Ukuba uya kuba notyando lwe- cancer yombele , ugqirha wakho unokuncoma ukuba une-node ye-node biopyi ngexesha elinye. Le nqubo yenziwa ukuze kuqinisekiswe ukuba umhlaza wakho unokusasazeka ngaphaya kwebele yakho kwii-lymph nodes zakho. Ekubeni iingcebiso zonyango ziyahlukana malunga nokuba i-lymph nodes zakho zibi okanye zilungile kwi-metastases (isasazeka) lo luvavanyo olubalulekileyo.
Yintoni ongayilindela ngexesha lakho le-node ye-biopsy kwaye iziphumo zithini? Masithathe inyathelo ngesinyathelo jonga kule vavanyo.
UVavanyo oluPhambili oluPhambili
I-nodeinel node biopsy yinkqubo yokuxilonga eyenziwa ukususa isampuli encinane yeelymode ukuze zihlolwe iiseli zomhlaza zesisu (i-metastases). I-nodeel ye-sentinel yileyunithi yokuqala ye-lymph i-cancer yombele iza kulindeleka ukuba isasazeke, kwaye ihlolwe ukubona ukuba umhlaza wakho usasaze ngaphaya kwe-tumor yakho yangaphambili.
Ukuba akukho nnye utyando lwenziwe ngexesha elifanayo, le nkqubo yonyango kwaye ibalulekile kwisiteji somhlaza wakho webele . Ukuba unayo i-lumpectomy okanye i-mastectomy, i-nodeetel node biopsy ingenziwa kunye nale nkqubo. Ukusebenza ngokuchanekileyo, kuya kuthi, kukuncedise wena nodokotela wakho ukhethe ukhetho olungcono lwempilo okanye umdlavuza wakho webele.
Amanyathelo abandakanyekayo
Kukho amanyathelo athile abandakanyekayo ukwenzela ukuba unqume ukuba yeyiphi i-lymph node yakho yee-sentinel nodes, phawula ngale ndlela, uze uvavanye la manqaku.
Inkqubo yonke ithatha kwiiyure eziliqela ukususela ngexesha ufika kufika kwixesha lakho. Nazi iindlela onokuzilindela.
Ukuqalisa Ngomfanekiso Wezonyango
Ngaphambi kwenkqubo yakho, ugqirha wakho uza kulufuna ukwazi indawo yakho yomzimba kunye ne-lymph nodes. Ukuhlanganiswa kwamagcisa okucatshulwa kuya kusetyenziswa ukufumana nokuphawula ezi ndawo phambi kokuhlinzwa.
Ukufumana i-Tumor
Uya kuza kwiSebe lezeMpilo leNyukliya esibhedlele okanye kwikliniki apho kuya kwenziwa khona i-sentinel node biopsy. Njengoko ubuya ku-mammogram okanye kwi-breast ultrasound, uya kuguqa kwiqonqa, kwaye ubeke isambatho esibhedlele. Emva koko, uya kulala phantsi kwitheyibhile yokuhlola. Uchwepheshe we-radiology uya kusebenzisa umatshini we- ultrasound ukufumana isisu sakho. Indawo yokuxhamla iya kuphawulwa esikhumbeni sakho, ngoko ugqirha wakho unokuyifumana kalula.
I-Anesthesia ne-Inject of the Dye ne-Tracer
Ingcali ye-radiologist okanye ingcali yonyango lwenyukliya iya kuphazamisa loo ndawo phezu kwesisu sakho sebele. Oku kunokwenziwa nge-topical lidocaine patch (kuba le yindawo enomgangatho wethenda) elandelwa ngumjovo we-lidocaine esiswini sakho. Xa unelukhuni ngokwaneleyo, uza kufaka idayi ephosakeleyo yomsakazo (i-technetium-label label-sulfur colloid) kunye nedayi eluhlaza okwesibhakabhaka (i-isosulfan eluhlaza okwesibhakabhaka) kwisayithi le-tumor. Injoza ithatha ixesha elide kunokuba umkhuhlane uphendulele ngokuqhelekileyo kwaye ungadinga ii-injections eziliqela. Ngamanye amazwi, unokuba unqwenela ukucela ngokugqithiseleyo unyango olungenakunzima nangona ucinga ukuba kuya kuba nokunyamezela.
