Molecular pathology in the cancer clinic – where are we now and where are we headed?

Molecular pathology is a developing sub-microscopic discipline of pathology that studies the effects of molecular variations and mutations on disease processes. The ultimate goal of molecular pathology in cancer is to predict risk, facilitate diagnosis and improve prognostication based on a complete understanding of the biological impact of specific molecular variations, mutations and dysregulations. This knowledge will provide the basis for customised cancer treatment, so-called precision medicine. Rapid developments in genomics have placed this field at the forefront of clinical molecular pathology and there are already a number of well-established genetic tests available for clinical use including PCR of antigen receptor rearrangement and KIT mutational analysis. Moving beyond tests assessing a single gene, there are significant research efforts utilising genomics to predict cancer risk, forecast aggressive behaviour and identify druggable mutations and therapeutic biomarkers. Researchers are also investigating the use of circulating cells and nucleic acid for clinically useful low morbidity genomic assessments. If we are to realise the full potential of molecular pathology and precision medicine there are a number of challenges to overcome. These include developing our understanding of the underlying biology (in particular intra-tumoural heterogeneity), methodological standardisation of assays, provision of adequate infrastructure and production of novel therapeutics backed by high-quality clinical data supporting the precision medicine approach. The era of molecular pathology holds the potential to revolutionise veterinary cancer care, but its impact on clinical practice will depend upon the extent to which the inherent challenges can be overcome.     

Equine glaucoma: Where are we now?

The following article discusses the pathophysiology, clinical signs, diagnosis, medical treatment and surgical management of glaucoma in the horse.     

Statistics: are we related?

This short addition to our series on clinical statistics concerns relationships, and answering questions such as “are blood pressure and weight related?” In a later article, we will answer the more interesting question about how they might be related. This article follows on logically from the previous one dealing with categorical data, the major difference being here that we will consider two continuous variables, which naturally leads to the use of a Pearson correlation or occasionally to a Spearman rank correlation coefficient.     

Elephant dental pulp tissue: where are the nerves?

Dental pulp tissue from three elephants was examined histologically with hematoxylin and eosin and s-100 protein stains. In all specimens, normal pulp was found with the exception that no nerve fibers (myelinated or non-myelinated) were demonstrable in any of the numerous sections prepared.