M'mbuyomu, odwala sankadziwa zolemba za kansa yawo. Koma masiku amenewo, zikondwerero, apita. Anthu ambiri akupempha makope awo achidziwitso cha zachipatala, ndipo malo ena opatsirana khansa amapereka chipatala cha odwala chimene chirichonse kuchokera ku radiology chimafika kwa mabala angakhoze kupezeka pa intaneti. Koma pazochitika zonsezi, malipoti a kansa yamapapo amatha kukhala chimodzi chovuta kwambiri kuti adziwe ngati munthu wamba.
Kotero ndiyesera kufotokoza zina za mankhwala kuti ndikuthandizeni kumvetsa lipoti lanu.
Kodi Ndondomeko Yabwino Kwambiri Ndi Chiyani?
Lipoti la matenda ndizofotokozera za khansara yanu ndi wodwala matenda, pambuyo pofufuza minofu yotengedwa mthupi lanu kudzera mu chiopsezo kapena opaleshoni. M'malo molemba inde kapena ayi (kodi ndi khansa?) Malipotiwa akhoza kutenga zambiri zomwe sizikuthandizani dokotala wanu kumvetsa zomwe mukuchita koma njira yabwino kwambiri yothandizira. Izi zikuti, mauthenga okhudza matendawa sagwiritsidwa ntchito payekha koma m'malo mwake akuphatikizidwa ndi mbiri, kuunika kwa thupi, maphunziro a radiology, ndi maphunziro a labu kuti apeze chithunzi chabwino cha khansara yanu.
Zolembedwa zingapo zimathandiza musanapitirize. Imodzi ndi yakuti khansara iliyonse ndi yosiyana. Ngati kuli anthu 30 omwe ali ndi kansa ya m'mapapo mu chipinda, padzakhala mitundu 30 ya khansa ya m'mapapo. Lipoti la matenda ndi chimodzi mwa zipangizo zomwe zimagwiritsidwa ntchito pomvetsetsa khansa yanu.
Mfundo ina yofunika ndi yakuti ngakhale kuti kawirikawiri kupeza maganizo achiwiri (kapena mwina atatu kapena ochuluka) okhudzana ndi khansa yanu, kafukufuku wanu wachiwiri angayambe kunyalanyazidwa. Kupeza lingaliro lachiwiri pa zovuta zanu kungakhale kofunika kwambiri poti mutenge lingaliro lachiwiri pa mankhwala anu.
Dzina, Tsiku, ndi Zachidziwitso Chachipatala
Lipoti lanu la matenda lidzaphatikizapo dzina lanu, ndi zina zowonjezera komanso zizindikiro zomwe mungathe kuziwona komanso zizindikiro zomwe mwakhala mukukumana nazo.
Zitsanzo
Mawu akuti specimen amawoneka owopsya, koma kwenikweni amatanthauza zitsanzo za minofu zomwe dokotala wa opaleshoni, wa radiologist, kapena dokotala wina amachotsa. Chigawo ichi chikufotokozera malo omwe thupi lawo linatengedwa. Ngati pulojekiti imapezedwa ndi kulandizidwa ndi dokotala wogwira ntchito, imayesedwa mu zochepa.
Kuyeza Kwambiri (kumatchedwanso Gross Examination)
Monga "macro" amatanthawuza zazikulu, ndipo "chokwanira" muzogwiritsira ntchito zachipatala zimatanthauza kuwonetseredwa ndi diso lakuda, kufufuza uku kumatanthawuza zomwe wodwalayo amachiwona poyang'ana zitsanzo zanu popanda kugwiritsa ntchito microscope-chithunzi chachikulu makamaka. Zingaphatikizepo miyeso, kulemera kwa chotupa, ndi zizindikiro zina monga mtundu ndi kusagwirizana. Matenda ena amadziwika bwino (monga chithunzi pamwambapa chikuwonetsa) koma nthawi zina palibe zosaoneka zomwe zimawonekera mpaka sitepe yotsatira ikuchitika.
