"Pathologists work mostly with living people," Professor Ivana Kholová points out.
At the turn of the year, Kholová started as Professor of Pathology at the Institute of Clinical Medicine of the University of Eastern Finland. In addition, she is a part-time Chief Physician of Pathology at the Imaging Center of Kuopio University Hospital. "I also train a lot of my colleagues and find it important to keep in touch with routine work."
Contrary to popular belief, being a pathologist is mostly something else than autopsies. "For the most part, we examine cell and tissue samples from living patients. The findings guide diagnosis and treatment selection, such as precision therapy that targets the patient's cancer type.
"The diagnostic methods in pathology are constantly evolving, samples can be studied more diversely, and more information can be obtained from them. In addition, digital pathology is already commonplace in many laboratories, so samples are scanned and digitised, and they are examined from a computer screen instead of a microscope."
The aim of digital pathology is to refine and speed up diagnostics also by utilising artificial intelligence in the analysis of samples. For the time being, AI is mainly used by researchers.
More detailed cancer diagnostics
Kholová specialises in cytopathology, i.e. diagnostics based on cell samples. "We are still looking for the best solutions for digitising cell samples, as scanning entire three-dimensional cells is more challenging than scanning thin tissue sections."
Developing digital cytology and further refining the diagnostics of cervical cell samples are topical in research projects led by Kholová in the European Federation of Cytology Societies (EFCS).
In Finland, women aged 30–65 are screened for cervical cancer by Pap test or HPV test. "Screening has significantly reduced the number of cancer cases, but the prevalence increased during the COVID-19 years, especially in the youngest age group.
"On the other hand, screening can lead to unnecessary follow-up visits for some women. The aim is to improve the ability to distinguish those at risk of cancer from those with only temporary inflammation."
Kholová has also been involved in developing the diagnostics and international cytopathology classifications of thyroid and salivary gland as well as lung specimens.
"Salivary gland tumours are rare, for example, but there are more than 40 different types that partly resemble each other."
Thyroid nodules, on the other hand, are common and often benign, but they may contain cellular changes that mimic cancer. "It is important to distinguish these from actual cancer to avoid unnecessary surgery."
On the borderline of benign and malignant is NIFTP, a non-invasive thyroid tumour that Kholová and partners have analysed in an extensive meta-analysis.
In lung cancer diagnostics, insufficient cytology samples are a major challenge. One improvement to this is the multiplex staining method developed by Kholová's research group. The method enables the examination of multiple biomarkers in the same section.
Aortic samples shed light on the causes of dissection
For a long time, Kholová has also studied cellular and tissue alterations related to cardiovascular diseases, especially aortic and aortic valve diseases and atrial fibrillation. A recently published study, for example, shed light on the link between aortic aneurysms and dissections and atherosclerosis, and it showed that atherosclerotic changes are more common in the thoracic aorta than thought. New information has also been collected on lymphatic vessel changes in the heart valves in different diseases.
"Here, the dead teach and help the living, as heart samples can usually only be obtained during an autopsy."
Kholová participated in an international expert group that prepared a consensus statement on surgical pathology of the aorta to guide pathologists on the examination and classification of aortic samples. "This helps to better differentiate the effects of genes and lifestyle on aortic dissection in patients of different ages, for example."
At the University of Eastern Finland, she is responsible for both medical students´ education in pathology and medical specialist training in the field. She has been involved in developing cytology education nationally as President of the Finnish Society of Clinical Cytology.
"I want to ensure a high level of cytology competence in Finland, as cytological samples account for at least one third of the pathology routine. It is also important as cytology diagnostics is fast and inexpensive."
Another goal of Kholová is to inspire young doctors to specialise in the field. "If you are interested in research, pathology offers significant opportunities for it. This is clean indoor work with samples, and we do not have to be on call at night."
The Czech-born Kholová has worked in Tampere for the past few years, but she is familiar with the Kuopio campus since the early 2000s, when she worked as a resident at KUH and a post-doc researcher in Professor Seppo Ylä-Herttuala’s research group. "New cooperation opportunities and partners are already in sight."
Ivana Kholová
- Professor of Pathology at the University of Eastern Finland 1 January 2025-
- Doctor of Medicine (MUDr.), Charles University, Czech Republic 1998
- PhD (Pathology), Charles University, Czech Republic 2002
- Pathology Specialist 2008
- Adjunct Professor (Docent) in Experimental Pathology, University of Kuopio 2008
- Adjunct Professor (Docent) in Pathology, University of Tampere 2016
Key positions
- Chief Physician (part-time), KUH 1 January 2025-
- Clinical Lecturer, University of Tampere 2017-
- Consultant Pathologist and Deputy Chief Physician, Fimlab Laboratories 2009-
- Clinical Lecturer and Resident in Pathology, University of Kuopio and Kuopio University Hospital, 2006–2008
- Postdoctoral Researcher, University of Kuopio 2003–2009
