Qhov Tseem Ceeb ntawm Histopathology hauv Kev Kuaj Mob
Kev kawm txog histopathology yog ib qho tseem ceeb ntawm kev kho mob niaj hnub no, tshwj xeeb tshaj yog hauv kev kuaj mob ntawm ntau yam kab mob. Lo lus "histopathology" los ntawm cov lus "histo," txhais tau tias cov nqaij, "patho," txhais tau tias kab mob, thiab "logy," txhais tau tias kev tshawb fawb. Yog li, histopathology yog kev kawm txog kev hloov pauv hauv cov nqaij ntawm lub cev uas tshwm sim los ntawm cov txheej txheem kab mob. Kev kuaj mob histopathological yog ua los ntawm kev soj ntsuam cov nqaij hauv qab lub tshuab microscope tom qab ua ntau yam txheej txheem npaj. Txawm hais tias nws yuav zoo li kev siv tshuab, nws lub luag haujlwm yog qhov tseeb: cov txiaj ntsig histopathological feem ntau yog qhov txiav txim siab kawg ntawm kev kuaj mob, kev npaj kho mob, thiab txawm tias kev kwv yees ntawm kev nce qib ntawm kab mob (kev kwv yees).
Kev kuaj mob histopathology yog dab tsi?
Kev kuaj mob histopathological yog kev soj ntsuam cov nqaij mos uas tau los ntawm tus neeg mob lub cev los ntawm kev siv lub tshuab microscopic. Feem ntau cov qauv nqaij mos yuav tau los ntawm kev kuaj nqaij mos (tshem tawm ib daim nqaij me me), kev txiav tawm (tshem tawm tag nrho cov qhov txhab), lossis kev phais mob (tshem tawm ntau cov nqaij mos). Cov txheej txheem kuaj mob suav nrog kev kho cov nqaij mos (feem ntau yog siv formalin), ua cov nqaij mos ua cov paraffin blocks, txiav nyias siv microtome, pleev xim (feem ntau yog siv hematoxylin-eosin/HE), thiab kev soj ntsuam los ntawm tus kws kho mob pathologist.
Ntxiv rau kev siv cov xim yooj yim, histopathology kuj tseem siv tau cov txheej txheem ntxiv xws li immunohistochemistry (IHC) los nrhiav cov protein tshwj xeeb, cov xim tshwj xeeb rau cov kab mob me me, thiab kev kuaj cov ntaub so ntswg. Nrog rau kev sib xyaw ua ke ntawm cov txheej txheem no, histopathology tsis yog tsuas yog piav qhia txog "hom" ntawm cov ntaub so ntswg xwb tab sis kuj tseem tuaj yeem piav qhia txog cov yam ntxwv ntawm tus kab mob hauv qab.
Vim li cas histopathology thiaj li tseem ceeb?
Muaj ntau yam ua rau histopathology tseem ceeb heev rau kev kuaj mob thiab kev kho mob. Ua ntej, ntau yam kab mob muaj cov tsos mob zoo sib xws. Cov pob, o, lossis cov qhov txhab hauv qee lub cev tuaj yeem tshwm sim los ntawm kev kis kab mob, cov kab mob autoimmune, cov qog nqaij hlav zoo, lossis mob qog noj ntshav. Kev kuaj mob hauv tsev kho mob thiab kev kuaj mob radiological pab txo qhov ua tau, tab sis feem ntau lawv tsis txaus los lees paub qhov kev kuaj mob. Qhov no yog qhov uas histopathology muab cov lus teb tseeb dua vim nws ncaj qha tshuaj xyuas cov kev hloov pauv ntawm qib cellular thiab cov nqaij.
Qhov thib ob, kev kuaj mob tso cai rau kev soj ntsuam qhov hnyav ntawm tus kab mob. Piv txwv li, hauv mob qog noj ntshav, cov kws kho mob xav tau cov ntaub ntawv xws li hom mob qog noj ntshav, qib ntawm kev mob qog noj ntshav (qib), qhov tob ntawm kev nkag mus, cov hlab ntsha lossis cov hlab ntsha koom nrog, thiab qhov xwm txheej ntawm cov npoo ntawm kev phais. Tag nrho cov kev ntsuas no cuam tshuam rau kev xaiv kev kho mob (phais mob, chemotherapy, radiotherapy, targeted therapy) thiab kwv yees qhov kev pheej hmoo ntawm kev rov tshwm sim.
