hepatocellular carcinoma (HCC) tissue microarray

In the vast and chaotic oncology universe, hepatocellular carcinoma (HCC) is as complicated as a nebula. It is not a single disease, but a galaxy composed of various heterogeneous malignant tumors, each of which has its own unique gene mutation, molecular pathway and clinical behavior. In order to explore this complexity, researchers are no longer limited to studying a single tumor in isolation, but seek a tool that can observe the whole galaxy at one time, identify patterns, identify abnormalities, and formulate effective treatment plans. This tool is hepatocellular carcinoma tissue microarray (TMA). It is not only a technical platform, but also a carefully constructed constellation, a celestial atlas that guides us through the darkness of this devastating disease. tissue microarray

Imagine that every patient’s tumor is a distant and unique galaxy. Traditional pathological sections are like high-resolution photos of a single planet in the galaxy-rich in details and information, but lacking in background information. It tells us about a planet’s atmospheric composition or geological conditions, but it can’t provide any information about its neighboring planets, the stars around them or its position in the arm of the larger galaxy. HCC TMA has solved the problem of loneliness in this universe with its outstanding elegance. It is an astronomical curatorial activity. A tiny representative core is extracted from hundreds of donor paraffin blocks (each paraffin block is a “galaxy” containing the complete story of the patient’s disease) as a “light sample” from the star. Then these hundreds of light samples are accurately arranged in a receptor paraffin block, thus creating a new artificial sky.

This new starry sky, the TMA slice, is a miracle of concentrating information. Under the microscope, it is not chaotic, but an orderly grid, a pre-designed constellation, in which each light spot represents a person’s story, a clinical result or a therapeutic response. When we began to detect it with different filters, the real power of this map was revealed. Immunohistochemical (IHC) staining is like astronomers using spectral filters. What we are looking for is not hydrogen or helium, but specific protein, an “element” in cancer biology, such as p53, AFP or PD-L1. With the progress of dyeing, constellations began to appear. We may see a group of “bright” stars (high protein expression) associated with low survival rate, which is as clear as Orion’s belt in the night sky. Or, we may recognize a weak but unique expression pattern, which indicates an amazing response to a certain targeted therapy and is a guiding light for the journey of personalized therapy.

This is a change from descriptive astronomy to applied astrophysics. Hccmta enables us to go beyond simply classifying celestial bodies and understand the basic laws governing them. By analyzing hundreds of tumors at the same time, we can make a robust statistical analysis that can’t be achieved by a single case study. We can ask some questions that resonate on the cosmic scale: Is there a universal “law of gravity” that governs the tumor progression of HCC? Is there a specific “binary system” (symbiotic mutation) to produce a super invasive phenotype? TMA provides data sets and group-level evidence needed to verify these assumptions. It transforms anecdotal observation into a statistically significant biomarker, that is, a “physical law” that clinicians can use to predict tumor behavior and intervene effectively.

In addition, TMA is a dynamic map, not a static map. With the emergence of digital pathology and artificial intelligence, we can scan this artificial sky and create a high-resolution digital universe. Machine learning algorithm can act as our most powerful telescope to identify subtle patterns and associations that the human eye can’t detect. They can analyze the texture, shape and spatial arrangement of cells in each core, so as to find “dark matter”-these previously unknown morphological characteristics have predictive ability. The combination of TMA technology and artificial intelligence, just like giving our constellation the ability to predict solar flares, can not only predict the current situation, but also predict the future situation.

Of course, a map is not a territory. The 0.6 mm core is just a snapshot, which is a pixel in a high-definition image. It can’t capture the complete intra-tumor heterogeneity, that is, the various ecosystems existing in a single tumor. But its purpose is not to replace the detailed study of the case, but to provide the necessary overview, that is, to turn the background of the case into a “global”. It is a strategic map that tells us where to deploy the most powerful and resource-intensive research tools.

In a word, HCC tissue microarray is far more than an ingenious Qualcomm screening method. It is a conceptual masterpiece and a tool of systematic thinking, which can help people to think systematically in this field that is often mired in reductionism. It is a constellation chart, an atlas of celestial bodies, which gathers the scattered stars in the experience of individual patients into a coherent and navigable whole. By studying this atlas, we are not only dyeing the slices; We are reading the universe of cancer, reading its pattern, and finally learning how to draw a safe road for patients and cross the dangerous abyss of hepatocellular carcinoma.