2017 Annual Meeting
SC02-Molecular Diagnostics in Cytopathology:Opportunities, Limitations, Pitfalls
March 8 2017, 8:00am to 12:00pm
SC02 Molecular Diagnostics in Cytopathology: Opportunities, Limitations and Pitfalls
Session Credits: 3 CME and 3 SAMs
Faculty: Sinchita Roy-Chowdhuri, MD, PhD, UT MD Anderson Cancer Center, Houston, TX and Michael Roh, MD, PhD, University of Michigan Health System, Ann Arbor, MI
Molecular diagnostics are increasingly being utilized to help guide targeted therapy in solid organ tumors and hematologic malignancies. A large proportion of molecular diagnostic testing is performed on limited volume samples obtained via minimally invasive techniques such as fine needle aspiration. Increasingly, cytopathologists, are at the forefront of triaging specimens during rapid on-site evaluation and selecting specimens for ancillary testing. Therefore, it is imperative that practicing cytopathologists, stay abreast of up-to-date diagnostic and prognostic ancillary tests utilizing limited cytologic material. Cell blocks are traditionally and most commonly utilized for ancillary studies including immunocytochemistry and molecular assays; however, variations in cell block cellularity, in a large fraction of cases, represent a significant limitation of cell block preparations. We will discuss cell blocks and other alternative cytologic specimen sources for ancillary studies, along with the advantages and disadvantages of each, to help the participants triage cytologic specimens for ancillary testing in their own practices. We will also provide participants with an overview of current molecular diagnostics in the context of the cytology specimen, together with a basic understanding and working knowledge of the available technology and platforms, clinical applications, limitations, regulatory issues, and integration into patient care. The overall goal of this short course is to serve as a timely discussion of this topic at a critical juncture when pathologists must meet the challenge of optimally utilizing FNA material for diagnosis and necessary ancillary studies. Upon completion of this educational activity, participants should be able to:
1. Recognize current molecular ancillary studies in the context of cytologic specimens and understand the basics of ancillary testing with an emphasis on analytic sensitivity, how they affect testing, and how best to utilize a specimen to fit a specific molecular ancillary test.
2. Compare and contrast different cytologic specimen preparations (e.g., cell blocks, direct smears, Whatman cards, frozen specimens, liquid-based preparations etc.) as well as different molecular technologies (Sanger sequencing, pyrosequencing, real-time, next-generation sequencing etc.) and recognize the advantage and disadvantage of each.
3. Identify qualitative and quantitative requirements for molecular analysis including pre-analytical variables and devise strategies for implementation of optimal cytologic specimen triage for performing relevant ancillary studies.
4. Implement specimen triage strategies via a case-based approach demonstration.
The course is designed for general pathologists, cytopathologists, cytotechnologists, and advanced trainees in pathology and cytopathology. Registrants will be able to view the comprehensive syllabus consisting of the PowerPoint slides and references on the USCAP website prior to the meeting.