Esikhathini esidlule, iziguli azivame ukuzithanda imibhalo echaza umdlavuza wabo. Kodwa lezo zinsuku, ngokubonga, zihambile. Abantu abaningi bacela amakhophi ngolwazi lwabo lwezokwelapha, kanti ezinye izikhungo zomdlavuza zinikeza isilonda sesiguli lapho izinto ezivela kuma-radiology zibika kuma-labs zingatholakala ku-intanethi. Kodwa kulo lonke lolu lwazi, imibiko ye-lung cancer pathology ingaba yinto enzima kunazo zonke ukuchaza njengomuntu olele.
Ngakho-ke ngizozama ukuchaza ezinye zezinkinga zezokwelapha ukukusiza uqonde umbiko wakho.
Umbiko Wenzani Ngempela?
Umbiko we-pathology yiyona incazelo ebhaliwe yomdlavuza wakho ngumuntu we-pathologist, ngemuva kokuhlola izicubu ezithathwe emzimbeni wakho nge- biopsy noma ukuhlinzwa. Esikhundleni sokuthi u-yebo noma u-akukho umbiko (ingumdlavuza?) Le mibiko ingakwazi ukuthwala ulwazi oluningi olungasiza udokotela wakho ukuba aqonde ukuchaza kwakho kodwa indlela yokuphatha yokwelashwa okungcono kakhulu. Lokhu kusho ukuthi imibiko yokukhubazeka ayisetshenziswanga yedwa kodwa kunalokho ihlangene nomlando, ukuhlola ngokomzimba, izifundo ze-radiologi, kanye nokuhlolwa kobuchwepheshe ukuze uthole isithombe esihle kakhulu somdlavuza wakho.
Amanothi ambalwa ayasiza ngaphambi kokuqhubeka. Enye ukuthi yonke imdlavuza ihlukile. Uma kwakunabantu abangu-30 abanomdlavuza wamapapu ekamelweni, kuzoba nezinhlobo ezingafani ezingama-30 zomdlavuza wamaphaphu. Umbiko wokukhubazeka ungenye yamathuluzi asetshenziselwa ukuqonda umdlavuza wakho ngamunye.
Enye iphuzu elibalulekile yukuthi nakuba kuvamile ukuthola imibono yesibili (futhi mhlawumbe yesithathu noma ngaphezulu) ngomdlavuza wakho, ukufundwa kwesibili kombiko wakho wezokwelapha kunganakwa. Ukuthola umbono wesibili ku-biopsy yakho kungase kubaluleke kakhulu njengokuthola umbono wesibili ekwelapheni kwakho.
Igama, Usuku, nolwazi lomtholampilo
Umbiko wakho wokubeletha uzokufaka igama lakho kuqala, nolunye ulwazi oluyisisekelo kanye nokuxilongwa okubonakalayo kanye nezibonakaliso ezinokwenzeka oye wazibona.
I-Specimen
I-specimen yezwi izwakale, kodwa ngokuyinhloko isho isampula yamathishu okuthiwa udokotela ohlinzayo, i-radiologist, noma omunye udokotela ususa. Lesi sigaba sichaza indawo emzimbeni lapho isampula sithathwe khona. Lapho kutholakala uchungechunge futhi kutholakala umnyango wezokwelapha kuhlolwa ngezindlela ezimbalwa.
Ukuhlolwa kwe-Macroscopic (okubizwa nangokuthi Ukuhlolwa Okukhulu)
Njengoba "i-macro" isho ukuthi inkulu, futhi "okweqile" emgodini wezokwelapha kusho ukuthi kubonakala emehlweni ahlanzekile, lokhu kuhlolwa kubhekisela kulokho okubonwa yi-pathologist ngokubheka isampula sakho ngaphandle kokusebenzisa i-microscope-isithombe esikhulu ngokuyinhloko. Kungabandakanya ubukhulu, isisindo sesisu, nezinye izici ezifana nombala nokuvumelana. Ezinye izicubu zisobala (njengoba isithombe esenhla sibonisa) kodwa ngezinye izikhathi akukho okungajwayelekile okubonwayo kuze kube yilapho isinyathelo esilandelayo senziwa.
