Le travail des spécialistes en anatomie pathologique consiste à examiner, à l’œil nu et au microscope, les organes, les parties d’organes, les tissus et les cellules pour y rechercher un cancer, confirmer sa présence ou déterminer ses caractéristiques (son extension, son agressivité, son caractère héréditaire…). Le rôle de cette spécialité médicale dans la prise en charge des patients est primordial car ce sont les caractéristiques du cancer qui vont déterminer le traitement.
During the diagnosis, the anatomopathological examination concentrates on small fragments of tissue, called biopsies, obtained during an endoscopy (when a tube is introduced into a cavity such as the stomach, bronchi, colon or bladder allowing samples to be taken by means of a small pincer located at its end) or from material obtained from punctures carried out using a needle. Simple brushing or rubbing is sometimes sufficient to obtain the cells required for a microscope examination, as in gynaecological smears. This illustrates the importance of anatomopathology in the detection of certain cancers.
After a surgical operation, it is the anatomopathologist who receive the surgical sample and conducts a detailed examination of the tumour removed during the operation. After taking suitable samples, he then looks under the microscope to find all the important elements that will allow the level of aggression of the cancer to be determined. Finally, the anatomopathological examination contributes to the quality of surgical treatment before and after the operation: in particular, it allows the surgical process to be properly orientated and to ensure that the cancer has been wholly removed.
The contribution made by anatomopathology to the diagnostic and therapeutic approach to cancer is very significant, indeed a determining factor, at several stages in the course of a cancer.
At Cliniques Universitaires Saint-Luc, advances in knowledge have led anatomopathologists to specialise and sectorise on the basis of various types of tumours treated in the Cancer Centre. This organisation allows them to be at the forefront of knowledge in the field of oncology, to which they dedicate almost all of their activity, remaining continually in touch with the most recent developments and thus providing their clinician contacts with key elements in providing care that consists with ultra-modern standards.
Anatomopathologists are at the crossing point of many paths. They work closely with the doctors who take the organ or tissue samples examined under the microscope (gastroenterologists, pneumologists, gynaecologists etc) and with specialists in the treatment of cancer (surgeons, chemotherapists, radiotherapists etc). At the Cliniques Universitaires Saint-Luc Cancer Centre, this work specifically takes the form of multidisciplinary meetings, held weekly, at which the specialists in the various fields pool their knowledge and observations in order to provide patients with the most suitable care and set up a treatment specific to each case, according to the profile of the tumour advised by the pathologist during the meetings.
As well as macroscopic and microscopic aspects, much research into pathological anatomy is currently aimed at better defining the nature of tumours. This means that ever more effective tools are allowing pathologists to identify, under the microscope, the proteins of which the production by certain genes is associated with a more or less favourable development of the tumour. The progress realised in this field has thus led to the discovery of a great number of proteins or “markers” that have provided a better description of the nature of a tumour and allowed its behaviour and potential for development to be better understood. Sometimes, the markers have an effect on the monitoring of other family members; their presence can indicate a possible hereditary nature and thus necessitate a consultation at the Human Genetics Centre. In other cases, these markers are used to advantage to predict the efficacy of treatment. Their identification, therefore, also helps optimise the care of patients. The pathological anatomy laboratory at Cliniques Universitaires Saint-Luc is able to identify almost three hundred different markers, most of which concern the nature and behaviour of tumours.
In the fight against cancer, the pathological anatomy department is also involved in studies to determine the efficacy of new treatments. Such is its level of activity that a large number of so-called “residual samples” can be stored in a biobank. This material, provided the patient consents, is used in research activity. To find out more about our biobank, click here (link to “biobank”).
The pathological anatomy department at Cliniques Universitaires Saint-Luc plays an active part in the development of the national and European recommendations that set the required quality standards for an anatomopathological examination. In fact, this examination should be conducted according to a specific standardised procedure, especially with regard to methods, the number of samples taken, the measurements to be made, the description of lesions etc. Our pathological anatomy department applies all these recommendations for all types of cancer