[Pathology: on the way to molecular analysis]. / Anatomie pathologique: en marche vers l'analyse moléculaire.

ABSTRACT

For a long time, pathology has been playing an important role in digestive diseases, especially in digestive cancers. This contribution was based and is still based on classical morphological techniques staining of cells and tissues and recognition of diagnostic morphological patterns characteristic for a disease. Pathology is changing, and accompanies major improvements in endoscopy and imaging of gastrointestinal diseases, and new high throughput biological techniques. Recent examples show that molecular pathology (including immunohistochemistry), often included in wider "biopathology" processes, participates to pathophysiological research (for example recognition of the serrated pathway in colorectal carcinogenesis and its relation with microsatellite instability and methylation of promoters), and to diagnostic and therapeutic procedures (for example targeted therapies of gastrointestinal stromal tumours). However, the current example of the recognition of predictive factors of response to anti-EGFR treatments in colorectal cancer shows that morphological and non morphological techniques have to find their respective role in this kind of process.