Kuyeza kwa Microscopic
Pambuyo poyang'ana zitsanzo za minofu yanu, odwala nthawi zambiri amatenga magawo oonda omwe amawunika pansi pa microscope. Izi nthawi zina zimakhala zowonongeka (pofuna kuyika minofu kwambiri kwambiri) ndipo akhoza kuthandizidwa ndi tepi yapadera kapena zinthu zina asanaikidwe pazithunzi. (Njirayi ikhoza kutenga nthawi komanso chifukwa chimodzi chomwe dokotala wanu sangakhale nacho pamene mukuyembekezera mwachidwi.) Pali zigawo zingapo zofunika kwambiri zomwe zimabwera kuchokera ku mayeso awa:
- Mitsempha yotupa - Chidziwitso chimodzi chodziwika ndi za mitsempha ya m'mimba (kapena mapiritsi opanga opaleshoni.) Izi zikutanthauza ngati khansara yonse idachotsedwa, ndipo ngati zonse zitachotsedwa, kutali ndi malo otulutsirapo panali umboni wa khansa. Mwachitsanzo, lipoti likhoza kunena kuti chotupacho chinapitirira 1.2 masentimita kuchokera kumalo opaleshoni.
- Kugonjera kalasi - Mimba imatha kukhazikitsidwa ndi chiwerengero cha mimba. Chosavuta kwambiri chotupa cha 1 chikhoza kukhala chosakwiya, ndipo chotupa chachitatu chikanakhala chowawa kwambiri. Ndi khansara yamapapu, lipoti lanu likhoza kukhala ndi mawu osiyana kwambiri, osamvetsetseka, kapena osayanjanitsika. Matenda osiyanitsa bwino amayamba kukula pang'onopang'ono, pamene matenda osalimba amakula kwambiri mofulumira. Kuphatikiza pa maonekedwe a maselo a kansa, akatswiri a zachipatala amayang'ana zinthu zambiri kuti adziwe momwe chifuwa chimakhalira. Izi zikuphatikizapo zinthu monga mitotic zochita (momwe maseĊµera a khansa akuwonekera akugawikana) pakuwona kuwerengeka kwa chotupa.
- Mtundu wa kansa - Ndi khansa yamapapu, pali mitundu iwiri ikuluikulu. Mankhwala osakanikirana a maselo amatha kukhala pafupifupi 80 peresenti ya khansa ya m'mapapo ndi maselo ali ndi mawonekedwe ake pansi pa microscope. Maselo ang'onoang'ono a mapangidwe a khansa amapanga zambiri mwa otsala ndipo amakhala ndi mawonekedwe osiyana pansi pa microscope. Mankhwala osaphatikizapo maselo am'kati amagawanika kukhala adenocarcinomas , lalikulu cell carcinomas , ndi squamous cell carcinomas malingana ndi mtundu wa selo khansara inachokera, mawonekedwe pansi pa microscope, komanso mayesero a lab omwe amayang'ana zizindikiro zina (onani pansipa .) Kusokoneza maganizo kwa anthu ambiri pamene akuyang'ana kafukufuku wawo ndikuti ziwalo sizingagwirizane bwino mu gulu limodzi kapena lina. Mwachitsanzo, lipoti likhoza kunena kuti chotupa ndi kansa yaing'ono ya mapapu ya mapapu ndi zina za kansa yaling'ono ya m'mapapo.
- Mu Situ vs Infiltrating / Invasive - Chinthu china chomwe mungaone pa lipoti lanu ndi chakuti chotupa chiri mu situ kapena kuti chimalowa kapena chosokoneza. In situ ikufotokoza khansara yomwe ilipo mu maselo kumene idayambira. Asayansi ambiri amaona kuti izi ndi maselo osakanikirana osati maselo a khansa. Khansara ya m'magazi yomwe imapezeka pa sitejiyi ikuonedwa ngati gawo lachitatu. Nthawi yochuluka ya khansa ya m'mapapo chifuwa chimatanthauzidwa kuti chimalowa kapena chosasintha. Izi zikutanthauza kuti chotupacho chafalikira kupyola minofu yomwe idapangidwira ndipo ili ndi mphamvu yofalitsa (kuchepetsa mphamvu) kumbali zina za thupi. Akatswiri odwala matenda a chifuwa amatha kuzindikira chinthu china chimene chimatchedwa kuti angiolymphatic invasion. Izi zimatanthawuza ngati chotupachi chasokoneza mitsuko yapafupi ndi / kapena mitsempha ya mitsempha.
