Systems pathology: a paradigm shift in the practice of diagnostic and predictive pathology

Diagnostic tumor pathology in the context of personalized medicine has progressed from an interpretive, subjective science to a more objective, evidence-based practice. This has resulted in the development of several tissue-based, molecular-driven tests that provide information regarding prognosis and response to therapy. The challenge, however, for both the pathologist and the treating physician is how best to effectively integrate this data into a comprehensive treatment plan that includes a patient-specific risk assessment. To address this need, the authors developed a systems pathology approach to the practice of clinical molecular medicine through technical advances in object-oriented image analysis, and phenotyping at the microanatomical level using deparaffinized tissue section and quantitative biomarker multiplexing. With support vector regression for censored data, they have been able to integrate complex information and provide a patient-specific risk profile based on the clinical endpoint under investigation. Cancer 2009;115(13 suppl):3078-84. (c) 2009 American Cancer Society.