Techniques

Our techniques are reviewed, monitored and constantly updated in Patológika and Patológika Molecular. We are open to the erection of any technique that can be applied in the diagnosis field, in order to remain at the forefront of diagnosis, training of our professionals and offer the best possible service to our patients.

 We only use diagnostic kits with , and   brand to warrant a perfect diagnose.

 

CYTOLOGICAL STUDIES:

· Fine

· Exfoliative cytology.

· Ginecological Cytology.

· Body Fluids' Citology. 

 

ANATOMOPATHOLOGICAL STUDIES:

· Biopsies.

· Surgical pieces.

· Intraopertive.

· Mohs' surgery.

 

STAINING METHODS:

· All classic and special techniques that are performed in Pathology

 

IMMUNOFLUORESCENCE:

· Immunoglobulins IgA, IgG, IgM.

· Complement Proteins: C3c, Cq1

 

IMMUNOHISTOCHEMISTRY:

· Over 200 antibodies panel for differential diagnose.

· BREAST cancer panel: Estrogens, Progesterone, Ki-67, c-erbB-2, p53, E-cadherin, Bcl-2, Mammaglobin, S100, Smooth Muscle Actin, Myosin, Caldesmon, EMA, CD31, CD34, GCDPF-15, etc.

· LINFOMA and BONE MARROW panel: ALK, DAK-Pax5, Bcl2, Bcl6, CD1a, CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD15, CD19, CD20, CD21, CD23, CD30, CD31, CD34, CD43, CD45, CD56, CD57, CD68, CD79a, CD138, Cyclin D1, EMA, IgA, IgD, IgGm IgM, Kappa, Lambda, Ki67, MUM1, Myeloperoxidase, Nucleophosmin, S100, TDT, Factor VIII, Zap-70

. LUNG panel: Ki-67, p53, TTF-1, Vimentin, Synaptphyisin, CKs, S100, Calretinin, CEA, Chromogranin A, EMA, D2-40, etc.

. COLON panel: MLH1, MSH2, MSH6, PMS2, CK20, p53, MDM2

. SKIN panel: CD45, E-cadherin, EMA, Melan-A, HMB-45, S100, Tyrosinase, Smooth Muscle Actin, Synaptphyisin.

. PROSTATE panel: p504, VK5/6, Ki-67, p53, PSA, Synaptphyisin.

. NERVOUS SYSTEM: CD45, Chromogranin A, CKAE1/AE3, GFAP, Neurophilament protein, S100, Synaptphyisin.

· etc.

 

MACROPHOTOGRAPHY AND MICROPHOTOGRAPHY:

We perform macrophotography of biopsies and surgical specimens and conventional and fluorescent

microphotography of slides.

 

MOLECULAR BIOLOGY:


. PCR and Low Density Micro-array to detect microorganisms causing infections of the urogenital tract (Bacteria: Chlamydia, Neisseria, Mycoplasma, Ureaplasma, Treponema, Haemophilius; Viruses: HSV1 y 2; Parasites: Trichomonas; Hongos: Candida sp.)

· PCR and Low Density Micro-array to detect Human Papilloma Virus (35 strains).

· PCR and Low Density Micro-array to detect other viruses: HSV-1 y 2, VZV, EBV, CMV, HHV-6, HHV-7,

HV-8, Coxsackievirus, Poliovirus and Enterovirus.

· PCR in IgH and TCR rearrangements in lymphoma.

. Paternity and maternity tests and human genetic identification tests (DNA Fingerprinting).

· Multiplex Real-Time PCR:

 

GEN

MUTACIONES

INDICACIONES

MARCADO

EGFR

29 mutations

NSCLC (Gefitinib, Erlotinib), TKI therapies


KRAS

19 mutations

Colon cancer, lung cancer, pancreas cancer, Cetuximab o Panitumumab

 

RUO

NRAS

16 mutations

NSCLC, melanoma, colon.

 

RUO

BRAF

6 mutations

Melanoma, colon cancer, thyroid cancer, ovarian cancer, prostate ca.

 


PIK3CA

5 mutations

Breat cance, NSCLC,

 


EML4/ ALK

21 transcrits protein fusion

NSCLC

 


ROS1

14 transcrits protein fusion

Eficiency to TKI therapies in NSCLC.

 


JAK2

V617F

Policitemia vera, trombocitopenia, mielofibrosis idiopática.

 

RUO

BCR/ABL

T315I

Leucemia Mieloide Crónica, resistencia a Glivec1, 2

 

RUO

C-KIT

D816V

Leucemia Mieloide Aguda, GIST, cáncer testículo

 

RUO

ERCC1

(Excision Repair Cross-Complementation 1)

expression level

Sensibilidad a terapias basadas en platino 3, 4, 5

 


RRM1

(Ribonut. Reductasa M1)

expression level

Response to Gemcitabine

 

RUO

TYMS

(Timilidato sintetasa)

expression level

Response to fluorinated chemotherapy

 

RUO

 

1. Druker BJ, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 2001;344:1031–7.

2. Jabbour E, et al. Characteristics and outcomes of patients with chronic myeloid leukemia and T315I mutation following failure of imatinib mesylate therapy. Blood 2008;112:53–5.

