[Pathology and clinical medicine in the 21st Century]

The major task of pathology is to bridge the gap between basic science and clinical medicine. Consequently, pathology has to keep pace particularly with the progress in molecular biology and genetics and has to transfer the progress of basic research to studies of disease. Pathology has to test and continuously incorporate new methods into its scientific and diagnostic repertoire to improve diagnostic sensitivity and accuracy. The recognition of genetic alterations, particularly associated with tumors and chronic degenerative diseases, and its consequences in correlation with morphology allows the evaluation of changes in the genetic set-up and related cellular functions. This greatly improves the basis for understanding the biological background and clinical behavior of disease, thus adding a dynamic component to the snap-shot picture provided by the histologic slide. Application of genomics and proteomics will have significant impact on diagnostic pathology in the 21st century regarding definition and classification of pathologic processes, assessment of prognosis and guidance of treatment. The modern pathologist has to accept this challenge in order to maintain his position in the center of clinical medicine. However, despite all present and future advances, experience and skills in the morphologic evaluation of disease processes will still remain the "gold standard" in our field and the basis for proper application of these new technologies. When we accept the promising new techniques and tools already at the present early stage of development we may not only improve the clinical relevance of our work but gain invaluable information on the nature of diseases and the basic principles responsible for the complex morphologic pictures we enjoy in our daily work.