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Diagnostic department

History
I. Establishment and Initial Development (1949-1965)
In 1949, Prof. Suiyue Gu came to Shanghai Radium Hospital (now referred to as Fudan University Shanghai Cancer Center) with two technicians, Shixiong Chen and Jingqing Zhang. Along with Dr. Xinsheng Yu and Dr. Yiling Wang, they established one of the earliest Pathology departments in China. After the establishment, the department started active participation in improving public health. In the 1950s, they took the initiative to build a tumor registration system in China. After that all tumor patients have been registered in the system. This system is still used across the country today. The department also started to take advantage of various new techniques such as Pap Smear (1956). With the official establishment of the Clinical Cytology Laboratory in 1963, various cytological examination techniques including fine-needle aspiration were used.
 
Stared in 1957, authorized by the Ministry of Health, the department began to offer the training courses of tumor pathology for 1-2 times annually. By year 2009, the department has provided 65 histopathology courses and 75 cytology courses, and more than 1000 pathologists across the county have been trained here.
 
The department is also one of the pioneers in medical education in China. In 1959, the department began to provide postgraduate educations as one of the first national programs. At the same time, the first textbook on surgical pathology in China was published with wide acclamation from domestic pathology society.
II. Cultural Revolution Stage (1966-1977)
The department joined the coordinated effort to standardize the national system for pathology classification and terminology. In 1977, the department improved the existing standard and published a new China pathology classification and terminology system based on immunophenotyping.
 
In 1973 and 1974, as a member of the Shanghai Cancer Prevention and Treatment Cooperative Group, the department took part in the research of early diagnosis of liver cancer with AFP detection. The effort won the Collective Award of National Science Conference in 1978.
 
In 1975, Practical Tumor Cytology, one of the first and classical cytology books in China was published here.
 
In 1976, the department started to set up "Immunopathology Laboratory", "Histochemistry Laboratory", and "Genetic Pathology Laboratory ", taking the lead in applying immunohistochemistry to routine histological sections in China.
 
In 1977, Textbook on Surgical Pathology, one of the earliest reference books on surgical pathology in China, was officially published. It gained wide acceptance among pathologists due to its practicality and since has been reprinted twice.
III. Development Stage (1977-1995)
The classification criteria of non-Hodgkin's lymphoma were proposed in 1977 and approved for trial by National Lymphoma Conference (1977, 1979). After successful trail, the criteria were officially accepted by National Lymphoma Work Conference in 1982. From then on, a great number of research papers have been published, laying the foundation of China’s unique classification criteria of lymphoma.
 
In 1978, the department enrolled five postgraduate students.
 
Since 1979, a great number of our pathologists have visited UK, Sweden, USA, Canada, Australia and other countries for academic exchange. They brought back a lot of valuable information on pathology and injected vigor into the growth of the department.
 
In 1982, the department first carried out double PAP and ABC immunohistochemical method in China. With accumulated experience, the Immunohistochemistry Lab held more than ten training courses and provided continuing education for hundreds of pathologists and technicians. In 1989, the department performed the first immunocytochemical test in the country. Due to the tremendous contribution to public health and medical education, the department received Shanghai Science and Technology Progress Award in 1989, 1990 and 1993.
 
In 1984, Genetic Pathology Laboratory produced monocyte monoclonal antibody using the hybridoma technique.
 
In 1986, the department welcomed the first PH.D candidate majoring in Pathology. This marked the beginning of doctoral education in our department.
 
In 1987, the department took the lead to build the first tissue bank in China.
 
In 1994, Shanghai QC and QA Center of Clinical Pathology was founded. The Department of Pathology,as the affiliated department, has taken charge of its management and daily operations, playing an active and positive role in improving the pathology quality control in Shanghai.
IV. Successful Past, Glorious Tomorrow(1995-2010)
In 1995,the first molecular pathological laboratory in Shanghai was established in our department.
 
Later, the department became the leading Pathology Department (Tumor Pathology) in Shanghai for two rounds (1995-1997 and 1998-2000 respectively).
 
In 1998, the department held the Second Academic Symposium for the Committee of Tumor Pathology of Chinese Anti-Cancer Association.
 
In 1999, a grand celebration was conducted to commemorate the 50th anniversary of Professor Wang Yiling’s medical practice. Her life-long dedicaiton to pathology has inspired several generations of young pathologists.
 
In 2002, the Shanghai Annual Academic Conference for Pathology was held to commemorate the 90th anniversary of Prof. Gu Suiyue’s birth.
 
