Enye indlela yokuqonda kangcono ukuxilongwa kwakho kwe- melanoma kwaye isicwangciso sonyango esiphumelayo kukuba ufunde ingxelo yakho ye-melanoma pathology, ithunyelwa kwigqirha yakho kwaye iqulethe ingcaciso ebalulekileyo njengesiqendu esona sesifo sakho. Le ngxenye yokuqala yoluhlu lwamanqaku aza kukunceda ukucacisa inkcazo yezobugcisa kule ngxelo.
Ukuxilongwa ngokubanzi
Ukuba i-lesion okanye i-moleyi esicangcazelayo ifunyenwe ngexesha lokuhlolwa kolukhuni , ugqirha wakho oyinyango okanye ugqirha wezilwanyana uza kuthatha i-specimen ye- biopsy ye-pathologist (ugqirha ovavanya izicubu kunye namanzi okuxilonga izifo ukuze ancede ekwenzeni izigqibo zonyango ) ukuhlola phantsi i microscope.
Ukuba ugqirha wezilwanyana ufumana iiseli ezinomdla (ezinomdlavuza) kwi-biopsy, ugqirha wakho wokunyamekela ugqirha unokuyalela ezinye iimvavanyo - i-lymph node, igazi, umchamo kunye nokuhlola i- imaging- ukuba ufumane ukuba awukho umhlaza. Ezi mvavanyo zinceda i-pathologist ukuvavanya indawo, isasazeka kunye nesigaba se-melanoma. I-pathologist iqhagamshelana nodokotela wakho osisiseko emva kokuphonononga iziphumo zokuvavanya nokugqiba isigaba somhlaza. Ababini, banokukhetha iindlela zokonyango ezifanelekileyo kakhulu kwiimeko zakho.
Umthamo weMitotic
Ingxelo yakho yokukhubazeka iqulethe ulwazi, njenge-tumor stage, i- Clark level , i- Breslow thickness , isilonda (kwenzeka xa i-melanoma igqithisa i-skin) kunye ne-mitotic rate (MR).
Iqondo eliphezulu le-mitotic lidibanisa kunye nomdla wokuba ne-positiveininel ye-lymph node biopsy.
UMongameli ulinganiswa ngokuhlolisisa i-tumor (excursion) ekhutshwe nge-microscope kwaye ngokubala ngokubala inani leeseli ezibonisa i- mitosis , into ebonakalayo ekwahlula iiseli.
Ngokuqhelekileyo, i-MR ibikwa njengenye yeentlobo ezintathu (nangona ngamanye amaxesha zidweliswe njengenombolo eqhubekayo, engabonakaliyo):
- ngaphantsi kwe-1 nge-millimeter yesi-square
- 1 ukuya ku-4 nge-millimeter ye-square
- ngaphezulu kwe-4 kwi-millimeter ye-square
Ukuphakama kwamanani e-mitotic, mhlawumbi i-tumor iya kuhlaliswa (isasazeka). Iingcamango kukuba iiseli ezininzi ziyahlula, mhlawumbi ziya kungena kwiinqanawa zegazi okanye i-lymphatic kwaye zandwendwela emhlabeni wonke.
Uphando luye lwabonisa ukuba iingxaki zokusinda kwizigulane nge-melanoma yesigaba kunye ne-mitotic rate ye-0 nge-square millimeter ngezihlandlo ezilishumi elinesibhozo zezigulane ezinezinga le-mitotic elingaphezulu kwe-6 kwi-millimeter nganye. Kwakhona, kuphela i-4% yezilonda kunye ne-MR ephindaphindiweyo (ubuyele) ifaniswe ne-24% yabantu abane-MR ephezulu. Inqanaba le-mitotic linokukunceda ukuqikelela ukuba i-lymph node biopsy yakho iya kuba yintle okanye ayikho.
Ngaba ukulinganisa MR ngokufanelekileyo?
Ukususela kuma-1990s, uphando oluninzi luye lwaqinisekisa ukuba izinga le-mitotic liyi-predictor of results kwizigulane ezine-melanoma, nangona kukho ukungqubuzana. Imiba emibini ingaphantsi kwengxoxo: 1) UMongameli ozimele kwezinye izinto zokuxela ? kunye no-2) ukuba akunjalo, ukulinganisa i-MR kuxabisa ixesha kunye neendleko?
Nangona i-MR ayinayo indima kwinkqubo yokuhlaziya i-melanoma, uphando luye lwabonisa ukuba kubaluleke kakhulu ukuchazwa kwesilonda, enendima ebalulekileyo kwimigangatho. Noko ke, abanye oogqirha bakholelwa ukuba i-mitotic rate ayiyiyo yokuzimela ngokuzimeleyo kuba ihlobene ngokusondeza (i-Breslow) ubukhulu kunye nesilonda. Ngokomzekelo, i-American Academy of Dermatology ithi uMongameli kufuneka abe ngumntu ozikhethelayo kwiingxelo ze- biopsy . Ngakolunye uhlangothi, iNational Cancer Comprehensive Centre ikhuthaza ukuba i-MR ifanele ixelwe zonke izilonda kwizigulane ze-II ukuya kwi-II.
Sekunjalo, ezinye iingcali zithi ukulinganisa i-MR kufanele kwenziwe kuphela kwiziko lemfundo (eyunivesithi) enkulu yezocwangciso zophando ngexesha elizayo. Ukuba uM MR akafakiwe kwingxelo yakho yokugula, qi niseka ukuba ubuze ugqirha wakho malunga nokucinga kwakhe.
Isiphelo
Njalo ucele ikopi yengxelo yakho yokugula. Yifunde kwaye ubuze imibuzo yakho ngogqirha. Unganqikazi ukufumana uluvo lwesibini malunga nokuxilongwa kwi-specialist, njenge-dermatopathologist. Isigulane esinolwazi sisigulane esinamandla, kwaye isigulane esinamandla sinokwenza ukhetho olungcono lwempilo olukhokelela kwiziphumo ezingcono.
Oluthe ngakumbi malunga nendlela yokuchaza ingxelo yakho ye-Melanoma Pathology Report
- I-Clark kunye neNombolo engqalileyo: Kuthetha ntoni?
- Izigaba zeMelanoma
- Igalari yomfanekiso weMelanoma
Imithombo:
IMelanoma. INational Cancer Network Network. V1.2009.
Ukuqonda i-Cancer Diagnosis: I-Melanoma yesikhumba. College of American Pathologists.
Attis MG, Vollmer RT. "Inqanaba leMitotic kwi-melanoma: ukuhlaziywa kwakhona." Am J Clin Pathol 2007 127 (3), 380-4.
Barnhill RL, Katzen J, Spatz A, Fine J, Berwick M. "Ukubaluleka kwemilinganiselo ye-mitotic njengento yokuxela i-melanoma yangaphakathi." J Cutan Pathol 2005 32 268-273.