At Oncomet, we put together the best of technology and years of experience which has enabled us to be a one stop solution for Cancer Diagnosis. Working alongside with the consulting onco-specialist, our only aim for each patient is that he/she gets an absolute diagnosis of her condition. Listed are just a few of the technologies that we have adopted.
Histopathology refers to the microscopic examination of tissue in order to study the manifestations of disease. Specifically, in clinical medicine, histopathology refers to the examination of a biopsy or surgical specimen by a pathologist, after the specimen has been processed and histological sections have been placed onto glass slides
Anatomic pathology is a medical speciality that is concerned with the diagnosis of disease based on the macroscopic, microscopic, chemical, immunologic and molecular examination of organs and tissues.
Liquid Based Cytology
Liquid-based cytology is a method of preparing samples for examination in cytopathology. The sample is collected, normally by a small brush, in the same way as for a conventional smear test, but rather than the smear being transferred directly to a microscope slide, the sample is deposited into a small bottle of preservative liquid. At the laboratory the liquid is treated to remove other elements such as mucus before a layer of cells is placed on a slide. The technique allows more accurate results. The advantage of liquid based cytology is that it allows sample preservation and the same sample could be reflexed to further ancillary tests like HPV DNA analysis.
Immunohistochemistry (IHC) refers to the process of selectively imaging antigens (e.g. proteins) in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots “immuno”, in reference to antibodies used in the procedure, and “histo,” meaning tissue (compare to immunocytochemistry). Immunohistochemical staining is widely used in the diagnosis of abnormal cells such as those found in cancerous tumors. IHC also has theranostic (Therapy + Diagnostic) applications i.e utilized for defining the targets,for which specific therapies are available.
The morphology of a cancer refers to the histological classification of the cancer tissue (histopathological type) and a description of the course of development that a tumour is likely to take: benign or malignant (behaviour).
Bone Marrow Studies
Currently, inspection of bone marrow is considered one of the most valuable diagnostic tools for evaluating hematologic disorders.  Indications have included diagnosis, staging, and therapeutic monitoring for lymphoproliferative disorders such as chronic lymphocytic leukemia (CLL), Hodgkin and non-Hodgkin lymphoma, hairy cell leukemia, myeloproliferative disorders, myelodysplatic syndrome and multiple myeloma.
In this sophisticated technique, we measure properties of cells in a sample of bone marrow, lymph nodes, or blood. The sample is first treated with special antibodies and passed in front of a laser beam. If the antibodies attach to the cells, the cells will give off light. Looking for certain substances, or antigens, on the surface of cells helps us to identify the cell type.
Flow cytometry can also be used to measure the amount of DNA in cancer cells. In this case, the cells are treated with special light-sensitive dyes that react with DNA. For patients with breast, prostate or bladder cancer, an abnormal amount of DNA may indicate a recurrence.
FISH is a rapid sensitive targeted technique that bridges the gap between Cytogenetics and Molecular biology. FISH is complementary to classical karyotyping and is used as an indispensable tool for identification of recurrent genetic abnormalities such as translocations, deletions, duplications, inversions and amplifications at molecular level in hematological malignancies as well as solid tumors. FISH is also used for detection of chromosomal rearrangements and fusions, such as the fusion of ALK tyrosine kinase domain with the promoter and 5’ region of EML4 in lung cancer. ALK-positive tumors are a clinically relevant subgroup as they can be very effectively treated with the ALK inhibitor crizotinib.
Chromogenic in situ hybridization (CISH) is a cytogenetic technique that combines the chromogenic signal detection method of immunohistochemistry (IHC) techniques with in situ hybridization. CISH is frequently applied to assess gene amplification, such as HER-2/neu status in breast cancer samples.
Apart from cancers, CISH has also been shown to be useful in detecting viral infections like EBV(Epstein Barr virus) & CMV (Cytomegalovirus)
It is a molecular biology technique that allows for quick replication of DNA. With PCR, minute quantities of genetic material can be amplified millions of times within a few hours allowing for the rapid and reliable detection of target gene or mutation. The method relies on thermal cycling, consisting of cycles of repeated heating and cooling of the reaction for DNA melting and enzymatic replication of the DNA. Primers (short DNA fragments) containing sequences complementary to the target region along with a DNA polymerase (after which the method is named) are key components to enable selective and repeated amplification. Amplified gene products can further help in detecting molecular markers for accurate diagnosis, prognosis and to predict response, resistance, or toxicity to therapy.
Real Time PCR
A real-time polymerase chain reaction (RT-PCR), also known as quantitative polymerase chain reaction (qPCR), is based on the polymerase chain reaction (PCR). It monitors the amplification of a targeted DNA molecule during the PCR, i.e. in real-time, and not at its end, as in conventional PCR. It provides enhanced sensitivity over PCR and hence can be used for detection of low levels of somatic mutations.
DNA sequencing is the determination of the precise sequence of nucleotides in a sample of DNA or PCR product. DNA sequencing is performed using the chain termination method developed by Frederick Sanger. This technology is used for detection of different types of pathogenic mutations or variations such as point mutations, small insertions and deletions – both germ line and somatic (acquired). This gold standard technology can also detect novel variants.
Multiplex Ligation Dependent Probe Amplification (MLPA)
MLPA is a semi-quantitative technique that is used to determine the relative copy number of up to 60 DNA sequences in a single multiplex PCR-based reaction. This technology enables detection of deletions, duplications or large rearrangement across the gene.
Next generation” or “deep” sequencing (NGS) refers to a new, versatile technology of DNA sequencing that has an ability to massively parallel sequence millions of DNA templates. It permits high-throughput, highly adaptable whole genome-scale assays at reasonable cost and high accuracy. Technical and bioinformatical advances make the NGS technology increasingly more powerful.
Recently, DNA micro-array-based tumor gene expression profiles have been developed and used in the tumor diagnosis and classification. Many studies have demonstrated that a subset of genes is characteristically expressed in ovarian cancers, oral cancers, melanomas, colorectal carcinomas and prostate carcinomas. Molecular classifications using DNA micro-array is useful for the determination of primary sites in metastatic carcinomas and the classification of soft tissue sarcomas.
Cancer Cytogenetics is a gold standard technology that identifies numerical as well as gross structural chromosomal abnormalities that help for diagnosis, prognosis, classification, risk stratification and treatment decisions in cancers.