DeLellis R A
Am J Clin Pathol. 1981 Mar;75(3 Suppl):476-82.
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.
近期概念和方法学的进展有可能为在细胞和分子水平上研究人类疾病提供新的研究途径。外科病理学家凭借其在识别疾病发展不同阶段不同疾病状态方面的培训，处于独特地位，能够引领利用人体组织作为主要研究资源的研究工作。在外科病理实验室获取的许多组织可用于直接实验研究，而不会影响其用于常规诊断目的。此外，从这些研究中获得的实验数据可能会带来更准确、更有意义的诊断。例如，组织培养方法和异种移植技术的进展，现在使得直接在人体组织中研究致癌机制以及对不同致癌物反应的差异成为可能。可以直接在正常细胞和肿瘤细胞培养物中分析物理和化学微环境对各种表型特征表达的影响。免疫细胞化学技术的应用将在诊断和研究病理学的许多领域产生重大影响。这些方法利用抗体作为诊断试剂对多种抗原可视化的极高灵敏度，使病理学家能够扩展形态学观察范围，纳入各种生化参数。潜在应用包括表征显性肿瘤发生之前整个增殖事件谱、分析完全发展的肿瘤中肿瘤亚群的出现情况以及评估新的肿瘤标志物系统。在临床上，这些技术有望有助于早期诊断、确定预后以及预测对各种治疗形式的反应。未来的一个主要挑战取决于认识到人体组织在生物医学研究中的独特重要性，以及在这一努力中发展和扩大外科病理学家的传统作用。
