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癌症:一位病理学家从形态学到分子学的历程。

Cancer: A pathologist's journey from morphology to molecular.

作者信息

Sahai Kavita, Ahuja Ankur

机构信息

Addltional DGAFMS (HR), O/o DGAFMS, Ministry of Defence, Africa Avenue, New Delhi, India.

Hematopathologist & Registrar, 92 Base Hospital, C/o 56 APO, India.

出版信息

Med J Armed Forces India. 2022 Jul;78(3):255-263. doi: 10.1016/j.mjafi.2022.06.009. Epub 2022 Jun 24.

Abstract

The journey of cancer has taken significant positive steps towards better diagnosis and management. Pathologists have taken a leading role in this journey. Started with morphology which itself went through substantial developments in knowing the aetiology, pathogenesis, classification based upon the pattern, cellular details of the cancer. However, the histomorphologists met some road blocks in the form of ambiguities and some limitations that led to the expansion of pathologist's field to various other ancillary tests to enhance its values form diagnosis to therapeutics. This new journey facilitated the confidence of pathologist in the diagnosis, expanded their role in the clinical management through targeted therapy, monitoring of drugs, suggestions of prognosis. Various molecular diagnostic tests have been developed for the identification of tumor molecular profile for exploration of targeted therapy. The major problems in the management of cancer were resistance to chemotherapy, relapses and wide-spread side effects of chemotherapy. All these major problems to some extents are getting resolved with time as the molecular profiling is opening the gates. Many questions are being answered with the evolution in pathology. With the revolution of targeted therapy many difficult cancers are being treated with fewer side effects. In this review we will go through the journey from histomorphology, its advancement, digital pathology to the molecular pathology. These advancements interestingly haven't replaced the other, rather have enhanced others for the better management of cancer.

摘要

癌症治疗在实现更好的诊断和管理方面已经迈出了重要的积极步伐。病理学家在这一进程中发挥了主导作用。最初是形态学,其本身在了解癌症的病因、发病机制、基于模式的分类以及细胞细节方面经历了重大发展。然而,组织形态学家遇到了一些障碍,比如存在模糊性以及一些局限性,这导致病理学家的领域扩展到各种其他辅助检查,以提升其从诊断到治疗的价值。这一新进程增强了病理学家在诊断方面的信心,通过靶向治疗、药物监测和预后建议扩大了他们在临床管理中的作用。为了探索靶向治疗,已经开发了各种分子诊断测试来识别肿瘤分子特征。癌症治疗中的主要问题包括对化疗的耐药性、复发以及化疗广泛的副作用。随着分子分析打开大门,所有这些主要问题在一定程度上正随着时间的推移得到解决。随着病理学的发展,许多问题正在得到解答。随着靶向治疗的革命,许多难治性癌症正在以更少的副作用得到治疗。在这篇综述中,我们将探讨从组织形态学、其进展、数字病理学到分子病理学的历程。有趣的是,这些进展并没有取代其他方面,而是为了更好地管理癌症而增强了其他方面。

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