Addressing the Lack of Widespread Metabolomic Profiling of Clinically Diseased Conditions Through the Use of Surgical Pathology Specimens

Abstract

Our goals are to primarily determine if metabolites present in tissue can be extracted from surgical pathology specimens without altering morphology, and if the extracted fluid can be used for evaluation by mass spectrometry technology. Our secondary goal is to determine if this pre-analytic step can be incorporated into the surgical pathology workflow of a clinical laboratory.

We immersed unfixed tissues in methanol followed by routine formalin fixation paraffin embedding. We then compared morphology of tissues immersed in methanol to matching tissue not exposed to methanol. We also examined methanol extracts for suitability as substrate for analysis by mass spectrometry. Further, we determined the amount of time this additional step requires. Our results show that only minor changes are noted in methanol fixed tissues but are insignificant and not sufficient to alter diagnostic value. Methanol extracts with analytes are present for evaluation, with different tissue types possessing different profiles. Addition of this pre-fixation step only adds under 15 minutes of dedicated work. In conclusions, tissues can be pre-fixed in methanol to create extracts suitable for mass spectrometric analysis without significant changes in morphology. The potential merit of adding supplementary bio-informative data for research and clinical studies exceeds the value of the time commitment needed to create these extracts.

[N A J Med Sci. 2026;19(1):012-018.   DOI: 10.7156/najms.2026.1901012]