{"entity":{"id":"preanalytics-sample-stabilisation","kind":"technology","name":"Pre-analytics: blood-collection tubes and tissue fixation","aka":[],"tldr":"The tubes and fixatives that keep a sample stable between the patient and the lab. Unglamorous, but they decide whether a liquid biopsy or PD-L1 stain is trustworthy.","summary":"Cell-free DNA stabilising tubes (Streck Cell-Free DNA BCT, PAXgene ccfDNA, Roche Cell-Free DNA Collection Tube) allow ctDNA to be shipped at room temperature for days; formalin fixation time and ischaemia time affect IHC scoring and nucleic-acid quality (CAP/CLSI and ASCO/CAP HER2 guidelines set 6-72 hour fixation windows); RNAlater and vacuum-sealed transport are alternatives. Pre-analytic variability is a major source of discordant biomarker results.","status":"standard-of-care","asOf":"2026-09-08","links":[{"label":"Wolff et al., HER2 testing in breast cancer: ASCO/CAP clinical practice guideline focused update, including fixation requirements (Journal of Clinical Oncology 2018)","url":"https://doi.org/10.1200/JCO.2018.77.8738"}],"tags":["supporting"],"related":[],"cancers":[],"sections":["diagnostics"],"technologies":["liquid-biopsy","histopathology-ihc","biobanking","reference-laboratories"],"targets":[],"drugs":[],"companies":["streck","qiagen","roche-genentech"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-wolff-j-clin-oncol-2018"],"journals":[],"dependsOn":[],"notes":[],"principle":"Chemical stabilisers prevent leukocyte lysis and nuclease activity in blood; cross-linking fixation preserves morphology and antigens in tissue within validated time windows.","strengths":["Enables centralised liquid biopsy testing","Standards exist for key biomarkers"],"limitations":["Fixation artefacts degrade DNA/RNA","Adherence to windows uneven","Little attention outside reference labs"]},"route":"/technologies/preanalytics-sample-stabilisation/","neighbours":{"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"}],"technology":[{"id":"biobanking","kind":"technology","name":"Biobanking and tissue procurement","route":"/technologies/biobanking/"},{"id":"histopathology-ihc","kind":"technology","name":"Histopathology & immunohistochemistry","route":"/technologies/histopathology-ihc/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"reference-laboratories","kind":"technology","name":"Reference laboratories and companion-diagnostic testing","route":"/technologies/reference-laboratories/"}],"company":[{"id":"qiagen","kind":"company","name":"QIAGEN","route":"/companies/qiagen/"},{"id":"roche-genentech","kind":"company","name":"Roche / Genentech","route":"/companies/roche-genentech/"},{"id":"streck","kind":"company","name":"Streck","route":"/companies/streck/"}],"paper":[{"id":"paper-wolff-j-clin-oncol-2018","kind":"paper","name":"Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update","route":"/key-papers/paper-wolff-j-clin-oncol-2018/"}]}}