Kwixesha elidlulileyo, izigulane azizange zithandwe ngamaxwebhu achaza umhlaza wabo. Kodwa loo mihla, ngokubulela, iyabuya. Abantu abaninzi bacela iikopi zeenkcukacha zabo zezokwelapha, kwaye amanye amaziko omhlaza anikezela ngesigulane segulane apho yonke into evela kwi-radiology ibika kwiilabhu ingafumaneka kwi-intanethi. Kodwa kukho konke olu lwazi, iingxelo ze-pathology yomdlavuza wemiphunga yimizimba ingaba yinto enzima kakhulu ukuyichaza njengomntu olele.
Ngoko ndiza kuzama ukuchaza ezinye zegciwane ukuze ndikuncede uqonde ingxelo yakho.
Ingxelo Yenzani Ingxelo YePathology?
Ingxelo yentsholongwane yinkcazo ebhaliweyo yomhlaza wakho ngumhlaza wezilwanyana, emva kokuvavanya izicubu ezithathwe emzimbeni wakho nge- biopsy okanye utyando. Kunokuba nje u-ewe okanye akukho nhlobo ingxelo (ingumdlavuza?) Ezi ngxelo ziyakwazi ukuthwala ulwazi oluninzi olungamncedi ugqirha wakho ukuba aqonde ukuxela kwakho kodwa indlela yokunyanga engcono kakhulu. Oko kwathiwa, iingxelo ze-pathology zisetyenziswanga yedwa kodwa kunoko zidibaniswe nembali, ukuhlolwa ngokomzimba, izifundo ze-radiology, kunye nokufundela i-lab ukufumana umfanekiso obalaseleyo womhlaza wakho.
Amanqaku ambalwa anceda ngaphambi kokuba uqhubeke. Enye kukuba yonke umdlavuza uhlukile. Ukuba bekukho abantu abangama-30 abaneomdlavuza wamaphaphu egumbini, bekuza kuba neentlobo ezahlukeneyo zomhlaza wemiphunga ezingama-30. Ingxelo yokukhubazeka yenye yezixhobo ezisetyenziselwa ukuqonda umhlaza wakho ngamnye.
Enye ingongoma ebalulekileyo kukuba nangona kuqhelekile ukufumana imibono yesibini (kwaye mhlawumbi yesithathu okanye ngaphezulu) ngomhlaza wakho, ukufundwa kwesibili kwengxelo yakho yokugula kunokungahoywa. Ukufumana imbono yesibini kwi-biopsy yakho inokuba yinto ebalulekileyo ngokufumana umbono wesibini kunyango lwakho.
Igama, Umhla, kunye nolwazi lweKliniki
Ingxelo yakho yokukhubazeka izakuquka kuqala igama lakho, kunye nolunye ulwazi oluyisiseko kunye nokuxilongwa okubonakalayo kunye neempawu ezinokuthi uhlangabezana nazo.
Iimpawu
Igama leempawu livakala, libhekiselele kwisisampula seetyhuni, udokotela we-radiologist okanye omnye ugqirha. Eli candelo lichaza indawo emzimbeni apho isampuli ithathwe khona. Xa i-specimen ifunyenwe kwaye ifunyenwe yisebe le-pathology livavanywa ngamanyathelo ambalwa.
Uvavanyo lweMacroscopic (olubizwa ngokuba yi-Gross Examination)
Njengoko "i-macro" ithetha ikhulu, kwaye "inkulu" kwimbonakalo yonyango ibonisa ukubonakala kwiso iso, le mviwo ibhekisela kwizinto ezibonakalayo kwi-pathologist ngokujonga i-sampuli yakho ngaphandle kokusebenzisa i-microscope-umfanekiso omkhulu ngokwenene. Ingabandakanya ubukhulu, ubunzima besifo, kunye nezinye iimpawu ezifana nombala kunye nokuvumelana. Ezinye izicubu zibonakala zicacile (njengoko umfanekiso olapha ngentla ubonisa) kodwa ngamanye amaxesha akukho ukungaqhelekanga kubonwa kuze kube yinyathelo elilandelayo lwenziwa.
