Clinical Integration of Molecular Results on Cytology (Post-analytical Phase)

Abstract

Since coining the term diagnostic molecular pathology more than a decade ago, we have seen the rise of diagnostic and stratified, personalised, targeted medicine utilising small cytopathology samples. Molecular technologies have advanced to the point where they can be as cost-effective for high-throughput testing as they are for single biomarker analysis. Similarly, technologies such as immunocytochemistry have seen increasing utilisation as molecular techniques. Such developments are inviting us to revisit the concept of the cytopathologist as a pure morphologist to become morpho-molecular specialists with opportunities in leading teams of clinicians through a maze of developing therapeutic options. Scientists and laboratory personnel too have faced challenges and we have seen career and skill development for these groups as well. We review here our experience and suggest how all staff can grasp the challenge and opportunity provided by genomic medicine, through recognising the properties of the morpho-molecular integration and highlighting how structured training can help to integrate these disciplines to address current clinical needs.