3. Olaussen KA, Dunant A, Fouret P, Brambilla E, André F, Haddad V et al. (2006). "DNA repair by ERCC1 in non-small-cell lung cancer and cisplatin-based adjuvant chemotherapy". N Engl J Med 355 (10): 983–91.
4. Bellmunt, et al. (2007) “Gene expression of ERCC1 as a novel prognostic marker in advanced bladder cancer patients receiving cisplatin-based chemotherapy”. Ann Oncol. 2007 Mar;18(3):522-8. .
5. Ceppi, et al. (2008) “Excision repair cross complementing-1 and topoisomerase IIalpha gene expression in small-cell lung cancer patients treated with platinum and etoposide: a retrospective study”.
J Thorac Oncol. 2008 Jun;3(6):583-9.

 

 

CYTOGENETICS:

· FISH amplifications in Breast Cancer HER-2/NEU gene, TOP2-α gene.

· FISH amplification EGFR gene (lung cancer, pancreatic cancer, colon cancer).

. FISH translocations in ALK gene 2p23 in lung cancer.

· FISH translocations in Follicular Lymphoma (Bcl2/IgH) t(14:18) gene.

· FISH translocations in Mantle Cell Lymphoma (Bcl1/IgH) t(11:14) gene.

. FISH translocations in Synovial Sarcoma t(X;18) (p11.2;q11.2)

· FISH in spermatozoid cells (disomy studies in sexual chromosomes).

. FISH in cytological specimens.

. etc.

 

 

Diagnostics and Therapeutic Targets in Cancer

 

Breast Cancer:

 

Parámetro

Técnica

Indicación

Receptores hormonales, Ki67, p53

Inmunohistoquímica

Hormonoterapia

Expresión de Her2/neu

Inmunohistoquímica

Sensibilidad a Trastuzumab

Amplificación de HER-2/NEU

FISH

Sensibilidad a Trastuzumab

Amplificación de TOP2α

FISH

Tolerancia a antraciclinas

 

 

Colorectal Cancer:

 

Parámetro

Técnica

Indicación

Mutaciones en K-RAS, codones 12, 13 y 61 (9 mutaciones).

Biología Molecular

Respuesta a Cetuximab y a Panitumumab

Mutaciones EGFR

Biología Molecular

Respuesta a Erlotinib/Gefitinib

Amplificación de EGFR

FISH

Respuesta a Erlotinib y Gefitinib

HNCC (MLH1, MSH2, MSH6)

Inmunohistoquímica

Fenotipo de HNCC

ERCC1, Thymidylate Synthase, Thymidine Phosphorylase

Inmunohistoquímica

Tratamiento con 5FU, xeloda o tomudex

 

 

Lung Cancer:

 

Parámetro

Técnica

Indicación

Mutaciones EGFR exones 18 a 21

Biología Molecular

Respuesta a Erlotinib/Gefitinib

Mutaciones en K-RAS, codones 12, 13 y 61 (9 mutaciones)

Biología Molecular

Respuesta a Cetuximab y Panitumumab

Amplificación de EGFR

FISH

Respuesta a Erlotinib y Gefitinib

ERCC2-ERCC1

FISH

Tratamiento con Platino o Erlotinib

 

 

 

Other Molecular Studies in Cancer Diagnostics:

 

Parámetro

Técnica

Indicación

Estudio de t(8;14) (MYC,IGH)

FISH

Linfomas de células grandes, linfoma de Burkitt

Estudio de t(¿;22) (EWS)

FISH

Sarcoma de Ewing y otros tumores de células redondas

EBER (RNA del Virus de Epstein Barr)

Biología molecular

Linfomas (Burkitt), MI, Carcinoma nasofaríngeo,
Mononucleosis Infecciosa

HPV (35 cepas)

Biología molecular

Cáncer cuello útero, cáncer pene, cáncer boca, lengua y esófago

CMV (citomegalovirus o HHV-5)

Biología molecular

Glioblastoma multiforme, Mononucleosis Infecciosa

Herpes Virus Simplex (HSV-1, 2 y VZV o Varicela Zoster)

Biología molecular

Neoplasias Hematológicas, Hepatitis, etc.

Herpes Virus Humano (HHV-6, 7 y 8)

Biología molecular

Sarcoma de Kaposi

Enterovirus (Poliovirus, Echovirus, Coxsakievirus)

Biología molecular

Neoplasias Hematológicas