LINK is the opportunity to have real world experiences in a three week internship of our choosing. Where students have to have 30-40 hours per week, and complete and project for the businesses that they intern at. At the end of the internship we have to present what we did at our internship and our project.
Cedar Diagnostic is a pathology laboratory. In house they do drug testing, and has access to many different staining technology for a wide variety of diagnostics.
First each specimen goes into the computer to enter the system, specimens can be acquired many different ways such as a fine needle biopsy, surgeries, and scopes. Then goes to the grossing room to get a gross description of it and put into a cassette.
Next the specimen is embedded in wax then cut and put on a slide.
Next the slides get an H&E stain, and whatever additional stain that the pathologist thinks is necessary.
Finally the slides are looked at by the pathologist and given a diagnosis.
LINK Anticipation and Preparation
To find my internship I asked my parents what cities I would have a place to stay, and then looked up crime labs in those cities. I emailed about nine places, half of them didn't respond back to me the other half said I needed to be eighteen and in college. Then I started to look locally and my mom told me about Cedar and I emailed them and they said yes. I thought they would be a nice fit because they had labs and told me they would try and get me into an autopsy since I was interested in forensics. I was really excited that I would be able to find out if I could actual handle the gruesome things in real life. I hped to bring enthusiasm to the workplace. I hope to leave the impression that teenagers can be hard workers too.
For my project I had to learn about the validations for immunohistochemistry (IHC) stains and for the new gonorrhea and chlamydia (GC/CT) machine, viper. I then had to come up with a plan to validate IHC stains for estrogen receptor (ER), progesterone (PR), and human epidermal growth factor receptor (HER2).
Antigens are targeted through antibodies that have a catalyst attached, so when the sample is dyed the antibodies produce color.
Antibodies and Antigens
Antibodies - Is a large Y-shaped protein produced mainly by plasma cells that is used by the immune system to neutralize pathogens. Antigens - A toxin or other foreign substance that induces an immune response in the body, especially the production of antibodies.
Production of Antibodies
Antigens are injected into laboratory or farm animal to evoke high expression levels of antigen-specific antibodies in the serum, which is recovered from the animal.
What was Validated
Er, PR, and HER2 all antibodies. ER and PR target general breast tissue that has the antigen. While HER2 targets the breast cancer cells and detects the herceptin, which is a drug in breast cancer. These needed to be validated because the lab ordered new clones for PR and HER2 because they were cheaper. Since the lab still had their old validated slide, the lab just needed to re-cut new slides, stain them and compare them to the already validated slide. With ER they only needed to compare two slides because it wasn’t a new clone but they did have to buy a new batch of it. The PR and HER2 need 20 samples of positive and negatives each to revalidate them.
How to Validate
Known controls can be used and tested, and a practice will also do a patient study, where they test patients sample and and send them to another lab to have them tested and test them in their own lab to validate the results. Labs will use about 20 positive and negatives each for known controls, that will always test positive or negative, and about 40 positive and negatives each for the patient study. In order to validate something you must have a licence and be accredited by the College of American Pathology (CAP) and use their regulations. A certain percentage of the tested specimen need to be accurate in order for the practice to test for that disease.
The most helpful thing for the internship was to be flexible, and go with the flow, because things could change. Though the most important skilled learned would be that it's good to ask for confirmation, if you are not sure you are doing something right. Like when staining slides,it's okay to ask what the next step is, or to check the number on the cassette to make sure they are labeled right. I would have to double check labels a lot because I would mis label. I would also have instructions repeated and say them back to my mentor to make sure. I was a really hard worker and was very open to do anything they wanted me to do even if it was boring. The internship really made me think about my career choice because first I wanted to go into forensic anthropology, knowing there were no jobs for that, but now I', thinking about forensic pathology because I loved the pathology work and still want to work in crime.