Search

An overview of how Bioinformatics has developed within Anthony Nolan, it's key projects and its impact moving forward. Areas covered will include:

A brief overview of Bioinformatics
Using Bioinformatics at Anthony Nolan;
The IPD reference Databases, in particular the IPD-IMGT/HLA Database
Population genetics of the HLA register
An insight into HLA sequencing and clinical impact
The future of bioinformatics at Anthony Nolan

Delegates will:

Gain an appreciation of the diversity and range of tumour types that can be assessed using Mohs.
Comprehend the complexity of technical requirements to ensure cases are dealt with effectively.
Recognise unusual findings and be able to adjust the investigative procedures in a 'live' setting
Appreciate tumour pattern recognition in Mohs cases

Develop an understanding of the required equipment used in a modern Mohs laboratory
Understand how to embrace design and automation in a modern Mohs laboratory.
Understand the required skills while they are using automated and advanced equipment in Mohs laboratory.
To be aware how automated and advanced equipment will provide enhanced and more accurate results and improve quality performance.

Molecular testing is now part of the standard of care pathway for many types of solid tumours with new tests being required to be introduced into laboratories quite rapidly. As part of the quality process external quality assessment (EQA) is required to ensure that the results obtained in this testing are accurate.

This talk will provide an overview of how EQAs for molecular pathology are delivered, summarise the results for some of these EQAs highlighting some of the issues observed. It will also highlight some of the different technologies used for testing and how reporting of results is assessed in the EQAs

Delegates will learn:

What Gestational trophoblastic disease is, including the different types and how they arise
How to handle a sample at the dissection bench including comparison with normal products of conception
How to distinguish between the different types of disease and mimics
What a diagnosis of gestational trophoblastic disease means for the patient
What the malignant entities of Gestational Trophoblastic Disease include

This presentation will give delegates attending an:

Overview of the pre-analytical processing pathway and potential risks associated with each stage.
Historical/current/prospective optimisation of the pre-analytical pathway.
Understanding of the near-future perspectives for standardisation-will technologies such image analysis and spatial profiling affect the practice of pathology laboratories.

Digital imaging for remote viewing to enable reporting is becoming increasingly prevalent in the NHS cellular pathology services. Sea change levels of improvement in the technology that enables digital image acquisition, viewing, transfer and storage has allowed its widespread deployment and adoption and concomitant to this has been the development of software applications to enable the analysis of those digital images for a huge variety of reasons.

In my talk I will discuss the application of digital image analysis to the scans of the slides that we assess as part of our routine external quality assessment (EQA) workload. Both as aids to improve the information and the accuracy of that information e.g., in the assessment of the proliferation marker Ki-67 in breast cancer to improve its use as a prognostic marker, and as a tool to verify and quality control our own processes and EQA materials e.g., the measurement of reproducibility and homogeneity in tissue and cell line samples used in the assessment of PD-L1 immunohistochemistry staining in non-small cell lung cancer.

This presentation will examine a specific case study submitted as part of the 'Advanced Specialist Diploma in Breast Pathology'. The case in question was a mastectomy sample for the treatment of diffuse multifocal invasive ductal carcinoma.

Within the presentation I intend to highlight the importance of pre-analysis and emphasise its correlation with macroscopic examination and block sampling. I will also highlight the importance of post analysis and the understanding of how the role of the Advanced Practitioner can directly impact patient treatment.

Delegates attending this presentation will:

Receive an overview of the clinical history of MMR/Lynch Syndrome, EQA and data from UK NEQAS ICC & ISH
Gain a better understanding of the importance of MMR testing and the UK NEQAS ICC & ISH assessment process.
The presentation will also focus on acceptable and not acceptable tests, and the importance of ideal controls.

NGS for molecular profiling of cancer in routine practice.

There is legitimate expectation that molecular profiling of cancers can bring precious information to guide the treatment.

The clinically relevant alterations are of varied types: gene mutations, copy numbers, rearrangements, but also protein levels of expression. Profiling of tumours in routine practice is complex logistically, due to the high number of patients and targets, the small size of the samples and the quick turn around time required. An exhaustive assessment requires a variety of platforms.

Furthermore, it becomes relevant to repeat profiling on tissue and on blood during the patient’s treatment.

Next Generation Sequencing (NGS) offers the possibility of multiplex testing, with high sensitivity and specificity. There are multiple approaches: whole genome sequencing, whole exome sequencing and panels of varied sizes.

In practice, the focus is to concentrate on providing an exhaustive clinically relevant assessment for all patients, which is guided, for each type of tumour, by WHO and NICE or equivalent guidelines.

There has been initially an excess of enthusiasm about what NGS could offer in routine practice; the technology had yet not reached the stage of being implementable within clinical practice without significantly destabilising the management.

However, thanks to significant improvement, including automation of the process, efficient IT and Bioinformatics, NGS is now safely implementable.

Pending a coherent political and funding approach, molecular diagnostic laboratories are able to provide high throughout sequencing of tumours on real life tissue samples and on blood.

It is important to mention that the molecular diagnostic laboratories also need to maintain single gene testing, immunohistochemistry, FISH and to implement artificial intelligence based assays on tissue, which will be essential and complementary to NGS testing.

The results of the molecular profiling will need to be transcribed in a comprehensive, integrated and clinically relevant report.