The most important diagnostic responsibilities include histopathological, molecular tumor pathological and various cytodiagnostic activities, which basically cover the study of causes and mechanisms of diseases.
For histological diagnostics tissues and organs removed from the human body are processed (formalin fixing, paraffin embedding and deparaffinization) and then slices are assessed under the microscope. An important part of diagnostics is the various histochemical reactions performed on the processed samples (tissue blocks), consultation if necessary with the attending doctors, and archiving of blocks, slides. An important factor in histological diagnostics is rapid, frozen section diagnosis. The tissue samples are typically removed during surgery but the number of samples removed via minimally invasive sampling (endoscopy, laparoscopy, core biopsy, etc.) is steadily growing Our Institute examines about 65,000 histological samples requested in 17,000 requisition forms observing the latest international professional guidelines.
In certain tumor cases histological diagnosis is vital but may not be enough to accurately classify the disease; this often requires clarification of the genetic background. Molecular diagnostics is the close cooperation of the pathologist who recognizes tumor cells and a professional of molecular genetic diagnostics coupled with special, new technologies so that certain differences at the molecular level may be found in the patient’s tumor tissue. Molecular diagnostics in pathology covers the DNA or RNA analysis of samples, mostly tumor samples sent for histopathological analysis. The goal of molecular analysis includes:
- Discovering the chromosome or gene disorder that is typical of a certain disease (tumor), which may in some cases either confirm or refute a diagnosis.
- Defining the potential outcome in certain diseases or defining intensity of treatment.
- The findings above may be used for following up on the disease, and define the response to treatment.
- Studying the etiology of a condition (development, background), for example, confirming the presence of a viral genome (EBV, CMV, etc.).
- Confirmation of the molecular background of a potential effect in the case of targeted therapy options (such as, for the administration of EGFR attacking drugs in certain common epithelial tumors)
Cytodiagnostic tests examine cells mostly in materials of fluid consistency that are obtained from the body by various sampling techniques. ENT, breast pathology and endocrinology are the areas most often examined with the help of this test, but it also lends itself for tumor diagnostics of other regions, for following the course of a disease, for defining the origin of inflammations, for tumor screening, and so forth.
The advantage of aspiration cytology tests is that they are the least stressful for patients. For the test cells that are appropriate for cytological assessment are obtained from the lesions that seem benign or malignant with the help of a needle.
Pathological examinations are the last possibility for confirming the real nature of a disease, or assessing the efficiency of the applied treatment Nowadays up-to-date laboratory tests and imaging methods provide detailed information but the checkup time is often not long enough and unexpected events may occur during the curative treatment. When death occurs an autopsy is ordered in compliance with the obligations and responsibilities stipulated in the Medicine Act; the results of the autopsy are summarized in the detailed autopsy report. Our institute performs about 1030 autopsies of people who died at the clinics of the university, or within the territory of the city of Debrecen.