Implementación de la medicina de precisión en el diagnóstico anatomopatógico

Abstract

he precision medicine has to be based on 3 pillars: 1. In a correct pathological diagnosis. 2. In precise tumor staging.3. In the application of biomarkers associated with targeted therapy. Therefore, for the first step to implement a correct precision medicine is mandatory to optimize the pathological diagnosis, which goes through the digitization of the images, which allow telepathology and the application of computational pathology algorithms to objectify the quantification of biomarkers in tissue sections. In relation to molecular studies, it is mandatory to study NGS in most lung, colon and melanoma tumors, as well as sarcomas and brain tumors for their differential diagnosis. To implement NGS technology and extend it to the largest possible number of patients, it is essential to concentrate molecular studies in a few centers that can allow more experience for biologists and pathologists, and also optimize the cost per sample. In Catalonia, by government decision, 5 pathological anatomy laboratories have been selected to carry out all the molecular sequencing studies of a community of almost 8 million inhabitants. The hospitals which depend on our Institution send us the samples and we return the molecular study in a week The results obtained must be integrated into the pathological diagnosis of the referral hospital. Joint molecular committees are held weekly with the reference centers. This network concentration of pathological and molecular studies allows this molecular study to be extended to the entire population with a similar quality, regardless of their place of residence.