Qhov thib peb, kev kuaj mob ua lub luag haujlwm tseem ceeb hauv kev txiav txim siab txog kev kho mob ntxiv. Hauv ntau qhov xwm txheej, cov txiaj ntsig ntawm kev kuaj mob txiav txim siab seb tus neeg mob puas xav tau kev phais mob ntau dua, kev kho mob ntxiv, lossis kev saib xyuas txaus. Yog tsis muaj kev kuaj mob, kev txiav txim siab hauv kev kho mob tsuas yog kwv yees xwb.
Lub luag haujlwm ntawm histopathology hauv kev kuaj mob qog noj ntshav
Qhov chaw paub zoo tshaj plaws txog histopathology yog oncology. Yuav luag txhua qhov kev kuaj mob qog noj ntshav yuav tsum tau kuaj pom histopathological. Qhov no yog vim "mob qog noj ntshav" tsis yog ib lo lus dav dav xwb, tab sis yog ib pawg loj ntawm cov kab mob uas muaj ntau yam ntxwv sib txawv. Ob lub qog nqaij hlav hauv tib qho chaw tuaj yeem muaj cov hom cell sib txawv, kev teb rau kev kho mob, thiab kev kwv yees sib txawv.
Piv txwv li, hauv mob qog noj ntshav hauv lub mis, histopathology tsis yog tsuas yog lees paub qhov mob qog noj ntshav xwb tab sis kuj tseem ntsuas subtype, histological grade, lymph node invasion, thiab ua cov kev kuaj ntxiv xws li ER, PR, thiab HER2 immunohistochemistry. Cov ntaub ntawv no txiav txim siab seb tus neeg mob puas xav tau kev kho mob hormonal, kev kho mob tiv thaiv HER2, lossis kev sib xyaw ua ke ntawm cov tshuaj chemotherapy.
Hauv mob qog nqaij hlav ntsws, kev tshawb nrhiav keeb kwm pab qhia qhov txawv ntawm adenocarcinoma, squamous cell carcinoma, lossis lwm hom. Qhov kev sib txawv no cuam tshuam rau kev kho mob thiab kev kuaj mob tom qab, xws li EGFR, ALK, ROS1 mutations, thiab lwm yam cim molecular, uas tam sim no tseem ceeb heev hauv lub caij nyoog ntawm kev kho mob kom raug.
Histopathology hauv cov kab mob sib kis thiab inflammatory
Txawm hais tias feem ntau cuam tshuam nrog mob qog noj ntshav, histopathology kuj tseem ceeb heev rau cov kab mob sib kis thiab mob o. Piv txwv li, hauv tuberculosis, qhov tshwm sim ntawm granulomas nrog caseous necrosis tuaj yeem yog qhov cim qhia zoo. Hauv cov kab mob fungal, cov kws kho mob pathologist tuaj yeem siv cov xim tshwj xeeb xws li PAS lossis GMS los qhia txog cov qauv fungal hauv cov ntaub so ntswg.
Ntxiv rau kev kis kab mob, ntau yam kab mob autoimmune thiab kev mob o yuav tsum tau kuaj xyuas cov nqaij. Piv txwv li, hauv cov kab mob siab ntev, kev kuaj mob siab tuaj yeem ntsuas qhov mob thiab fibrosis, uas yog qhov tseem ceeb rau kev txiav txim siab qhov kev kwv yees thiab qhov xav tau kev kho mob. Hauv cov kab mob plab hnyuv xws li ulcerative colitis lossis Crohn's kab mob, histopathology pab cais hom kev o, ntsuas kev ua haujlwm ntawm kab mob, thiab saib xyuas qhov kev pheej hmoo ntawm kev hloov pauv precancerous.
Kev soj ntsuam qhov kev vam meej ntawm kev kho mob thiab kev mob nkeeg
Kev kuaj mob histopathology tsis yog siv thawj zaug los txiav txim siab seb puas muaj mob xwb tab sis kuj tseem ua lub luag haujlwm hauv kev ntsuam xyuas tom qab kev kho mob. Hauv cov mob qog noj ntshav uas tau kho nrog chemotherapy lossis radiotherapy ua ntej phais (neoadjuvant), cov nqaij mos uas raug phais tshem tawm tuaj yeem raug soj ntsuam kom paub tseeb tias mob qog teb rau kev kho mob. Qhov loj dua thaj chaw mob qog noj ntshav uas muaj kev tuag ntawm cov cell lossis regression, qhov kev teb zoo dua, feem ntau.
