eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-09-30 18 3 2434 2445 10.13005/bpj/3267 67653 article Afraa Asif 1 Yusra Khan 2 Manahel Khuram 1 Mohammed Khalil 1 Sunil Bylappa 2 Abid Shaheer 1 Department of Biomedical Sciences, College of Medicine, Gulf Medical University, United Arab Emirates. Department of Pathology, Thumbay Labs, Gulf Medical University, United Arab Emirates. This prospective comparative study evaluated the diagnostic accuracy of Elastic Tissue Staining (ETS) versus Hematoxylin and Eosin (H&E) staining for detecting venous invasion in colorectal, breast and thyroid malignancies, with emphasis on clinical implications. Archived cancer specimens from 94 patients with histologically confirmed colorectal (n=30), breast (n=32) and thyroid cancers (n=32) were analyzed. ETS, performed using Verhoeff-Van Gieson (VVG) staining, was compared with consensus H&E staining, which is considered the gold standard for diagnosis. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, the Chi-square test, the Phi coefficient and McNemar's test. ETS demonstrated perfect sensitivity (100%) and NPV (100%) across all cancer types, effectively eliminating false-negative results. Specificity is highest in colorectal cancer (80%), moderate in breast cancer (63.6%) and lowest in thyroid cancer (50%). ETS achieved significantly higher diagnostic accuracy (91.3%, p<0.001) when compared to H&E, particularly its superior detection of venous invasion in thyroid cancers (81.2% with ETS vs. 62.5% with H&E, p=0.031). ETS substantially improves the diagnostic accuracy of venous invasion compared with conventional H&E staining, ensuring no false-negative cases and enhancing clarity in histologically challenging tissues, especially thyroid cancer. Although specificity varied, the consistently exceptional sensitivity strongly supports the routine integration of ETS into pathological practice to improve staging accuracy, prognostic assessment and clinical management. https://biomedpharmajournal.org/vol18no3/elastic-tissue-staining-significantly-enhances-detection-of-venous-invasion-compared-to-conventional-h-and-e-staining-in-colorectal-breast-and-thyroid-carcinomas/ Breast Neoplasms Colorectal Neoplasms Elastic Tissue Thyroid Neoplasms Venous Invasion