Pathologyis the studies in which one theorizes and understands disease, as the language implies disease (pathos hardship) + theory (logus logic). Later, as research subjects that caused diseases were subdivided and research methods advanced, bacteriology (microbiology), parasitology (medical zoology), immunology, and molecular biology became independent from the category of pathology. In recent years, academic fields have been restructured beyond the framework of conventional academic fields, and there is a tendency for them to be further subdivided according to purposes, research subjects, and research methods. At present, pathology, based on morphology, is the study of understanding and organizing the causes of diseases (etiology), the formation of lesions (histogenesis), and disease status (pathogenesis). In the recent pathology, the fields of experimental pathology, in which hypotheses are experimentally proven using laboratory animals and cultured cells, and the fields of surgical pathology and diagnostic pathology, which are closely related to the clinical medicine, tend to be separated, and the number of pathologists engaged in the latter, which deals with human tissues, is increasing.
In the field of Human Pathology of TMDU, we aim to train pathologists who can accurately make pathological diagnosis of various human diseases, and at the same time, to develop pathologists who have a research mind capable of carrying out research that leads to improvement of pathological diagnosis, with the aim of elucidating the etiology, histogenesis and mechanism of human diseases.
About human cancer:
There are three main purposes.
(1) Carcinogenesis and histogenesis of cancers: For the understanging of G-I tract cancers, such as esophageal cancers, gastric cancers, colorectal cancers, and colitic cancers, and lung cancers, premalignant lesions will be clarified by histopathological analyses, clinicopathological analyses, and genetic analyses, and the process and molecular basis of carcinogenesis from premalignant lesions will be clarified.
(2) Objective diagnosis of pathological diagnosis related to cancer: Cancer originating from any organ is difficult to differentiate from benign tumors originating from that organ, and there are also borderline tumors of benign and malignant tumors. In addition, many of the pathological findings with clinical significance are based on subjective judgment, and the objectivity, reproducibility, and agreement rate among observers of the findings are problematic. In pathological diagnosis, it is important to apply computer, Ai, and image analysis technology, and establishment of new pathological diagnosis which integrates genome information and various marker expression information of which the advance is remarkable recently is required.
(3) Malignant tumor progression and mechanism of metastasis: In human esophageal cancer, gastric cancer, colorectal cancer, and lung cancer, early cancer is often found, and reduced operations and treatments such as endoscopic resection are often performed. However, there are some high-grade cases showing metastasis from the early stage, and it is necessary to diagnose them in the early stage and select an appropriate therapy. In the process of invasion of early cancers, it is important to clarify the pathological findings related to metastasis and recurrence and to clarify the molecular basis closely related to them. By establishing markers that can be applied to pathological diagnosis, more accurate pathological diagnosis will become possible.
About chronic inflammatory diseases:
To clarify the etiology and origin of a chronic inflammatory disease of unknown origin by thoroughly analyzing the lesion site from a pathological standpoint. In addition, markers useful for diagnosis will be developed and applied to actual pathological diagnosis.
1) The possibility that intracellular latent infection in the deep organ of Propionibacterium acnes and rapid activation of autophagy and induction of Th1 immune response with the endogenous activation are causes of granuloma formation is studied on the sarcoidosis from the immunopathology viewpoint. Acne infection has been reported to be associated with diseases other than sarcoidosis, and its relationship to other diseases is also being studied.
2) Regarding the pathogenetic mechanism of chronic gastritis caused by infection of Helicobacter pylori on the surface of gastric mucosa, we found that Helicobacter pylori invades the lamina propria and translocates to regional lymph nodes of the stomach due to injury of the surface epithelium of the mucosa. Therefore, we investigated the possibility that Helicobacter pylori contributes to chronic inflammation of the gastric mucosa by directly stimulating immunocompetent cells in the mucosa and chronically stimulates the immune system in the paracortical region after influx to the lymph nodes. It is also known that the risk of developing gastric cancer varies depending on the structure of Helicobacter pylori. We are also developing test kits that can clarify the relationship between the structure of H. pylori and the risk of carcinogenesis and evaluate the risk of carcinogenesis by H. pylori.
