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Here, we establish a mass spectrometry-based proteomic method using isolated regions of interest in formalin-fixed, paraffin-embedded tissue sections. This protocol is used to analyze proteome from specific tissue areas in archived formalin-fixed, paraffin-embedded tissue sections.
Mass spectrometry (MS)-based proteomics enables comprehensive proteome analysis across a wide range of biological samples, including cells, tissues, and body fluids. Formalin-fixed, paraffin-embedded (FFPE) tissue sections, commonly used for long-term archiving, have emerged as valuable resources for proteomic studies. Beyond their storage benefits, researchers can isolate regions of interest (ROIs) from normal tissue regions through collaborative efforts with pathologists. Despite this potential, a streamlined approach for proteomic experiments encompassing ROI isolation, proteomic sample preparation, and MS analysis remains lacking. In this protocol, an integrated workflow that combines macrodissection of ROIs, suspension trapping-based sample preparation, and high-throughput MS analysis is presented. Through this approach, the ROIs of patients' FFPE tissues, consisting of benign serous cystic neoplasms (SCN) and precancerous intraductal papillary mucinous neoplasms (IPMN) diagnosed by pathologists, were macrodissected, collected, and analyzed, resulting in high proteome coverage. Furthermore, molecular differences between the two distinct pancreatic cystic neoplasms were successfully identified, thus demonstrating the applicability of this approach for advancing proteomic research with FFPE tissues.
For decades, surgically excised human tissues have been archived as formalin-fixed, paraffin-embedded (FFPE) blocks. These tissue blocks initially preserve the three-dimensional (3D) structure embedded in paraffin. The tissues are subsequently sliced using microtomes, mounted onto slides, and stained-commonly with hematoxylin and eosin (HE) or immunohistochemistry (IHC)-to facilitate histopathological diagnosis by experienced pathologists1,2. FFPE tissues offer distinct advantages for long-term storage due to the protein crosslinking induced by formalin, which halts enzymatic and proteolytic activity3. Because they support the construction of large, well-archived sample sets, FFPE tissues have been regarded as a cornerstone for biomarker discovery across diverse fields, including genomics4,5,6,7.
However, their application in liquid chromatography-mass spectrometry (LC-MS)-based proteomics has historically posed challenges. A key limitation is the formalin-induced protein crosslinking, which interferes with tryptic digestion -- a critical step in global proteome analysis8. Furthermore, the small amount of protein retrievable from tissue slides often renders conventional sample preparation methods unsuitable. Despite these challenges, advances have demonstrated that protein crosslinks can be reversed through prolonged high-temperature treatment9,10,11. Concurrently, sample preparation methods optimized for low-amount protein samples have expanded the use of FFPE tissues in proteomics research12,13,14,15.
One significant advantage of using FFPE tissue slides in proteomics lies in their capability to enable a region-specific analysis. FFPE slides typically contain both lesions and adjacent normal tissue (ANT). Analyzing the entire tissue indiscriminately risks confounding results due to mixed molecular signatures. In contrast, isolating and analyzing regions of interest (ROIs) -- lesions versus ANT -- enables more precise characterization of molecular features specific to pathological regions. Consequently, FFPE-based approaches have become increasingly popular in proteomics studies16,17,18,19,20. Despite their growing application, a streamlined workflow that describes the whole proteomic experiment step-by-step still remains scarce. In particular, a video-based protocol has not been published.
In this study, a robust LC-MS-based proteomics workflow tailored for the accurate profiling of molecular changes within lesion-specific regions was established. Using FFPE tissues diagnosed by two pathologists, the ROIs from benign serous cystic neoplasms (SCN) and precancerous intraductal papillary mucinous neoplasms (IPMN) were macrodissected, collected, and analyzed. The protocol incorporates a macrodissection of ROIs, suspension trapping-based sample preparation optimized for minimal protein inputs, and narrow-range data-independent acquisition (DIA)-MS analysis. This method enabled the identification of over 9,000 proteins from tissue areas approximately 1 cm², deciphering distinct proteomic signatures associated with SCN and IPMN.
This study was reviewed and approved by the Institutional Review Board of Seoul National University Hospital (IRB No. 1904-114-1028). All participants provided written informed consent to participate in the study. Detailed information on all materials used in this protocol is presented in the Table of Materials.
1. FFPE tissue antigen retrieval for proteomics sample preparation
NOTE: Ensure that the scalpels and all materials, such as the tube used, are sterile to avoid any cross-contamination. Protocols of this study can be adapted for any FFPE tissue with minor modifications based on the laboratory setup.
2. FFPE tissue protein extraction
3. Protein quantification of FFPE tissue lysate
NOTE: Most bicinchoninic acid assay steps for protein quantification are based on the manufacturer's instructions with minor modifications. It is recommended that reagents be prepared according to the manufacturer's guidelines.
4. Acetone precipitation of protein
NOTE: Ensure that a total of 100-300 µg of protein is used for acetone precipitation and suspension trapping-based protein digestion.
5. Suspension trapping-based protein digestion
NOTE: The suspension trapping filter-based protein digestion procedure was adapted from the manufacturer's instructions with minor modifications.
6. Peptide quantification
NOTE: Most of the steps of quantitative colorimetric peptide assay are adapted from the manufacturer's instruction with minor modifications. It is recommended that reagents be prepared according to the manufacturer's guidelines.
