López J I, De Petris G
Department of Pathology, Cruces University Hospital, Biomarkers in Cancer Unit, Biocruces Research Institute, University of the Basque Country (UPV/EHU), Barakaldo, Spain.
Department of Pathology and Laboratory Medicine, Penrose St Francis Hospital, Colorado Springs, CO, USA.
Pathologica. 2017 Jun;109(2):110-113.
Discovering intratumor heterogeneity is a crucial issue in modern oncologic medicine. Highly sophisticated technology such as high-throughput DNA sequencing has demonstrated the real dimension of the problem. The overwhelming majority of malignant tumors show high levels of intratumor heterogeneity when thoroughly studied. Intratumor heterogeneity develops both in temporal and spatial domains and its distribution is not deterministic making each case truly unique and unrepeatable. Pathologists are main actors in intratumor heterogeneity detection since they are the medical specialists who sample the tumors. Recent evidences have shown that currently applied sampling protocols are insufficient for a reliable intratumor heterogeneity detection. Pathologists must adapt classic sampling to the new times thus continuing being key pieces in the multidisciplinary approach to neoplasia that modern medicine demands.
发现肿瘤内异质性是现代肿瘤医学中的一个关键问题。诸如高通量DNA测序等高度精密的技术已经揭示了这一问题的实际规模。绝大多数恶性肿瘤在经过深入研究后都显示出高水平的肿瘤内异质性。肿瘤内异质性在时间和空间维度上都会出现，其分布并无确定性，使得每个病例都真正独一无二且不可重复。病理学家是肿瘤内异质性检测的主要参与者，因为他们是对肿瘤进行取样的医学专家。最近的证据表明，目前应用的取样方案不足以进行可靠的肿瘤内异质性检测。病理学家必须使传统取样适应新时代，从而继续成为现代医学所要求的肿瘤多学科治疗方法中的关键环节。
