Uma uzobe uhlinzwa ngenxa yomdlavuza wesifuba , udokotela wakho ohlinzayo angase ancoma ukuthi une-nodeinel node biopsy ngesikhathi esifanayo. Le nqubo yenziwa ukuze unqume ukuthi umdlavuza wakho ungase usakaze ngaphesheya kwesifuba sakho kumagciwane akho lymph. Njengoba izincomo zokwelapha ziyahlukahluka ngokuthi ngabe ama-lymph nodes akho angalungile noma ayenayo ama-metastases (ukusakaza) lokhu kuyilingo olubalulekile.
Yini ongayilindela ngesikhathi sakho se-sentinel node biopsy futhi imiphumela yisho ukuthini? Masithathe isinyathelo ngesinyathelo bheka lokhu kuhlolwa.
Ukuhlolwa Okubalulekile Kokuhlola
I-nodeinel node biopsy yinkqubo yokuhlola yokuhlinzwa eyenziwe ukususa isampula encane ye-lymph nodes ukuze ihlolwe ngamaseli omdlavuza webele. Ama-node we-sentinel yi-lymph nodes yokuqala umdlavuza webele uzolindeleke ukuba usakaze, futhi uhlolwe ukubona ukuthi umdlavuza wakho usakaze ngaphesheya kwesisu sakho sangempela.
Uma kungekho okunye ukuhlinzwa okwenziwa ngesikhathi esifanayo, lokhu kuyindlela yokwelapha futhi kubalulekile ekumenikeni komdlavuza wakho webele . Uma une-lumpectomy noma i-mastectomy, i-reninel node biopsy ingenziwa kanye nale nqubo. Ukulinganisa okulungile, kuzokusiza wena nodokotela wakho ukhethe okukhethwa kukho okungcono kakhulu ukwelashwa noma umdlavuza wakho webele.
Izinyathelo Ezibandakanyekile
Kunezinyathelo eziningana ezihilelekile ukuze uthole ukuthi iyiphi i-lymph nodes eyizinombolo zakho ze-sentinel, ziphawule ngale ndlela, bese uhlola lawa magama.
Yonke inqubo ithatha amahora amaningana kusukela ngesikhathi ufika kuze kube nesikhathi unayo imiphumela yakho. Nazi izinyathelo ongazilindela.
Ukuqala Ngomfanekiso Wezokwelapha
Ngaphambi kwenqubo yakho, udokotela wakho ohlinzayo uzodinga ukwazi indawo kokubili isisu sakho namagciwane we-sentinel. Inhlanganisela yezindlela zokucabanga zizosetshenziselwa ukuthola nokubeka lezi zindawo ngaphambi kokuhlinzwa.
Ukuthola i-Tumor
Uzoya eMnyangweni wezeMithi weNyukliya esibhedlela noma emtholampilo lapho kuzodingeka khona i-sentinel node biopsy. Njengombana ungathanda ukuthoma i-mammogram noma i-breast ultrasound, uzokugodla kusukela ekhondweni, bese ubeka ingubo yesibhedlela. Okulandelayo, uzolala phansi etafuleni lokuhlola. Uchwepheshe we-radiology uzosebenzisa umshini we- ultrasound ukuthola isisu sakho. Isayithi lesisu lizobekwa uphawu esikhumbeni sakho, ngakho-ke udokotela wakho ohlinzayo angayithola kalula.
I-Anesthesia ne-Injection YeDeyi ne-Tracer
Udokotela wezokwelapha noma ochwepheshe bezokwelapha zedikliya uzodonsa indawo phezu kwesisu sakho sebele. Lokhu kungenziwa nge-topical lidocaine patch (njengoba lokhu kuyindawo enethenda kakhulu) okulandelwa umjovo we-lidocaine esifubeni sakho. Uma usunomkhuhlane ngokwanele, uzofaka inja epholile emsakazweni (i-technetium-label-sulfur colloid) kanye nedayi elihlaza okwesibhakabhaka (i-isosulfan eluhlaza okwesibhakabhaka) endaweni yesisu. Umjovo uthatha isikhathi eside kunomkhuhlane odutshulwa ngokuvamile futhi ungadinga izijovo eziningana. Ngamanye amazwi, ungase ufise ukubuza ngokujulile imishanguzo engaphelele ngisho noma ucabanga ukuthi iyobekezelela kakhulu.
