Effects of prefixation and fixation times on apoptosis detection by in situ end-labeling of fragmented DNA

Objective.-Apoptosis is considered to play an important role in the pathogenesis and progression of neoplasia. An in situ 3'-end DNA labeling (TUNEL) method was recently developed and has been widely used to identify apoptotic cells in tissue sections. However, sometimes the TUNEL method labels many more cells than expected. We investigated the effects of prefixation time and fixation time on the apoptotic index detected by this method. Materials and Methods.-Using the spleen and thymus of rats, the effects of prefixation time (0, 1, 2, 4, 6, 12, 24, 48, and 72 hours) at 4 degrees C and fixation time (6, 12, 24, 48, 72, and 96 hours; i, 2, and 3 weeks) on the apoptotic index were examined by the TUNEL method. Agarose gel electrophoresis of extracted DNA from the specimens of each prefixation time was also performed. Results.-In comparison with control tissue (no prefixation time), which showed scattered positive cells with distinct staining restricted to the nucleus, the splenic tissue unfixed for 2 hours or more and the thymic tissue unfixed for 4 hours or more showed cytoplasmic staining in the positive cells. Moreover, as the prefixation time was prolonged, the number of positive cells gradually increased. Agarose gel analysis of DNA extracted from tissue sections left unfixed longer than 24 hours showed a ladder pattern consisting of multiples of about 200 base pairs. Conclusions.-Two hours was the limit of prefixation time for the precise identification of apoptosis by the TUNEL method. The false-positive cells in tissue sections left unfixed for longer time intervals may have been due to internucleosomal DNA cleavage following necrosis. In contrast, the length of fixation time in buffered formalin seemed to have no effect on the results obtained by this method.