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Skok K, Bräutigam K. Tumor infiltrating lymphocytes (TILs) - Pathologia, quo vadis? - A global survey. Pathol Res Pract 2025; 266:155775. [PMID: 39700663 DOI: 10.1016/j.prp.2024.155775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 11/27/2024] [Accepted: 12/12/2024] [Indexed: 12/21/2024]
Abstract
Tumor-infiltrating lymphocytes (TILs) and the tumor microenvironment have become increasingly important in cancer research, and immunotherapy has achieved major breakthroughs in improving patient outcomes. Despite the significant role of the pathologist in identifying, subtyping and reporting TILs, the implementation and assessment of TILs in pathology routine remains vague. To assess the actual use of TILs in routine clinical practice, a formal standardized questionnaire was disseminated on two social media platforms ("X" and LinkedIn) and by email in June 2024. Based on the results, we conducted a literature review on TILs via Medline/Pubmed in the two most scored and reported entities, namely malignant melanoma and colorectal cancer (CRC). 77 participants from 24 different countries around the world, mostly pathologists (n = 63, 82.0 %), completed the survey. More than half of the participants do not assess or report TILs in their daily (clinical) practice, a trend consistent across the countries included in the study. A variety of methods are used to report TILs, ranging from Artificial Intelligence (AI)-based scoring algorithms to quantification by eyeballing. Despite recognizing the importance of TIL assessment in clinical routine, many participants find it time-consuming and express a strong preference for AI-based quantification. Our survey reflects the perspective of mostly early career pathologists who recognize the importance of TILs in cancer but face challenges in implementation. The development of AI tools and consensus guidelines could alleviate these barriers. In addition, increasing the visibility and understanding of the role of pathologists within the medical community remains critical.
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Affiliation(s)
- Kristijan Skok
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Stiftingtalstraße 6, Graz 8010, Austria; Institute of Biomedical Sciences, Faculty of Medicine, University of Maribor, Taborska Ulica 8, Maribor 2000, Slovenia
| | - Konstantin Bräutigam
- Centre for Evolution and Cancer, Institute of Cancer Research, London, SM2 5NG, United Kingdom.
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Bräutigam K. The Pathologist Job. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2025; 40:150-151. [PMID: 39222292 PMCID: PMC11846758 DOI: 10.1007/s13187-024-02492-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Konstantin Bräutigam
- Institute of Tissue Medicine and Pathology, University of Bern, Murtenstrasse 31, 3008, Bern, Switzerland.
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Hanbazazh M, Khashab RM, Ameen NK, Alghamdi MA, Aldawsari LS, Altoukhi SM, Samargandy S, Zakariyah A. Medical Students' Perception of Pathology in Saudi Arabia. Int J Surg Pathol 2024; 32:1269-1274. [PMID: 38321866 DOI: 10.1177/10668969241226708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Pathology is the bridge between basic science and clinical practice. An inadequate perception of pathology leads to an incomplete understanding of diseases, which consequently affects its management. This study aims to identify medical students' perceptions of pathology in medical colleges around Saudi Arabia and use their feedback to improve teaching strategies. A validated online self-structured questionnaire form was distributed to medical students in basic and clinical years, including private and governmental universities in all regions of Saudi Arabia. The study comprised a total of 476 medical students. It revealed that n = 226 (48%) of the participants were not aware of pathologists' roles, and n = 262 (55%) of students reported that the main reason was insufficient exposure to actual pathology practice. A total of n = 209 (44%) students believed the current teaching methods in the basic years were insufficient to provide clear perceptions of pathology. The majority of participants n = 366 (77%) chose practical sessions as the most effective strategy in teaching pathology. Our study demonstrated that medical students require more engagement in laboratories to improve their perception. We suggest that Saudi medical schools need to deliver more comprehensive and practical teaching methods that reflect the actual practice of pathology.
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Affiliation(s)
- Mehenaz Hanbazazh
- Department of Pathology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | - Nada K Ameen
- Collage of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | | | | | - Saad Samargandy
- Department of Community Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer Zakariyah
- Medical Genetics Department, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Girardot J, Faraji N. Studying the history of histopathology in preclinical medical education as a guide for the uniform integration of radiology in medical education. Curr Probl Diagn Radiol 2024; 53:541-543. [PMID: 38729815 DOI: 10.1067/j.cpradiol.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
Radiology and pathology, though distinct fields within medical education, share a common foundation in their essential roles for accurate diagnosis and understanding of diseases. While pathology, particularly histopathology, has long been integrated into preclinical medical education in the United States, radiology education has traditionally been less emphasized. This paper examines the historical development of histopathology training in medical education and its central role, contrasting it with the comparatively peripheral position of radiology education. We explore the historical context of medical education in the United States, tracing the integration of histopathology following the Flexner Report of 1910. In contrast, radiology, emerging later as a specialized field, has faced challenges in achieving comparable integration into medical curricula. Despite the increasing importance of medical imaging in diagnosis and treatment, radiology education remains variable and often lacking in standardization across medical schools. We highlight the need for greater emphasis on radiology education to better prepare medical students for modern clinical practice, where medical imaging plays an increasingly pivotal role. A call for a comprehensive assessment of radiology education and advocacy for its integration into preclinical curricula is made, emphasizing the importance of collaboration between the radiology profession and accrediting bodies to ensure competence in imaging across medical specialties. As medical imaging continues to advance and become more integral to healthcare, it is imperative that medical education reflects this evolution by establishing radiology as a fundamental component of preclinical training.