Ukuhlolwa okuncane
Ngemva kokubona isampula yamathambo akho, ngokuvamile i-pathologists ithatha amathanga amancane abese ewahlola ngaphansi kwe-microscope. Lezi zikhathi ezithile zifriziwe (ukuze uhlukanise izicubu ezincane kakhulu) futhi zingelashwa ngombala okhethekile noma ezinye izinto ngaphambi kokufakwa kwisilayidi. (Le nqubo ingathatha isikhashana futhi kungesinye isizathu udokotela wakho angase abe nemiphumela ngenkathi ulinda ngokukhathazeka.) Kunezingxenye ezimbalwa ezibalulekile zolwazi ezivela kuloluhlolo:
- Amaphesenti amathumba - I-notation eyodwa evamile imayelana ne-tumor margins (noma ama-margins wokuhlinzwa.) Lokhu kubhekisela ukuthi noma ingabe yonke isuswe isuswe noma cha, ngabe ngabe kude kangakanani nesayithi lokususa kwakukhona ubufakazi bomdlavuza. Isibonelo, umbiko ungasho ukuthi i-tumor yafinyelela ku-1.2 cm ukusuka emkhawulweni wokuhlinzwa.
- I-Tumor Grade - Izicubu zingase ziphinde zibekwe ngesigaba se-tumor. Ngokulula nje isisu segreyidi singaba yinye esingesiyalukhuni kakhulu, futhi isisu sebanga lesi-3 singaba nobudlova. Ngomdlavuza wamaphaphu, umbiko wakho kungenzeka esikhundleni salokho ube namagama afana nokuhlukaniswa kahle, okungafani kahle, noma okungaxhunyiwe. Izicubu ezihlukaniswe kahle zivame ukukhula kancane, kanti izicubu ezingenakwenzeka zivame ukukhula ngokushesha kakhulu. Ngaphandle kokubukeka jikelele kwamangqamuzana omdlavuza, i-pathologists ibheka izinto eziningi ukucacisa ukuthi ubuhlungu bubuhlungu kangakanani. Lokhu kufaka phakathi izinto ezifana nomsebenzi we-mitotic (ukuthi amangqamuzana omdlavuza ngokushesha avela kanjani uma ehlukanisa) uma kunqunywa ibanga lesifo.
- Uhlobo lomdlavuza - Ngomdlavuza wamaphaphu, kunezinhlobo ezimbili ezinkulu. Amangqamuzana angamancane amaphaphu amaphaphu ahlanganisa cishe amaphesenti angu-80 wamanqamu wamaphaphu namaseli anokubonakala okuthile ngaphansi kwe-microscope. Amagciwane amancane amaphaphu amaphaphu enza ingxenye enkulu yalokho okusele futhi abe nokubukeka okuhlukile ngaphansi kwe-microscope. Amanqamu angamancane amaphaphu amaphaphu ayahlukaniswa abe adenocarcinomas , ama-carcinomas amakhulu , kanye ne- squamous cell carcinomas kuye ngokuthi uhlobo lweseli umdlavuza uvelaphi, ukubonakala ngaphansi kwe-microscope, kanye nokuhlolwa kwebhu okubukeka kwamakaki athile (bheka ngezansi Iphuzu elididekayo kubantu abaningi lapho bebukeka umbiko wabo wokukhubazeka ukuthi izicubu azivumelani ngaso sonke isikhathi ngesigaba esisodwa noma esinye. Isibonelo, umbiko ungasho ukuthi isisu singumdlavuza omncane wamangqamuzana wamaphaphu nezinye izici zesifo somdlavuza omncane wamaseli weseli.
- E-Situ vs Infiltrating / Invasive - Enye inothi ongayibona embikweni wakho ukuthi i-tumor is in situ noma ingena ngaphakathi noma ingena. In situ ichaza umdlavuza okhona kuphela kumaseli lapho uqala khona. Ososayensi abaningi bacabanga ukuthi lezi zingqamuzana ezinamaqanda kunama cell cancer. Umdlavuza wegciwane otholakala kulesi sigaba ubhekwa njengesigaba 0. Iningi lesikhathi esinomdlavuza wamaphaphu isifo sikhuhlane sichazwa njengokungena ngaphakathi noma ukungena. Lokhu kusho ukuthi i-tumor isakaze ukudlula izicubu ezakhiwe ngaphakathi futhi unamandla okusabalalisa (ukufaka imithi) kwezinye izingxenye zomzimba. I-pathologists ingase ibone into okuthiwa yi-angiolymphatic invasion. Lokhu kuchaza ukuthi i-tumor iye yahlasela izitsha zegazi eziseduze kanye / noma izitsha ze-lymphatic.
