USE OF A NEW FIXATIVE FOR HISTIOPATHOLOGICAL STUDIES BASED ON METHYL-ETHYL- KETONE PEROXIDE IN ORDER TO ELIMINATE THE CARCINOGENIC RISK OF FORMALDEHYDE

Silvestro Mauriello¹, Manuela Montanaro², Manuel Scimeca², Filippo Milano¹, Francesca Servadei², Erica Giacobbi², Gian Luca Marella³, Luigi Tonino Marsella¹, Saverio Potenza¹ 

¹Forensic Medicine, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome 00133, Italy - ²Anatomic Pathology, Department of Experimental Medicine, University of Rome Tor Vergata, Rome 00133, Italy - ³Forensic Medicine, Department of Surgical Sciences, University of Rome Tor Vergata, Rome 00133, Italy

Introduction: Formaldehyde is a fixative agent which has many uses, including also that one in hospitals for its relevant role in maintaining and preserve tissues, allowing their bio-morphological analysis. Known also as formalin, several are its advantages, but also disadvantages emerged over time; many studies focused their attention on occupational exposure of workers to this substance and its risks: the incidence of cancer among workers exposed to formalin led it to be classified as carcinogen agent. In order to protect workers from formalin exposure, this study aims to evaluate a new substance formalin-free, namely Fluytan, and its properties to preserve and fix tissues.  

Material and methods: Starting from 10 judicial autopsies, heart, lung, liver and kidney were collected and divided in different study groups, to evaluate the fixation power of Fluytan at different concentrations. All specimens undergone 48 hours of fixation. Haematoxylin & Eosin and immunohistochemical staining were performed to assess the quality of Fluytan and its ability to preserve tissue morphology.  

Results: Our analyses revealed any complication for both sectioning procedures and morphological evaluation of specimens. In particular, from Fluytan 10% and 20% solution fixed tissue no differences in cellular structures emerged, as compared to formalin fixed samples; supporting these results, also immunohistochemical analysis of Fluytan fixed samples displayed an equivalent cell positivity, with respect to formalin fixed tissues, thus, maintaining the proper specificity with any artifact increased risk of background.   

Conclusion: Considering inherent health risks in the use of formalin to date, Fluytan can certainly find applications in forensic medicine and tanatopraxis, thus eliminating the risk linked to exposure of all operators involved in these fields and considering our results. Other studies might reveal Fluytan as a promising candidate for formalin replacement in the surgical pathology.