Te Hiranga o te Histopathology i roto i te Tātaritanga
He pou matua te histopathology o te rongoā hou, inā koa i roto i te tātaritanga o ngā mate maha. Ko te kupu "histopathology" i ahu mai i ngā kupu "histo," ko te tikanga he kiko, "patho," e pā ana ki te mate, me te "logy," e pā ana ki te pūtaiao. Nō reira, ko te histopathology te ako i ngā huringa o te kiko o te tinana i puta mai i ngā tukanga mate. Ka mahia ngā whakamātautau histopathological mā te tirotiro i ngā wāhanga kiko i raro i te karuārai i muri i te whai i tētahi raupapa o ngā tukanga whakarite. Ahakoa he ahua hangarau, he tino pono tana mahi: ko ngā hua histopathological te nuinga o te wā hei whakatau whakamutunga mō te tātaritanga, te whakamahere maimoatanga, tae noa ki te matapae i te ahunga whakamua o te mate (prognosis).
He aha te whakamātautau histopathology?
Ko te whakamātautau histopathological he aromatawai mariko o te kiko i tangohia mai i te tinana o te tūroro. Ko te tikanga ka tangohia ngā tauira kiko mā te koiora (te tango i tētahi wahi iti o te kiko), te tango (te tango i te whara katoa), te tango pokanga rānei (te tango i tētahi nui o te kiko). Kei roto i te tukanga whakamātautau te whakapiri kiko (te whakamahi i te formalin), te tukatuka i te kiko hei poraka paraffin, te tapahi angiangi mā te whakamahi i te microtome, te tae (te nuinga o te wā mā te hematoxylin-eosin/HE), me te aromatawai e te tohunga mate.
Haunga te tae taketake, ka taea hoki e te histopathology te whakamahi i ētahi atu tikanga pēnei i te immunohistochemistry (IHC) hei kimi i ngā pūmua motuhake, ngā tae motuhake mō ngā moroiti, me te whakamātautau ngota o te kiko. Mā tēnei huinga o ngā tikanga, ehara i te mea ko te histopathology anake te whakaahua i te "āhua" o te kiko engari ka taea hoki te whakamārama i ngā āhuatanga koiora o te mate pūtake.
He aha te hiranga o te histopathology?
He maha ngā take he mea nui te histopathology mō te tātaritanga me te rongoā. Tuatahi, he rite tonu ngā tohu o te maha o ngā mate. Ka puta pea ngā puku, te mumura, te whara rānei i roto i ētahi okana i ngā mate pāwera, ngā mate pūnaha ārai mate, ngā pukupuku pai, te mate pukupuku rānei. Mā ngā whakamātautau haumanu me ngā whakamātautau hihi-X ka āwhina i te whakawhāiti i ngā mea ka taea, engari he maha ngā wā kāore e ranea hei whakaū i te tātaritanga. Koinei te wā e whakarato ai te histopathology i tētahi whakautu tino tika nā te mea ka tirotirohia tika ngā huringa i te taumata pūtau me te kiko.
Tuarua, mā te histopathology ka taea te aromatawai i te kaha o te mate. Hei tauira, mō te mate pukupuku, me mōhio ngā tākuta ki ngā mōhiohio pēnei i te momo mate pukupuku, te nui o te mate pukupuku (te whakarōpūtanga), te hohonu o te whakaekenga, te hononga o ngā uaua toto, o ngā io rānei, me te āhua o ngā taha tapahi pokanga. Ka pā nui ēnei tawhā katoa ki te whiriwhiri i te rongoā (pokanga, chemotherapy, radiotherapy, therapy arotahi) me te whakatau tata i te mōrearea o te hokinga mai.
Tuatoru, he mea nui te mahi a te histopathology ki te whakatau i ētahi atu maimoatanga. I roto i te nuinga o ngā wā, ka whakatauhia e ngā hua o te koiora mēnā me nui ake te pokanga, te rongoā tāpiri, te aroturuki rānei i te manawanui. Ki te kore he histopathology, he whakaaro noa iho ngā whakataunga haumanu.
Te tūranga o te histopathology i roto i te tautuhi i te mate pukupuku
Ko te mara tino rongonui e pā ana ki te histopathology ko te oncology. Tata ki ngā tātaritanga mate pukupuku pakari katoa me whakaū histopathological. Nā te mea ehara te "mate pukupuku" i te kupu whānui noa iho, engari he rōpū nui o ngā mate me ngā āhuatanga rerekē. Ka rerekē pea ngā momo pūtau, te urupare ki te rongoā, me te matapae o ngā pukupuku e rua i te wāhi kotahi.
Hei tauira, i roto i te mate pukupuku o te ū, ehara i te mea ko te histopathology anake te whakaū i te mate pukupuku engari ka aromatawaihia hoki te momo, te taumata histological, te whakaekenga o ngā kōpū lymph, ā, ka whakahaerehia he whakamātautau tāpiri pēnei i te ER, PR, me te immunohistochemistry HER2. Mā ēnei mōhiohio ka whakatau mēnā me whai rongoā homoni te tūroro, he rongoā arotahi anti-HER2, he huinga chemotherapy motuhake rānei.
I roto i te mate pukupuku pūkahukahu, ka āwhina te histopathology ki te wehewehe i te adenocarcinoma, te squamous cell carcinoma, me ētahi atu momo. Ka pā tēnei wehewehenga ki te maimoatanga me ngā whakamātautau i muri mai, pērā i te EGFR, te ALK, ngā whakarerekētanga ROS1, me ētahi atu tohu ngota ngota, he mea nui i tēnei wā o te rongoā tika.