7. Liquid chromatography-mass spectrometry analysis
8. Data analysis for proteomics search
NOTE: For proteomic search of MS raw data, open-source tools were used to convert LC-MS data format and perform proteome search (refer to Table of Materials). The parameters used for data analysis are detailed in Supplementary File 2. For basic usage instructions for open-source tools, refer to the link included in the Table of Materials.
9. Statistical analysis
NOTE: For statistical analysis to identify differentially expressed proteins, an open-source tool was used to perform univariate analysis (e.g., Student's t-test; refer to Table of Materials). It is recommended to refer to basic usage instructions for the open-source tool via the link provided in the Table of Materials.
10. Bioinformatics analysis
NOTE: A commercial bioinformatics tool was used for over-representation analysis (e.g., Ingenuity pathway analysis, refer to Table of Materials). Before using this tool, it is recommended to refer to the manufacturer's instructions.
The established suspension trapping filter-based proteomics sample preparation, combined with label-free quantitation using single-shot data-independent acquisition, were applied to pancreatic cystic FFPE tissues (Figure 1). Precise ROI isolation during the FFPE tissue processing was achieved across different pancreatic cystic FFPE tissues (Figure 2A), resulting in the acquisition of reproducible total ion chromatograms between biological tri-replicates for each...
This protocol outlines a rapid and efficient proteomics method that utilizes ROIs isolated from FFPE tissue sections mounted on glass slides for pathological diagnosis. When surgical intervention is advantageous, solid neoplasms such as cancers and cysts are surgically resected and preserved for pathological evaluation. For long-term storage, tissues are fixed in formalin and embedded in paraffin (FFPE). FFPE tissue blocks are then sectioned to a thickness of 4-10 µm, mounted on glass slides, subjected to antigen re...
The authors have no conflict of interest to declare
All figures in this article were created with BioRender (http://www.biorender.com). This work was supported by a National Research Foundation of Korea (NRF) grants (Grant No. RS-2023-00253403 and RS-2024-00454407).
Name | Company | Catalog Number | Comments |
0.1% FA in ACN (LC-MS grade) | Fisher Chemical | LS120-212 | |
0.1% FA in Water (LC-MS grade) | Fisher Chemical | LS118-4 | |
0.5M TCEP | Thermo Scientific | 77720 | |
10% SDS | Invitrogen | 2679093 | |
1M TEAB (pH 8.5) | Sigma-Aldrich | 102545001 | |
1M Tris-cl (pH 8.5) | BIOSOLUTION | BTO21 | |
A-14C centrifuge | Satorious | 167709 | |
Acetone (HPLC grade) | Fisher Scientific | A949-4 | |
ACN (HPLC grade) | J.T.Baker | 9017-88 | |
CHCl3 (HPLC grade) | Thermo Scientific | 022920.k2 | |
CR paper | ADVANTEC | 70406001 | |
DIA-NN ver 1.9 | Open source | https://github.com/vdemichev/DiaNN | Proteomics Search Engine |
EPOCH2 microplate reader | Agilent | 2106208 | |
Ethanol | MERCK | K50505283 836 | |
FA (LC-MS grade) | Fisher Chemical | A117-50 | |
Ingenuity Pathway Analysis (IPA) | QIAGEN | 830018 | Bioinformatics tool |
Lyophilizer (SRF110R+vaper trap) | Thermo Scientific | SRF-110-115 | |
MeOH (HPLC grade) | MERCK | UN1230 | |
Microplate BCA protein Assay kit-Reducing Agent Compatible | Thermo Scientific | 23252 | |
MSConvert | Open source | http://proteowizard.sourceforge.net/tools.shtml | MS data transformation software |
Orbitrap Exploris 480 | Thermo Scientific | MA10813C | MS |
PepMAP RSLC C18 separation column | Thermo Scientific | ES903 | |
Perseus | Open source | https://cox-labs.github.io/coxdocs/perseus_instructions.html | Statistical tool |
PIERCE chloroacetamide No-Weigh Format | Thermo Scientific | A39270 | |
PIERCE Quantitative colorimetric peptide Assay | Thermo Scientific | 23275 | |
Plate shaker | Green SSeriker | VS-202D | |
Probe sonicator | VibraCellTM | VCX750 | |
Protein LoBind Tube 1.5 mL | Eppendorf | 22431081 | |
QSP 10 µL pipette Tip | Thermo Scientific | TLR102RS-Q | |
QSP 300 µL pipette Tip | Thermo Scientific | TLR106RS-Q | |
Scalpel | Bard-Parker | 372615 | |
S-Trap: Rapid Universal MS sample Prep | PROTIFI | CO2-mini-40 | |
SureSTART Vial 0.2 mL | Thermo Scientific | 6pk1655 | |
TFA | Sigma-Aldrich | 102614284 | |
ThermoMixer C | Eppendorf | 5382 | |
Trypsin/Lys-C (LC-MS grade) | Promega | V5073 | |
Vanquish NEO | Thermo Scientific | 8348249 | LC |
Water (HPLC grade) | Honeywell | AH365-4 | |
Xcalibur ver 4.7 | Thermo Scientific | 30966 | MS data acquisition software |
Xylene | Sigma-Aldrich | 102033629 |
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