In 2003, the department held the 4th National Academic Seminar of Diagnostic Pathology, Endocrine Tumor Pathology, and SARS Pathology.
 
From 2005 to 2007, the department was awarded the Shanghai Medical Science Key Program (Clinical Pathology).
 
From 2007 to 2011, the department was awarded the National Key Program (Pathology and Pathophysiology) by the Ministry of Education.
 
From 2008 to 2010, the department was awarded the Clinical Medicine Key Program (Tumor Pathology) by the Ministry of Education.
 
In 2009, the department moved into a new building with a total space of 3,500 square meters.
 
Department Structure
The department has 78 staff members including 41 doctors and 37 technicians.  In addition, there are 5 professors and 5 technicians who are working as consultants after their retirements. Of all the staff members, 6 are professors and 12 are associated professors.
 
I.Histopathology
With scientific development and technological advancement, the simple model of pathomorphological diagnosis can hardly meet the clinical needs.  Recently the department has constructed a comprehensive diagnostic model which combines morphology, immunohistochemistry and molecular pathology techniques and has been applied to a large number of diagnostic works. In 2009, a total of 50,144 histopathology cases were performed in our department. Of all these cases, 43,239 were surgical specimen and 6,905 were introperative samples with rapid diagnosis. With pathological diagnosis being one of the strongest branches, the department of FUSCC now performs nearly 19,000 consultation cases every year, more than half of which are difficult cases, making the department one of the busiest in China.
 
From the year 2007, the department began to put subspecialty pathological diagnosis into trial. Nine subspecialties have been set up, including lymphoma, breast, gastrointestinal tract, thoracic tumors, soft tissue and bone tumors, urinary tumors, cytopathology, immunohistochemistry, and molecular pathology. In recent years, the hospital carries out multidisciplinary cancer treatment.  The specialists in charge participate in multidisciplinary comprehensive discussion every week, and take part in clinical pathology seminars of the hospital. With their efforts, the communication between pathologists and clinicians becomes smoother and pathological diagnosis matches much better.
 
II. Cytopathology
Early in 1956, a few doctors including Dr. Shanglinan Liu, Dr. Jianren Gu, and Dr. Shixiong Chen started to perform cytopahtology in Shanghai Cancer Hospital. Due to its simplicity, speed and accuracy, the cytologic diagnosis was extensively accepted by clinicians. This extended the diagnosis beyond the earliest Pap smear to other cytology examinations such as the cytologic diagnosis of sputum, serous fluids, urine, esophageal and gastric brush. The Clinical Cytology Laboratory (Cytology in short) was formally established in 1963. At the end of 1971, fine needle aspiration cytology was established. In addition to the tremendous accomplishments in clinical diagnosis, the Lab also started to offer continuing education courses on clinical cytology. Since then, a large number of cytology professionals across the country have been trained. In October 1975, Practical Tumor Cytology edited by this lab was published. In 1989,the lab carried out the first test of immunocytochemstry in China. Currently, the lab is able to provide various examinations covering most fields of cytology, especially featuring in fine needle aspiration (FNA) cytology. In 2009, a total number of 32,616 cases were performed.
 
III. Immunohistochemistry
Since the initial development in the late 1970s, immunohistochemistry has experienced the changes of technical methods, reagents and workflow. In 2009, a total number of 15,524 cases were performed. Immunohistochemistry has been mainly used for the pathological consultation cases, routine pathological diagnosis, detection of prognostic indicators and research. Now, the department has five sets of automated immunostainers including LEICA Bond-Max and Ventana Medical Systems Inc - BenchMark XT/LT.  The pathology lab has over 100 types of routinely used antibodies, making it one of the labs that have the most variety of antibodies in China. The department has also organized the Workshop of Immunohistochemical Diagnosis and the Training Course on the Latest Advance of Immunohistochemistry and Molecular Pathology several times,and has subsequently made greater contributions to the growth, expansion and improvement of immunohistochemical technology across the country.
 
