Sanjia Tiantuan
Wang Wenting
Attending physician of the Department of Pathology, Shanghai Children's Hospital
Wu Ying
Chief Physician of the Department of Pathology, Shanghai Children's Hospital
When it comes to tumors, people feel "so scary." Even at this point in the development of medicine, people are still "talking about tumor discoloration".
If we have a "tumor" on our body and the clinician surgically cuts it off, then we all ask, "Doctor, is this benign or malignant?" ”
Clinicians usually reply: "Now that the 'specimen' has been sent to the pathology department, it is ultimately necessary to look at the pathology report to determine whether it is benign or malignant." ”
Doctor's doctor
Pathologists are also known as Doctor's Doctors in Foreign Countries, that is, doctors' doctors, pathologists can be described as "Sherlock Holmes" in the medical circle, good at looking at cells with a diameter of several microns through the microscope and finding clues to various tissue lesions.
The characterization of tumors, the advent of new drugs, and the treatment of diseases, including the rapid development of new crown vaccines in the mainland, are inseparable from the support of pathology.
Even Academician Zhong Nanshan said: "Pathologists are a judge with the highest authority, and only after they make a judgment do clinicians know how to treat and what to treat." ”
You must be asking, "How does a pathologist know about the benign and malignant nature of a tumor?" ”
Perhaps you only know that after clinical surgery, the lesion "meat" (specimen) cut off on the body is sent to the pathology department, but you do not know that the specimen is "surging" after it reaches the pathology department.
The "arsenal" of pathologists
| | microscope Pathologists, like ordinary people, are "mortal with naked eyes", but after years of "cultivation", they have cultivated a pair of "fire eyes and golden eyes", of course, this is also inseparable from the "small partner" around them - microscope. |
| | HE slices The specimen was sent to the pathology department, and after a series of "elaborate" by doctors and technicians, it became a crystal clear glass HE slice - this is the "conventional weapon" of pathologists. Note: HE slices are slices made using hematoxylin-ebony staining. HE slices are "memory cards" that record tumor vectors, and pathologists can use a microscope to magnify tumors on HE slices by a factor of 40 to 1,000. By observing the tumor cells, the pathologist can determine which type of tumor it is and provide the clinician with the direction of treatment. |
| | Immunohistochemical techniques With the development of science and technology, the emergence of immunohistochemical technology has made tumors more invisible. Tumors are like princesses who have been cast with a spell, and they have a unique spell on their bodies - antigens. Immunohistochemical reagents are like the prince's kiss – antibodies. Just as only a prince's kiss can wake up to a princess, only specific antibodies can recognize the antigens on the tumor and determine the type of tumor. Especially in some metastatic tumors with unclear primary lesions, markers of immunohistochemistry are particularly important. At present, we have more than 200 immunohistochemical reagents in our "arsenal", which is enough to "sweep away" those tumors. |
| | Special staining techniques In fact, in the clinic, not only the judgment of the tumor makes people "head big", but also the infectious lesions of some bacteria and fungi also make people "difficult". Bacteria and fungi are too small to determine which species they are, so there is no way to treat them symptomatically. In the past, bacteria and fungi were like a needle in the sea, since there is a "magic weapon" - special dyeing technology, by using special dyeing reagents and the structure of the pathogenic microorganism's sandwich, spores, hyphae and other structures, you can distinguish which pathogenic microorganism this is. |
| | Molecular detection technology Including gene sequencing, fluorescent in situ hybridization (FISH) detection, polymerase chain reaction (PCR) detection, etc., is now the "trump weapon" of pathology. The human body is composed of large and small cells, and the composition of cells includes the nucleus and cytoplasm, and there is genetic material in the nucleus - chromosomes. Many people have tumors because of abnormal mutations in chromosomes, and the so-called molecular testing is to detect the source of tumors - chromosomes. Detecting the mutation anomaly site of chromosomes and then using targeted drugs to overcome tumors can bring good news to more tumor patients. |
In fact, the "weapons" of the pathology department are far more than these, as well as electron microscopy, immunofluorescence and so on. In the future, our medical development will be even more remarkable.
With the help of the oncology "judge" pathology department, defeating tumors is not a dream!