Mapulogalamu a Lipoti la Zake Zake ndi Zovomerezeka Zotsatsa
Matenda ake ndi kufufuza minofu kuchokera ku thupi pansi pa microscope kuti muwone zizindikiro ndi zizindikiro za matenda. Kufufuza kwake ndiko kuphunzira za ziphuphu, ndipo matenda ndi kufufuza matenda.
Choncho kugwiritsidwa ntchito pamodzi kuzipatala kumatanthawuza kuphunzirira kwa matenda kumakhudzana ndi matenda. Lipoti la zakuthambo limafotokoza minofu yomwe yatumizidwa kuti ifufuze ndi zomwe zimaoneka ngati khansa ikuoneka pansi pa microscope .
Lipoti la zakuthambo nthawi zina limatchedwa lipoti la biopsy kapena lipoti la matenda.
Lipoti lakumwamba
Dokotala wa sayansi yemwe amachititsa kufufuza pogwiritsa ntchito microscope amatchedwa Pathologist. Minofu yomwe imaphunziridwa imachokera ku biopsy kapena opaleshoni yomwe mwachitsanzo timasankha timene timasankha ndikutumizidwa ku labotore. Amagwiritsidwa ntchito ndikudulidwa mu zigawo zochepa kwambiri (zomwe zimatchedwa zigawo), amawonongeka ndi kuyesedwa pansi pa microscopes kuti amvetsetse tsatanetsatane wa maselo a minofu. Pa matenda ena, dokotalayo amatha kupeza zitsanzo za minofu yomwe imamasuliridwa mofulumira kwambiri pogwiritsa ntchito zigawo zachisanu. Gawo kapena magawo ozizira amagwiritsidwa ntchito mochepa mu lymphoma, komabe, chifukwa cha mavuto omasuliridwa ndi sampuli. M'matenda am'mimba, maselo a mitsempha ndi minofu yomwe imapezeka kwambiri m'maganizo. Kwa mitundu yambiri ya khansa ya magazi, mafupa a mafupa amatha kuyeneranso kuti azindikire bwinobwino.
Zophatikiza za Lipoti
Malipoti a zaumphawi za zitsanzo za khansa za opaleshoni zikuwonjezeka kwambiri. Zingaphatikizepo izi:
- Kuwoneka kochepa kwambiri kwa minofu yomwe imakhudzidwa
- Madontho apadera
- Njira zamagulu
- Mayesero ena
Njira zamakono zimatanthawuza luso lofufuza maselo ndi ziphuphu pa maselo a maselo, omwe ali pamlingo wa mapuloteni, mapuloteni , ndi majini omwe amalemba zinthu izi.
Kutanthauzira Lipoti
Zambiri mwa zomwe anapeza pofufuza ziphuphuzi zimagwirizana ndi zizindikiro. Zizindikiro zowonjezera zingaphatikizepo chiwerengero cha mimba ndi kukula kwa kufalikira, ndipo ngati khansayo idachotsedwa kapena kupyolera pa maselo abwino a mzindawo, kapena ngati pali khansara yafalikira kuposa zomwe zinachotsedwa.
Maofesiwa amasiyana malinga ndi mtundu wa khansara, koma kawirikawiri maselo amawongolera malinga ndi momwe amachitira zachilendo pansi pa microscope, ndi matenda a Gulu 1 kukhala akuwoneka bwino ndi okalamba 4 omwe akuwonetsa zovuta zambiri. Chotupa chapamwamba kwambiri, ndiye, chimakhala chimodzi mwa maselo omwe ali osowa kwambiri. Kulemba sikofanana ndi ma stage. Kuphatikizana kumakhudza kwambiri kumene khansayo imapezeka mu thupi ndi momwe imafalikira.