Te histopathology i roto i ngā mate pipiri me ngā mate mumura
Ahakoa he maha ngā wā e pā ana ki te mate pukupuku, he mea nui anō hoki te histopathology i roto i ngā mate pipiri me ngā mate mumura mau tonu. Hei tauira, i roto i te mate kohi, ko te putanga mai o ngā granulomas me te caseous necrosis he tohu kaha. I roto i ngā mate harore, ka taea e ngā tohunga pathology te whakamahi i ngā tae motuhake pēnei i te PAS, te GMS rānei hei whakaatu i ngā hanganga harore i roto i te kiko.
Haunga ngā mate pāwera, he maha ngā mate pūnaha ārai mate me ngā mate mumura e hiahia ana kia whakaūtia te kiko. Hei tauira, i roto i te mate hepatitis mau tonu, ka taea e te koiora ate te aromatawai i te nui o te mumura me te fibrosis, he mea nui tēnei hei whakatau i te matapae me te hiahia mō te rongoā. I roto i ngā mate puku pērā i te ulcerative colitis, te mate a Crohn rānei, ka āwhina te histopathology ki te wehewehe i te momo mumura, te aromatawai i te mahi a te mate, me te aroturuki i te mōrearea o ngā huringa o mua i te mate pukupuku.
Te aromatawai i te angitu o te rongoā me te ahunga whakamua o te mate
Ehara i te mea ko te histopathology anake te mea e whakamahia ana i te tīmatanga hei whakatū i te tautuhi mate engari ka taea hoki te whai wāhi ki te aromatawai i muri i te rongoā. Mō ngā take o ngā pukupuku i rongoatia ki te chemotherapy, ki te radiotherapy rānei i mua i te pokanga (neoadjuvant), ka taea te aromatawai i te kiko i tangohia mā te pokanga hei whakatau i te urupare a te pukupuku ki te rongoā. Ko te nui ake o te rohe pukupuku e pāngia ana e te mate pūtau, e te hokinga mai rānei, ko te pai ake o te urupare, i te nuinga o te wā.
I ētahi wā, ka whakamahia hoki te histopathology hei aroturuki i te hokinga mai, i ngā huringa rānei o te āhua o te mate. Hei tauira, ko tētahi whara kiri pai i mua ka huri hei dysplastic, hei kino rānei; mā te tirotiro anō i te kiko ka whakatau i ngā mahi e whai ake nei.
Te tika o te tātaritanga: te mahi tahi a ngā tākuta me ngā tohunga mate
He nui te pānga o te kounga o te tauira me ngā mōhiohio haumanu e haere tahi ana me te tika o te tātaritanga histopathology. Me whai raraunga ngā tohunga mate pēnei i te wāhi o te whara, te rahi, ngā kitenga ira-X, te hītori hauora, me ngā maimoatanga o mua. Ki te kore ēnei mōhiohio, ka uaua ake te whakamārama. Hei tāpiri, ka taea hoki e ngā tikanga koiora iti ake te whakaatu i ngā whakatau kāore e whakaata i te āhuatanga tūturu.
Nō reira, ko te mea pai ko te histopathology hei wāhanga o tētahi huarahi maha-mātauranga. He maha ngā hōhipera e whakatinana ana i ngā huihuinga kōrero mō ngā take, pērā i ngā poari pukupuku, te wāhi e huihui ai ngā taote pokanga, ngā tohunga pukupuku, ngā tohunga x-ray, me ngā tohunga pathology ki te matapaki i ngā hua o te whakamātautau hei whakatau i te rongoā pai rawa atu.
Ngā wero me ngā whanaketanga i roto i te histopathology hou
He maha ngā wero e pā ana ki ngā mahi histopathology, pērā i ngā herenga tauira, te rerekētanga o te whakamaoritanga i waenga i ngā kaiaromatawai, me te roa o te wā tukatuka i ētahi wā. Heoi anō, kei te whakapai tonu ngā whanaketanga hangarau i te kounga me te tere o te tautuhi mate. Hei tauira, mā te pathology mamati ka taea te matawai i ngā kiriata kiko ki ngā whakaahua mamati kounga teitei ka taea te tātari, te penapena, me te tirotiro mamao. Kei te tīmata te whakamahi i te matauranga horihori hei āwhina i te kimi i ngā tauira motuhake, te tatau i ngā tohu tipu, te aromatawai rānei i ngā wāhi pukupuku i runga i te whakaaro tika.
Hei tāpiri atu, mā te whakaurunga o te histopathology me te whakamātautau ngota ka whānui ake te tātaritanga. Ināianei, ehara i te mea ko te hiahia noa o ngā tākuta ki te mōhio "he mate pukupuku, kāore rānei," engari me "he aha te momo mate pukupuku, he aha ngā whakarerekētanga kei a ia, me te rongoā tino whai hua." Mā te histopathology ka taea te whakautu i ēnei pātai katoa.
Whakamutunga
He mea nui te mahi a te histopathology i roto i te tautuhi mate nā te mea e whakaatu tika ana i ngā huringa pūtau me ngā kiko i puta mai i te mate. Ka āwhina i te wehewehe i ngā mate rite haumanu, te whakatau i te momo me te nui o te mate pukupuku, te aromatawai i te kaha o te mumura, te mate rānei, ā, hei pūtake mō te whakamahere i te rongoā tika. I tēnei wā o te rongoā tika, kei te piki haere te whanaketanga o te histopathology me te tautoko o te immunohistochemistry, ngā whakamātautau ngota, me te mamati, ehara i te mea he taputapu tautuhi mate anake engari he kāpehu matua hoki hei whakatau i te ahunga o te maimoatanga tūroro. Nō reira, ko te māramatanga pai me te whakamahinga pai o te histopathology he mea nui ki te whakapai ake i te tika o te tautuhi mate me te kounga whānui o te hauora.