Mapping Node Mapping
Xa usujoyiwe, iidayi zifuna ixesha lokuhamba ukusuka kwisayithi lakho lesisu eliya kwii-lymph nodes. Ngesinye kwisayithi yomzimba, idayi kufuneka ikhethwe ngamashishini amancinci amancinane ahamba kwii-lymph nodes.
Uza kuchitha ixesha elithile kwigumbi lokulinda elikufuphi, ngoko ukuzisa izinto ezithile zokufunda okanye umculo. Xa idayi ifinyelele kwindawo eya kuyo, ucelwa ukuba ubuyele kwiSebe lezeMpilo eNyukliya kwaye ulale phantsi kwiteyibhile yokuhlola kwakhona. Izifundo zokucinga (i-lymphoscintigraphy) ziya kwenziwa ukwenzela ukubonisa ukuba yeyiphi i-lymph nodes efumana idayi, kwaye ibonisa apho i-lymph node yakho ye-sentinel iya kufumaneka khona. Umchwephesha uza kuphawula le ndawo kwesikhumba sakho, ngoko ugqirha wakho uyazi apho uqala ukukhangela khona.
Ukususa i-Lymph Node yeStinel
Uya kufakwa kwigumbi lokusebenza, apho ugqirha wakho oza kuba ulungele ukuqala emva kokuba unikezwe i- anesthetic jikelele .
Udokotela ogqirha uya kusebenzisa iprojebhini ephethe ngesandla ukuze afumane i-lymph nodes eziqukethe idayi e-radioactive. Kuleyo ndawo, udokotela wakho otyando uza kwenza udidi oluncinci lwengqongqelo, kwaye ujonge i-lymph nodes eziye zenziwe ngombala obomvu. Kuye kususwe enye iisodes ezintathu kuphela ngaphandle kokuba ezininzi zininzi. Ezi node zithunyelwa kwisebe lesifo, apho zihlolwe khona nge- metastasis kunye ne- micrometastasis . Ukufakela kwakho kuya kuvaliwe kwaye kugqoke, kwaye uya kuthathwa kwiNtshukumo.
Ukuvavanya kwiPathology
Ngesinye i-lab ye-pathology lab, i-nodes yakho iya kuvavanywa ngumhlaza. Ngamanye amaxesha ugqirha wakho uya kulandisa uvavanyo lwecandelo leqabileyo leenombolo, ukuze ufumane iziphumo ngokufanelekileyo. Ukuba iinombolo zakho ziqulethe iiseli zomhlaza, unokuba ne-lymph node dissection epheleleyo ngokukhawuleza, ukufumana ubungqina obupheleleyo bokubandakanyeka kwe-lymph node. Ukuba iqela eligciniweyo lingalaywanga, kwaye iinombolo zakho ziqulethe umdlavuza, i-lymph node dissection epheleleyo ingenziwa emva koko.
Ukubuyisela kwi-Yourininel Node Biopsy yakho
Ukuba idayi ebhakabhile isetyenziselwa ukufumana i-lymph node yakho ye-sentinel, lindela ukubona idayi eluhlaza okomhlaza kwimizuzu engama-24. Ngamanye amaxesha kuya kubakho idayi eluhlaza kunye neluhlaza okwesibhakabhaka elukhumbeni olujikeleze isixhobo. Uya kuba nokugqoka kunye ne-sutures ukuze uhlale omile kwaye ungadinga unyango lweentlungu uze uqale ukuphilisa. Sebenzisa ingalo yakho yecala ngokunyanisekileyo (akukho ukuphakamisa!) Ubuncinane iveki emva kwenkqubo. Amacwecwe avela eluhlaza obomvu iya kunciphisa kwaye izivuno zakho ziya kuphulukisa; ukuchithwa ngokwayo kuya kuphelelwa kwinqanaba elifanelekileyo phezu kwexesha.