Mafotokozedwe a Maselo ndi Njira Zina Zopangidwira
Kuphatikiza pa zakuthambo, njira zina zingagwiritsidwe ntchito poyesa kukhalapo kwa khansa m'magazi, kuphatikizapo bwino singano yopuma cytology, ndipo zina mwa njirazi zingagwiritsidwe ntchito kwambiri mu zochitika zaumoyo padziko lonse lapansi. Matenda a leukemias ndi maimymphomas amapezeka ndi maonekedwe awo-momwe maselo amawonera (morpholose), zizindikiro kapena mapuloteni apamwamba omwe angapezeke pogwiritsa ntchito mayesero a antibody (immunophenotype), mavitamini awo omwe angathandize kuti maselo ena amachitidwe (cytochemistry), ndi kusintha kwawo kwa chromosomal (karyotype).
Kaŵirikaŵiri m'matenda a mitsempha ndi khansa zina , njira yotchedwa immunohistochemistry imagwiritsidwa ntchito kuthandizira kuyeza mtundu wa chotupa, kufalikira ndi chithandizo. Immunohistochemistry ikuphatikizapo kugwiritsa ntchito ma antibodies kuti amangirire ku zizindikiro zina kapena kunja kwa maselo a kansa.
Zida zomwe ma antibodies amamatira nthawi zambiri amakhala ndi "CD" m'dzina lawo, zomwe zimayimira magulu osiyanitsa. Mwachitsanzo, CD23 ndi CD5 ndi timagulu ting'onoting'ono ta maselo a khansa, omwe angagwirizane ndi lingaliro lakuti chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL) ndi yotheka kupezeka. Zomwezi zimayambanso kupezeka muzinthu zina zoipa, komabe, kotero madokotala amagwiritsa ntchito njira yowonongolera pogwiritsa ntchito zidziwitso zomwe zilipo komanso zomwe zimadziwika ndi zizindikiro zosiyanasiyana za malungo ndi ma "CD" awo.
Chitsanzo china cha chilemba cha CD ndicho CD20, yomwe imapezeka m'matenda ena ena koma palibe. Kusakaza B cell lymphoma, kapena DLBCL, ndilo lofala kwambiri la lymphoma lomwe limagwirizanitsidwa ndi CD20.
Pakati pa maselo a khansa ya khansa ya m'magazi kapena ma lymphoma, zizindikiro zingayesedwe pogwiritsa ntchito gulu lonse la ma antibodies omwe amamatirira zosiyana, ndi zowononga zabwino ndi zoipa, zomangidwa.
Phunziro la maselo ndi chromosomal likhoza kuchitidwa kuti ayang'ane zowonongeka kwa jini ndi kusintha kokha kwa ma chromosome. Nthawi zina amalowetsedwa kapena kuchotsedwa majini amathandizidwa kuti adziŵe zambiri zokhudza kutsegula. Mwachitsanzo, mu chronic lymphocytic leukemia, kapena CLL, kachilombo kakang'ono ka chromosome kamatayika, ndipo kawirikawiri kamatayika limodzi ndi jini lomwe limathandiza kuchepetsa khansa. Kuchotsa 17p kumapezeka pafupifupi 3 mpaka 10 peresenti ya anthu omwe ali ndi CLL, onse. Kuchotsa CLL ndi mtundu wa CLL umene uli wovuta kuchiritsa; anthu omwe ali ndi mphamvu 17L kuchotsa CLL amakhala ovuta kuchiza ndi mankhwala ochizira.
Zotsatira:
Ho C, Rodig SJ. Zizindikiro za immunohistochemical mu malignancies: Amapulotini amatha kusintha kusintha kwa maselo. Seminars mu matenda ozindikira . 2015. 32 (5): 381-91.
Kufotokozera Zam'mimba: Malangizo a Khansa Yopaleshoni. Ndi Derek C Allen. Springer Science & Business Media, Jun 29, 2013.
> Taylor J, Xiao W ndi Abdel-Wahab O. Kuzindikira ndi kusanthula zizindikiro za matenda a hematologic pogwiritsa ntchito majini. Magazi . 2017 Jul 27; 130 (4): 410-423.