- Ukubandakanyeka kwe-lymph node - Uma uye wahlinzwa ukukhipha isisu sakho, ama- lymph nodes angase asuswe ukuze abone ukuthi anesifo somdlavuza (esiphezulu) noma engenawo umdlavuza (angabi.) Lokhu kuzobekwa embikweni ngemininingwane efana nokuthi I-lymph nodes yayiseduze ne-tumor, noma ikude kakhulu, futhi ingase idlale ingxenye enkulu ekwelapheni i-oncologist yakho.
- Ukugxilonga - Ngezinye izikhathi isigaba sinikezwa njengengxenye yombiko wakho wezokwelapha. Ukuze unqume isigaba, i-pathologists ibheka inhlanganisela yesayizi sofuba, ukubandakanyeka kwe-lymph node, nokuthi ngabe isifo sofuba sisakaze kwezinye izingxenye zomzimba (noma yini esetshenzisiwe). Kunezindlela ezimbalwa umdlavuza wakho ongachazwa ngawo. Umdlavuza ongasona omncane wamaphaphu uhlukaniswe ngezigaba ezine eziyinhloko . Ukunquma lezi zigaba odokotela basebenzisa into ebizwa ngokuthi i- TNM stage . Ngalesi simiso T simele usayizi we-tumor, i-N imele ukuba khona kanye nenani lama-lymph nodes, futhi i-M imelela imitha elula. Ngomdlavuza omncane we-cell wamaphaphu kunezigaba ezimbili kuphela: isiteji esikhulu nesigaba esincane .
Amaprotheni / ama-Gene Markers
Kunezivivinyo eziningana ezengeziwe ezitholwa yi-pathologist ngesifo sakho sokudla ukuze usize ukuthi unjani uhlobo lomdlavuza wamaphaphu, noma ngabe isisu sakho empeleni ngumdlavuza owavela kwenye ingxenye yomzimba wakho futhi usakazeka emaphashini akho. Izibonelo ezimbalwa zalezi zihlanganisa TTF-1, p63, CD56, ne-chromogranin.
Ukufometha kwamakhemikhali
Muva nje, intuthuko yenzeke ekwelapheni umdlavuza wamaphaphu ngokuqonda ukushintshashintsha kwezakhi zofuzo ezenza "ukushayela" ukukhula komdlavuza. Kubantu abathile, ikakhulukazi abantu abane-adenocarcinoma, okuhloswe ngayo ukwelashwa kuyatholakala ukuphatha lesi sifo esivame ukuba nemiphumela emibi kakhulu kunokwelashwa kwemithi ejwayelekile. Izinguquko ezivamile ezivivinywa zihlanganisa i- EGFR , i-KRAS, i- ROS1 , ne- ALK . Manje kunconywa ukuthi abantu abanomdlavuza we-cell wamaphaphu okungewona omncane bahlolwe ngalezi zinguquko- kodwa ukutadisha kwakamuva kwaphakamisa ukuthi amaphesenti angu-60 kuphela we-oncologists okwamanje enza kanjalo.
Ukuxilongwa
Ingxenye yokugcina yombiko wokukhubazeka i-diagnostic lapho i-pathologist efingqa khona lokho okutholakele. Lokhu kuzovame ukufaka uhlobo lomdlavuza, ibanga (ukuthi lihlukaniswe kanjani,) ngabe ngabe yiziphi izilonda zelinfo ezihle, nesiteji.
Okulandelayo
Uma usanda kuthiwa unomdlavuza wamaphaphu, hlola lezi zinyathelo zokuqala ukuthatha , cabanga ngemibono yesibili , futhi njalo ubuze imibuzo eminingi. Ungalokothi uzizwe uthatha isikhathi esiningi somdokotela wakho-ukuthi 'lokho okukhokhelwe. Uma imibuzo yakho ingaphenduliwe ngokwanele, thola udokotela ongayiphendula.
Imithombo:
I-National Cancer Institute. FactSheet. Imibiko ye-Pathology. Kubuyekezwe 09/23/10.