Muaj tej lub sij hawm, kev kuaj mob histopathology kuj siv los saib xyuas seb puas rov qab muaj dua lossis hloov pauv ntawm tus kab mob. Piv txwv li, qhov mob ntawm daim tawv nqaij uas tsis muaj mob ua ntej yuav dhau los ua qhov tsis zoo lossis mob qog; kev kuaj dua ntawm cov nqaij yuav txiav txim siab txog cov kauj ruam tom ntej.
Kev kuaj mob raug: kev koom tes ntawm cov kws kho mob thiab cov kws kho mob pathologist
Qhov tseeb ntawm histopathology yog cuam tshuam los ntawm qhov zoo ntawm cov qauv kuaj thiab cov ntaub ntawv kho mob nrog. Cov kws kho mob xav tau cov ntaub ntawv xws li qhov chaw mob, qhov loj me, cov ntaub ntawv radiological, keeb kwm kho mob, thiab kev kho mob yav dhau los. Yog tsis muaj cov ntaub ntawv no, kev txhais lus tuaj yeem nyuaj dua. Ntxiv mus, cov txheej txheem biopsy uas tsis sawv cev kuj tseem tuaj yeem tsim cov lus xaus uas tsis qhia txog qhov xwm txheej tiag tiag.
Yog li ntawd, kev kawm txog keeb kwm ntawm cov qog nqaij hlav yuav tsum yog ib feem ntawm txoj kev kawm ntau yam. Ntau lub tsev kho mob siv cov rooj sib tham txog cov neeg mob, xws li cov rooj sib tham txog qog nqaij hlav, qhov chaw uas cov kws phais mob, cov kws kho mob qog nqaij hlav, cov kws kho mob hluav taws xob, thiab cov kws kho mob kab mob sib sau ua ke los tham txog cov txiaj ntsig ntawm kev kuaj mob kom paub txog kev kho mob zoo tshaj plaws.
Cov teeb meem thiab kev txhim kho hauv kev tshawb fawb txog keeb kwm niaj hnub no
Cov kev coj ua ntawm histopathology ntsib ntau yam teeb meem, xws li cov qauv txwv, kev hloov pauv ntawm tus neeg ntsuas hauv kev txhais lus, thiab lub sijhawm ua tiav ntev hauv qee kis. Txawm li cas los xij, kev nce qib ntawm thev naus laus zis txuas ntxiv txhim kho qhov zoo thiab ceev ntawm kev kuaj mob. Piv txwv li, kev kho mob digital tso cai rau cov ntaub so ntswg kom raug luam theej duab rau hauv cov duab digital zoo uas tuaj yeem tshuaj xyuas, khaws cia, thiab sab laj nrog deb. Kev txawj ntse dag txawm tias pib siv los pab nrhiav cov qauv tshwj xeeb, xam cov ntsuas kev loj hlob, lossis ntsuas thaj chaw mob qog noj ntshav kom ncaj ncees dua.
Tsis tas li ntawd xwb, kev koom ua ke ntawm histopathology nrog kev kuaj molecular ua rau kev kuaj mob muaj ntau yam ntxiv. Tam sim no, cov kws kho mob tsis yog tsuas xav paub "nws puas yog mob qog noj ntshav lossis tsis yog," tab sis kuj xav paub "nws yog hom mob qog noj ntshav dab tsi, nws muaj kev hloov pauv dab tsi, thiab kev kho mob twg zoo tshaj plaws." Histopathology muab lub rooj vag rau tag nrho cov lus nug no.
Xaus
Kev kawm txog histopathology ua lub luag haujlwm tseem ceeb hauv kev kuaj mob vim nws muab pov thawj ncaj qha ntawm kev hloov pauv ntawm cov hlwb thiab cov nqaij uas tshwm sim los ntawm kab mob. Nws pab cais cov kab mob zoo sib xws, txiav txim siab hom thiab qib ntawm kev mob qog nqaij hlav, ntsuas qhov hnyav ntawm kev o lossis kev kis kab mob, thiab ua lub hauv paus rau kev npaj kho mob kom zoo. Hauv lub caij nyoog ntawm kev kho mob kom raug, histopathology tau tsim ntau ntxiv nrog kev txhawb nqa ntawm immunohistochemistry, kev kuaj mob molecular, thiab kev siv digital, ua rau nws tsis yog tsuas yog lub cuab yeej kuaj mob xwb tab sis kuj yog lub tswv yim tseem ceeb hauv kev txiav txim siab qhov kev coj ntawm kev kho mob rau tus neeg mob. Yog li ntawd, kev nkag siab zoo thiab kev siv histopathology yog qhov tseem ceeb rau kev txhim kho qhov tseeb ntawm kev kuaj mob thiab qhov zoo ntawm kev kho mob tag nrho.
