Nick Myles- MD (Far-Eastern State),MSC(Oxon), PhD (RAMS,Moscow), FRCP(Canada)
- clinical professor of pathology and laboratory medicine at University of British Columbia
Nick Myles
- MD (Far-Eastern State),MSC(Oxon), PhD (RAMS,Moscow), FRCP(Canada)
- clinical professor of pathology and laboratory medicine at University of British Columbia
30 years of experience in cancer pathology, cytopathology and research
About
72
Publications
10,245
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Introduction
I am a MD pathologist with more than two decades of broad-base practical experience in surgical pathology, cytopathology , autopsy pathology and clinical cancer research. In addition, I employ methods of evidence-based medicine in respect to measuring efficiency of medical interventions, accuracy of diagnostic procedures and mapping evidence to inform future cancer research.
Skills and Expertise
Current institution
Current position
- clinical professor of pathology and laboratory medicine
Additional affiliations
June 2018 - June 2019
Position
- Fellow
Description
- I 've added higher level (read: subspecialty) diagnostic cytopathology to the roster of my skills having completed Royal College Diploma in Cytopathology at McGill University in Montreal under the supervision of Prof. Manon Auger.
March 2011 - present
UBC
Position
- Professor
Description
- I am teaching " on job" anatomical pathology and general pathology residents, and elective MD students and residents from the other programs, focusing on cancer pathology, breast diagnostic surgical pathology and evidence-based clinical practice.
September 2008 - February 2011
Position
- Teaching Faculty
Description
- Taught undergraduate medical students, biomedical graduate students and pathology residents.
Publications
Publications (72)
The WHO Classification of Tumours (WCT) guides cancer diagnosis, treatment, and research. However, research evidence in pathology continuously changes, and new evidence emerges. Correct assessment of evidence in the WCT 5th edition (WCT-5) and identification of high level of evidence (LOE) studies based on study design are needed to improve future...
Aims
Ductal carcinoma in situ (DCIS) is recognised by the World Health Organisation (WHO) Classification of Tumours (WCT) as a non‐invasive neoplastic epithelial proliferation confined to the mammary ducts and lobules. This report categorises the references cited in the DCIS chapter of the 5th edition of the WCT (Breast Tumours) according to prevai...
Evidence-based medicine (EBM) can be unfamiliar territory for those working in tumor pathology research and there is a great deal of uncertainty about how to undertake an EBM approach to planning and reporting histopathology-based studies. In this article, endorsed by the WHO International Agency for Research on Cancer’s (IARC) International Collab...
Pathology Evidence Got A Grading System, based not on opinion but consensus building research (Delphi method)
Real-time polymerase chain reaction (PCR) for SARS-CoV-2 is the mainstay of COVID-19 diagnosis, yet there are conflicting reports on its diagnostic performance. Wide ranges of false negative PCR tests have been reported depending on clinical presentation, timing of testing, specimens tested, testing method and reference standard used. We aim to est...
Background:
COVID 19 caused by the novel coronavirus SARS CoV 2 has caused the greatest public health emergency of our time. Accurate laboratory detection of the virus is critical in order to contain the spread. Although real time polymerase chain reaction (PCR) has been the cornerstone of laboratory diagnosis, there have been conflicting reports o...
Introduction
Recent cytology classification systems have become more evidence-based and advocate for the use of risk of malignancy (ROM) as a measure of test performance. From the statistical viewpoint, ROM represents the post-test probability of malignancy, which changes with the test result and also with the prevalence of malignancies (or pre-tes...
Implementing The Paris System for Reporting Urinary Cytology results in a decrease in the rate of the "atypical" category and an increase in its prediction of subsequent high-grade urothelial carcinoma. Pre-vs post-Paris systems: comparable diagnostic accuracy Test Category Pre-Paris (LR) Post-Paris (LR) Benign 0.3 [95%CI 0.2-0.5] 0.2 [95%CI 0.1-0....
Three unusual peritoneal cytology studies which underscore the importance of both morphology and evidence synthesis in order to prevent overdiagnosis of malignancies.
