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February 25, 2008
Marquette General Hospital, Northern Michigan University collaborate on Cytogenetics and Molecular Pathology Laboratory
Marquette General Hospital has collaborated with Northern Michigan University on its newly established Cytogenetics and Molecular Pathology Laboratory.
“This combined effort between Northern Michigan University and Marquette General Health System results in another improvement to health care in the Upper Peninsula,” said NMU President Les Wong. “Additionally, MGHS’s need for employees in these labs and NMU’s interest in enhancing the diagnostic genetics student’s experiences are perfectly served by this collaborative arrangement.”
Sitting at the microscopes are Lab Assistant Andrea Hales and Cytogeneticist Sarah Paternoster analyzing a leukemia patient’s bone marrow slides. Standing on the left in the forefront is Cytogeneticist Kristen Rolig harvesting a leukemia specimen for chromosome analysis. Standing and discussing a set of chromosome results are (from the forefront to back) Lab Supervisor Tom Dole, Lab Director Dr. Ramakrishnan Sasi, and NMU Clinical Laboratory Science Department Head Lucille Contois.
Cytogenetics is the study of chromosomes and chromosome abnormalities. This includes examination of chromosome structure, learning and describing the relationships between chromosome structure and phenotype, and seeking out the causes of chromosomal abnormalities.
“The results from cytogenetic testing can tell us how to categorize a patient’s disease, what clinical course the patient needs to follow and which sub-set of drugs the patient responds to,” said Dr. John Weiss, anatomic and clinical pathologist at Marquette General.
The project to build the cytogenetics lab started more than a year ago. The lab is located in the West Science building on NMU’s campus, and is outfitted with the best equipment for conventional and molecular cytogenetics. A newly purchased state-of-the-art imaging system, cutting edge Nikon microscopes, and humidity- and temperature-controlled slide dropping chambers and rooms are a few of the key features of the lab.
Cytogeneticists Kristen Rolig (left) and Sarah Paternoster analyze a breast cancer tissue sample for amplification of a cancer-causing gene Her-2 by the fluorescent in-situ hybridization method. This DNA-based diagnostic method will quantitate the Her-2 gene copy number in the breast cancer cells. Based upon this test, MGHS physicians can prescribe a targeted drug Herceptin® for treatment of breast cancer.
“Along with the newly established cytogenetics lab, Marquette General continues to have a growing partnership with Northern on other programs,” said Marquette General CEO A. Gary Muller, FACHE. “These present programs include the Upper Michigan Brain Tumor Center, Clinical Laboratory Sciences Department, the NMU-MGHS School of Respiratory Therapy, School of Radiography, Emergency Medical Technician Training and the School of Nursing.”
The cytogenetics lab offers comprehensive diagnostic services in all types of chromosome studies, including cancer cytogenetics, congenital disorders, prenatal diagnosis and high-resolution chromosome analysis. These studies utilize both traditional cytogenetic techniques as well as molecular cytogenetics by fluorescent in situ hybridization. FISH testing is a technique used to identify the presence or absence of exact DNA sequences on chromosomes.
(Bone Marrow Karyotype.jpg) - A bone marrow karyotype is used by a cytogeneticist to examine the chromosome makeup of a patient’s cells. This examination helps a cytogeneticist identify whether genetic problems are factors in a disease, such as leukemia.
John Rhoades, laboratory director at Marquette General, said, “The cytogenetics lab provides a service that was previously unavailable in the Upper Peninsula. The lab’s results are superior to what has been done before. We are put on par with other health care facilities like Mayo Clinic.”
For the past six months the lab has been doing correlation studies, and is now releasing patient results and performing in-house testing. Testing must be ordered by the patient’s physician.
“Before the cytogenetics lab was available, genetic testing would have to be done at Mayo Clinic,” said Rhoades. “Turnaround time for a specimen would typically be 10-14 days, and the longer a specimen has to wait to be tested, the lower the quality. The new cytogenetics lab has a two to three day turnaround, which maintains the specimen integrity.”
Ramakrishnan Sasi, Ph.D., DABMG, FACMG, director of the Cytogenetics and Molecular Pathology Laboratory, said, “The shorter turnaround time gets us more accurate and dependable results so we can better diagnose patients. Early detection gives the patient an opportunity to change their lifestyle, postpone the disease and increase their life expectancy.”
Dr. Sasi added that in congenital disorders such as Down syndrome cytogenetic testing could determine the nature of the chromosomal defect present in parents and/or in the fetus. Dr. Sasi said this would also help to predict the reproductive risk of future pregnancies.
The nearest centers with a cytogenetics lab are Milwaukee, Minneapolis and Detroit.
“Before, patients had to be referred out of the U.P. to get testing done,” said Dr. Weiss. “Now patients living in the U.P. can stay in the area and get state-of-the-art genetic testing at MGH.”
The Cytogenetics and Molecular Pathology Laboratory is also an opportunity for NMU students studying genetics to learn first-hand from the on-site lab.
“Students at Northern who are in the diagnostic genetics curriculum will have the opportunity to complete an initial internship at MGH’s new lab before going to Mayo Clinic for the final internship,” said Lucille Contois, director of the NMU clinical laboratory sciences department. “Also, students in Dr. Sasi’s cytogenetics class have one-on-one learning opportunities in the new lab. This laboratory and our collaborative arrangement with Dr. Sasi’s position as an NMU faculty member and director of MGH’s Cytogentic and Molecular Pathology Laboratory is a unique and wonderful addition to NMU’s program.”
Dr. Sasi added, “We have a fantastic, hardworking team at the cytogenetics lab. The employees are very seasoned in their field and come from highly-regarded academic and medical institutions.”
The lab employs five people, and comprises of Dr. Sasi, director; Tom Dole, supervisor, from the University of Michigan; Kristen Rolig, cytogeneticist, previously employed by Mayo Clinic, and a 2005 NMU graduate; Sarah Paternoster, cytogeneticist, previously employed by Mayo Clinic; and Andrea Hales, lab assistant, a 2007 NMU graduate.
For more information about the Laboratory Science curriculum at NMU, visit the university website at www.nmu.edu.
Patients interested in genetic testing should discuss their questions with their physicians.
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