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Affiliation(s)
- Jeffrey Girardot
- Case Western Reserve University School of Medicine, Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 USA.
| | - Navid Faraji
- University Hospitals Cleveland Medical Center, Department of Radiology, 11100 Euclid Ave # 2600, Cleveland, OH 44106 USA
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Schukow C, Abdul-Karim FW, Crane GM. Proper Tweeting Etiquette Guidelines for Pathologists, Trainees, and Medical Students on #PathTwitter. Int J Surg Pathol 2024; 32:449-455. [PMID: 37533372 DOI: 10.1177/10668969231186927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
The use of social media in pathology has broadly had a positive impact on pathology education and outreach with the frequent posting of high-quality educational material of potential value to trainees, practicing pathologists, and other clinical and laboratory specialists. These posts are also of potential utility and interest to members of the public, who are now more than ever able to gain a window into the field and the role of pathologists in their medical care. There can be a lighthearted aspect to teaching material with the use of food items/analogies, emojis, or other descriptors, which may cross over into the classroom. However, when pathology discussion is taken to a public forum, such as on Twitter (parent company: X Corp.), there is the potential for posted material to be misunderstood, such as when certain emojis or adjectives may be used to describe a human disease state or patient sample. The authors present examples of potential areas of caution, suggestions of how to create a positive impact, and brief guidelines for social media etiquette on #PathTwitter that may apply to other social media platforms widely used by pathologists (including, but not limited to, Facebook, Instagram, YouTube, and KiKo). While the points discussed here may be common knowledge and well-known to pathologists who use social media for virtual medical education, the concerns mentioned here (such as using language like "beautiful" to describe abnormal mitotic figures and cancer cells) still exist and, henceforth, bear reinforcing.
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Affiliation(s)
- Casey Schukow
- Department of Graduate Medical Education, ProMedica Monroe Regional Hospital, Monroe, MI, USA
- *Current affiliation: Department of Pathology, Corewell Health, Royal Oak, MI, USA
| | - Fadi W Abdul-Karim
- Pathology, Case Western Reserve University and Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Genevieve M Crane
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA
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Rau TT, Neppl C, Esposito I. [A European comparison of continuing education in pathology]. PATHOLOGIE (HEIDELBERG, GERMANY) 2022; 43:106-110. [PMID: 36378288 DOI: 10.1007/s00292-022-01153-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/16/2022]
Abstract
In the coming years, the shortage of pathologists will become internationally evident. In addition, the increase in knowledge, technical transformation processes, and the attractiveness of working conditions pose clear challenges for the field of pathology. A bi-directional opening for international mobility of pathologists could be a potential solution.In this analysis, the European training concept of the European Union of Medical Specialists (UEMS) was compared with its implementation in the 27 countries of the EU plus its 4 associated countries with regard to nationally differentiated concepts, type and implementation of the specialist examination, and additional qualifications. Subsequently, questions regarding the recognition of exams, titles, and specialist exams were elicited.The duration of training ranges between 4 and 6 years. The number of cases also varies considerably. Obtaining the specialist title can be done by simply completing the specifications up to a structured examination. In the EU, exams are mutually recognized, but this does not necessarily apply to academic titles and additional qualifications. Increasingly, on-site training centers are also subject to auditing procedures.The European agreements allow a high degree of permeability. However, national regulations pose hurdles for international mobility. The UEMS is therefore focusing on harmonization, including the certification of training centers. The so-called European Pathology Progress Test of the European Society of Pathology (ESP) is a further step towards the development of a future European specialist title. It remains the joint responsibility of residents and institutes to shape the future of the next generation of pathologists from the variety of different concepts.
