Advanced Techniques in Diagnostic Cellular Pathology.

Cellular Pathology in recent years has become more closely involved in thedirect management of patients with the introduction of molecular technologiesand targeted therapies. Through this, we have seen the introductionof specialist pathology. It is the aim of this book to introduce theseconcepts and the key technologies that are influencing clinical practicetoday. Throughout this book we show how clinical practice has beenaffected by these respective technologies and how further development willinfluence the practice and delivery of Cellular Pathology, which will impacton the patient through targeted therapeutics and diagnostics.In Virtual Microscopy, we deal with the changing face of the mosttraditional aspect of Cellular Pathology: that of microscopy itself. Forcenturies, the glass microscope slide has been the sole method of visualisingcells and tissues, but with the addition of computing, imaging andcommunications technologies, it is now possible to digitise the glass slideand deliver it via the World Wide Web, transforming the ability of thepractitioner to deliver a diagnosis, consultation or high-throughput imageanalysis for biomarker research.Cytopathology and the introduction of Liquid-based Cytology havegreatly improved the quality and thus the sensitivity of the traditionalPapnicolaou smear and non-gynaecological cytology specimens. An addedbonus of this technology is the surplus of well-preserved material that canbe used for additional diagnostic procedures and for research. The introductionof the Human Papilloma Virus vaccination programme may wellchange the future of the cervical screening programme; only time will tellhow effective it will be.Flow Cytometry has expanded over recent years with the introduction ofmulticolour cell and protein labelling. Yet it is through understanding thecomponents of the flow cytometer and the properties of the labels that theprecise identification of elements important to the practitioner will beenabled.Immunocytochemistry has seen the continued expansion of the antibodyrepertoire with diagnostic, prognostic and therapeutic demands. Theexperience of peer groups and external quality assurance is a vital part indelivering on the promise of identifying patients suitable for targetedtherapies.The search for new biomarkers and therapeutic targets continues and wehighlight a strategic means of identifying these key genes and proteinsthrough array Comparative Genomic Hybridisation, and outline how thisis used in association with companion diagnostic technologies.In Situ Hybridisation has shown promise of being used in the routinelaboratory for more than a decade but it is the introduction of thetechnology for Her2/Neu gene amplification that has realised this potential.Its extension to other biomarkers has followed rapidly.The content of this book is particularly suitable for students with a basicworking knowledge of Cellular Pathology, although each author has givenspace to providing some basic principles and key references for students lessfamiliar with these new technologies. The book is a suitable text for studentsto Masters Level in Cellular Pathology but it is hoped that it will supportboth students and practising scientists who wish to understand more fullythe principles and clinical value of the technologies described within.Mary Hannon-Fletcher, ColerainePerry Maxwell, BelfastOctober 2008