Microdissection: Insights and progress in the era of precision medicine

Intratumoral heterogeneity is a real challenge for understanding the key mechanisms involved in cancer progression, but also for pathologists to make a reliable diagnosis. The development of precision medicine in oncology allows each treatment to be tailored to the specific characteristics of the tumours. However, the ability to isolate pure cell populations is a very difficult task and makes accurate analysis difficult. The development since the 90's of precise dissection techniques, known as microdissection, has helped to overcome problems associated with tumor heterogeneity. Since then, a few techniques have been developed that provide dissection accuracy down to the sub-cellular level. These technologies have enabled key principles to be understood in basic research but handling difficulties have prevented their use in pathology laboratories. Working with microquantities can also be a difficult task and requires several technical adaptations. This review provides an overview of all microdissection techniques currently available. In addition to their main advantages, examples of applications and adaptations of molecular biology techniques to microquantities are proposed to illustrate the interest of these technical approaches in both basic research and clinical applications.