Educational session on issues with the evidence in clinical diagnostic and prognostic biomarker testing
Teaching Course on Diagnostic Accuracy statistics for pathologists and clinical scientist
The estrogen receptor (ER) is a key predictive biomarker in the treatment of breast cancer. There is uncertainty regarding the use of hormonal therapy in the setting of weakly positive ER by immunohistochemistry (IHC). We report intrinsic subtype classification on a cohort of ER weakly positive early-stage breast cancers. Consecutive cases of breas...
introductory lecture for undergraduate medical students and medical technologists on breast pathology
Several Study Cases in Diagnostic Breast Surgical Pathology. Large file due to images - be patient.
Breast conserving surgery and radiotherapy for ductal carcinoma in situ of the breast: Meta-analysis of randomized controlled trials
Breast cancer mammographic screening leads to detection of premalignant and preinvasive lesions with an increasing frequency. Nevertheless, current epidemiologic evidence indicates that the screening reduces breast cancer specific mortality, but not overall mortality in breast cancer patients. The evidence is lacking whether aggressive eradication...
Overview of critical appraisal of diagnostic literature with the examples of the efficient use of free on-line tools and calculators.
The Canadian Immunohistochemistry Quality Control program monitors clinical
laboratory performance for estrogen receptor and progesterone receptor tests used in
breast cancer treatment management in Canada. Current methods assess sensitivity
and specificity at each time point, compared to a reference standard. We investigate
alternative performance...
Pathology is interpretative diagnostic clinical discipline based on visual evaluation of pattern of tissue alterations in disease as opposed to norm. It is an integrated heuristic process, resulted in formalized pathology report which contains diagnostic and prognostic items, which frequently correlate to each other, and which interpretation is fre...
This paper aims to help health care providers to advise the healthy female patients age of 40-49 y.o. who have one first degree relative with breast cancer, whether she should or should not participate in mammographic screening. The author’s patient is anxious whether she should have her mammogram done and whether it will benefit her. Her sister wa...
“Unnecessary surgery” as a possible harm from breast cancer screening needs to be elucidated.1 Many indeterminate or “atypical” breast lesions are found on breast core biopsy after abnormal results in screening mammography.
Most current recommendations assume that surgery …
Context.—External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs.
Objective.—To explore reference values for estrog...
External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs.
To explore reference values for estrogen receptor and prog...
Human epidermal growth factor receptor 2 (HER2) status is routinely assessed by immunohistochemistry (IHC) in patients newly diagnosed with invasive breast cancer to determine eligibility for treatment with antagonists of HER2 such as trastuzumab (Herceptin) and lapatinib (Tykerb). The Canadian Immunohistochemistry Quality Control (cIQc) program wa...
Background:
Breast cancer is heterogeneous and the existing prognostic classifiers are limited in accuracy, leading to unnecessary treatment of numerous women. B-cell lymphoma 2 (BCL2), an antiapoptotic protein, has been proposed as a prognostic marker, but this effect is considered to relate to oestrogen receptor (ER) status. This study aimed to t...
Background:
Breast cancer is heterogeneous and the existing prognostic classifiers are limited in accuracy, leading to unnecessary treatment of numerous women. B-cell lymphoma 2 (BCL2), an antiapoptotic protein, has been proposed as a prognostic marker, but this effect is considered to relate to oestrogen receptor (ER) status. This study aimed to...
Panels of immunomarkers can provide greater information than single markers, but the problem of how to optimally interpret data from multiple immunomarkers is unresolved. We examined the expression profile of 12 immunomarkers in 200 endometrial carcinomas using a tissue microarray. The outcomes of groups of patients were analyzed by using the Kapla...
Breast cancer accounts for approximately 15% of all cancer deaths. Currently, axillary nodal status is the most reliable prognostic indicator for breast cancer. Tumor size and histological grade are used to stage breast cancer. Estrogen receptor/progesterone receptor (ER/PR) and HER-2/neu status are useful in predicting patient survival and relapse...
CD10 is a zinc-dependent peptidase (metalloproteinase), which degrades a variety of bioactive peptides. Earlier studies suggested that CD10 expression in tumor stroma is associated with biological aggressiveness of the tumor. To date, only one study has addressed the clinical significance of stromal CD10 expression in invasive carcinoma of the brea...
Amplification of the 11q13 locus is commonly observed in a number of human cancers including both breast and ovarian cancer. Cyclin D1 and EMS1 have been implicated as candidate oncogenes involved in the emergence of amplification at this locus. Detailed analysis of the 11q13 amplicon in breast cancer led to the discovery of four regions of amplifi...
