[Paradigm shift in surgical pathology of cancer: molecular diagnostics, prognosticators and predictive pathology]

Classical methodology of surgical pathology extended first with ultrastructural methods, then with immunohistochemistry and more recently with molecular/ genomic techniques. These changes added new dimensions to the classical tissue-and cellular levels of diagnostics: the molecular level. This change is the primary motor of the development of the diagnostic as well as the prognostic and predictive pathology. It is now possible to identify an etiological factor (HPV) or reclassify an entire entity (soft tissue tumors). Prognosis of cancer relies more and more on molecular/genetic parameters such as microsatellite instability, gene amplifications etc. Targeted therapy of cancer develops parallel with the molecular predictive pathology such as the anti-HER2 or anti-EGFR therapies. In conclusion, it is fair to say that molecular pathology contributes significantly to the development of clinical oncology.