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Affiliation(s)
- Tilman T Rau
- Institut für Pathologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - Christina Neppl
- Institut für Pathologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - Irene Esposito
- Institut für Pathologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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Rakovic K, Colling R, Browning L, Dolton M, Horton MR, Protheroe A, Lamb AD, Bryant RJ, Scheffer R, Crofts J, Stanislaus E, Verrill C. The Use of Digital Pathology and Artificial Intelligence in Histopathological Diagnostic Assessment of Prostate Cancer: A Survey of Prostate Cancer UK Supporters. Diagnostics (Basel) 2022; 12:1225. [PMID: 35626380 PMCID: PMC9141178 DOI: 10.3390/diagnostics12051225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 12/03/2022] Open
Abstract
There has been particular interest in the deployment of digital pathology (DP) and artificial intelligence (AI) in the diagnosis of prostate cancer, but little is known about the views of the public on their use. Prostate Cancer UK supporters were invited to an online survey which included quantitative and qualitative questions exploring views on the use of DP and AI in histopathological assessment. A total of 1276 responses to the survey were analysed (response rate 12.5%). Most respondents were supportive of DP (87%, 1113/1276) and of testing AI in clinical practice as a diagnostic adjunct (83%, 1058/1276). Respondents saw DP as potentially increasing workflow efficiency, facilitating research, education/training and fostering clinical discussions between clinician and patient. Some respondents raised concerns regarding data security, reliability and the need for human oversight. Among those who were unsure about AI, information was requested regarding its performance and others wanted to defer the decision to use it to an expert. Although most are in favour of its use, some are unsure, and their concerns could be addressed with more information or better communication. A small minority (<1%) are not in favour of the testing of the use of AI in histopathology for reasons which are not easily addressed.
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Affiliation(s)
- Kai Rakovic
- Institute of Cancer Sciences, University of Glasgow, Switchback Road, Glasgow G61 1QH, UK
- Department of Pathology, Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, UK
| | - Richard Colling
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (R.C.); (L.B.); (C.V.)
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
| | - Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (R.C.); (L.B.); (C.V.)
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
| | - Monica Dolton
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
| | | | - Andrew Protheroe
- Department of Oncology, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, UK;
- Oxford Cancer & Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Old Road, Oxford OX3 7LE, UK
| | - Alastair D. Lamb
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Old Road, Oxford OX3 7LE, UK
| | - Richard J. Bryant
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Old Road, Oxford OX3 7LE, UK
| | - Richard Scheffer
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
| | - James Crofts
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
| | - Ewart Stanislaus
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
| | - Clare Verrill
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (R.C.); (L.B.); (C.V.)
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; (M.D.); (A.D.L.); (R.J.B.); (R.S.); (J.C.); (E.S.)
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK
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Mitchell RN. Do Not Go Gentle…Random Walks, Mentorship, and the State of Pathology Education in the 21st Century. Cardiovasc Pathol 2022; 60:107431. [DOI: 10.1016/j.carpath.2022.107431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022] Open
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Masuadi EM, Mohamud MS, Alhassan AM, Alharbi KG, Hilabi AS, Alharbi FA, Tatwani AT, Farraj AI, Al-Nasser S, Safi MF. Factors and Determinants of Choosing Pathology as a Future Career: Results From a Multi-Institution Study. Cureus 2021; 13:e15790. [PMID: 34295597 PMCID: PMC8293683 DOI: 10.7759/cureus.15790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/05/2022] Open
Abstract
Background Globally, less than 10% of graduating medical students select pathology as a future career. Many factors were reported from different settings to influence the choice of pathology. The aim of this study was to investigate the factors that determine medical students' preferences in choosing pathology as a future career. Methods This cross-sectional study surveyed students from three governmental medical schools in Riyadh, Saudi Arabia. A self-administered questionnaire that contained demographic questions and items that addressed perceived factors that affect the choice of pathology was distributed to medical students. Collected data were analyzed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). A chi-square test was used to determine the association between independent variables and interest in pathology. Results Out of the 400 questionnaires distributed, 338 students completed the survey with a response rate of 84.5%. Overall, surgery (24%) and internal medicine (20%) were the most favored, specialties with only 5% of the students selecting pathology as their first choice. Patient-doctor interaction (72.2%) was perceived as the most important factor in not choosing pathology as a future career. Taking an elective course, younger age groups, and year in medical school were all significantly associated (p<0.001) with an interest in pathology. Conclusion In this study, most of the students indicated surgery and internal medicine as their first specialty choices. Only 5% of the students chose pathology as their first choice. Two-thirds of medical students perceived pathologists do not interact with patients. A significant association was found between younger age groups, enrolling for a pathology course, and having an interest in pathology.
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Affiliation(s)
- Emad M Masuadi
- Research Unit/Biostatistics, King Saud Bin Abdulaziz University for Health Sciences/King Abdullah International Medical Research Centre (KAIMRC), Riyadh, SAU
| | - Mohamud S Mohamud
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulrahman M Alhassan
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Khalid G Alharbi
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ahmed S Hilabi
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal A Alharbi
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdullah T Tatwani
- Medical Education, College of Medicine/King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdullah I Farraj
- Pathology and Laboratory Medicine, College of Applied Medical Sciences/King Saud University, Riyadh, SAU
| | - Sami Al-Nasser
- Medical Education, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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