Kufunika kwa Histopathology mu Kuzindikira Matenda
Histopathology ndi chinsinsi chachikulu cha mankhwala amakono, makamaka pakupeza matenda osiyanasiyana. Mawu akuti "histopathology" amachokera ku mawu akuti "histo," kutanthauza minofu, "patho," kutanthauza matenda, ndi "logy," kutanthauza sayansi. Chifukwa chake, histopathology ndi kuphunzira kusintha kwa minofu ya thupi komwe kumachitika chifukwa cha matenda. Kufufuza histopathological kumachitika poyang'ana magawo a minofu pansi pa maikulosikopu pambuyo pochita njira zingapo zokonzekera. Ngakhale zingamveke ngati zaukadaulo, ntchito yake ndi yeniyeni: zotsatira za histopathological nthawi zambiri zimakhala chizindikiro chomaliza cha matenda, kukonzekera chithandizo, komanso kulosera kupita patsogolo kwa matenda (kulosera).
Kodi kuyesedwa kwa histopathology ndi chiyani?
Kuyezetsa histopathological ndi kuyesa minofu kuchokera m'thupi la wodwalayo pogwiritsa ntchito microscope. Zitsanzo za minofu nthawi zambiri zimapezeka kudzera mu biopsy (kuchotsa chidutswa chaching'ono cha minofu), kuchotsa (kuchotsa chotupa chonse), kapena kuchotsa minofu yambiri pa opaleshoni. Njira yoyezetsayi imaphatikizapo kukonza minofu (nthawi zambiri pogwiritsa ntchito formalin), kukonza minofuyo kukhala paraffin blocks, kuduladula pogwiritsa ntchito microtome, kupukuta (nthawi zambiri ndi hematoxylin-eosin/HE), ndikuwunika ndi katswiri wa matenda.
Kuwonjezera pa kudzola utoto woyambira, histopathology ingagwiritsenso ntchito njira zina monga immunohistochemistry (IHC) kuti izindikire mapuloteni enaake, madontho apadera a tizilombo toyambitsa matenda, ndi kufufuza maselo a minofu. Ndi kuphatikiza njira izi, histopathology sikuti imangofotokoza "mawonekedwe" a minofu komanso imatha kufotokoza bwino zamoyo za matenda omwe amayambitsa matendawa.
Chifukwa chiyani histopathology ndi yofunika kwambiri?
Pali zifukwa zingapo zomwe histopathology ilili yofunika kwambiri pozindikira ndi kuchiza. Choyamba, matenda ambiri ali ndi zizindikiro zofanana. Ziphuphu, kutupa, kapena zilonda m'ziwalo zina zimatha kuyambitsidwa ndi matenda, matenda a autoimmune, zotupa zosaopsa, kapena khansa. Kufufuza zachipatala ndi za radiology kumathandiza kuchepetsa mwayi, koma nthawi zambiri sikokwanira kutsimikizira matendawa. Apa ndi pomwe histopathology imapereka yankho lomveka bwino chifukwa imayang'ana mwachindunji kusintha kwa maselo ndi minofu.
Chachiwiri, histopathology imalola kuwunika kuopsa kwa matenda. Mwachitsanzo, mu khansa, madokotala amafunika chidziwitso monga mtundu wa khansa, kuchuluka kwa khansa (kuchuluka kwa khansa), kuzama kwa kulowa kwa khansa, kukhudzidwa kwa mitsempha yamagazi kapena mitsempha, komanso momwe ming'alu ya opaleshoni imakhalira. Zonsezi zimakhudza kwambiri kusankha chithandizo (opaleshoni, chemotherapy, radiotherapy, chithandizo cholunjika) ndikuyerekeza chiopsezo chobwereranso.
Chachitatu, histopathology imagwira ntchito yofunika kwambiri posankha chithandizo china. Nthawi zambiri, zotsatira za biopsy zimatsimikizira ngati wodwala akufunika opaleshoni yayikulu, chithandizo china, kapena kuyang'aniridwa mokwanira. Popanda histopathology, zisankho zachipatala zimakhala zongoganizira chabe.
