title: Multisite tumor sampling: a new tumor selection method to enhance intratumor heterogeneity detection.
abstract: Intratumor heterogeneity (ITH) is increasingly being recognized as a highly complex process with high clinical impact that deserves special attention from practicing pathologists. The value of the ITH detection depends on the correctness of the pathologist's sampling. The goal of this review is 2-fold. On the one hand, we provide a basic scientific context for the practical pathologist's perspective. On the other hand, we encourage pathologists to adopt a more scientific and up-to-date approach to a key component of their daily work, namely, how to sample a tumor for reliable histological and molecular analysis. In particular, we review the consecutive steps of an efficient alternative to traditional approaches for detecting ITH: multisite tumor sampling. Notably, this type of sampling, based on a divide-and-conquer algorithm, is supported by scientific evidence showing its clinical applicability and practical advantages at no extra cost.
authors.affiliation: Department of Pathology, Cruces University Hospital, 48903 Barakaldo, Spain; Biomarkers in Cancer Unit, Biocruces Research Institute, 48903 Barakaldo, Spain; University of the Basque Country (UPV/EHU), 48940 Leioa, Spain. Electronic address: joseignacio.lopez@osakidetza.eus.
authors.forename: José I
authors.initials: JI
authors.lastname: López
authors.affiliation: Quantitative Biomedicine Unit, Biocruces Research Institute, 48903 Barakaldo, Spain; Ikerbasque: The Basque Foundation for Science, 48013 Bilbao, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain.
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Cortés
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D001706:Biopsy; D006801:Humans; D007150:Immunohistochemistry; D025202:Molecular Diagnostic Techniques; D009369:Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D010338:Pathology, Clinical / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results
chemical_list: D014408:Biomarkers, Tumor
keywords: Carcinogenesis; Intratumor heterogeneity; Laboratory cost; Pathology; Targeted therapies; Tumor sampling