$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
In a hematoxylin-and-eosin-stained slide from the paraffin-embedded cell block (Figure 3A,B), most of the nuclei and cytoplasm of the cells are intact, suggesting that the morphological preservation is excellent with the current protocol (Figure 3A). In the immunocytochemical staining, positive CKAP2 staining was observed in condensed chromatin, mitotic spindle, and cytoplasm (Figure 4), as previously reported10. Ki-67 staining was observed in the cell nuclei, as expected (Figure 4). Only the cells with CKAP2 staining in condensed chromatin (see the arrows in Figure 4A,B) were mitotic cells. Many CKAP2-positive cells were shown in the highly mitotic HeLa cells that had been prepared after an incubation in complete medium (Figure 4A). In comparison, there were few CKAP2-positive cells in the serum-starved HeLa cells (Figure 4B). Most of the highly mitotic HeLa cells were Ki-67 positive (Figure 4C). Contrastingly, the Ki-67-positive rate in the serum-starved HeLa cells remained as high as ~50% (Figure 4D). These results are quite comparable to those of a previous report11, which suggests that CKAP2 is a more reliable proliferation marker in cancer cells than is Ki-67.
In poorly prepared cell blocks, the nuclei are separated from the cytoplasm, and there is also, resultantly, poor morphologic preservation. Longer-than-overnight incubation of fixed cells in a refrigerator might cause such poor results. Another important problem is that cells are not stained well by immunocytochemistry, notwithstanding the excellent morphology. This problem arises more often when the cell clot is small. Typically, the staining intensity is irregular as shown in Figure 3B; but when the cell clot is larger, there is much less chance of irregular staining. Therefore, in this protocol, we increased the volumes of plasma, thromboplastin, and calcium chloride in order to form a large cell clot.

Figure 1: Cell-block preparation scheme. Please click here to view a larger version of this figure.

Figure 2: Illustration of paraffin cell-block preparation. (A) Thromboplastin-plasma cell clot in tube. (B) TP Cell clot after PBS washing. (C) Cell clot on moistened filter paper. (D) Tissue-embedding station with molten wax. Metal mold (arrow) holds molten wax for solidification. (E) Paraffin-embedded cell clot (arrow) embedded in paraffin or paraffin-embedded cell block. (F) Thin paraffin section on the middle part of a coated slide. Please click here to view a larger version of this figure.

Figure 3: Cell-block preparation and confirmation of quality by hematoxylin and eosin and immunostaining. (A) Hematoxylin-and-eosin-stained image of HeLa cells in a paraffin-embedded cell-block section. (B) Irregular staining of Ki-67 in immunocytochemistry on a poorly prepared paraffin-embedded cell-block section. Scale bars are (A) 100 and (B) 200 μm. Please click here to view a larger version of this figure.

Figure 4: Immunocytochemical staining on paraffin-embedded cell block for HeLa cells. (A) CKAP2 staining under highly mitotic conditions. (B) CKAP2 staining under serum-starved conditions. (C) Ki-67 staining under highly mitotic conditions. (D) Ki-67 staining under serum-starved conditions. 100 μm scale bars are shown. The arrowheads indicate CKAP2-positive cells. Please click here to view a larger version of this figure.
| Procedure | Steps | Solution | Time/Temperature |
| Dehydration | 1 | 70% alcohol | 15 min/RT |
| 2 | 80% alcohol | 15 min/RT |
| 3 | 95% alcohol | 15 min/RT |
| 4 | 100% alcohol | 15 min/RT |
| Clearing | 1 | Xylene | 60 min/4 °C |
| 2 | Xylene | 10 min/RT |
| 3 | Xylene | 10 min/RT |
| 4 | Xylene | 10 min/RT |
| *RT, room temperature | | | |
Table 1. Tissue processing procedure.