Anatomia patologica

| Department Overview |--------------

The predecessor of the Department of Pathology of Huashan Hospital—the Surgical Pathology Room of Huashan Hospital—was established in 1960. Initially, it mainly relied on the Department of Pathoanatomy of Shanghai First Medical College. During this period, renowned professors including Gu Suiyue, Ying Yueying, Chen Zhongnian, and Zhu Shineng successively came to the hospital to preside over its work.

In 1979, the Department of Pathology of Shanghai First Medical College sent Chen Changchun and Wang Hong to rebuild the Pathology Room of Huashan Hospital. In 1980 and 1987, respectively, Zhang Luo and Wang Hong became the earliest officially appointed physicians in the Pathology Room of Huashan Hospital.

In 1992, the hospital integrated the Surgical Pathology Room, Neuropathology Room, and Dermatopathology Room into the Department of Pathology of Huashan Hospital, with Professor Qiu Bingsen as Director and Professors Zhang Fulin and Fang Jun as Deputy Directors.

In June 1998, it was integrated with the Department of Pathology of Shanghai First Medical College, with Hu Xiqi, Xu Zude, and Zhu Hongguang successively serving as Directors of the Department of Pathology.

In 2015, the Neuropathology Room was formally merged into the Department of Pathology of Huashan Hospital, with Professor Tang Feng as Director and Professor Wang Yin as Deputy Director. Under the leadership of the hospital Party Committee and leaders at all levels, the discipline has developed vigorously and formed a favorable pattern of coordinated development integrating medical care, teaching, and research.

In 2019, the department ranked third in the Scientific Research Competitiveness Ranking of Pathology Departments of Grade III Class A Hospitals in Shanghai. In 2020, it was nominated 14th in the national pathology specialty reputation ranking, and it was also among the first batch of national clinical pathology physician standardized training bases and national resident physician standardized training specialty bases (Clinical Pathology). In 2021, it was rated a national PQCC Demonstration Laboratory.

For a long time, Huashan Pathology has received strong support and assistance from domestic peers. Academician Bian Xiuwu has been appointed Honorary Professor of the Department of Pathology and regularly participates in MDT activities. In recent years, through the joint efforts of all department personnel and with the support and guidance of all experts, the discipline has developed vigorously, and it is hoped that it will reach an even higher level in the future.

| Talent Team and Hardware Facilities |--------------

At present, the Department of Pathology of Huashan Hospital has 29 practicing physicians and 19 technical personnel, distributed among the Main Hospital, Hongqiao Campus, Pudong Campus, and Baoshan Campus. Among them, 13 hold senior professional titles (5 senior and 8 associate senior), 11 hold doctoral degrees, and 14 hold master's degrees. Department members serve as committee members and young core members of various academic groups at the national and Shanghai municipal levels, respectively. Director Tang Feng serves as a member of the Pathology Branch of the Chinese Medical Association, Chair of the Pathology Branch of the Shanghai Medical Association, and Deputy Chair of the Professional Committee of Difficult Tumors of the China Medical Education Association.

The Department of Pathology is equipped with fully automated tissue processors, cryostats, paraffin microtomes, fully automated immunohistochemical staining machines, fully automated staining and coverslipping machines, optical microscopes, fluorescence microscopes, ten-headed microscopes, and fully automated network scanning microscopes, among other instruments and equipment. The pathology reporting and image analysis system allows all pathology records since 1999 to be viewed and printed at any time. The projects currently performed by the department include paraffin sections, special stains, immunohistochemical staining, intraoperative rapid frozen sections, cytological diagnosis, and molecular pathological diagnosis. A comprehensive diagnostic platform integrating pathological morphology, immunohistochemistry, and molecular pathology techniques has been established. The annual number of routine external examination cases is nearly 100,000; more than 15,000 rapid frozen-section diagnoses are performed each year; several hundred types of special stains and immunohistochemical stains can be performed; molecular pathology testing is also performed, with approximately 10,000 cases annually; and several thousand difficult pathology consultations are accepted each year.

The department is currently actively preparing to establish a telepathology consultation center. Once completed, it will not only be able to accept remote pathology consultations from hospitals at all levels, but will also be able to transmit controversial pathology slides to internationally renowned pathology diagnostic centers for remote consultation.

| Discipline Characteristics and Work Achievements |--------------

Department personnel participated in drafting expert consensuses including the “Expert Consensus on the Pathological Diagnosis of Neoadjuvant Therapy for Breast Cancer,” “Clinical Practice Guidelines for the Pathological Diagnosis of Melanoma (2021 Edition),” “Expert Consensus on the Pathological Diagnosis of Laryngeal Precancerous Lesions and Invasive Carcinoma (2021 Edition),” “Guidelines for Central Nervous System Lymphoma of the Chinese Anti-Cancer Association,” “Guidelines for Pediatric Germ Cell Tumors of the Chinese Anti-Cancer Association,” and “Expert Consensus on the Diagnosis and Treatment of Candidiasis in China,” making their due contribution to the standardized development of pathology in China.

