Publication Analysis 2005-2011
by Kathleen Gransalke, Labtimes 07/2013

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Presence of amyloid placques in the brain are one of the pathological hallmarks of Alzheimer’s disease. Image: National Institute on Aging

Not dead yet, Pathology has entered the molecular age and contributes its shares to cancer and neurodegenerative diseases’ research.

Leafing through past publication rankings, we realised with surprise that Pathology is next in line. Alright – but what does a pathologist do? Does this discipline even still exist? As a matter of fact, Pathology, in contrast to its objects of research, is very much alive and kicking. With the arrival of technological advances in molecular biology and genomics, it has now entered a transitional phase – away from disease diagnosis, based on the gross examination of bodily fluids and organs in anatomical and clinical pathology, to a more modern approach in the shape of Molecular Pathology.

Not only is it modernised, pathology often also reaches out to many other disciplines; most extensively to cancer research. There are two types of pathologist, Giuseppe Viale, from the University of Milan, once revealed to Cancer World, “Those active in multidisciplinary teams, say in cancer institutions, and those who are not. The second group doesn’t see the full picture of a tumour that has to be treated according to biological features, the presence of specific targets, within the context of the tumour burden, within a given person at a given time and with given resources. So for them, the diagnosis of cancer, ‘yes’ or ‘no’, is the peak of their activity.” Most modern pathologists and especially those that made our most-cited authors list, however, belong to the first group, who work together tightly with, for example, cancer researchers or even at Cancer Institutes.

Two types of pathologists

This broad expanse also led to one or the other identification issue within our publication analysis, in particular concerning the most-cited authors list – more about that later. For our nations’ ranking, however, we could comfortably lean on our specialist journals, clearly identified for us as such by Thomson Reuters’ Web of Science database, which we used for this analysis. According to Thomson Reuters, the three journals with the highest impact in Pathology are: the Annual Review of Pathology-Mechanisms of Disease (IF: 25.8), the Acta Neuropathologica (IF: 9.8) and the Journal of Pathology (IF: 7.6). More than 20,000 articles were published by European pathologists between 2005 and 2011, most of them in the American Journal of Pathology (6%), followed by the Journal of Clinical Pathology (5.2%) and the Journal of Pathology (4%).

Leaders in pathology research are Germany, England and Italy. No surprises there but looking a little further down the table, we see a very rare guest among our rankings. Hungary made the top 20 with over 4,000 citations, surpassing a large research nation like Israel, who came in at place 21, for instance. Turkey also did pretty well, climbing five spots to 17th, compared to our previous pathology ranking, dating back to 2007 (LT 5-2007 pp. 38-40). When it comes to citations per article, Switzerland leads the pack with, on average, 21.8 citations per article. Close behind is another surprise nation, Portugal, with 20.5. A cross-continental comparison revealed that European and US-American pathologists are more or less on a par regarding citation numbers; EU pathologists, however, published a few more articles than their US colleagues.

Let’s approach our most-cited pathologists in Europe between 2005 and 2011. Who is a pathologist? Everyone studying a disease? No, this cannot be, we thought, because these days almost every molecular biologist or geneticist is trying to link his or her research to a certain disease. If nothing else, it may serve to convince funding agencies that their topic of research is relevant to society and thus, is worthy of being financially supported. Hence, we needed to determine other criteria to find the needles in the haystack. Also, to avoid too many overlaps with other publication rankings, we decided to make the clearest cut of all rankings and include only those researchers in our Pathology ranking, who either work at Institutes of Pathology or in Departments or Divisions of Pathology. In addition, we checked the biographical background of a few ranking aspirants and also included them if they were members of pathological societies or identified clearly as pathologists, of any kind, on their website.

A shadow of the Cancer Research ranking

The top 30 list of most-cited pathologists in Europe we obtained in the end, turned out to be a shadow of the cancer research ranking we will be tackling in a future issue of Lab Times. More than half of the top 30 highly-cited pathologists work on cancer in its many forms. Especially high on the research agenda are breast cancer and lymphomas. Breast cancer is the topic of our numbers one and two, Mitch Dowsett (1st) and Alan Ashworth (2nd), who both work at the Institute of Cancer Research in London, in the Division of Molecular Pathology. Ashworth is currently the division’s interim head. Incidentally, Mitch Dowsett scored 25th place in LT’s Cancer Research ranking from 2012 (LT 1-2012 pp 40-42). Our number three, Chris J. L. M. Meijer, is an “old acquaintance” in our rankings. The cervical cancer researcher, who works at the Department of Pathology at the VU University Medical Center, Amsterdam, achieved 7th place in the 2012 Cancer Research ranking and even topped the 2012 Virus Research ranking (LT 7-2012, pp 38-40).

Lymphomas and Alzheimer’s

As already mentioned, lymphomas are the second hot topic in cancer pathology. Doing this publication analysis, we learnt that there’s not only one kind of lymphoma but many, including diffuse large B-cell, mantle cell, splenic marginal zone and gamma delta T-cell lymphomas, to name but a few. Elias Campo (5th) studies several lymphoma types, while Andreas Rosenwald (10th), for example, focusses on Burkitt’s lymphomas and large B-cell lymphomas.

Besides cancer pathologists, neuropathologists dedicated to the study of neurodegenerative diseases make up the second biggest subgroup of our Pathology publication analysis. Hans Kretzschmar (7th), for example, studies Alzheimer’s disease as well as prion diseases and amyotrophic lateral sclerosis (ALS), also known as motor neuron disease. Alzheimer’s is also the research topic of choice for David M. A. Mann (14th), who, by the way, runs the Manchester Brain Bank. Also, Tamas Revesz (29th) has brain bank duties, namely co-directing the Queen Square Brain Bank for Neurological Disorders, associated with the University College London. The bank specialises in parkinsonian movement disorders. Manuela Neumann (13th) is one of just two women in the ranking. She has devoted her research career to the study of ALS and frontotemporal dementia, the second most common form of dementia behind Alzheimer’s.

A third group, comprised of more “exotic” pathologists, includes cellular pathologist, Siamon Gordon (4th), who also very recently made seventh place in our Immunology ranking with his research on macrophages and biochemical pathologist, James Shepherd (6th). Shepherd is best known to the scientific and especially medical world through his research on the cholesterol-lowering statins to prevent cardiovascular disease.

Pathology is even more necessary in the molecular era

What does the future have in store for Pathology? Will it fuse completely with cancer or neuroscience research or will it remain a separate discipline, adding valuable information about a disease from a different perspective? Giuseppe Viale (9th), also one of the pathologists committed to breast cancer research, wrote in a 2008 symposium article published in the Annals of Oncology, “It is unwise to claim that the new molecular assays should replace the traditional pathological evaluation [of breast cancer], when we could take the greatest advantage by combining the two approaches for the maximum benefit of the patients. I am convinced that pathology is, indeed, even more necessary in this molecular era than it used to be; first to precisely identify the subgroups of tumours deserving additional molecular investigations to address very specific questions, and second to bring to the bedside the discoveries of the new molecular assays.” On this note, we are already looking forward to our next Pathology publication analysis, coming up in a few years from now.

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Last Changed: 26.11.2013