Greeting

In recent years, genetic testing and immunohistochemistory have become indispensable for treatment selection, and pathologists are required to respond to such requests, but the scientific basis for such requests is often limited to the fact that they have been approved by the FDA or that they have been determined to be so in clinical trials. As a result of this passive attitude, pathologists are losing the habit of thinking for themselves based on genomic and clinical information, conference presentations, and articles. Integrated classification and integrated understanding of genomics, clinical practice, and pathology (morphology and phenotype) is a well-known phrase, but data science is becoming the sole domain of pathologists. However, the information on pathology (morphology and phenotype), which is the source of data, is limited to histological types and differentiation levels at best. Can it really be called integrated? Pathologists should communicate more. There are things that only we, pathologists, can understand. We are familiar with the heterogeneity of cancer and can analyze background lesions, microscopic lesions, early stage lesions, and the process of progression in individual cases and in many cases. This kind of realistic analysis based on pathological observations and accumulated experience is important and something to be proud of. On top of this, we would like to incorporate the latest technology and conduct pathological research unique to Japan. For example, TCGA data from overseas is mostly analysis of advanced cancers, with very few cases of early-stage cancers. In Japan, where there are many early-stage cancers, it should be possible to conduct unique Japanese research focusing on early-stage lesions and microdefects while utilizing technologies such as whole genome sequencing analysis and spatial genomics/transcriptomics. EVG staining is useful in identifying invasion, which is well known to all pathologists in Japan. EVG staining is useful for identifying invasion. Taking advantage of this fact, if we collect a large number of EVG-stained specimens and analyze them by AI, we may be able to construct an AI diagnosis system that can make a better diagnosis than one based simply on HE specimens (this is already being promoted in our laboratory). It is also a specialty of Japanese pathologists to value individual cases and pursue them in depth.
Even though pathologists are busy, it is important to collect information, and it is important to keep one's so-called antenna up. The importance of morphological observation by pathologists will never be lost if they maintain a fresh interest, curiosity, and sensitivity to new information.