Genetics and Pathology
In today's world, pathology and genetics are like two married branches. Especially in cancer studies, particularly in the investigation of somatic mutations, the two branches work together. When tissue arrives at the laboratory, macroscopic studies are conducted in the pathology unit. Depending on the type of cancer, it is determined from which areas and how many sections will be taken and how the study will be conducted. Regardless of the study to be performed on the tissue, the first step is to identify which part of the incoming tissue is cancerous. It is determined how much of the examined area is occupied by cancerous tissue. After this preliminary study, detailed work is initiated according to the method to be used. If sequencing analysis is to be performed, tissue is taken from the marked area, DNA isolation is carried out, and the study for the targeted gene is started. If FISH is to be performed, sections of appropriate thickness for FISH analysis are taken. In these sections, the cancerous area is marked, and the probe is applied to this area for the study.
Intergen is one of the few laboratories that have both pathology and genetics labs. It is a center that transforms the culture of working together into an advantage for the benefit of the patient. Clinical information is obtained for the incoming samples, and a joint pathology-genetics council is held to determine the most appropriate tests for the patient.
Similarly, in “fetal pathology” studies, pathology and genetics must work together. When a fetus is evacuated due to anomalies detected by fetal ultrasonography or a diagnosis is requested for an intrauterine deceased fetus, genetics and pathology must again collaborate. The geneticist establishes a preliminary diagnosis based on dysmorphic findings identified in the postmortem examination, prenatal findings, ultrasound findings, obstetric history, and family information obtained from the family, and provides detailed information to the pathologist. The pathologist learns the critical details that should not be overlooked. In light of this information, the pathologist performs the autopsy. The placenta is very important at this stage. Sometimes a diagnosis can be made by examining only the placenta. Therefore, when such a study is requested, information should be obtained from our center regarding how the sample should be sent and stored, ensuring that such a valuable tissue is studied under the best conditions. These studies are very important for determining the risks for future pregnancies of the family and whether there are other individuals at risk within the family.
Biopsy
A small piece of tissue taken from accessible organs in the body is called a biopsy sample. Examples include: samples taken from skin moles, gastric-intestinal samples taken endoscopically, lung tissue samples taken by bronchoscopy, and bladder samples taken cystoscopically. These samples are examined under a microscope after special staining and provide valuable information about the presence of disease. When necessary, it serves as a preliminary diagnostic method before a larger surgical intervention.
Resection
The surgical removal of part or all of an affected organ is called resection or complete removal. The removed tissue is delivered to our laboratory in protective fluids. Our specialists examine the tissue, take the necessary samples, and place them in a special processing machine for further fixation. Later, sections as thin as an onion peel are made from the prepared samples and stained. At this point, our pathology specialists are ready to examine the cells under a microscope. Sometimes special staining methods are required to diagnose the examined tissue. When these staining methods are used, the success rate of diagnosis increases. Moreover, for some treatments to be applied, it is essential to perform these stains and obtain their results beforehand.
What is Cytopathology?
Cytology means the science of cells. The first changes in diseases begin in the body's smallest living unit, the cell. These changes later spread and manifest the disease. Cytopathology is a sub-branch of pathology that examines samples taken from tissue and body fluids to identify changes occurring in cells for disease diagnosis.
In various body fluids, swabs taken from the cervix and vagina, and needle aspiration materials from the thyroid, breast, liver, and bone marrow, different cells or cancer cells are searched.
Cervicovaginal Smear Test
The smear test (Pap smear) for cervical cancer screening has been performed worldwide for nearly 100 years and has proven its efficacy. Smear tests are reported within approximately 24-72 hours. Unlike conventional smears, liquid-based smear preparations require an additional molecular test, the HPV PCR test, for typing the Human Papilloma Virus (HPV) when suspicious dysplastic cells are observed during routine examination. If the sample is collected appropriately for liquid-based preparation at the time of initial sampling, HPV studies can be planned without needing to take another sample from the patient. It should not be forgotten that cervical cancers are treatable when detected early. Screenings are very important.
Fine Needle Aspiration Biopsies
Fine needle aspiration biopsy (FNAB), which allows the analysis of live tissue samples and enables rapid and easy diagnosis of diseases, is most commonly used for the diagnosis of thyroid nodules, salivary gland masses, lymph nodes, and lung nodules. FNAB is a painless, comfortable, and reliable diagnostic method that offers significant advantages to both the physician and the patient. If the results after the procedure are as desired, the patient can avoid unnecessary surgical procedures and anesthesia. Fine needle aspiration biopsy, which can also be safely performed during pregnancy, has shown a very rare risk of spreading cancer or seeding cells according to studies.
Cytology in Body Fluids
It covers exfoliative cytology studies in body fluids (such as saliva, cerebrospinal fluid, urine, bronchoalveolar lavage, effusions, pleural, intra-abdominal, intra-articular fluids, etc.).