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Grand RoundsWeekly Evidence Brief

Pathology

Edition

30-Second Takeaway

  • Rapid AE1/AE3 IHC substantially improves intraoperative STAS assessment on lung frozen sections without delaying cases.
  • Standardized H&E-based TIL scoring in gastro-oesophageal carcinoma is ready for routine reporting and trial harmonization.
  • Optical genome mapping and refined flow cytometry scores reclassify AML and MDS risk in clinically meaningful ways.
  • Generalizable AI tumour segmentation shows scanner- and cancer-agnostic performance suitable for real-world deployment.
  • Tumor-informed liquid biopsies across head and neck, cervical, and CNS tumors provide early, genotype-specific residual disease detection.

Week ending February 7, 2026

Pathology workflows are shifting: rapid intraoperative tools, refined flow scores, and liquid biopsies add actionable precision

Rapid AE1/AE3 IHC boosts frozen-section STAS detection in lung adenocarcinoma

HISTOPATHOLOGYFeb 7, 2026

In 153 lung adenocarcinomas, adding rapid AE1/AE3 IHC to frozen H&E significantly increased intraoperative STAS sensitivity and specificity versus H&E alone. Intraobserver agreement rose from substantial to almost perfect, and interobserver agreement improved meaningfully across pathologists with differing experience. Mean diagnostic time actually decreased by about half a minute despite the additional stain, without prolonging overall frozen-section processing time. Misclassified cases commonly had very few STAS clusters or confusion with macrophages and artefact, highlighting specific interpretive pitfalls.

Consensus guidance for H&E-based TIL assessment in gastro-oesophageal carcinoma

HISTOPATHOLOGYFeb 5, 2026

The International Immuno-Oncology Biomarker Working Group provides detailed recommendations for morphological TIL scoring in gastro-oesophageal carcinoma on routine H&E slides. The framework addresses TIL compartmentalization, scoring areas, and minimum reporting elements, aiming to standardize assessment across laboratories and trials. The review summarizes evidence linking TIL density and distribution with prognosis and potential immunotherapy responsiveness in gastro-oesophageal carcinoma. It also highlights GEC-specific pitfalls, such as inflammation related to ulceration or treatment effect, that can confound TIL quantification.

Optical genome mapping uncovers cryptic high-risk lesions in ostensibly low-complexity AML

BRITISH JOURNAL OF HAEMATOLOGYFeb 2, 2026

In 100 adults with newly diagnosed, low-complexity AML lacking WHO-defining rearrangements or baseline ELN adverse karyotypes, optical genome mapping was added to conventional cytogenetics. Optical genome mapping recapitulated most chromosomal banding abnormalities and provided additional structural information in over one-third of patients. The technique reclassified a notable subset into unfavourable cytogenetic or ELN 2022 adverse risk categories, aligning with descriptively worse survival. Previously unrecognized KMT2A and NUP98 rearrangements were identified in 10% of cases, revealing high-risk biology and potential therapeutic targets. These data support optical genome mapping as a complementary frontline tool for AML karyotypic risk assessment when available.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Multiple studies support layering higher-resolution tools—rapid IHC, OGM, advanced flow MRD—onto existing pathology workflows to refine risk and guide therapy.
  • Robust, standardized scoring systems for TILs and flow cytometry can elevate commonly available assays into strong prognostic biomarkers.
  • Deep learning tumour segmentation has matured to cross-cancer, multi-scanner generalization, enabling reliable automation of upstream histologic tasks.