Until now, large diagnostics companies have been slow to get involved in the industry's biggest paradigm shift in a decade: the move to molecular markers that will help make diagnostics part of the treatment process. At this year's AACC, the small companies leading the way in this field were beginning to make their presence felt. And the big companies, J&J, Roche, Abbott, Beckman, were starting to talk about their own programs in the field. But they're moving slowly in a fast-moving field, and thus are vulnerable to new competitors.

Tiny Vysis scored big this spring, winning the backing of two major therapeutic and diagnostic companies for its products. But is its core technology ready for prime time? Vysis sees an opportunity to expand use of its FISH diagnostics technology beyond niche applications in the clinical market. But skeptics say the technology is too complex and expensive for routine clinical use.

TriPath Imaging is getting a financial boost from one of its founding technology and equity providers, Roche. The company--the merged result of three different cytology start-ups--needs the money to go up against the so-far only successful player in the automated cytology market, Cytyc, hoping to exploit a much broader platform of technologies.