Uvavanyo lweMicroscopic
Emva kokujonga iisampuli zeethambo zakho, i-pathologists zidla ngokuthatha iincetu ezincinci eziza zivavanya phantsi kwe-microscope. La maxesha amaqabunga (ukuze ucoce iicu ezincinci) kwaye unokuphathwa ngetayi ekhethekileyo okanye ezinye izinto ngaphambi kokufakwa kwislayidi. (Le nkqubo inokuthabatha ixesha kunye nesinye isizathu sokuba ugqirha awunakho iziphumo xa ulinda ngokuxhalabisa.) Kukho iingqungquthela ezibalulekileyo zolwazi ezivela kulo mvavanyo:
- Iintlambo ezixhaphakileyo - Inqaku eliqhelekileyo lithetha malunga neengcambu zomzimba (okanye izigulane ezigqityiweyo.) Oku kubhekiselele ukuba ingawususwanga okanye awuyiyo yonke into yomhlaza, ukuba bekude kangakanani na indawo ekukhutshweni kuyo kwakukho ubungqina bomhlaza. Ngokomzekelo, ingxelo ingathi isifo sikhombisa kwi-1.2 cm ukusuka kumda wokugqitywa.
- Ukuxhamla kweBanga - Izibilini zingabhalwa kwakhona ngebanga le-tumor. Ngokulula nje isisu se-grade 1 siza kuba sisona sikrakra, kwaye i-tumor yesithathu iya kuba yintloni. Ngomdlavuza wamaphaphu, ingxelo yakho ingenokuba ibe namazwi afana nehlukeneyo, ahluke kakuhle, okanye ahluleki. Izicubu ezihluke kakuhle zikhula ngokukhawuleza, kanti izicubu ezingenasiphako zivame ukukhula ngokukhawuleza. Ukongeza kokubonakala kwimizimba yesifo somhlaza, i-pathologists ikhangele izinto ezininzi ukucacisa ukuba ubuhlungu bubuhlungu kangakanani. Ezi zibandakanya izinto ezifana nomsebenzi we-mitotic (ukuba iiseli zomdlavuza zikhawuleza njani zikwahlula) xa uqikelele ibakala le-tumor.
- Uhlobo lomhlaza - Ngomdlavuza wamaphaphu, kukho ezimbini iindidi ezinkulu. Amanqamzana amancinci amancinci amancinci aquka malunga ne-80 ekhulwini yamanomdla emiphunga kunye neeseli ezibonakalayo phantsi kwe-microscope. Amanqamzana amancinci amancinci emiphunga ayenzela ininzi yentsalela kwaye abe neembonakalo ezahlukeneyo phantsi kwe-microscope. Amanqamzana amancinci amancinci amancinci ahlukaniswe ngokwengeziwe kwi- adenocarcinomas , ezinkulu i-cell carcinomas , kunye ne- squamous cell carcinomas ngokuxhomekeka kuhlobo lweseli umhlaza ovela kuyo, ukubonakala phantsi kwe-microscope, kunye neemvavanyo zelabhu ezibukeka kumakethi athile (jonga ngezantsi .) Inqaku elididekayo kubantu abaninzi xa bekhangele ingxelo yabo yokukhubazeka kukuba iimvumi azihambelani ngokufanelekileyo kwisigaba esinye okanye esinye. Ngokomzekelo, ingxelo ingathi isifo sinomhlaza omncinci wesifo somhlaza kunye nezinye iimpawu zesifo somhlaza wesifo somnxeba omncinci.
- Kwi-Situ vs Infiltrating / Invashive- Enye inqaku ongayibona kwingxelo yakho kukuba i-tumor ikhona okanye ingena ngaphakathi okanye ingenayo. In situ ichaza umhlaza okhoyo kuphela kwiiseli apho waqala khona. Iingcali ezininzi zenzululwazi zicinga ukuba ezi ziiseli ezinqabileyo kuneeseli zomhlaza. Umdlavuza womlenze ofunyaniswayo kweli nqanaba uthathwa njengesigaba 0. Ubuninzi bexesha kunye nomdlavuza wamaphaphu i-tumor ichazwa ngokungena ngaphakathi okanye ukungena. Oku kuthetha ukuba i-tumor sele isasaze iinqununu eziye zaphuhliswa kuyo kwaye zinako ukusabalalisa (ukulungelelanisa) kwezinye iindawo zomzimba. I-pathologists inokuthi ibone into ebizwa ngokuba yi-angiolymphatic invasion. Oku kuchaza ukuba i-tumor iye yahlasela imilambo yegazi kufuphi kunye / okanye iinqanawa ze-lymphatic.
