TITLE: Gynecologic Oncology Tissue Processing (10% Formalin Fixation)
AUTHORS: Mary Mullen M.D., Rachel Abbott

[DESCRIPTION]
This is a description of the steps that the Washington University's Gynecologic Oncology Tissue Bank has developed to collect surgical resection biospecimens, for molecular and genomic characterization. There are multiple protocols with various preservation methods and targeted assays. Here only the Formalin-Fixed Paraffin-Embedded (FFPE) related information is provided. 

[STEPS]
SECTION: Specimen Collection &amp; Handling (10% Formalin Fixation)
1.     Tissue should be no bigger than 1x1x0.5 cm. 
SECTION: Specimen Collection &amp; Handling (10% Formalin Fixation)
2.     Label cassettes using pencil with Tissue Bank ID, date, and tissue type. 
SECTION: Specimen Collection &amp; Handling (10% Formalin Fixation)
3.     Place tissue in a cassette that is adequate for the size of tissue being fixated. 
SECTION: Specimen Collection &amp; Handling (10% Formalin Fixation)
4.     Place cassette in specimen cup filled with ~60 mL 10% formalin to transport to the lab at room temperature. 
SECTION: Tissue Processing (10% Formalin Fixation)
5. Tissue should be no bigger than 1x1x0.5 cm 
SECTION: Tissue Processing (10% Formalin Fixation)
6. Label cassettes using pencil with Tissue Bank ID, date, and tissue type. 
SECTION: Tissue Processing (10% Formalin Fixation)
7. Place tissue in a cassette that is adequate for the size of tissue being fixated. 
SECTION: Tissue Processing (10% Formalin Fixation)
8. The volume of formalin should be 30 times the volume of the tissue samples. Containers should be capped and leak-proof. 
SECTION: Tissue Processing (10% Formalin Fixation)
9. Leave tissue in the container for at least 24 hours in the hood.  
a.    For omentum samples, leave tissue for 24-48 hours depending on thickness.  
b.    For samples collected on Friday, leave samples in formalin over the weekend.  
SECTION: Tissue Processing (10% Formalin Fixation)
10. After fixation, transfer tissue to water rinses, 3 rinses for 15 minutes (on a shaker preferably). The volume of DI water should be 30 times the volume of the tissue sample. 
SECTION: Tissue Processing (10% Formalin Fixation)
11. After water rinses, transfer tissue to the following for the given times: 
a.    30% ethanol for 30 min 
b.    50% ethanol for 30 min 
c.    70% ethanol for 30 min 
The volume of ethanol used for these rinses should be 30 times the volume of the tissue sample. 
SECTION: Tissue Processing (10% Formalin Fixation)
12. All specimens are to be received by HistoCore in 70% ethanol, unless otherwise stated by the Histotechnologist. Samples should be turned in to HistoCore before 3:00 p.m. every day, except Fridays. 
SECTION: Tissue Processing (10% Formalin Fixation)
13. One quality control slide per sample should be labeled with Tissue Bank ID, date, and tissue type.  
SECTION: Tissue Processing (10% Formalin Fixation)
14. Complete the submission form: Histocore Submission Form.
SECTION: Tissue Processing (10% Formalin Fixation)
15. Deliver the tissue in 70% ethanol, labeled slides, and submission form to Histocore. 
SECTION: Tissue Processing (10% Formalin Fixation)
16. When the FFPE block and slide are received back from Histocore, attach pre-printed Open Specimen labels and store in designated location.
SECTION: Tissue Processing (10% Formalin Fixation)
17. The H&E slide should be submitted to Dr. Hagemann for QC when possible.
SECTION: Research Specimen Disposal Procedure (10% Formalin Fixation)
18. Dispose transport container in a biohazard waste box.
SECTION: Research Specimen Disposal Procedure (10% Formalin Fixation)
19. Collect formalin and washes in a flask using an aspirator. 
SECTION: Research Specimen Disposal Procedure (10% Formalin Fixation)
20. Transfer liquid collected in flask to the appropriate unwanted material container.