Services

Including: skin, breast, oral cavity, larynx, bronchial, lung, stomach, duodenum, large and small intestine, anus, liver, gallbladder, pancreas, kidney, ureter, urinary bladder, urethra, testis, prostate, ovary, endometrium, uterine cervix, vulva, soft tissues, lymph nodes, bone, thyroid, parathyroid, adrenals, pituitary, brain, spinal cord, etc.

The procedure of a histological examination requires the processing of tissues with various liquid solutions (formalin, ethanol, xylene, paraffin), thin sectioning with a dedicated microtome, and staining. This process usually takes 24 to 48 hours to complete

Consultation during a surgical operation, where the pathologist is asked to give in a few minutes an initial (but not definitive) diagnosis regarding the nature of a tumor (benign or malignant) or to evaluate if the tumor margins are clear. In addition, frozen sections may be used as an initial evaluation for the presence or not of metastatic disease in lymph nodes.

In every case frozen sections are followed by the permanent paraffin sections, on which the final (definitive) diagnosis are based.

Fetal autopsies of all gestational ages, for identification of the cause of a intrauterine death, and for the identification or exclusion of any congenital malformations. In these cases the placenta, the umbilical cord, and the fetal membranes are also evaluated.

The time needed to conclude a fetal autopsy is usually two weeks.

These are based on the natural chemical properties of tissues, like PAS/diastase and Αlcian Blue which stain mucin, PAS which stains fungi and glycogen, Giemsa which stains the helicobacter pylori, Gomori for reticular fibers, Verhoeff for elastic fibers, Perl for hemosiderin, etc.

These stains detect cellular proteins with the use of specific antibodies. Immunohistochemistry is required as an additional method to conclude the result of the histological diagnosis in the following cases:
α) for the distinction between an in situ and an invasive carcinoma.
b) for typing of a malignant tumor, as it is required for example in lymphomas, soft tissue tumors (sarcomas), neuroendocrine tumors, etc.
c) for the determination of the origin of a metastatic tumor of unknown primary site.
d) for the detection of minute metastatic foci in lymph nodes.

Immunohistochemistry is also a valuable tool for the determination of prognostic and predictive factors in various tumors. These factors predict the response of a tumor to a certain targeted therapeutic agent, as is used routinely for breast cancer for example (hormonal receptor status, ΗΕR2) or for gastric cancer (HER2). Based on these results, the Oncologist will decide which therapeutic scheme is the most suitable for each patient.

In many cases patients come to us seeking a second opinion on their diagnosis, in order to confirm their results. In these cases, the slides and the paraffin blocks of the original diagnosis should be submitted to the lab of second opinion. This material is released after signing the appropriate documents.
Our lab has the experience and the accreditations to provide second opinion for histological examinations, if the referring doctor, the patient or his close relatives need to do so.

Our lab Istotypos IKE, in a joint venture with the Pathology Lab of Istodierevnitiki SA, entered the field of cancer molecular biomarkers, with the IDYLLA platform of the Belgian company BIOCARTIS. This a innovative RT-PCR method for personalised high precision diagnostics, which combines the following characteristics:
– Single-use cassette, where the sample of a single patient is placed (paraffin section or plasma). The platform does not need collection of multiple specimens to operate.
– Rapid processing time: 2 to 2,5 hours turnover time for results, the same day the test is requested from the oncologist.
– High sensitivity: It requires presence of only 10% of cancer cells in a paraffin section. It may give results where NGS fails.
– High accuracy, comparable with NGS reference methods.
– Zero chance for contamination from other samples, since this is a one-step, closed system.
– Fully automated method: does not need specialised personnel.

The tests provided at the moment are:

1. Lung cancer:
– EGFR: detects 51 mutations in paraffin sections.

2. Colorectal cancer:
– ΚRAS: detects 21 mutations in paraffin sections and plasma (liquid biopsy).
– NRAS/BRAF: detects 18 mutations of NRAS and 5 of BRAF in paraffin sections and plasma (liquid biopsy).
– MSI: detects 7 monomorphic biomarkers in paraffin sections.

3. Melanoma:
– BRAF: detects 7 mutations at codon 600 in paraffin sections.

More is awaited from the IDYLLA platfrom during 2020, including introduction of Oncotype DX for breast cancer, Oncotype DX for prostate cancer, and all clinically validated fusion genes for lung cancer.
In the near future we are planning to cover all the clinically relevant molecular biomarkers for cancer, gradually introducing other technologies, beyond ΙDYLLA platform.