- Ukubandakanyeka kwe-Lymph node - Ukuba uye wahlinzwa ukuba ususe i-tumor yakho, i- lymph nodes ingasuswa ukuze ibone ukuba ngaba nomdlavuza (unobungozi) okanye awunomdla (ungekho.) Oku kuya kuqatshelwa kwingxelo ngeenkcukacha ezifana nokuba i-lymph nodes yayisondele kwidumbu, okanye ikude ngakumbi, kwaye inokudlala indima enkulu kwonyango lakho le-oncologist.
- Isitatimende - Ngamanye amaxesha isigaba sinikezelwa njengenxalenye yengxelo yakho yokugula. Ukuze kuqinisekiswe isigaba, i-pathologists ijonge ukudibanisa ubungakanani besisu, ukubandakanyeka kwe-lymph node, nokuba ingaba isifo sikholele kwenye indawo emzimbeni (i-metastasized.) Kukho iindlela ezahlukeneyo zomhlaza wakho ongachazwa. Umdlavuza ongasetyenzana weseli wamaphaphu uhlukaniswe kwiinqanaba ezi- 4 eziphambili . Ukugqiba ezi zigaba amagqirha asebenzisa into ebizwa ngokuba yi- TNM . Ngale nkqubo T ibonisa ubukhulu be-tumor, i-N imele ubukho kunye nenani le-lymph nodes ezintle, kwaye iM imelela i-metastases ede. Ngomdlavuza omncinci wamaseli omnxeba kukho izigaba ezi-2 kuphela: isigaba esikhulu kunye nesigaba esincinane .
Iiprotheni / iimpawu zeGen
Kukhona iimvavanyo ezongezelelweyo ezongezelelweyo zakho zentsholongwane onokuzenza kwi-tumor yakho ukukunceda ukuba unjani uhlobo lomhlaza wamaphaphu, okanye ukuba isifo sakho somhlaza empeleni sisifo somhlaza esisuka kwenye inxalenye yomzimba wakho kwaye sisasazeka emiphakeni yakho. Imizekelo embalwa yalezi ziquka i-TTF-1, i-p63, i-CD56 kunye ne-chromogranin.
Profilation
Kungekudala, ukuqhubela phambili kuye kwenzelwa unyango lomhlaza wemiphunga ngokuqonda ukuguqulwa kwezinto eziphilayo ezenza "ukuqhuba" ukukhula komhlaza. Kwabanye abantu, ngokukodwa abantu abane-adenocarcinoma, ezijoliswe kwizigulane ziyafumaneka ukunyanga kwesi sifo esoloko sineziphumo ezincinci ezimbalwa kunokhemotherapy yendalo. Iinguqu eziqhelekileyo ezivanywayo ziquka i- EGFR , i-KRAS, iROS1 kunye ne- ALK . Ngoku kuyacetyiswa ukuba abantu abanomdlavuza wesiliva ongasomncinci bavavanywe ngenxa yolu tshintsho-kodwa uphando olutshanje lucetyise ukuba kuphela iipesenti ezingama-60 ze-oncologists okwenjenjalo.
Ukuxilongwa
Ingxelo yokugqibela ye-pathology report is diagnostic apho i-pathologist isishwankathela iziphumo. Oku kuya kubandakanya uhlobo lomhlaza, ibanga (indlela ezahlukileyo ngayo), nokuba ingaba ziphi i-lymph nodes ezichanekileyo, kunye nesigaba.
Inyathelo elilandelayo
Ukuba usandul 'utsho ukuba unomdlavuza wamaphaphu, qwa lasela amanyathelo okuqala ukuba uthathe , cinga ngombono wesibini , kwaye uhlale ubuza imibuzo eninzi. Musa ukuziva uthabatha ixesha lakho logqirha-oko kukuthi uhlawulelwa. Ukuba imibuzo yakho ayiphenduliwe ngokwaneleyo, fumana ugqirha onokuziphendula.
Imithombo:
National Cancer Institute. Ishiti yeenyani. Iingxelo zePathology. Ukuhlaziywa 09/23/10.