Why is pathological diagnosis of great significance and irreplaceable for tumor patients?

The diagnosis of malignant tumors requires sufficient evidence, and doctors never rely solely on clinical diagnosis or imaging examinations to "make judgments" on patients.

Generally speaking, the diagnosis of tumors requires five steps, namely clinical diagnosis, imaging diagnosis, surgical diagnosis, cytopathological diagnosis, and histopathological diagnosis. These five steps increase in reliability in sequence, and histopathological diagnosis is the highest level and most reliable diagnostic basis, which is the gold standard for diagnosing cancer.

Today, let's introduce to you what information pathological diagnosis can provide, and why is pathological diagnosis significant for the treatment of patients?

How to make a pathological diagnosis

Histopathological diagnosis is made by performing hollow needle puncture, forceping, cutting or removing biopsy tissue from a tumor, and then making pathological sections for histological examination. After biopsy, the pathologist needs to perform a series of tests to make a diagnosis.

Firstly, the biopsy specimen should be stored in a container containing water and formaldehyde (formalin) or other liquids. Pathologists observe tissue samples with the naked eye and provide relevant general descriptions.

Afterwards, the pathologist makes the specimen into permanent sections, frozen sections, or smears. Slices or smears are placed on glass slides and then immersed in a series of dyes to change the color of tissues, cells, and substructures. These colors make cells easier to observe under a microscope. For most biopsy specimens, this staining treatment is necessary.

Usually, on the second day after the biopsy is completed, the pathologist will observe the tissue sample under a microscope to make a diagnosis and generate a pathological report. Pathologists usually provide a histopathological report within 10 days after biopsy or surgery.

How much important information does pathological diagnosis contain

Qualitative analysis of tumors

The most direct significance of pathological diagnosis lies in determining the benign or malignant nature of the tumor or vegetation. If there is no pathological diagnosis, all suspicions are just "looking very similar" and cannot be concluded; Just like judges need to focus on evidence in their judgments, not just on their eyes and feelings.

Guiding treatment

In addition to qualitative analysis of suspicious tissues, pathological diagnosis also describes the type and staging of the tumor. For example, for lung cancer, whether it is adenocarcinoma or squamous cell carcinoma has a significant impact on medication and treatment strategies. The current pathological diagnosis has added molecular level biomarkers (immunohistochemistry and gene testing), which are important for predicting drug responses, especially targeting and immunotherapy drugs. In addition, pathology can also assess the degree of tumor development, including the location of tumor growth, degree of infiltration, presence of regional lymph node metastasis, and presence of distant metastasis. This determines the pathological staging of the tumor, which is the prerequisite and basis for correct and reasonable treatment.

Evaluate prognosis

Pathological diagnosis is an important basis for guiding treatment and also a major indicator for predicting patient prognosis. For example, Grade grading reflects the degree of malignancy of the tumor and is also an important indicator of prognosis; For example, the information mentioned earlier about the degree of tumor infiltration and the presence or absence of metastasis is also an important indicator for evaluating prognosis.

Under what circumstances do pathological consultations need to be conducted

Pathological consultation is one of the routine tasks in the pathology department, with the aim of seeking a second or more medical opinion to improve the quality of pathological diagnosis and obtain better treatment plans for patients.

Due to the fact that histological slices used for pathological diagnosis can be permanently preserved and can be evaluated by different or identical pathologists, one or more at the same or different times, this provides the possibility of consultation for difficult or controversial cases.

Pathological diagnosis itself is very complex, and there are various situations that require consultation. Generally speaking, pathological consultation may be necessary in the following situations.

1. The condition is relatively complex, and consultation is required in any level of hospital when encountering this situation.

2. The technical conditions are limited, and special staining, immunohistochemistry, molecular biology testing, and electron microscopy examination conditions cannot be performed. Pathological diagnosis cannot be completed and consultation is required.

3. Pathological diagnosis is controversial, different doctors have different opinions, or the disease itself is in a controversial field, all of which should undergo pathological consultation.

4. Small biopsy specimens are relatively small in quantity, and many common specimens such as gastroenteroscopy, bladder biopsy, breast biopsy, kidney biopsy, liver biopsy, etc. have a limited number of samples, which brings great difficulties to diagnosis. This factor poses difficulties in diagnosis and pathological consultation should be conducted.

5. If tissue damage or deformation makes diagnosis difficult and patients are unwilling to undergo another biopsy, they can consider attempting pathological consultation, which may solve the problem

6. Patients do not trust and trust the diagnostic results, and always want to find higher-level hospitals and more authoritative doctors to provide conclusions. In this case, pathological consultations can also be conducted.