I-Lymph Node Mapping
Uma usujojwe, ama-dyes adinga isikhathi sokuhamba kusuka kusayithi lakho le-tumor kuya kuma-lymph nodes akho. Ngesinye isikhathi endaweni yomzimba, ama-dyes kufanele athathwe yiziteshi ezincane zellymatic eziya ezitokisini ze-lymph.
Uzochitha isikhathi esithile egumbini lokulinda eliseduze, ngakho ulethe izinto ezithile zokufunda noma umculo. Lapho ama-dyes afinyelele endaweni abaya kuyo, ucelwa ukuba ubuyele eMnyangweni Wezokwelapha eNyukliya bese ulala phansi etafuleni lokuhlola futhi. Ucwaningo lokucwaninga (lymphoscintigraphy) luzokwenziwa ukukhombisa ukuthi yikuphi ukuhlukumeza kwama-lymph nodes okwamukela ama-dyes, futhi lokho kubonisa ukuthi i-lymph node yakho ye-sentinel izotholakala kuphi. Uchwepheshe uzobeka le ndawo esikhumbeni sakho, ngakho udokotela wakho ohlinzayo uzokwazi ukuthi uzoqala kuphi.
Ukususa i-Sentinel Lymph Node
Uzolethwa egumbini lokusebenza, lapho udokotela wakho ohlinzayo uzobe esilungele ukuqala ngemva kokuba unikezwe isifo sokubulala umzimba .
Udokotela ohlinzayo uzosebenzisa isofthiwe esabanjwa ngesandla ukuze athole i-lymph nodes equkethe idayi enomsakazo kakhulu. Kuleyo ndawo, udokotela wakho ohlinzayo uzokwenza ukukhwabanisa okuncane, futhi ubheke ama-lymph nodes ayenziwe ngombala obuluhlaza okwesibhakabhaka. Amanothi amathathu kuphela azosuswa ngaphandle kokuthi amanye amaningi athathwe. Lezi zinombolo zithunyelwa emnyangweni wezokwelapha, lapho zihlolwa khona nge- metastasis ne- micrometastasis . Ukukhokha kwakho kuzovaliwe futhi kugqoke, futhi uzoyiswa ekubuyiseleni.
Ukuhlola ku-Pathology
Ngesinye isikhathi ebhodini lokugula, ama-node akho azohlolwa ngomdlavuza. Ngezinye izikhathi udokotela wakho ohlinzayo uzohlelela ukuhlolwa kwesigaba seqhwa ama-node, ukuze uthole imiphumela khona ngaleso sikhathi. Uma ama-node akho anama-cancer amangqamuzana, ungase ube ne-lseph node dissection egcwele ngokushesha, ukuze uthole ukugcwele kokubandakanyeka kwe-lymph node. Uma isigaba esiqhwaziwe singalawulwa, futhi ama-node akho aqukethe umdlavuza, i-dissection egcwele i-lymph node ingenziwa ngokuhamba kwesikhathi.
Ukubuyisela kusuka ku-Yourininel Node Biopsy yakho
Uma idayi eluhlaza okwesibhakabhaka isetshenziselwa ukuthola i-lymph node yakho ye-sentinel, lindela ukubona idayi eluhlaza okwesibhakabhaka emcini wakho cishe amahora angu-24. Ngezinye izikhathi kuyoba nokunye okudayayo nokuluhlaza okwesibhakabhaka esikhumbeni esizungeze ukuqubuka. Uyothola ukugqoka kanye ne-sutures ukuze uhlale owomile futhi ungadinga imithi yobuhlungu kuze kuqale ukuphulukiswa. Sebenzisa ingalo yakho yokuhlinzwa ngokucophelela (akukho ukuphakamisa!) Okungenani ngesonto ngemuva kwenqubo. Amabala avela eluhlaza okwesibhakabhaka ayokwehlisa futhi izivuno zakho zizophulukisa; ukucubungula ngokwayo kuzokwenyuka kulayini omuhle ngokuhamba kwesikhathi.