I. Medical Services

Taking into account the advantages of the hospital’s comprehensive clinical disciplines and the work characteristics of the Department of Pathology itself, multiple pathology subspecialties have been established. The key and specialty subspecialties include:

（1）Central nervous system disease subspecialty: The Departments of Neurology and Neurosurgery of Huashan Hospital are nationally renowned clinical specialties. They have achieved outstanding results in the diagnosis and treatment of central nervous system tumors and difficult and complicated diseases in neurology and neurosurgery, as well as in scientific research. At present, the Department of Pathology has authority in the diagnosis of nervous system diseases. The teams of Professors Wang Yin, Chen Hong, and Xiong Ji conduct approximately 3,000 national consultations annually and also possess considerable research strength. In recent years, they have received National Natural Science Foundation of China grants and published multiple SCI papers.

（2）Digestive system disease subspecialty: ① Liver diseases: The Department of Infectious Diseases of Huashan Hospital is a nationally leading discipline and treats a large number of patients with difficult and complicated liver diseases. The Department of Pathology of our hospital has authority in the pathological diagnosis of chronic liver diseases such as viral hepatitis, autoimmune hepatitis, drug-induced hepatitis, and alcoholic hepatitis. Professors Hu Xiqi and Du Zunguo receive approximately 1,000 pathological consultations and inquiries annually from patients with chronic liver disease across the country. The Department of Pathology also has traditional advantages in the diagnosis of liver tumors. In terms of scientific research, it has obtained National Natural Science Foundation of China projects over the years and has also published SCI articles. ② Pancreatic diseases: Relying on the strong development of the Department of Pancreatic Surgery of Huashan Hospital, the Department of Pathology has certain distinctive features and advantages in the pathological diagnosis of pancreatic tumors, the pathological diagnosis of pancreatic biopsy specimens, and cytological diagnosis.

（3）Breast and thyroid disease subspecialty: The volume of breast surgeries and the number of breast cancer patients treated rank among the highest of all major hospitals in Shanghai. The Department of Pathology has also established a breast disease subspecialty group, with Director Tang Feng (a member of the Breast Tumor Group of the Oncology Pathology Committee of the Chinese Anti-Cancer Association) as the group leader. Its diagnoses are authoritative, and it is capable of testing various breast cancer-related indicators, providing assurance for individualized clinical treatment of breast cancer patients. In recent years, our department has obtained multiple National Natural Science Foundation of China projects related to breast tumors and published a series of SCI articles, thereby developing its own characteristics and advantages in this field. Over the past 5 years, the construction and development of the thyroid FNA cytopathology subspecialty have been mainly led by Professor Bao Yun and have received recognition from physicians in relevant clinical departments.

（4）Skin disease subspecialty: The Department of Dermatology has more than one million outpatient visits annually, more than 10,000 skin surgical biopsy cases, and approximately 1,000 consultation cases. It possesses abundant clinical resources. Director Tang Feng serves as Deputy Leader of the Dermatopathology Group of the Pathology Branch of the Chinese Medical Association and has considerable authority in the pathological diagnosis of skin diseases and skin tumors.

（5）Lymphohematopoietic system tumor subspecialty: In recent years, the incidence of hematologic tumors has increased year by year, and the number of patients treated by the Department of Hematology of Huashan Hospital has also increased annually. In response to this development trend, the Department of Pathology established a subspecialty for the pathological diagnosis of lymphohematopoietic system tumors more than 10 years ago and has developed its own characteristics in the diagnosis of lymphoma and the pathological diagnosis of bone marrow aspiration specimens.

In 2016, the Department of Pathology undertook the task assigned by the hospital’s Medical Affairs Department, “Accelerating the Continuous Improvement of Pathology Report Issuance (PDCA),” and improved its pathology workflow. From 2016 to the present, the 3-day pathology report issuance rate at Huashan Hospital has consistently exceeded 85%, far surpassing the requirement of the Shanghai Pathology Quality Control Center that pathology reports be issued within 5–7 days.

