Hofman Véronique, Ilie Marius, Gavric-Tanga Virginie, Lespinet Virgine, Mari Mireille, Lassalle Sandra, Butori Catherine, Coelle Céline, Bordone Olivier, Selva Eric, Lamy Aude, Sabourin Jean-Christophe, Hofman Paul
Laboratoire de pathologie clinique et expérimentale, hôpital Pasteur, CHU de Nice, 30, avenue de Voie-Romaine, BP 69, 06002 Nice cedex, France.
Ann Pathol. 2010 Apr;30(2):85-93. doi: 10.1016/j.annpat.2010.03.003. Epub 2010 Apr 13.
The advent of the targeted cancer therapies administered to patients, according to the results of molecular biology techniques (in particular, in situ hybridization, "polymerase chain reaction" amplification and sequencing), has modified the practice of the surgical pathology laboratories. The necessity to answer to the needs of physicians for optimizing the medical care for patients who develop cancer has led to a policy of national debate, spurred by the National Institute of Cancer (INCa), in order to implement new procedures in the pathology laboratories. Thus, in addition to the structuring of molecular biology platforms and their labeling by INCa, the upstream control of the steps present between resection of tumor samples and molecular analysis has proved to be crucial. Indeed, the quality of this upstream time, called "pre-analytical" phase, determines the reliability of the molecular biology results and therefore the therapeutic strategy. We describe here the main steps to be checked in the pre-analytical phase. The optimization of this pre-analytical phase within the surgical pathology laboratory aims to reduce or render insignificant the risk of errors of molecular biology tests. These errors can indeed lead to false negative or false positive results whose therapeutic consequences can be particularly harmful to patients with cancer.
根据分子生物学技术(特别是原位杂交、“聚合酶链反应”扩增和测序)的结果,对患者进行靶向癌症治疗的出现改变了外科病理实验室的工作方式。为了满足医生优化癌症患者医疗护理的需求,在国家癌症研究所(INCa)的推动下,引发了一场全国性的辩论,以在病理实验室实施新程序。因此,除了分子生物学平台的构建及其由INCa进行的标记外,肿瘤样本切除与分子分析之间各步骤的上游控制已被证明至关重要。事实上,这个被称为“分析前”阶段的上游时间质量决定了分子生物学结果的可靠性,进而决定了治疗策略。我们在此描述分析前阶段需要检查的主要步骤。外科病理实验室内对这一分析前阶段的优化旨在降低或使分子生物学检测误差的风险微不足道。这些误差确实可能导致假阴性或假阳性结果,其治疗后果可能对癌症患者特别有害。