The Role of Molecular Pathology in Precision Medicine: The Anatomical Pathology Perspective

The era of molecular pathology (MP) is gaining momentum and has tremendously changed the practice of pathology, transforming it from a morphological discipline to a molecular discipline. MP is an essential component of precision medicine in modern medicine. Precision medicine has revolutionised diagnoses and therapeutic approaches, which are specifically tailored towards an in-depth understanding of patient’s unique biological characteristics. This article aimed at providing an insight to the underlying foundation and concept of MP in precision medicine and highlighting the key techniques, applications and limitations of this evolving field. A total of 60 articles were searched and reviewed from different databases and search engines using search terms such as MP, precision medicine, multiomics, targeted therapy, molecular biomarkers and next-generation pathologists. Fifty-one articles were finally used following data triangulations, and the authors experience in the field of molecular diagnosis was also included. The key modern techniques utilised include gene sequencing, in situ hybridisation, polymerase chain reaction, digital pathology with the utilisation of artificial intelligence, immunohistochemistry (IHC), tissue biobanking and bioinformatics. Emerging newer techniques paving the way in this field include liquid biopsy, patient’s derived organoid, modern IHC, organs-on-chips, personalised stem cell therapy and virtual autopsy. Pathology has featured prominently in the practice of precision medicine, especially in the areas of drug development and targeted therapy for different diseases and forensic medicine. This emerging field indeed has certain limitations depending on varying factors. Undoubtedly, MP in precision medicine has created a light at the end of the tunnel, and this concept should be integrated into the training curriculum pathologists.