II. Scientific Research

Over the past 10 years, the department has led a cumulative total of 10 National Natural Science Foundation of China projects (including General and Young Scientists’ Fund projects) and 6 Shanghai municipal projects. Its main research focuses on the pathogenesis and mechanisms of invasion of breast, pancreatic, and central nervous system tumors; the relationship between drug resistance and infiltrative metastasis; and the role and function of miR-194 during the repair of chronic HBV-induced liver injury, among other areas. The department also participated in receiving the Second Prize of the National Science and Technology Progress Award.

In 2019, the department ranked third in the Scientific Research Competitiveness Ranking of Pathology Departments of Grade III Class A Hospitals in Shanghai. It has compiled the medical works “Histopathology of Skin Tissue,” “Modern Dermatology,” “A Series of Pathological Studies on Hepatitis B,” “A Series of Clinical and Pathological Studies on Chronic Hepatitis, Cirrhosis, and Hepatocellular Carcinoma in Infants and Children,” “Illustrated Liver Disease by Hu Xiqi—Clinical Pathological Diagnosis and Differential Diagnosis of Difficult Liver Diseases,” and “Principles and Techniques of Modern Histochemistry,” among others.

III. Education

The Department of Pathology of Huashan Hospital is one of the first approved clinical pathology training bases. The Clinical Pathology Base of Huashan Hospital integrates the resources of the clinical pathology department of Huashan Hospital and the Department of Pathology of Fudan University, providing base trainees with training at all levels in basic pathology and clinical pathology. It also collaborates with the Departments of Pathology of Children’s Hospital of Fudan University and the First Maternity and Infant Health Hospital Affiliated to Tongji University, achieving comprehensive coverage of internal medicine, surgery, obstetrics and gynecology, pediatrics, dermatopathology, and neuropathology. Physicians who complete standardized resident training and remain in this pathology department automatically enter a 3-year specialist physician training program. From the recruitment of the first batch of trainees nationwide in 2010 through August 2023, the department had cumulatively trained 62 residents, with 15 residents in training and a 100% pass rate for those completing the program. It had cumulatively trained 11 pathology specialists (including those in training). As a master’s and doctoral degree-granting site of Fudan University Affiliated Hospitals, since the department was established, it has trained 11 doctoral students (including those currently enrolled) and 20 master’s students (including those currently enrolled). In addition, the Department of Pathology of Huashan Hospital has accepted and trained a total of 26 visiting trainees from Qinghai, Jilin, Sichuan, Yunnan, and other parts of the country, contributing to the improvement of the diagnosis and treatment capabilities of primary hospitals in remote areas. Each year, it successfully organizes 3 national continuing education courses: Central Nervous System Disease Pathology, Liver Disease Pathology, and Breast Disease Pathology, providing the latest and most accurate information on theoretical and technological advances in the relevant specialties.

IV. International Exchanges and Cooperation

The Department of Pathology of Huashan Hospital has engaged in multiple friendly mutual visits with numerous international medical institutions. Director Tang Feng spent 1 year as a visiting scholar at MD Anderson Cancer Center in the United States, specializing in breast pathology. Multiple young and mid-career physicians have successively visited Harvard Medical School (MGH), the University Medical Center Hamburg-Eppendorf in Germany, Aichi Medical University in Japan, and elsewhere as visiting scholars. Academic leaders visit one another to provide guidance, and young talent is regularly dispatched for study and exchange, with emphasis placed on talent development.

| Development Goals |--------------

Although the development of the pathology discipline at Huashan Hospital has made substantial progress with the support of existing platforms and resources, there is still room for improvement before it becomes an outstanding first-class discipline. First, breakthroughs should be made in the discipline’s areas of professional distinction, with a focus on developing internationally first-rate strong subspecialty directions. A smart pathology system should be developed to achieve the transition from an “image” model to a “digital” model, with informatization as the main focus and AI technology as the prospect. At the same time, talent development should be strengthened, academic research should serve as the guide, and interdisciplinary integration and innovative integration should be advanced. On the basis of consolidating the discipline’s professional characteristics, the three major platform development areas of the discipline should be further improved, strengthened, and expanded, including molecular pathology, cloud pathology, and artificial intelligence.

Liver Disease Course taught by Professor Hu Xiqi

2015.6.26 Professor Ralph H. Hruban, Director of the Department of Pathology at Johns Hopkins Hospital in the United States, visited Huashan Hospital,

Professor Tang Feng, Director of the Department of Pathology, and Professor Hruban signed a letter of intent for cooperation between the two departments

Fully automated immunohistochemical staining machine

National PQCC Demonstration Laboratory