The future research in surgical pathology.

Recent conceptual and methodologic advances have the potential for providing new avenues of investigation for the study of human disease at the cellular and molecular levels. Surgical pathologists, by virtue of their training in the recognition of different disease states at various points in their evolution, are in a unique position to lead research efforts utilizing human tissues as a major investigative resource. Many tissues obtained in the surgical pathology laboratory are available for direct experimental studies without jeopardizing their utilization for routine diagnostic purposes. Moreover, experimental data derived from their study may lead to more accurate and meaningful diagnoses. Advances in tissue culture methodology and xenotransplantation technics, for example, have now made possible the study of mechanisms of carcinogenesis and variations in responses to different carcinogens directly in human tissues. Analysis of the effects of the physical and chemical microenvironments on the expression of various phenotypic characteristics may be performed directly in cultures of normal and neoplastic cells. The application of immunocytochemical technics will have a major impact in many areas of diagnostic and investigative pathology. These methods, which exploit the exquisite sensitivity of antibodies as diagnostic reagents for the visualization of a variety of antigens, permit the pathologist to extent and expand morphologic observations to include a variety of biochemical parameters. Potential applications include the characterization of the entire spectrum of proliferative events preceding the development of overt neoplasms, analysis of fully developed neoplasms with regard to the emergence of tumor subpopulations, and evaluation of new tumor marker systems. Clinically, these technics may be expected to aid in early diagnosis, determination of prognosis, and prediction of response to various forms of therapy. A major challenge for the future depends on the appreciation of the unique importance of human tissues for biomedical research and on the development and expansion of the traditional role of the surgical pathologist in this effort.