Rearrangements of the neuregulin (NRG1) gene have been implicated in breast carcinoma oncogenesis. To determine the frequency and clinical significance of NRG1 aberrations in clinical breast tumors, a breast cancer tissue microarray was screened for NRG1 aberrations by fluorescent in situ hybridization (FISH) using a two-color split-apart probe com...
BACKGROUND
The clinical significance of coexpression of type 1 growth factor receptor (T1GFR) family members remains largely unknown. The objective of the current study was to determine the frequency and the possible prognostic effect of coexpression of HER-1, HER-2, HER-3, and HER-4 by breast carcinoma.METHODS
Tissue microarrays were constructed u...
Prognostically relevant cluster groups, based on gene expression profiles, have been recently identified for breast cancers, lung cancers, and lymphoma. Our aim was to determine whether hierarchical clustering analysis of multiple immunomarkers (protein expression profiles) improves prognostication in patients with invasive breast cancer. A cohort...
Podocalyxin is a CD34-related cell surface molecule with anti-adhesive qualities. We probed a tissue microarray (n = 272) linked to long-term outcome data and found that podocalyxin was highly overexpressed in a distinct subset of invasive breast carcinomas (n = 15; 6%). Univariate disease-specific (P < 0.01) and multivariate regression (P < 0.0005...
Tissue microarrays containing 348 cases of invasive breast carcinoma were studied by immunohistochemical staining for CD-117, CD-3, CD-20, CD-68, Her2, estrogen receptor protein, and progesterone receptor protein, and results were correlated with patient outcome. Hormone receptor status (both estrogen receptor and progesterone receptor) correlated...
The translocation t(12;15)(p13;q25), in which the ETV6 gene from chromosome 12 is rearranged with the NTRK3 gene from chromosome 15, has recently been identified in secretory breast carcinoma (SBC). This fusion gene was initially described in congenital fibrosarcoma and congenital mesoblastic nephroma. The biological consequence of this translocati...
Urokinase plasminogen activator (uPA) expression in breast cancer is associated with relapse and a reduction in disease-specific survival. Thus, efforts are under way to identify uPA inhibitors. By screening a chemical library of >1000 compounds, 17-allyaminogeldanamycin (17AAG) was identified as a potent inhibitor of uPA by the National Cancer Ins...
The aim of this study was to detect neuroendocrine differentiation (NE), to determine its association with major clinicopathological parameters of breast cancer, and to study the prognostic significance of NE differentiation in a group of breast carcinomas by using tissue microarray (TMA) methodology. NE differentiation was studied by using 3 marke...
Integrin-linked kinase (ILK), a key component of the extracellular matrix adhesion, has been studied extensively in recent years. Overexpression of ILK in epithelial cells results in anchorage-independent cell growth with increased cell cycle progression. Furthermore, increased ILK expression is correlated with progression of several human tumor ty...
Pathomorphosis of Ewing's tumors after the combined treatment is studied with the use of light and electron microscopy, DNA-flow cytometry. Necrosis and apoptosis of tumor cells produced by the therapy are characterized. Therapeutic forms of tumor cells representing hyperaneuploid population delayed at the G2-level of the cell cycle are described.
X-ray examination is considered to be the most effective procedure for diagnosis of Ewing's sarcoma of the rib. The extent of surgery and sequence of procedures are determined on the basis of its evidence. Treatment of infantile Ewing's sarcoma of the rib should include chemoradiation therapy and compulsory surgery.
The content of receptors for the epidermal growth factor and estrogens is studied in primary human bone tumors: osteogenic
sarcoma, chondrosarcoma, malignant fibrous histiocytoma, and giant cell tumor. In all of these tumors, radioligand analysis
reveals receptors for epidermal growth factor in the membrane fraction and receptors for estrogens in t...
Questions
Questions (6)
do chromosomes aways have two ends or it depends on their metaphase morphology ?
We know that 99.9% of humans share the same gene pools and therefore the targeted difference, i.e. pre-test probability is less than 0.1%. Therefore, by applying the Bayesian theorem, an acceptable healthy person's margin of error for false positive result is 1/100, the accuracy of the genomic testing should be near absolute . But what is it in reality? Can someone give me the number?
