Dr. Julia A. Bridge, the Young Investigator Award Recipient for 2003, is a trailblazer in solid tumor
cytogenetics and molecular cytogenetics. Early on, Dr. Bridge astutely employed her background in
Anatomic Pathology and Cytogenetics to determine whether genetic alterations were central to the
pathogenesis of bone and soft tissue neoplasms. Over the past one and one-half decades, she has studied
more than 5,000 benign and malignant bone and soft tissue tumors utilizing various combinations of
pathologic, conventional cytogenetic, molecular cytogenetic, and molecular genetic techniques, reporting
the findings of hundreds of these entities. Her seminal studies demonstrated that certain bone and soft
tissue neoplasms have recurrent, if not specific, genetic changes, particularly translocations. Such
findings have not only been of diagnostic relevance for pathologists confronted with vexing neoplasms,
but of greater importance, they directed attention to the site of molecular events wherein mutated genes
key to the neoplastic state reside.
Dr. Bridge received her B.S. and M.D. degrees from the University of Nebraska Medical Center in 1984.
She trained in Anatomic Pathology at the University of Kansas School of Medicine. As a pathology
resident, she independently developed a cytogenetic laboratory to evaluate lymphomas and, subsequently,
bone and soft tissue neoplasms. Her efforts did not pass unnoticed, as she was awarded in her senior
year, a grant from the Orthopaedic Research Education Foundation to study a wide range of benign and
malignant bone and soft tissue neoplasms. The final six months of residency were spent as a Special
Fellow in Clinical Cytogenetics at the University of Nebraska Medical Center.
Recognizing the importance of molecular biology in contemporary medical research, she electively pursued
additional training as a molecular biology fellow at the Southwest Biomedical Research Institute in
Scottsdale under the supervision of Dr. Avery A. Sandberg. This training was undertaken while she
simultaneously directed a research laboratory in Kansas and retained her first academic position as a
Clinical Assistant Professor in Pathology and Oncology.
In 1991, she was recruited to the University of Nebraska Medical Center as an Associate Professor of
Pathology, Pediatrics and Orthopaedic Surgery. In 1999, she was promoted to the rank of full Professor
in all three departments.
Dr. Bridge has delineated the precise cytogenetic alterations (including the exact chromosomal bands or
subbands involved) for more than 30 distinct bone/soft tissue entities. This information has served as a
basis for her molecular studies, and those of others, in identifying the genes altered and the clinical
phenotypes stemming from these genetic alterations. A significant outgrowth of these studies has been
the demonstration of specific and recurrent chromosome changes in benign and malignant bone and soft
tissue tumors which has added a new dimension to the formulation of a diagnosis. Chromosomal
translocations and/or associated gene fusions such as t(X;18)/SYT-SSX in orofacial and pulmonary synovial
sarcoma, t(12;22) in clear cell sarcoma, der(17)t(X;17)/ASPL-TFE3 in alveolar soft part sarcoma, t(1;3)
in epithelioid hemangioendothelioma, t(2;17)/CLTC-ALK or t(2;2)/RanBP2-ALK in inflammatory
myofibroblastic tumor, and t(13;21) in mesenchymal chondrosarcoma represent several tumor-specific
anomalies identified by Dr. Bridge and colleagues.
Dr. Bridge’s cytogenetic investigations have also been instrumental in uncovering the relationship
between a genetic aberration that occurs sporadically and that which is inherited. For example, the
identification of recurrent 5q21-22 and 8q24.1 chromosomal loss in sporadic desmoid tumors and
osteochondromas, respectively, and the loci of the putative tumor suppressor genes, familial adenomatosis
polyposis (FAP) and hereditary multiple exostoses (EXT1), confirmed the previously hypothesized
pathogenetic relationship between those lesions arising sporadically and those of a hereditary nature and
provided support for the theory that these genes were, in fact, tumor suppressor genes. Moreover, her
original cytogenetic descriptions of dermatofibrosarcoma protuberans, parosteal osteosarcoma, and, most
recently, pleomorphic hyalinizing angiectatic tumor, all revealing the presence of ring chromosomes and
low level genomic amplification as their defining genetic features, have provided evidence for a shared
mechanism of oncogenesis amongst mesenchymal neoplasms of low malignant potential.
Dr. Bridge has published the most detailed cytogenetic and molecular cytogenetic findings of
osteosarcomas and chondrosarcomas. Unlike karyotypic descriptions of Ewing’s sarcoma and several other
sarcomas which feature a single characteristic chromosomal rearrangement, osteosarcomas and
chondrosarcomas are characterized by recurrent, diverse, complex chromosomal imbalances, the patterns of
which can only be recognized by study of large numbers of these neoplasms.
Dr. Bridge has contributed significantly to the development and advancement of new molecular cytogenetic
(fluorescence in-situ hybridization) tests for the routine assessment of cancer patients in pathology
laboratories worldwide. Clinical studies which involve cutting edge DNA probe technology are most
challenging in terms of receiving FDA acceptance. Dr. Bridge served in the development and as key
investigator for two studies which resulted in approval for two novel gene-based tests: 1) breast cancer
prognosis (Oncor’s INFORM, HER-2/neu), and 2) bladder cancer recurrence (Vysis’ UroVysion). Both
approvals were the first of their kind. Most recently, Dr. Bridge’s laboratory was selected as one of
three worldwide to participate in clinical studies for a novel automated scanning/scoring microscope
system that may revolutionize fluorescence in situ hybridization in the clinical setting.
The cytogenetic, molecular cytogenetic and molecular diagnostic laboratories developed by Dr. Bridge at
the University of Nebraska Medical Center are recognized reference laboratories for numerous medical
centers across the continent as well as from laboratories beyond North America. In recognition of the
quality of her laboratory, rhabdomyosarcoma specimens from the former Intergroup Rhabdomyosarcoma Study
Group were sent to Nebraska for the last three years. Recently, her laboratory was selected as the sole
Cytogenetic Reference Laboratory for all soft tissue sarcomas for the national Children’s Oncology Group.
Dr. Bridge has demonstrated an impressive and continuous measure of extramural research funding, carried
a full clinical load on the diagnostic cytopathology, clinical cytogenetic and molecular genetic
services, and mentored graduate, medical and resident students for three separate departments. Dr.
Bridge’s scientific contributions to the orthopaedic community were recognized by her reception of the
Kappa Delta Investigator Award in 1999 from the American Academy of Orthopaedic Surgeons, an honor rarely
awarded to non-Orthopaedic Surgeons. Dr. Bridge serves on the Editorial Board of Cancer Genetics and
Cytogenetics and the Journal of Molecular Diagnostics and has published over 130 peer-reviewed papers and
20 book chapters including several chapters for the recently published WHO Classification of Tumours:
Pathology and Genetics of Tumours of Soft Tissue and Bone. In 1994, she co-authored the first
comprehensive text on the Cytogenetics of Bone and Soft Tissue Tumors with Avery Sandberg; the second
edition is “in preparation”. Currently, she is co-authoring the 4th series of the AFIP Fascicle on
Tumors of Bone with Drs. K.K. Unni, C.Y. Inwards, L-G Kindblom, and L.E. Wold. Her section on
genetics represents the first inclusion of this topic in this fascicle.
Regarding the USCAP, Dr. Bridge serves as a member of the Education Committee,has chaired an awards
committee and co-directed a short course on genetic approaches in the diagnosis of bone and soft tissue
tumors; developed and co-directs the Introductory Molecular Pathology course. She also serves as an
Ambassador. These efforts illustrate her commitment to the relevance of molecular techniques in