Izindlela Zokubika Zakhe Nezibikezelo Zokubikezela
Ukuphefumula kwakhe ukuhlolwa kwezicubu ezivela emzimbeni ngaphansi kwe-microscope ukubona izibonakaliso nezici zezifo. I-Histology yilokucwaninga kwezicubu, futhi ukukhubazeka ukuhlola izifo.
Ngakho-ke ukuhlanganiswa kwakhe ngokweqile kusho ukuthi ukutadisha kwezicubu kuhlobene nezifo. Umbiko wezemvelo uchaza izicubu ezithunyelwe ukuze zihlolwe kanye nezici zalokho umdlavuza ubukeka ngaphansi kwe-microscope .
Umbiko othile wezinye izikhathi ubizwa ngokuthi umbiko we-biopsy noma umbiko we-pathology.
Umbiko Wakhe Wezintambo
Udokotela ochwepheshe owenza ucwaningo ngaphansi kwe-microscope ubizwa ngokuthi i-Pathologist. Amathishu afundiswayo avela ku-biopsy noma inqubo yokuhlinzeka lapho isampula yamathishuso asolwa khona futhi sithunyelwa ebhokisatri. Ibuye isetshenziswe iphinde ibe yizingxenye ezincane kakhulu (ezibizwa ngokuthi izigaba), zihlanjululwe futhi zihlolwe ngaphansi kwezinto ezincane ukuze ziveze imininingwane yamaseli asezicubu. Kwezinye izifo, udokotela ohlinzayo angathola isampula yamathambo ahunyushwa ngokushesha kakhulu ngokusebenzisa ukusetshenziswa kwezigaba ezibandisiwe. Izigaba ezinamafutha noma izintwana zisetshenziswa kancane kancane e-lymphoma, noma kunjalo, ngenxa yezingqinamba ekuchazeni nasesampula. E-lymphomas, i- lymph nodes yizona izicubu ezivame ukuhlolwa ekuphefumuleni kwakhe. Ngezinhlobo eziningi zegazi lamangqamuzana egazi, i-bone marrow biopsy nayo ingadingeka ukuze ihlolwe ngokucacile.
Izingxenye zoMbiko
Imibiko ye-histopathology yemifanekiso yesifo somdlavuza ihlinzeka ngokwengeziwe. Zingafaka:
- Ukubukeka okuncane kakhulu kwezicubu ezihilelekile
- Izithako ezikhethekile
- Izindlela ze-molecular
- Okunye ukuhlolwa
Amasu amakhemikhali abhekisela ekutheni ahlaziye amangqamuzana nezicubu ezingxenyeni zamangqamuzana, ezisezingeni lamaprotheni, ama-receptors , kanye nezakhi zofuzo ezibeka lezi zinto.
Ukuhumusha Umbiko
Eziningi ezitholakala ekuhlolweni kwezicubu zixhunyaniswa nokubikezela. Izinkomba zokubikezela zingafaka ibanga lesisindo kanye nesilinganiso sokusabalalisa, nokuthi ngabe umdlavuza ususiwe noma umkhawulo wamangqamuzana aphilile owuzungezile, noma uma kukhona ubufakazi bokuthi umdlavuza usakaze ngaphezu kwalokho okwakususwe.
Izinhlelo zokuqoqa ziyahlukahluka kuye ngokuthi uhlobo lomdlavuza lubekwe kanjani, kepha ngokuvamile amaseli anikezwa ngokusekelwe kokungajwayelekile ngendlela ebonakalayo ngaphansi kwe-microscope, ne-Grade 1 izicubu zibheke ngokujwayelekile nezibuko zeBanga 4 ezibonisa okungavamile. Ngakho-ke, isisu esiphakeme kakhulu, ngokuvamile, lapho amangqamuzana anesimo esingavamile. Ukubamba akufani nokugijima. Ukugxila kunomsebenzi omkhulu lapho umdlavuza utholakala khona emzimbeni nokuthi usakaze kangakanani.
