The role of the pathologist as tissue refiner and data miner: The impact of functional genomics on the modern pathology laboratory and the critical roles of pathology informatics and bioinformatics

This article provides an overview of how functional genomics is likely to i mpact on the pathology laboratory and highlights how informatics and tissue banking will greatly facilitate the molecular age of medicine. Important a spects of functional genomics in the post-genome era, including the roles o f laser capture microdissection, DNA- and complementary DNA-based microarra ys, proteomic methods, collaborative human tissue banking, tissue microarra ys, and pathobioinformatics in the modern pathology laboratory are discusse d. The role of mass spectroscopy in the analysis of RNA, DNA, and protein a nd its impact on the clinical laboratory, particularly in cost-effectivenes s: and time savings, are evaluated. This article explores how laboratory in formation systems (LISs) and the devices that feed them information may nee d to be modified to adapt to greater volumes of data fur the new testing mo dalities that require understanding sophisticated fluorescence detection me thods and image processing. Emerging genomic testing methods and their impa ct on pathology laboratory testing, especially in the area of molecular cla ssification of neoplasms, are examined. The role of the tissue bank in the modern pathology laboratory as an archive of control normal tissues, as wel l as subsamples of the spectrum of progressive neoplastic states, is discus sed in light of its critical importance to the molecular classification of cancer. Establishing a database that combines structured reports in patholo gy LISs and construction of tissue banking information systems will provide a rich resource for pathology departments. The article discusses a hypothe tical resource, such as the Shared Tumor Expression Profiler, that would pr ovide access to well-characterized tissue-based research resources for clin icians and researchers. Last, the article emphasizes how LISs can prepare f ur these changes, and how training pathologists in pathology informatics an d bioinformatics (pathobioinformatics) is critical to ensure pathology's ov erall leadership role in the post-genome era.