Today we meet Robbie Wilson Discipline Manager for Histopathology & Mortuary in the Institute of Pathology in Belfast
Mr Robbie Wilson
Cytology samples; their use in Molecular Pathology and the move towards next generation sequencing
The use of Molecular Pathology is becoming more evident every year, with 92% of pathologists stating that they use molecular pathology on a regular basis when reporting diagnostic work.
This growth has been led not just through service development and improvement, but also with the introduction of new treatments offering patients significant improvement and overall better survival from cancer.
These new treatments tend to require a targeted genomic test to identify specific cohorts of patients that will benefit. This has led to a reform of genomic and molecular pathology testing across the four nations of the United Kingdom, with the introduction of new regional testing hubs.
These centres mainly use Next Generation Sequencing platforms, to test for both the inherited and somatic mutations which drive disease. Next Generation Sequencing offers high-throughput cost effective sequencing of DNA, either via sequencing; individual genes, groups of genes, coding DNA known as Exome sequencing and whole genome sequencing to analysis every base pair in the patients DNA.
This technology comes with new ways of working within the laboratory and relays heavily on the data analysis via bioinformatic analysis to; analyse, manipulate, quality control and interpret the vast about of data from these platforms.
With the regionalisation of testing to the genomic hubs, and with the increased movement of diagnostic cytopathology towards near patient sampling, this opens an opportunity for cytopathology departments to work in partnership with the new genetic testing hubs, to make sure that both parties can avail off the superior benefits offered by cytology samples; safe procurement, formalin free, high diagnostic value, rapid, minimally invasive and a high DNA yield.
Cytopathology can also offer a rapid report based on sample suitability for molecular testing based on cellular content, but this to will change with the possible presence of cell-free DNA (cfDNA) which has been reported to be present in abundance in serous fluid supernatants. This supernatant that is normally discarded in the preparation of samples may hold vast diagnostic potential in the move to NGS testing.
Robbie is the Discipline Manager for Histopathology & Mortuary in the Institute of Pathology, Belfast HSC Trust. He has a strong passion for Innovation and Quality Improvement, and developing new diagnostic services.
He started his career with the introduction of Human papilloma virus testing on gels before introducing the second generation high throughput testing platforms. This started his journey into Molecular Pathology and using cytology samples to better improve the patient testing pathway. Now with the changes in HPV primary testing, the introduction of centralised Next Generation testing, and the start of Digital Pathology his journey is changing