Iingxelo zeeNgxelo ze-Histopathology and Prognostic Predictors
Ubomi bakhe buhlolisisa iishubhu ezivela emzimbeni phantsi kwe-microscope ukuba zibone imiqondiso kunye nezifo zesifo. I-Histology yindlela yokufunda izicubu, kwaye ukukhubazeka kukufundwa kwezifo.
Ngoko kuthathelwe ndawonye ubuqu bakhe bendalo kuthetha ngokutyikitya kwezicubu ezinxulumene nezifo. Ingxelo yezolimo ichaza izicubu eziye zithunyelwa ukuhlolwa kunye neempawu zento umhlaza obukeka ngayo ngaphantsi kwe-microscope .
Ngxelo ngezinye izihlandlo ingxelo yezolimo ibizwa ngokuba yi-biopsy ingxelo okanye ingxelo ye-pathology.
Ingxelo Yakhe
Ugqirha oyingcali owenza uviwo phantsi kwe-microscope ubizwa ngokuba ngu-Pathologist. Izicubu ezifundwayo zivela kwi-biopsy okanye inkqubo yokucubungula apho isampula yamathambo esityholo esikhethweyo kwaye ithunyelwe kwi-laboratory. Iyakucwangciswa kwaye igalelwe kwiindawo eziqinileyo (ezibizwa ngokuba ngamacandelo), zonakaliswe kwaye zihlolwe ngaphantsi kwamancroscopes ukuba zichaze iinkcukacha zeeseli ezisisitheni. Kwezinye izifo, ugqirha unokufumana isampuli yeethambo ezichazwe ngokukhawuleza ngokusetyenziswa kwamacandelo aqingqiweyo. Amacandelo athileyo okanye iintlobo ezisetyenzisiweyo zisetyenziselwa kakhulu kwi-lymphoma, nangona kunjalo, ngenxa yeengxaki zokutolika kunye neesampulu. Kwi-lymphomas, i- lymph nodes yizona zicubu ezivame ukuvavanywa kwiindawo zakhe zokuphila. Kwiintlobo ezininzi zeengqimba zegazi, i-bone marrow biopsy nayo iyafuneka ukuba ihlolwe ngokucacileyo.
Iimpawu zeNgxelo
Iingxelo ze-Histopathology kwiimpawu zengqondo zomhlaza zithatha ngakumbi kwaye zinkimbinkimbi. Zingaquka:
- Ubonakala obukhulu beethambo ezibandakanyekayo
- Amacandelo akhethekileyo
- Zobugcisa
- Ezinye iimvavanyo
Iingcingo ze-molecular zibhekiselele ekukwazi ukuhlalutya iiseli kunye nezicubu kwinqanaba le-molecular, elisezingeni lamaprotheni, ama-receptors , kunye namajethi edibanisa ezi zinto.
Ukutolika ingxelo
Uninzi lwezinto ezifunyenweyo zivela kwiimeko ezinjalo zihlotshaniswa nokuxela. Izibonakaliso zengcebiso zibandakanya ibakala lesisu kunye nobukhulu bokusasazeka, nokuba ingaba umhlaza wawususwe kunye nomda weeseli eziphilileyo, okanye ukuba kukho ubungqina bokuba umhlaza usasazeke ngaphaya kokususwa.
Iinkqubo zokubamba ziyahluka ngokuxhomekeka kohlobo lwesifo somhlaza, kodwa ngokuqhelekileyo iiseli zixhomekeke kwiimeko ezingaqhelekanga zivela phantsi kwe-microscope, kunye neesibonda zeBanga 1 eziqhelekileyo zikhangeleka kunye ne-Grade 4 izihlamba ezibonisa ukungabonakali. I-tumor ephezulu, ngoko ke, ngokuqhelekileyo apho iiseli zinokungaqhelekanga. Ukubamba akufani nokokusebenza. Isiteji sinokubambisana nantoni apho umhlaza ufunyanwa khona emzimbeni nokuba usasazeka kangakanani.