Ukuthola Imiphumela Yakho Yezinkinga
Udokotela wakho ohlinzayo noma i-oncologist uzokubiza ngemiphumela ye-biopsy ngokushesha nje uma udokotela wezokwelapha eseqedile ukuhlaziywa kwakhe. Lo mbiko uzofaka ulwazi lokuthi zingaki, uma zikhona, izilonda zine-lymph nodes ziqukethe amangqamuzana omdlavuza. Cela ikhophi yombiko wakho wezempilo futhi ugcine ngamarekhodi akho wezempilo. Uma i-node iqukethe umdlavuza, itholakala ukuthi inhle, futhi uma kungekho mdlavuza itholakale ku-node, itholakale ingabi nhlobo. Ukuxilongwa kwezitho zomzimba zomshoshaphansi kusho ukuthi umdlavuza wakho usakazekile (umonakalo) ngaphandle kwe-tumor yangempela. Le miphumela izophazamisa isiteji kanye nokwelashwa okudingekayo ukuphatha umdlavuza wakho webele.
Uma sikhuluma ngama-metastases kuya kuma-lymph nodes lokhu akusho ukuthi umuntu unomdlavuza we-metastatic. Eqinisweni, izibeletho zesifuba zokuqala zesigaba 1A zingaba ne-micrometastases kuma-lymph nodes. Ukusakazeka komdlavuza webele ku-lymph nodes akusho ukuthi unomdlavuza webele wesisu, kodwa kuphela ukuthi isisu sakho sibonise "inhloso" yokusakazeka ngaphezu kwebele ne-lymph nodes.
Izingozi nemiphumela emibi
Iningi lemiphumela emibi ye-sentinel node biopsy ayincane. Kungase kungakhathazeki uma idayi noma i-tracer ifakwe. Inqubo ingafaka futhi kuze kube amahora amaningana kuze kube usuku olugcwele olugcwele lwekhanda lakho lomdlavuza webele.
Izingozi ezikhona zenkambiso zibandakanya i-lymphedema kanye nobungozi bokungalungi okungamanga. Lokhu kuxoxwe kabanzi lapha.
Lymphedema
Umphumela ovamile we-lymph node dissection egcwele yisimo esibizwa nge- lymphedema . Ngenxa yokuthi ama-lymph nodes endaweni yakho yokuphuza ayitholakali, i-lymph fluid evame ukusetshenzwa lapho ingakha futhi ibangele ukuvuvukala. Uma lokhu kuqhubeka noma kwanda, kungaba buhlungu. Kodwa-ke, uma udinga kuphela i-sentinel node biopsy, uzobe usenezinombolo ezanele zokuphatha i-lymph fluid ehamba ngesifunda sakho se-armpit, ngakho izinga le-lymphedema kuleso simo, lingamaphesenti amahlanu kuphela. Eqinisweni, okuningi kwesizathu esenza ukwenza ama-biopsies we-sentinel node esikhundleni sokwehlukana kwe-lymph node egcwele ukugwema i-lymphedema uma kunokwenzeka.
Amanga Amanga
Ama-lymph nodes angahluka ngobukhulu, amanye amancane njengenhloko ye-pin, enye inkulu kunebhontshisi. Udokotela wakho ohlinzayo uzobe ezingela ngesikhumba namanoni, efuna ama-node aluhlaza okwesibhakabhaka, futhi kumele asebenzise ikhono nokwahlulela. Kungenzeka ukuthi i-node sentinel izohlola okungalungile (ecacile yomdlavuza), kodwa umdlavuza ungase ube kwezinye izitho zomzimba. Lokhu kubizwa ukuthi kukhona okungalungile. Ukukuvikela emiphumeleni yamanga, amaqembu akho okuhlinzeka nokuhlinzwa azolandela imihlahlandlela eqinile, futhi uma imiphumela ikhona kunoma yikuphi ukungabaza, ama-node amaningi azosuswa futhi ahlolwe, ukuqinisekisa ukuthi imiphumela enembile.
Ngaphansi
Ukuba ne-biopsy ye-sentinel ye-node idinga izinyathelo eziningana futhi ungase uzibuze ukuthi kungani yonke imizamo iyadingeka. Ukukhetha ukwelashwa okungcono kakhulu kumdlavuza wesifu kudinga isiteji esinembile, futhi ukuchaza ngokunembile umdlavuza webele kudinga ukuthi ngabe noma yimuphi umdlavuza usakazeke kuma-lymph nodes. Ngaphezu kwalokho, sinquma ukuthi noma yikuphi ukubandakanyeka kwe-lymph node kunamacrometastase noma i-macrometastases kanye. Usuku lwe-biopsy yakho lungase lubonakale lude, kepha imiphumela izoba yinto ephawulekayo ezinsukwini nezinyanga ezizayo.