Ukufumana iziphumo zakho ze-Biopsy
Ugqirha wakho okanye u-oncologist uyakukubiza ngokuba neziphumo ze-biopsy ngokukhawuleza ukuba ugqirha wezilwanyana ugqibile ukuhlalutya kwakhe. Ingxelo iya kubandakanya ulwazi malunga nokuba zininzi, ukuba zikhona, i-lymph nodes ziqukethe iseli zomhlaza. Cela ikhophi yengxelo yakho yokugula kwaye uyigcine kunye neirekhodi zakho zezempilo. Ukuba i-node iqulethe umdlavuza, ifunyanwe ifanelekile, kwaye ukuba akukho mhlaza ufumaneke kwi-node, ifunyaniswa njengento engalunganga. Ukuxilongwa kwezilwanyana ezinomdla kuthetha ukuba umhlaza wakho usasazeke (umonakalo) ngaphaya kwe-tumor yokuqala. Ezi ziphumo ziyakuchaphazela isiteji kunye nokonyango olufunekayo ukunyanga umdlavuza wakho webele.
Xa sithetha ngeemastastas ukuya kuma-lymph nodes oku akuthethi umntu unomdlavuza we-metastatic. Enyanisweni, iintsholongwane zesifuba ezinjengezithuba ze-1A zinokukwazi ukuba ne-micrometastases kwi-lymph nodes. Ukusasazeka komhlaza wesifuba kwi-lymph nodes akuthethi ukuba unomdlavuza webele we-metastatic, kodwa kuphela ukuba i-tumor yakho ibonise "injongo" ukusasaza ngaphaya kwebele kunye neelymode.
Iingozi kunye neempembelelo ezingasemva
Uninzi lweempembelelo zesigxina se-sentinel node biopsy zincinci. Akunakukhathazeka xa idayi okanye umculi ejoyiweyo. Inkqubo inokudibanisa ukuya kwiiyure eziliqela ukuya kwixesha elide ligcweleyo lotyando lomhlaza webele.
Ingozi ekhoyo yenkqubo iquka i-lymphedema kunye nomngcipheko wobuxoki. Ezi zixutyushwa apha apha.
Lymphedema
Umphumo oqhelekileyo we-lymph node dissection yimeko ebizwa nge- lymphedema . Ngenxa yokuba i-lymph nodes kwindawo yakho ye-armpit ayikho, i-lymph fluid edlalwa yilapho ingakha kwaye ibangele ukuvuvukala. Ukuba oku kuqhubeka okanye kwanda, kunokuba buhlungu. Nangona kunjalo, ukuba ufuna kuphela i-nodeinel node biopsy, uya kuba neenombolo ezaneleyo zokusingatha i-lymph fluid ehamba ngommandla wakho, ngoko ke izinga le-lymphedema kwimeko, li-5% kuphela. Enyanisweni, uninzi lwezizathu ezenza emva kokuba i-sentinel node biopsies endaweni ye-lymph node ukuphazamiseka okupheleleyo kukugwema i-lymphedema ukuba kunokwenzeka.
Amanqaku Amanga
I-lymph nodes ziyakwazi ukuhluka ngobukhulu, ezinye ezincinci njengenhloko yepini, ezinye zikhulu kunobhontshisi. Udokotela wakho ugqirha uya kuzingela ngesikhumba kunye neoli, efuna i-nodes ezidayiweyo, kwaye kufuneka asebenzise ubuchule kunye nesigwebo. Kungenzeka ukuba i-nodeel ye-sentinel iya kuvavanya i-negative (ecacileyo yomhlaza), kodwa umdlavuza unokuba kwezinye i-lymph nodes. Oku kubizwa ngokuba yimbi. Ukukukhusela kwiziphumo ezingamanga, amaqela akho okugqithisa kunye nokukhubazeka aya kulandela izikhokelo eziqinileyo, kwaye ukuba iziphumo zikho nakuphi na ukungathandabuzeki, amanqaku amaninzi aya kususwa kwaye ahlolwe, ukuqinisekisa ukuba iziphumo ezichanekileyo.
Okukwintsusa
Ukuba ne-nodeinel node biopsy kudinga amanyathelo athile kwaye unokuzibuza ukuba kutheni yonke imfuneko iyimfuneko. Ukukhetha unyango olungcono kunomdlavuza wesifuba kufuna i-staging echanekileyo, kwaye ukuchaneka ngokucacileyo isifo somhlaza wesifuba sifuna ukuba nawuphi umhlaza usasazeke kwi-lymph nodes. Ukongeza, ukugqiba ukuba naluphi na ukubandakanyeka kwe-lymph node ine-micrometastase okanye i-macrometastases ngokunjalo. Usuku lwe-biopsy lungabonakala lude, kodwa iziphumo ziya kubaluleka kwiintsuku kunye neenyanga ezizayo.