- Kuphatikizika kwa minofu - Ngati mwachitidwa opaleshoni kuchotsa zotupa zanu, ziwalo zankhaninkhani zikhoza kuchotsedwa kuti ziwone ngati zili ndi khansa (zabwino) kapena zopanda khansa (zoipa) Izi zidzatsimikiziridwa mu lipoti ngati Zilonda zam'mimba zili pafupi ndi chotupacho, kapena kutali kwambiri, ndipo zingatengere mbali yaikulu pa chithandizo chanu cha oncologist.
- Kuyendetsa - Nthawi zina siteji imaperekedwa monga gawo la kafukufuku wanu. Pofuna kudziwa malo, odwala amatha kuyang'ana kuphatikizapo chotupa kukula, kutengeka kwa mitsempha, komanso ngati chotupacho chafalikira kumbali zina za thupi (kuchepetsedwa). Pali njira zingapo zomwe khansara ikhoza kufotokozera. Khansara yaling'ono yopanda maselo imagawidwa mu magawo 4 oyambirira . Kuti mudziwe magawo awa madokotala amagwiritsa ntchito chinachake chotchedwa TNM staging . Ndi dongosolo lino T imaimira kukula kwa chotupa, N imayimira kukhalapo ndi chiwerengero cha ma lymph node, ndipo M imayimilira kutali. Ndi khansa yaing'ono yamapapo ya m'mapapo pali magawo awiri okha: siteji yambiri komanso yoperewera .
Mapuloteni / Gene Markers
Pali mayesero ena ochulukirapo amene mthupi lanu angapange pa chotupa chanu kuti mudziwe mtundu wa khansa yamapapo yomwe ili, kapena khansara yanu kwenikweni ndi khansara yomwe inadza mu gawo lina la thupi lanu ndi kufalikira m'mapapu anu. Zitsanzo zingapo mwa izi ndi monga TTF-1, p63, CD56, ndi chromogranin.
Molecular Profiling
Posachedwapa, kupita patsogolo kwachitsala cha khansa ya m'mapapo mwakumvetsetsa kusintha kwa chibadwa chomwe chimayambitsa "kukula kwa khansara. Kwa anthu ena, makamaka anthu omwe ali ndi adenocarcinoma, amathandizidwa kuti athe kuchiza matenda omwe nthawi zambiri amakhala ndi zotsatira zochepa kusiyana ndi chibadwa cha mankhwala. Zosintha zomwe zimayesedwa monga EGFR , KRAS, ROS1 , ndi ALK . Panopa tikulimbikitsidwa kuti anthu omwe ali ndi kansalu yochepa ya sepulo yamapapu ayang'anike chifukwa cha kusintha kumeneku. Koma kafukufuku waposachedwapa amasonyeza kuti 60 peresenti ya a oncologist akuchita izi.
Kudziwa
Gawo lomalizira la lipoti la matendawa ndilo matenda omwe odwala matendawa amafotokozera mwachidule zomwe apeza. Izi zikhoza kukhala mtundu wa khansara, kalasi (zomwe zimasiyanitsa,) ngati maselo aliwonse amtunduwu ali abwino, ndi siteji.
Gawo lotsatira
Ngati mwauzidwa kuti muli ndi khansara yamapapu, onetsetsani izi zoyamba kuti mutenge , ganizirani lingaliro lachiwiri , ndipo nthawi zonse mufunse mafunso ambiri. Musamaganize kuti mukugwiritsa ntchito nthawi yochuluka kwambiri ya dokotala-kuti 'zomwe amapatsidwa. Ngati mafunso anu sakuyankhidwa mokwanira, pezani dokotala yemwe angawayankhe.
Zotsatira:
National Cancer Institute. FactSheet. Malipoti a Mafupa. Kusinthidwa 09/23/10.