Izinhlobo, Izinqubo kanye Nezinkinga Ze-Lung Biopsy
I-biopsy yamapayipi inganconywa uma une-nodule yamaphaphu noma ubukhulu, noma uma udokotela wakho ekhathazekile ukuthi unesifo noma isinye isimo sephaphu. Iyini i-biopsy yamaphaphu, kwenziwa kanjani futhi yiziphi izinkinga ezingenzeka?
Kuyini Ukuqhuma Kwemungulu?
I-biopsy yamaphaphu yinqubo yokuthola isampula yamathishu amaphaphu asolisayo. Ngokubheka isampula yezicubu ngaphansi kwe-microscope, odokotela bangakwazi ukunquma kangcono ukuthi yikuphi okubangela ukungajwayelekile, nokuthi ngabe inqubo ingumdlavuza noma cha.
Ngomdlavuza wamaphaphu, i-lung biopsy ibalulekile ukuze unqume uhlobo lomdlavuza wamaphaphu kanye nesimo se-molecular noma i-genetic ye-tumor.
Izizathu Ze-Biopsy Ye-Lung
Kunezizathu eziningana zokuthi i-lung biopsy inganconywa:
- Ukuhlola isicucu noma isisindo esibonweni esifundweni se-imaging esifubeni, futhi sibone ukuthi sinesifo esibi noma esibi (umdlavuza.) Umdlavuza wamaphaphu utholakala kanjani?
- Ukuze ulandele imiphumela engavamile ku-CT ukuhlolwa komdlavuza wamaphaphu. Yiziphi amathuba ukuthi umdlavuza uma ukuhlolwa komdlavuza wamaphaphu kwembula i-nodule ?
- Ukuhlola ukutheleleka kwamaphaphu. Ukutheleleka kwamagciwane kungaba amagciwane (njengesifo sofuba), i-viral noma i-fungal (njenge-aspergillosis noma i-coccidiomycosis.)
- Ukuze uhlolwe isifo se-lungs njenge- sarcoidosis , i- pulmonary fibrosis , i-wegener's granulomatosis noma isifo se-lung rhumum .
- Ukwenza ukuhlolwa kofuzo (ukuprofetha kwamangqamuzana) emdlavuza wamaphaphu . Lokhu kuhlolwa kubheka ukuguqulwa kwezakhi ze-"targetable" -ukuthi, ukuguquguquka kwamangqamuzana omdlavuza "okushayela" umdlavuza, eziningana zazo manje ezitholakala zokwelapha.
- Ukunquma uhlobo lomdlavuza wamaphaphu .
- Ukusiza ukunquma isigaba somdlavuza wemaphaphu owaziwayo.
Izinhlobo ze-Biopsy and Procedures
Kunezindlela ezine eziyinhloko odokotela abangakwazi ukuzenza kuzo indawo yesikhumba samaphaphu asolisayo:
- I-beal biopsy enhle (ngezinye izikhathi ibizwa ngokuthi i-needle core biopsy noma i-biopsy ye-needle ngayinye)
- I-Transbronchial biopsy (eyenziwe ngesikhathi se-bronchoscopy ne-endobronchial ultrasound)
- I-biopsy ye-Thoracoscopic
- Vula ukuphikisa kwephuphu
Ake sibheke ngayinye yalezi zinqubo ngokuhlukile.
I-Needle Lung Biopsy
Esimweni esihle senaliti yamaphaphu , odokotela bafaka inaliti ende emhlane wakho nasemapapheni akho ukuthola isampula yamathambo. Lokhu kwenziwa ngokusetshenziswa kwe-CT scanner noma i-ultrasound ukusiza ukuqondisa inaliti endaweni efanelekile. I-biopsy yenaliti yindlela encane engavamile yokusampula isifunda esolisayo emaphashini akho, kodwa akutholaki njalo izicubu ezanele zokwenza ukuxilongwa. I-needle lung biopsy ibizwa nangokuthi "i-transthoracic" ye-biopsy noma "i-biopsy" ebizwa nge "percutaneous".
I-Transbronchial Biopsy
I-biopsy ye-transbronchial yenziwa phakathi ne- bronchoscopy , inqubo lapho umthamo uqondiswa khona kusuka emlonyeni wakho kuze kube emoyeni ongenhla wamaphaphu akho. Ngosizo lwe-ultrasound ( endobronchial ultrasound ), odokotela bangakwazi ukuqondisa inaliti endaweni esolisayo futhi bathole isampula (i-transbronchial aspiration aspiration.) Le nqubo iphumelela kakhulu uma ukungavamile noma ukubola kutholakala noma eduze nemikhumbi ehamba phambili yezindiza amaphaphu.
