Roy Somak, LaFramboise William A, Nikiforov Yuri E, Nikiforova Marina N, Routbort Mark J, Pfeifer John, Nagarajan Rakesh, Carter Alexis B, Pantanowitz Liron
From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Drs Roy, LaFramboise, Nikiforov, Nikiforova, and Pantanowitz); the Department of Pathology, MD Anderson Cancer Center, Houston, Texas (Dr Routbort); the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri (Drs Pfeifer and Nagarajan); PierianDx, St Louis, Missouri (Dr Nagarajan); and the Department of Pathology and Laboratory Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia (Dr Carter).
Arch Pathol Lab Med. 2016 Sep;140(9):958-75. doi: 10.5858/arpa.2015-0507-RA. Epub 2016 Feb 22.
-Next-generation sequencing (NGS) is revolutionizing the discipline of laboratory medicine, with a deep and direct impact on patient care. Although it empowers clinical laboratories with unprecedented genomic sequencing capability, NGS has brought along obvious and obtrusive informatics challenges. Bioinformatics and clinical informatics are separate disciplines with typically a small degree of overlap, but they have been brought together by the enthusiastic adoption of NGS in clinical laboratories. The result has been a collaborative environment for the development of novel informatics solutions. Sustaining NGS-based testing in a regulated clinical environment requires institutional support to build and maintain a practical, robust, scalable, secure, and cost-effective informatics infrastructure.
-To discuss the novel NGS informatics challenges facing pathology laboratories today and offer solutions and future developments to address these obstacles.
-The published literature pertaining to NGS informatics was reviewed. The coauthors, experts in the fields of molecular pathology, precision medicine, and pathology informatics, also contributed their experiences.
-The boundary between bioinformatics and clinical informatics has significantly blurred with the introduction of NGS into clinical molecular laboratories. Next-generation sequencing technology and the data derived from these tests, if managed well in the clinical laboratory, will redefine the practice of medicine. In order to sustain this progress, adoption of smart computing technology will be essential. Computational pathologists will be expected to play a major role in rendering diagnostic and theranostic services by leveraging "Big Data" and modern computing tools.
下一代测序(NGS)正在彻底改变检验医学学科,对患者护理产生深远而直接的影响。尽管它赋予临床实验室前所未有的基因组测序能力,但NGS也带来了明显且突出的信息学挑战。生物信息学和临床信息学是两个通常仅有少量重叠的独立学科,但由于临床实验室积极采用NGS,它们被结合在一起。结果形成了一个开发新型信息学解决方案的协作环境。在受监管的临床环境中维持基于NGS的检测需要机构支持,以构建和维护一个实用、强大、可扩展、安全且具有成本效益的信息学基础设施。
讨论当今病理学实验室面临的新型NGS信息学挑战,并提供解决这些障碍的方案和未来发展方向。
对已发表的与NGS信息学相关的文献进行了综述。共同作者,分子病理学、精准医学和病理学信息学领域的专家,也分享了他们的经验。
随着NGS引入临床分子实验室,生物信息学和临床信息学之间的界限已显著模糊。如果在临床实验室中管理得当,下一代测序技术以及从这些检测中获得的数据将重新定义医学实践。为了维持这一进展,采用智能计算技术将至关重要。预计计算病理学家将通过利用“大数据”和现代计算工具在提供诊断和治疗诊断服务方面发挥主要作用。