For the development of 'personalized medicine' it is necessary to perform translational research on patient tissue samples. It is of crucial importance that the pre-analytical phase does not influence the desired results.

In this thesis a number of experiments on many levels (e.g. gene expression, immunohistochemistry) are described, which shed light on the adverse effects of ischemia and formalin fixation on gene expression and antigenicity.

Some of the main conclusions are that surgery can cause gene up or down regulation, smaller tissue samples decay faster than larger ones and that the adverse effects of formalin fixation can be undone by fine tuning the analytical phase, rather than standardizing the pre-analytical phase.

These results will become part of new ISO guidelines and protocols in the near future and will lead to less variabilty in down stream techniques.

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J.W. Oosterhuis (Wolter)
Erasmus University Rotterdam
The research described in this thesis was performed at the Department of Pathology, Josephine Nefkens Building, Erasmus MC Cancer Institute, Rotterdam, The Netherlands and financially supported by the European Union Seventh Framework Programme Project SPIDIA [FP7/2007–2013] under grant agreement number 222916.
Erasmus MC: University Medical Center Rotterdam