Iinkcazo zeMolcular kunye nezinye iindlela zokuThatha
Ukongeza kwimizimba yakhe, ezinye iindlela zingasetyenziselwa ukuvavanya ubukho bomhlaza kumathambo, kuquka i-nestle aspiration cytology, kunye nezinye zezi ndlela zingasetyenziselwa kakhulu kwiindawo zokunakekelwa kwezempilo emhlabeni jikelele. I-leukemias kunye ne-lymphomas zifunyaniswa ukuba zibandakanya ukudibanisa nokubonakala kwazo-ukuba iiseli zibukeka njani (i-morphology), iimpawu zabo okanye amaninzi omzimba onokufunyanwa ngokusebenzisa i-antibody test (i-immunophenotype), i-enzymes zabo ezinokubangela ukuba ezinye izimo zamakhemikhali zenzeke (i-cytochemistry) kunye noshintsho lwabo lwe-chromosomal (karyotype).
Amaxesha amaninzi kwi-lymphomas nakwezinye i-cancer , inqubo ebizwa ngokuthi i- immunohistochemistry isetyenziselwa ukuvavanya uhlobo lwe-tumor, ukuhlaziya nokunyanga. I-Immunohistochemistry iquka ukusetyenziswa kwamagciwane okunamathela kumathegi athile okanye amanqaku ngaphandle kweeseli zomhlaza.
La manqaku awamachiza omzimba anamathela rhoqo kwi "CD" egameni lawo, emele iqela lokuhlukana. Ngokomzekelo, ii-CD23 kunye neCD5 ziimpawu ezincinci, ukuba zikhona kwiiseli zomhlaza, ziyakwazi ukuxhasa ingcamango yokuba i-lymphocytic leukemia (CLL) / i-lymphocytic lymphoma (SLL) encinci isifo esinokuthi siyasifumana. Lawa manqaku afanayo akhona nakwezinye izigulane, nangona kunjalo, ngoko oogqirha basebenzisa uhlobo lwenkqubo yokuphelisa ngokusekelwe kwingcaciso ekhoyo kunye nento eyaziwayo malunga neentlobo ezimbi kunye neefayile zabo "eziqhelekileyo".
Omnye umzekelo we-CD marker yi-CD20, ekhona kwezinye i-lymphomas kodwa engekhoyo kwabanye. Ukusabalalisa i-larrge ye-B cell lymphoma, okanye i-DLBCL, yinto eqhelekileyo ye-lymphoma ehambelana nomenzi we-CD20.
Ukufumana isampula esinikwe ngamagciwane e-leukemia okanye i-lymphoma, iimakishi zinokuvavanywa zisebenzisa iipaneli ezipheleleyo zamanqindi ezinamathele kumanqaku ahlukeneyo, ngokulawulwa okulungileyo kunye nokungalunganga, okwakhiwe kuyo.
Izifundo zeMelecular and chromosomal zinokwenziwa ukujonga ukulungiswa kwemfuza kunye neenguqu ezithile kwiikromosomes. Ngamanye amaxesha kufakwe okanye kususwe iigesi zixhunyaniswa nolwazi malunga nokuhlaselwa. Ngokomzekelo, kwi-long-term lymphocytic leukemia, okanye i-CLL, iqela elithile le-chromosome elahlekile, kwaye ngokuphindaphindiweyo amaxesha alahlekileyo kunye nalo ngumziza onceda ukunciphisa umdlavuza. Ukususwa kwe-17p kufumaneka kwi-3 ukuya kwi-10 ekhulwini labantu abane-CLL, ngokubanzi. Ukukhishwa kwe-CLP ye-17p yindlela ye-CLL enzima ukuyiphatha; Abantu abane-CLP yokususa i-CLL banzima ukunyanga kunye ne-chemotherapy eqhelekileyo.
Imithombo:
Ho C, uRdig SJ. Amanqaku angama-immunohistochemical in malignancies: Iiprotheyini correlates zeenguqu zee-molecular. IiMinina kwi-Pathology ye-Diagnostic Pathology . 2015. 32 (5): 381-91.
Ukubikwa Kwakhe kweengqondo: Izikhokelo zoLutsha lweCancer. NguDerek C Allen. Umthombo weSayensi kunye neMedia Media, uJuni 29, 2013.
> Taylor J, Xiao W kunye no-Abdel-Wahab O. Ukuxilonga kunye nokuhlelwa kwezidalwa zezilwanyana ze-hematologic ngesiseko semfuza. Igazi . 2017 Julayi 27; 130 (4): 410-423.