Izincazelo zeMolomu nezinye Izindlela Zokutadisha
Ngaphezu kwalokho, ezinye izindlela zingase zisetshenziselwe ukuhlola ukuba khona komdlavuza kuzicubu, kufaka phakathi ama-asple aspiration cytology, kanti ezinye zalezi zindlela zingase zisetshenziswe kakhulu ezindaweni zokunakekelwa kwezempilo emhlabeni jikelele. Ama-leukemia ne-lymphomas atholakala esebenzisa inhlanganisela yokubukeka kwabo-ukuthi amangqamuzana abukeka kanjani (ama-morphology), amamaki abo noma amaprotheni angaphezulu angatholakala uma usebenzisa izivivinyo zama-antibody (immunophenotype), ama-enzyme awo angenza ukuthi ezinye izimo zamakhemikhali zenzeke (i-cytochemistry), kanye nezinguquko zabo ze-chromosomal (karyotype).
Izikhathi eziningi ezithombeni ze-lymphomas nezinye izifo zomshukela , inqubo okuthiwa i- immunohistochemistry isetshenziselwa ukuhlola uhlobo lwe-tumor, ukubikezela kanye nokwelapha. I-Immunohistochemistry ihilela ukusebenzisa ama-antibodies ukuze anamathele kumathegi athile noma amanothi ngaphandle kwamangqamuzana omdlavuza.
Lezi zimpawu ukuthi ama-antibodies anamathela njalo "ane-CD" egameni lawo, elimelela iqoqo lokuhlukanisa. Isibonelo, i-CD23 ne-CD5 yimiyalezo encane ukuthi, uma ikhona emangqamuzaneni omdlavuza, ingase isekele umbono wokuthi i-lymphocytic leukemia (CLL) / encane ye-lymphocytic lymphoma (SLL) isifo esitholakalayo. Lezi zimpawu ezifanayo zikhona nakweminye imilingo, kodwa-ke, ngakho odokotela basebenzisa uhlobo lwenqubo yokuqothula ngokusekelwe kolwazi olutholakalayo nokuthi yini eyaziwa ngezindlela ezihlukahlukene zokuhlukunyezwa kanye nama-CD "ajwayelekile".
Esinye isibonelo se-CD marker yi-CD20, ekhona kwezinye izilonda kodwa engekho kwezinye. Ukusakaza i-larrge B cell lymphoma, noma i-DLBCL, i-lymphoma ejwayelekile kakhulu ehambisana ne-CD20 marker.
Ukuze uthole isampula esinikeziwe yamaseli e-leukemia noma i-lymphoma, amakaki angahlolwa ngokusebenzisa iphaneli lonke lama-antibodies anamathele kumakaki ahlukene, ngokulawula okuhle nokubi, okwakhiwe kuwo.
Ucwaningo lwama-molecular ne- chromosomal lungenziwa ukubuka ukulungiswa kabusha kwezakhi kanye nezinguquko ezithile kuma-chromosomes. Ngezinye izikhathi kufakwe noma kususiwe izakhi zofuzo zixhunyaniswa nolwazi mayelana nokubikezela. Ngokwesibonelo, ku-lymphocytic leukemia, noma i-CLL, isakhi esithile se-chromosome ilahlekile, futhi kaningi izikhathi ezilahlekile kanye nayo yisisindo esiza ukucindezela umdlavuza. Ukususwa kwe-17p kutholakala kumaphesenti angaba ngu-3 kuya kwangu-10 abantu abane-CLL, jikelele. 17p ukususa CLL uhlobo lwe-CLL oluyinkimbinkimbi yokwelapha; Abantu abane-CLP yokukhishwa kwe-17p kunzima ukuphatha nge-chemotherapy evamile.
Imithombo:
Ho C, i-Rodig SJ. Izimpawu ze-immunohistochemical in malignancies lymphoid: Amaprotheni correlates ezinguquko zamangqamuzana. Ama-Seminar ku-Disagnostic Pathology . 2015. 32 (5): 381-91.
Ukubika Kwakhe Kwemvelo: Iziqondiso Zomdlavuza Wokuhlinzeka. NguDerek C Allen. I-Springer Science & Business Media, Juni 29, 2013.
> Taylor J, Xiao W kanye no-Abdel-Wahab O. Ukuhlonza nokuhlukaniswa kwezinhlungu ze-hematologic ngesisekelo sezakhi zofuzo. Igazi . 2017 Jul 27; 130 (4): 410-423.