IV. Molecular Pathology
Molecular Pathology Laboratory, founded in 1995, consists of eight professionals including two professors. The lab has two units, the Molecular Pathology Diagnosis Unit and the Molecular Pathology Research Unit with total space about 500 square meters. The labs also has a standardized clinical PCR room, dark observation room, cell culture room, and other advanced equipments and instruments such as ABI sequencer, 3 PCR thermocyclers, in situ hybridization machines, fluorescence quantitative PCR thermocyclers, 2 sets of fluorescence microscopies with image processing system, gel imaging system, laser capture microdissection system, Millipore ultrapure water system. It has established a mature and high-proficient experimental environment to perform different procedures such as in situ hybridization, FISH, PCR, DNA sequencing, immunohistochemistry, cell culture and Southern Blot, Northern Blot, Western Blot. It not only offers services to clinical pathology diagnosis but also provides an important platform for pathological studies.
 
V. Tissue bank
The Department of Pathology is responsible for the management of the Tissue Bank for the hospital in order to establish a standardized and systematic tumor resource bank. It is capable of sample processing, storage, information registration and sample related techniques. It owns equipments such as -20℃and -80℃ low-temperature refrigerators, liquid nitrogen tanks, low temperature centrifuge, water bath pan, frozen and paraffin section machine, tissue microarray device, bar codes and computer systems and specialized software to efficiently manage patients’ basic information, samples’ information, storage and the use of sample. Four full-time professionals are involved in this work and they have standardized the operating procedures for sample collection, processing, registration and storage, the mechanism for the mutual sharing of tumor sample resource and the rules and regulations for the use of the resource. It preserves the tissues and peripheral blood samples in many ways and so far it has collected 11,000 cases of various tumor samples and 16,000 cases of peripheral blood samples.
 
VI. Electronic Microscope
In October 2008, the Department built a fully functional Electronic Microscope room. It is equipped with a PHILIPS MORGAGNI 268D projection electronic microscope and other section–making electronic microscopy equipment such as Leica thin slicers, knife machine and block repair machine. Now, it has one full-time doctor and one technician. The specimens tested include the major tumors of breast, lung, ovary, soft tissue, salivary gland, gastrointestinal tract, and kidney. It is also capable of performing the electronic microscopic diagnosis of tumors. It not only plays an important role supporting tumor diagnosis and differential diagnosis, but also provides richer information for the in-depth study of tumors.
 
Medical Education
I. Graduate Education
In the summer of 1959, Shanghai First Medical College Cancer Hospital (now Fudan University Shanghai Cancer Center) started to offer graduate program for tumor pathology. Since then, 100 graduate students have successfully graduated from the department. Currently the department has 4 doctoral degree supervisors and 6 Master degree supervisors, and 19 graduate students (8 Master degree candidates, 10 doctoral degree candidates, and one post-doctoral candidate). Among the earliest graduates guided by Professor Suiyue Gu,three (Prof. Mingchang Shen, Prof. Daren Shi, and Prof. Xiongzeng Zhu) eventually became Professors in our department.  They have been part of the driving force behind the development of the department over the years and made outstanding contributions.  Following their footsteps,more graduate students have been working in the department after graduation and became the backbones to support the continuous growth of the department and the hospital. In addition, many of our graduates have played active roles and become the elite members of the Chinese Pathology Community across the country. Some graduates also explored the opportunities to work in famous universities and institutes overseas, such as M. D. Anderson Cancer Center and Johns Hopkins University School of Medicine in the United States, and the achievements were remarkable. 
 
II. Undergraduate Education
The department has been actively involved in the education of over 200 undergraduates every year.  Besides editing the textbook for the undergraduate course "Clinical Oncology", the department is also responsible for lecturing a number of sections of "Introduction," "Tumor Pathology", and "Tumor Biological behavior", etc.
 
III. Training of Fellows
The department has made outstanding contributions to improve the practice of pathology through different training programs. As one of the National Clinical Pathology Centers, the Department of Pathology, Fudan University Shanghai Cancer Center, is authorized by the Ministry of Health to offer training to pathologists. It has been offering annual training courses of tumor pathology since 1957. By the year 2010, 65 histopathology courses and 75 cytology courses have been offered and over 650 pathologists and 600 cytologists from all over the country received training. In addition, the department plays an important role in the pathology resident training program in Shanghai.
 
IV. National Continuing Medical Education Programs
The department has offered various training courses such as the workshop on New Pathological Classification and Diagnosis of Malignant Lymphoma, Immunohistochemical Diagnosis of Tumors, Pathological Diagnosis of Soft Tissue and Bone Tumor, Advanced Workshop on Tumor Pathological Diagnosis, New WHO Classification and Diagnostic Criteria for Malignant Lymphom, Latest Advancement of Immunohistochemical and Molecular Pathology , Seminars on the Advance of Tumor Pathological Diagnosis to domestic pathologists and shared the experience of pathological diagnosis and progress of the pathology.
 
