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《21世纪的病理学与临床医学》

[Pathology and clinical medicine in the 21st Century].

作者信息

Denk H

机构信息

Institut für Pathologie, Universität Graz.

出版信息

Verh Dtsch Ges Pathol. 2001;85:80-6.

Abstract

The major task of pathology is to bridge the gap between basic science and clinical medicine. Consequently, pathology has to keep pace particularly with the progress in molecular biology and genetics and has to transfer the progress of basic research to studies of disease. Pathology has to test and continuously incorporate new methods into its scientific and diagnostic repertoire to improve diagnostic sensitivity and accuracy. The recognition of genetic alterations, particularly associated with tumors and chronic degenerative diseases, and its consequences in correlation with morphology allows the evaluation of changes in the genetic set-up and related cellular functions. This greatly improves the basis for understanding the biological background and clinical behavior of disease, thus adding a dynamic component to the snap-shot picture provided by the histologic slide. Application of genomics and proteomics will have significant impact on diagnostic pathology in the 21st century regarding definition and classification of pathologic processes, assessment of prognosis and guidance of treatment. The modern pathologist has to accept this challenge in order to maintain his position in the center of clinical medicine. However, despite all present and future advances, experience and skills in the morphologic evaluation of disease processes will still remain the "gold standard" in our field and the basis for proper application of these new technologies. When we accept the promising new techniques and tools already at the present early stage of development we may not only improve the clinical relevance of our work but gain invaluable information on the nature of diseases and the basic principles responsible for the complex morphologic pictures we enjoy in our daily work.

摘要

病理学的主要任务是弥合基础科学与临床医学之间的差距。因此,病理学必须尤其跟上分子生物学和遗传学的进展,并将基础研究的进展转化为疾病研究。病理学必须测试并不断将新方法纳入其科学和诊断方法库,以提高诊断的敏感性和准确性。对基因改变的认识,特别是与肿瘤和慢性退行性疾病相关的基因改变,以及其与形态学相关的后果,使得能够评估基因组成和相关细胞功能的变化。这极大地改善了理解疾病生物学背景和临床行为的基础,从而为组织学切片提供的静态图像增添了动态成分。基因组学和蛋白质组学的应用在21世纪对于病理过程的定义和分类、预后评估及治疗指导方面将对诊断病理学产生重大影响。现代病理学家必须接受这一挑战,以便在临床医学中心保持自己的地位。然而,尽管有目前和未来的所有进展,对疾病过程进行形态学评估的经验和技能仍将是我们这个领域的“金标准”,也是正确应用这些新技术的基础。当我们在目前这个早期发展阶段就接受这些有前景的新技术和工具时,我们不仅可以提高工作的临床相关性,还能获得关于疾病本质以及造成我们日常工作中所见复杂形态图像的基本原理的宝贵信息。

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