I-Thoopsy Lung Biopsy
E-thoracoscopic lung biopsy, ububanzi buqaliswa ngodonga lwesifuba futhi endaweni yesiphaphu kumele ibe yi-biopsied.
Phakathi ne-biopsy ye-thoracoscopic, ikhamera yevidiyo isetshenziselwa ukusiza odokotela ukuthi bathole futhi bahlasele indawo yezicubu. Kule nqubo, eyaziwa nangokuthi ukuhlinzeka nge-thoracoscopic (VATS), i-VATS), odokotela bangase bakwazi futhi ukususa indawo yezicubu ezisolisayo noma i-lobe yamaphaphu anomdlavuza. (Qaphela: Ngeke benze lokhu ngaphandle kokuxoxa ngalokhu nawe ngaphambi kwenqubo.)
Vula i-Lung Biopsy
Njengendlela eyingozi kunazo zonke yokusampula izicubu, i-pulp biopsy evulekile ngezinye izikhathi kudingekile ukuba isampuli izicubu uma ezinye izindlela zihlulekile. Lena inqubo enkulu yokuhlinzwa, eyenziwe ngaphansi kwe-anesthesia jikelele. Kungadinga ukuhlukanisa izimbambo noma ukususa ingxenye yembambo ukuze uthole amaphaphu.
Ngezinye izikhathi, i-biopsy evulekile yenziwa njengengxenye yokuhlinzwa ukususa i-nodule noma ubuningi, ikakhulukazi uma udokotela wakho ohlinzayo eqinisekile ukuthi unomdlavuza.
I-Biopsy yamanzi
I- biopsy yamanzi iyindawo entsha ethokozisayo efundelwa ukuhlola umdlavuza wamaphaphu. Le nqubo, efuna igazi elilula lidwebe, libukeka lijikeleza amangqamuzana omdlavuza ukuze kuhlolwe i-DNA ye-tumor yokuguqula izakhi zofuzo-okungukuthi, ukuguqulwa kwamangqamuzana omdlavuza okumele kutholakale khona. Ngezinye izikhathi lapho kwenziwa i-biopsy yamaphaphu, odokotela abakwazi ukukhipha izicubu ezanele ukuze benze lokhu kuhlolwa, futhi i-biopsy ye-liquide ingenza le miphumela itholakale ngaphandle kokuthi ilandele ezinye izicubu zesisu.
Ngo-June 2016 i-biopsy yokuqala ye-liquid yavunyelwa ukuthola ukuguqulwa kwe-EGFR kubantu abane-non-cell encane yomdlavuza wamaphaphu.
Imiphumela Ye-Biopsy Yakho Yesibeletho
Uma udokotela wakho ekwazi ukuthola isampula esihle samathishu, cishe uzozwa ngemiphumela ezinsukwini ezimbili kuya kwezintathu-nakuba lokhu ngezinye izikhathi kuthatha isikhathi eside, ikakhulukazi uma ngaphezu kweyodwa i-pathologist efisa ukubukeza imiphumela. Kuwusizo ukubuza udokotela wakho ngesikhathi senqubo uma ungalindela ukuzwa imiphumela yakho, futhi uma uzothola ucingo noma uma kufanele wenze i-aphoyintimenti ukuze ufunde ngemiphumela. Abanye odokotela bakhululekile ukukubiza efonini ukukutshela okutholakeleyo ngenkathi abanye bengase bafise ukusetha ukuqokwa kokulandela ukuhamba ngemiphumela.
Lesi sihloko sikhuluma ngendlela yokuqonda umbiko wakho we-pathology kusuka kumaphaphu wakho wegazi.
Nakuba udokotela wakho engase abe nomqondo omuhle walokho okuzofunyanwa, akuyona into engavamile ukuba odokotela bephutha ngemuva kokubona isampula yamathambo. Umkhuba wokungajwayelekile ukuthi unomdlavuza uncike ezintweni eziningi, enye yazo ingayizi. Ama-nodules we-Lung (amaphaphu emaphashini angaba ngamamitha amathathu kuya kwangu-1,2 noma ngaphansi) ayinamathuba amancane okuba amabi kunamapayipi amaphaphu (amabala emaphashini angaphezu kwamamentimitha amathathu ngobukhulu). Uhlu lwezinye zezimbangela ezibonakalayo lungabonakala ngokuchofoza izixhumanisi ngezansi.
