Enye indlela yokuqonda kangcono ukuxilongwa kwakho kwe- melanoma futhi isulelo sokwelashwa okuholela ekutheni ufunde umbiko wakho we-melanoma pathology, othunyelwa kudokotela wakho futhi uqukethe ulwazi olubucayi njengezinga eliqondile lesifo sakho. Le yingxenye yokuqala yochungechunge lwezihloko ezizokusiza ukuthi uqonde imenyu yezobuchwepheshe kule mibiko.
Ukuhlola okujwayelekile
Uma i-lesion esolisayo noma imvukuzane itholakala ngesikhathi sokuhlolwa kwesikhumba , udokotela wakho oyinhloko noma udokotela wezempilo uyothatha isampula ye- biopsy ye-pathologist (udokotela ohlola izicubu namanzi okuhlonza izifo ukuze asize ekwenzeni izinqumo zokwelashwa ) ukuhlola ngaphansi i-microscope.
Uma udokotela wezinambuzane ethola amangqamuzana amancane (kanomdlavuza) e-biopsy, udokotela wakho oyinhloko ungayala ezinye izivivinyo - i-lymph node, igazi, umchamo kanye nokuhlola izithombe - ukuthola ukuthi ngabe umdlavuza usakazeke noma cha. Lezi zivivinyo zisiza i-pathologist ukuthi ihlole indawo, isakaze, nesigaba se-melanoma. I-pathologist ibheka udokotela wakho wokunakekela oyinhloko ngemuva kokubukeza imiphumela yokuhlola nokunquma isigaba somdlavuza. Kanye, banquma izinketho zokwelapha ezifanele kakhulu isimo sakho.
I-Mitotic Rate
Umbiko wakho we-pathology uqukethe ulwazi, njenge-tumor stage, i- Clark level , ubukhulu obuseduze , isilonda (kwenzeka lapho i-melanoma iphuma esikhumbeni) kanye nomthamo we-mitotic (MR).
Izinga eliphakeme le-mitotic libuye lihlobanise nethonya elikhulu lokuthola i-sentinel lymph node biopsy enhle.
UMongameli ulinganiswa ngokumane nje ahlole isisu esicacile (esasuswe ngokuhlinzwa) nge-microscope futhi ngesandla ngokubala inani lamaseli abonisa i- mitosis , isici esibonakala kalula sokuhlukanisa amaseli.
Ngokuvamile, i-MR ibikwa njengenye yezinhlobo ezintathu (nakuba ngezinye izikhathi zibalwe njengenombolo eqhubekayo, engahlukaniswanga):
- ngaphansi kuka-1 ngehora elilodwa lemitha
- 1 kuya ku-4 ngamakhilomitha ayi-square
- ngaphezulu kuka-4 ngamakhilomitha angama-square
Ukuphakama kokubalwa kwamamitha, cishe isifo sofuba kufanele sibe nesisindo (ukusakaza). I-logic yilapho amangqamuzana amaningi ehlukanisa, cishe azohlasela izitsha zegazi noma ze-lymphatic futhi ngaleyo ndlela asakaze emzimbeni.
Ucwaningo luye lwabonisa ukuthi izinkinga zokusinda iziguli ezine-melanoma yesigaba kanye nesilinganiso samamitha angu-0 nge-square millimeter ayizikhathi eziyishumi nambili zeziguli ezinezibalo ezingaphezu kuka-6 ngamakhilomitha angama-square. Futhi, kuphela ama-4% wezilonda ezine-MR ephansi (ukubuya) eziqhathaniswa nama-24% walabo abaneM MR ephakeme. Izinga le-mitotic lingasiza futhi ukubikezela ukuthi ngabe i-sentinel lymph node biopsy izoba yinto enhle noma cha.
Ingabe Ukulinganisa MR Kufanele?
Kusukela ngo-1990, izifundo eziningi ziye zaqinisekisa ukuthi izinga le-mitotic liwuphawu oluphawulekayo lwemiphumela kwiziguli ezine-melanoma, nakuba kunezingxabano ezikhona. Izimpikiswano ezimbili zingaphansi kwengxabano: 1) UM MR ozimele kwezinye izici zokubikezela ? futhi 2) uma kungenjalo, ukulinganisa uM MR kufanele isikhathi kanye nezindleko?
Nakuba uM MR engenawo indima ohlelweni lwamanje lwe-melanoma, ucwaningo luye lwabonisa ukuthi liyisici esibaluleke kakhulu kunokwesilonda, okubaluleke kakhulu emasimini. Kodwa-ke odokotela bakholelwa ukuthi isilinganiso se-mitotic asiyona into yokuzimela eyimfihlo ngenxa yokuthi ihlobene eduze ne-tumor (Breslow) ubukhulu nesilonda. Isibonelo, i-American Academy of Dermatology ithi iMM kufanele ibe yinto ekhethwayo emibikweni ye- biopsy . Ngakolunye uhlangothi, Isikhungo Sikazwelonke Somdlavuza Wezandulela Ngculaza sincoma ukuthi uM MR kufanele abikwe ngazo zonke izilonda ezigulini ze-I kuya kwezingu-II.
Noma kunjalo, abanye ochwepheshe bathi ukulinganisa i-MR kufanele kwenziwe kuphela ezikoleni ezinkulu zezokwelapha (izinyuvesi) ngezinjongo zokucwaninga zesikhathi esizayo. Uma uMRI engekho embikweni wakho wezempilo, qiniseka ukubuza udokotela wakho mayelana nokucabanga kwakhe.
Isiphetho
Njalo ucele ikhophi yombhalo wakho wezokwelapha. Yifunde bese ubuza udokotela wakho imibuzo ngakho. Unganqikazi ukuthola umbono wesibili mayelana nokuxilongwa kwesazi, njenge-dermatopathologist. Isiguli esinolwazi yisiguli esinamandla, futhi isiguli esinikezwe amandla singenza ukhetho olungcono lwezokwelapha oluholela emiphumeleni engcono.
Okuningi mayelana nendlela yokuchaza uMbiko wakho we-Melanoma Pathology
Imithombo:
I-Melanoma. I-National Comprehensive Cancer Network. V1.2009.
Ukuqonda Ukuthola I-Cancer: I-Skin Melanoma. I-College of American Pathologists.
I-Attis MG, i-Vollmer RT. "Isibalo sama-mitotic ku-melanoma: ukuhlolwa kabusha." Am J Clin Pathol 2007 127 (3), 380-4.
Barnhill RL, Katzen J, Spatz A, Fine J, Berwick M. "Ukubaluleka kwezinga le-mitotic njenge-prognostic factor for melanoma yangaphakathi." J Cutan Pathol 2005 32 268-273.