acids, and/or antibodies. Probes should have sufficient complementarity to the target nucleic acid sequence of interest so that stable and specific binding occurs between the target nucleic acid sequence and the probe. The degree of homology required for stable hybridization varies with the stringency of the hybridization.
• Example 1 Construction of Tissue Microarrays for a Survival Analysis of The Estrogen Receptor (ER) and HER2/neu and for Analysis of Nuclear Associated Beta-catenin
• Tissue microarray design Paraffin-embedded formalin-fixed specimens from 345 cases of node-positive invasive breast carcinoma were identified. Areas of invasive carcinoma, away from in situ lesions and normal epithelium, were identified and three 0.6cm punch "biopsy" cores were taken from separate areas. Each core was arrayed into a separate recipient block, and five-micron thick sections were cut and processed as previously described (Konenen, J. et al., Tissue microarrays for high-throughput molecular profiling of tumor specimens, (1987) Nat. Med. 4:844-7). Similarly, 310 cases of colon carcinoma were obtained and arrayed, as previously described (Chung, G.G. et al., Clin. Cancer Res.
• Pixels in which a significant degree of overlap was present were negated from further analysis.
• the pixel intensity of exponentially subtracted images of the target antigen were assigned to one of three compartments: nuclear, membrane, or non- nuclear non-membrane (cytoplasm).
• Target intensities were analyzed as described below. For E.R. only nuclear-localized signal was used, for HER2/neu only membrane-localized signal was analyzed. For beta-catenin total signal, the ratio of nuclear to membrane signal, and the ratio of nuclear to total signal was analyzed.
• staining scores from the breast cancers represent the averaged (for ER) or maximized (for HER2/neu) results from two scorable histospots. Subsequent studies revealed that analysis of a single histospot could provide significant statistical power to judge outcomes, so that staining scores from the colon cancer array represent the result of only one histospot.
• Overall survival analysis was assessed using Kaplan-Meier analysis and the Mantel-Cox log rank score for assessing statistical significance. Relative risk was assessed using the univariate Coxproportional hazards model. Analyses were performed using Statview 5.0.1 (SAS Institute, Cary NC).

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