Ngezinye izikhathi, isampula yamathishu ayibonakali ukuxilongwa. Umbiko ofana nalokhu ungabuyiselwa ngokuthi "awuhambisani." Uma kunjalo, kusekhona izinketho eziningi. Uma kungenzeka ukuthi iphansi ukuthi ukungavamile esifubeni sakho kungumdlavuza, ungakhetha ukulinda futhi wenze ukuphinda kuphinde ezinyangeni ezimbalwa. Ngokufanayo, noma ngabe indawo ingaba nomdlavuza futhi ukuxilongwa ngokuqondile ngeke kuguqule ukwelashwa, ungakhetha ukulinda.
Uma ngakolunye uhlangothi, ukuxilongwa kubalulekile, wena nodokotela wakho ungakhetha ukuphinda uphinde uphinde uthole izindlela ezihlukile zokuthola isampula lesisindo.Ungakwazi ukufunda kabanzi mayelana nokwahlukana phakathi kwezicubu ezinesifo esibuhlungu kanye nokuthi kungani ukwenza umehluko ngezinye izikhathi kunzima.
Ukufometha kwamakhemikhali
Kubalulekile ukuqaphela ukuthi wonke umuntu onomdlavuza wesifo samangqamuzana ongewona omncane kufanele abe nokuhlolwa kofuzo (ukuprofethwa kwamangqamuzana) okwenziwe ngesisu sakhe. Khuluma nodokotela wakho uma ungazange uzwe lokhu okukhulunywe ngakho. Njengamanje, imithi ivunyiwe kulabo abane- ALK rearrangements , izinguquko ze-EGFR , kanye nokulungiswa kabusha kwe-ROS1 nezinye izifo zokwelapha ezithintekayo zenziwa ekuhlolweni kwemitholampilo.
Izingozi ze-Biopsy ye-Lung
Izingozi ze-lung biopsy ziyahlukahluka kuye ngokuthi uhlobo lwenqubo, indawo yezicubu kanye nempilo yakho jikelele. Izinkinga ezivame kakhulu ukuphuma noma ukuvuza emoyeni kusuka emaphashini akho. Ezinye izinkinga ezikhona kungenzeka zibandakanya:
- I-Pneumothorax - ukuwa kwamaphaphu (ukuvuza emoyeni) - Uma uhlakulela i-pneumothorax ngenxa ye-biopsy, udokotela wakho ohlinzayo cishe kuzodingeka abeke ithubhu lesifuba . Leli bhubhu elivumela umoya ukuthi uphume emaphashini akho kuze kube yilapho ukuvuza kwe-air kufaka uphawu.
- Ukuphuza.
- Ukutheleleka.
- Ingozi ye-anesthesia. Zombili i-anesthesia yendawo kanye ne- anesthesia ejwayelekile ingathwala izingozi.
- I-airic system embolism - Ukuvuza emoyeni emithanjeni emikhulu engahamba enhliziyweni; okubizwa ngokuthi i-systemic air embolism, kwenzeka ngaphansi kwamaphesenti angaphansi kwesiguli se-needle maphepha.
- Ukudumala "ukuhlwanyela" - Kunobungozi bokuthi i-tumor izosakazeka eceleni kwethrekhi ye-needle biopsy uma isisekelo se-biopsy senziwa. Le ngozi ingavamile, futhi ngesikhathi samanje, ama-biopsies enaliti ibhekwa njengendlela ephephile kakhulu yokuthatha i-biopsy yamaphaphu uma kudingeka.
Imizwelo Yakho Ngaphambi Kokuqhuma Kwe-Lung
Kungakhathaliseki ukuthi kungani udokotela wakho ekhuthaze ukuphuza i-lung, ukungaqiniseki kungaba nzima ukubhekana nakho. Abantu abaningi baye bathi banomuzwa wokuthula ngokuhlaselwa okubi kunokuhlala endaweni engazi.
Ncika emndenini wakho nabangani ngalesi sikhathi. Finyelela kubantu obaziyo bazokusiza ukuba ubhekane nokulinda, njengalabo abavame ukuphakamisa. Lesi yisikhathi esihle sokubuza abathandekayo bakho ukuthi bangalutholi "ukuxilonga" kuze kube yilapho wazi okwengeziwe, futhi ungayeki ukwabelana izindaba zabo (lokho esikubiza ngokuthi izindaba ezesabekayo) ngabanye abaye babhekana nokunye okufanayo.
Uma ingqondo yakho iya ezibucayi kakhulu, khumbula ukuthi imithi ishintsha njalo. Uma unesifo esifanayo nogogo wakho eminyakeni edlule, akusho ukuthi uzoba nesipiliyoni esifanayo. Kwakukhona ezinye izindlela ezintsha zokwelapha ezivunyelwe ukwelashwa komdlavuza wamaphaphu phakathi kuka-2011 no-2016 kunaneminyaka engama-40 eyandulela ngo-2011.
Imithombo:
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