3) Characteristic pathological findings observed in inflammatory colitis such as ulcerative colitis and Crohn's disease are analyzed, and their occurrence mechanism and significance are verified. In addition, evaluation of the activity of inflammation using biopsy materials and expression of molecular markers are studied.
4) Diagnosis of the type of systemic amyloidosis is very important for deciding the treatment plan of patients, but useful antibodies for diagnosis are not sufficiently available. Research is being conducted on the development and application of diagnostic antibodies that can improve the accuracy of pathological diagnosis.
In the graduate school doctoral program, the acquisition of the pathology medical specialist qualification is also made to be a goal with the doctor degree acquisition. First of all, training in autopsy, biopsy tissue diagnosis, rapid tissue diagnosis, tissue diagnosis of surgical specimens, etc., will be conducted, and training in the department of Diagnostic Pathology, TMDU hospital, as well as in the department of pathological diagnosis of the related hospitals will be conducted, with the aim of forming the basis for a “pathologist”. During the training, participants will participate in various conferences or meetings in joint with clinical departments to announce pathological diagnoses, identify current problems in each clinical field, and discuss or collaborate with clinicians. While forming a basis as a pathologist, we will conduct research using clinicopathological, immunohistologic, and molecular pathological methods on issues directly related to the causes, diagnosis, and treatment of human diseases. The results will be published in academic meetings and academic journals in Japan and overseas.
Lectures & Courses
What society calls for in medical care is proper diagnosis and treatment. Therefore, in the field of Human Pathology, the aim is to study the etiology, histogenesis, diagnosis, and treatment of human diseases with a strong awareness of problems and deep thought, while focusing on the study of clinical pathology, including histopathological diagnosis of autopsy, biopsy and surgically resected specimens. The results of the research should not only deepen the understanding of diseases, but also be useful for medical care and pathological diagnosis.
Clinical Services & Other Works
As a general rule, all graduate students with a medical doctor's license are concurrently engaged in the Diagnostic Pathology department, TMDU hospital, where they are trained in pathological diagnosis and autopsy, with the aim of acquiring a qualification as a pathology specialist. In addition, staff and graduate students are working as part-time physicians at affiliated hospitals of TMDU in Tokyo, Kanagawa, Saitama, Chiba, and Ibaraki prefectures, which play a central role in supporting local medical care, to support pathological diagnosis and conduct joint research. In the field of Human Pathology, we hope to contribute to community medicine and society by improving the accuracy of pathological diagnosis. We are also actively cooperating in various academic activities, such as lecture presentations and conference participation in local hospitals. We also actively participate in and cooperate with the activities of various academic societies, including the Japanese Society of Pathology. In particular, we are involved in the management of the Japanese Society of Pathology and play a core role. Staff members also participate in and cooperate with various committees of ministries and agencies, including the Ministry of Health, Labour and Welfare.
After the Meiji Era, the department of Human Pathology in medical faculty belonged under the basic medical sciences; however, Pathology in the existing hospitals is essentially the clinical medicine. Diagnosis of patients in each clinical department is done by taking the biopsy of diseased tissues or collecting the cell samples by either endoscope or surgery. Then, the lesions are analyzed with the microscope, and pathological diagnosis is reported to the clinical departments. The samples of organs and tissues taken from the surgery are used to study the spread of the lesion and its characteristics, and also to examine the adequacy of surgery. It is also used to determine future treatment policy. During the course of patients’ treatments, sample tissues are taken periodically and are analyzed pathologically to see therapeutic effect. If a patient has unfortunately joined the majority, morbid anatomy is done by the pathologists along with the patient’s attending physician. They study the resulting effects of laboratory findings and choice of treatment, and improve the future diagnosis and treatments. The department of Human Pathology and Surgical Pathology technically work as one although they are separated in this university’s organizational structure. Human Pathology does not directly work with the patients; however, it is involved directly with the diagnosis as well as the treatments. Strong cooperation between clinicians and pathologists is essential for the best practice, and is required for the university hospital as an “advanced treatment hospital.” Therefore, doctors of Human Pathology study, research and practice pathology to be the great pathologists so-called the “doctor of doctors.