 
Scientific Research Achievements
With the joint efforts of all staff, the department has made tremendous achievements in the area of scientific research. So far it has received 12 grants from the National Natural Science Foundation, over 30 grants from the Ministry of Health, the Ministry of Education, and Science and Technology Commission of Shanghai municipal government respectively. There are over 20 books and 500 papers published both in national and international journals. Among these publications, more than 30 articles were accepted by journals with high SCI impact factors. In addition, some of our prestigious colleagues have been invited as editors and reviewers for various international and national journals.
 
Key Programs
–Leading Department of Pathology in Shanghai(Tumor Pathology)1995-1997 (first period) and 1998-2000 (second period)
–Shanghai Medical Science Key Program (Clinical Pathology) 2005~2007.
–Clinical Medicine Key Program (Tumor Pathology), Ministry of Health, China 2008-2010
–National Key Program (Pathology and Pathophysiology), Ministry of Education, China 2007-2011
 
Awards
The third prize of the Science and Technology Achievements Award from Shanghai Municipal Public Health Bureau (1986): Immunohistochemical study of B lymphocytes by double antibody method (PAP) and its application in the diagnosis of malignant tumors (Daren Shi)
 
The second prize of Shanghai Science and Technology Progress Award (1989): Study of the location of lectin in normal human tissues and tumor tissues. (Huazhong Zhang, Daren Shi).
 
The third prize of Shanghai Science and Technology Progress Award (1990): Enzyme-Linked Affinity Assay of estradiol and estrogen receptor of breast cancer. (Shanglian Liu)
 
The third prize of Shanghai Science and Technology Progress Award (1993): Biological characteristics of meningioma–Analysis of clinical-pathological correlation, flow cytometry and hormone receptor-related research. (Daren Shi)
 
The second prize of Shanghai Science and Technology Progress Award (1996): Study of cytology, histopathology and molecular biology of malignant lymphoma. (Liangzhong Xu)
 
The third prize of the Science and Technology Progress Award from the State Education Commission, and the third prize of Shanghai Scientific and Technological Progress Award (1997): Newly discovered tumors – research of plexiform fibrohistiocytic tumors and other special soft tissue tumors (Renyuan Zhang)
 
The second prize of Shanghai Medical Science and Technology Progress Award (2003): Study of cellular and molecular genetics of soft tissue and bone tumor (Xiongzeng Zhu)
 
The second prize of Shanghai Science and Technology Progress Award and the third prize of Shanghai Medical Science and Technology Award (2004): Strategies for clinicopathological and molecular genetic analysis of the Chinese HNPCC pedigrees (Daren Shi)
 
Academic Exchange
The department has established good research relationships with a number of prestigious institutes abroad, such as M.D. Anderson Cancer Center (MDACC), the University of Colorado Health Center in the United States, University of Occupational and Environmental Health in Japan, Centre Leon Berard in Lyon. The doctors have opportunities to visit these foreign institutes, study and research with the experts overseas. Now, More than 80% of the doctors have studied overseas and some of them received honorary titles from different foreign institutes.
 
Since 1997, three young pathologists visited the University of Occupational and Environmental Health in Japan successively to study molecular genetics of soft-tissue tumor. Under the guidance of Dr. Hiroshi Hashimoto, all of them received doctoral degree.
 
Since 2005, the Biennial Fudan University Shanghai Cancer Center-M.D. Anderson Cancer Center (FUDAN-MDACC) meeting attracted pathologists and scientists from all over the country. MDACC, one of the sponsors of the meeting is one of the most prestigious cancer centers in U.S.A. due to their groundbreaking concepts and advanced facilities. In conjunction with the 60th anniversary of the founding of the department, the Third FUSCC–MDACC Diagnostic Pathology Symposium was held on June 5, 2009.
 
In 1993, with the dedication and efforts of the pathologists from Shanghai and Osaka, the Annual Shanghai-Osaka Histopathology Conference commenced. Since then, it has become a great event for Shanghai pathology community. So far, a total of 17 conferences have been held. In addition to Shanghai and Osaka, Melbourne joined in recently and conference is renamed as "Shanghai-Osaka-Melbourne Histopathology Conference ". The best case reports shared at the meeting have been accepted in the journal of “Archives of Histopathologic Differential Diagnosis” with a total of 15 issues published. The 17th conference was held in our center on Dec. 11, 2010.