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在大数据与个性化医疗时代从事病理学实践。

Practicing pathology in the era of big data and personalized medicine.

作者信息

Gu Jiang, Taylor Clive R

机构信息

*Department of Pathology, Shantou University Medical College, Shantou, Guangdong, China †Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

出版信息

Appl Immunohistochem Mol Morphol. 2014 Jan;22(1):1-9. doi: 10.1097/PAI.0000000000000022.

Abstract

The traditional task of the pathologist is to assist physicians in making the correct diagnosis of diseases at the earliest possible stage to effectuate the optimal treatment strategy for each individual patient. In this respect surgical pathology (the traditional tissue diagnosis) is but a tool. It is not, of itself, the purpose of pathology practice; and change is in the air. This January 2014 issue of Applied Immunohistochemistry and Molecular Morphology (AIMM) embraces that change by the incorporation of the agenda and content of the journal Diagnostic Molecular Morphology (DMP). Over a decade ago AIMM introduced and promoted the concept of "molecular morphology," and has sought to publish molecular studies that correlate with the morphologic features that continue to define cancer and many diseases. That intent is now reinforced and extended by the merger with DMP, as a logical and timely response to the growing impact of a wide range of genetic and molecular technologies that are beginning to reshape the way in which pathology is practiced. The use of molecular and genomic techniques already demonstrates clear value in the diagnosis of disease, with treatment tailored specifically to individual patients. Personalized medicine is the future, and personalized medicine demands personalized pathology. The need for integration of the flood of new molecular data, with surgical pathology, digital pathology, and the full range of pathology data in the electronic medical record has never been greater. This review describes the possible impact of these pressures upon the discipline of pathology, and examines possible outcomes. There is a sense of excitement and adventure. Active adaption and innovation are required. The new AIMM, incorporating DMP, seeks to position itself for a central role in this process.

摘要

病理学家的传统任务是协助医生尽早对疾病做出正确诊断,从而为每个患者制定最佳治疗策略。在这方面,外科病理学(传统的组织诊断)只是一种工具。它本身并非病理学实践的目的;变革已在酝酿之中。2014年1月的《应用免疫组织化学与分子形态学》(AIMM)通过纳入《诊断分子形态学》(DMP)的议程和内容来迎接这一变革。十多年前,AIMM引入并推广了“分子形态学”的概念,并一直致力于发表与那些仍用于定义癌症及许多疾病的形态学特征相关的分子研究。与DMP的合并强化并扩展了这一意图,这是对广泛的基因和分子技术日益增长的影响做出的合理且及时的回应,这些技术正开始重塑病理学的实践方式。分子和基因组技术的应用已在疾病诊断中显示出明显价值,治疗也可针对个体患者进行定制。个性化医疗是未来的发展方向,而个性化医疗需要个性化病理学。整合大量新的分子数据与外科病理学、数字病理学以及电子病历中所有病理学数据的需求从未如此迫切。这篇综述描述了这些压力可能对病理学学科产生的影响,并探讨了可能的结果。我们能感受到兴奋与冒险的氛围。积极的适应和创新是必要的。合并了DMP的新AIMM力求在这一过程中发挥核心作用。

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