molecular pathology

Neoplasms develop through acquisition of capabilities that involve tumour cell aspects and modified microenvironment interactions, resulting in unrestricted growth due to a stepwise accumulation of cooperative genetic alterations that affect key molecular pathways.

The correlation of these molecular aspects with morphological changes is essential for better understanding of essential concepts as early neoplasms/precancerous lesions, progression/dedifferentiation, and intratumour heterogeneity.

The acquired capabilities include self-maintained replication (cell cycle dysregulation), extended cell survival (cell cycle arrest, apoptosis dysregulation, and replicative lifespan), genetic instability (chromosomal and microsatellite), changes of chromatin, transcription and epigenetics, mobilization of cellular resources, and modified microenvironment interactions (tumour cells, stromal cells, extracellular, endothelium).

The acquired capabilities defining neoplasms are the hallmarks of cancer, but they also comprise useful tools to improve diagnosis and prognosis, as well as potential therapeutic targets.

The application of these concepts in oncological pathology leads to consideration of the molecular test requirements (Molecular Test Score System) for reliable implementation; these requirements should cover biological effects, molecular pathway, biological validation, and technical validation.

See also

 biopathology

References

 General morphological and biological features of neoplasms: integration of molecular findings. Diaz-Cano SJ. Histopathology. 2008 Jul;53(1):1-19. doi : 10.1111/j.1365-2559.2007.02937.x PMID: 18282144

 New website pushes diagnostic molecular pathology to the forefront of electronic medical publishing. Stoler MH. Diagn Mol Pathol. 2009 Jun;18(2):61. PMID: 19430290

 Diagnostic molecular pathology in an era of genomics and translational bioinformatics. Farkas DH. Diagn Mol Pathol. 2008 Mar;17(1):1-2. PMID: 18303413