Udindo wa histopathology pakupeza matenda a khansa
Gawo lodziwika bwino lokhudzana ndi histopathology ndi khansa. Pafupifupi matenda onse olimba a khansa amafunika kutsimikiziridwa ndi histopathology. Izi zili choncho chifukwa "khansa" si mawu wamba chabe, koma ndi gulu lalikulu la matenda okhala ndi makhalidwe osiyanasiyana. Zotupa ziwiri zomwe zili pamalo amodzi zimatha kukhala ndi mitundu yosiyanasiyana ya maselo, momwe zimayankhira chithandizo, komanso momwe zimakhalira.
Mwachitsanzo, mu khansa ya m'mawere, histopathology sikuti imangotsimikizira khansa komanso imayesa mitundu yosiyanasiyana, kuchuluka kwa histological, kulowa kwa lymph node, ndikuchita mayeso ena monga ER, PR, ndi HER2 immunohistochemistry. Chidziwitsochi chimatsimikiza ngati wodwalayo akufunika chithandizo cha mahomoni, chithandizo chotsutsana ndi HER2, kapena kuphatikiza mankhwala enaake a chemotherapy.
Mu khansa ya m'mapapo, histopathology imathandiza kusiyanitsa adenocarcinoma, squamous cell carcinoma, kapena mitundu ina. Kusiyana kumeneku kumakhudza chithandizo ndi mayeso otsatira, monga kusintha kwa EGFR, ALK, ROS1, ndi zizindikiro zina zamamolekyu, zomwe tsopano ndizofunikira kwambiri munthawi ya mankhwala olondola.
Histopathology mu matenda opatsirana ndi otupa
Ngakhale kuti nthawi zambiri zimagwirizanitsidwa ndi khansa, histopathology ndi yofunika kwambiri pa matenda opatsirana komanso otupa nthawi zonse. Mwachitsanzo, mu chifuwa chachikulu, kuwoneka kwa granulomas yokhala ndi caseous necrosis kungakhale chizindikiro champhamvu. Mu matenda a bowa, akatswiri a matenda amatha kugwiritsa ntchito madontho apadera monga PAS kapena GMS kuti awonetse kapangidwe ka bowa m'minofu.
Kuwonjezera pa matenda opatsirana, matenda ambiri odziteteza ku matenda a autoimmune ndi matenda otupa amafunika kutsimikiziridwa kwa minofu. Mwachitsanzo, mu matenda a chiwindi osatha, biopsy ya chiwindi imatha kuwona kuchuluka kwa kutupa ndi fibrosis, zomwe ndizofunikira pozindikira nthawi yodziwira matenda komanso kufunikira kwa chithandizo. Mu matenda am'mimba monga ulcerative colitis kapena matenda a Crohn, histopathology imathandiza kusiyanitsa mtundu wa kutupa, kuwunika momwe matendawo akuyendera, komanso kuwunika chiopsezo cha kusintha kwa khansa.
Kuwunika kupambana kwa chithandizo ndi momwe matendawa akuyendera
Histopathology siigwiritsidwa ntchito poyamba podziwitsa matenda komanso ingathandize poyesa pambuyo pa chithandizo. Pa milandu ya zotupa zomwe zimathandizidwa ndi chemotherapy kapena radiotherapy musanachite opaleshoni (neoadjuvant), minofu yochotsedwa opaleshoni imatha kuyesedwa kuti idziwe momwe chotupacho chimayankhira chithandizocho. Malo otupa omwe amafa kapena kubwereranso kwa maselo akakula, nthawi zambiri amayankha bwino.
Nthawi zina, histopathology imagwiritsidwanso ntchito kuyang'anira kubwereranso kapena kusintha kwa matenda. Mwachitsanzo, chilonda cha pakhungu chomwe chinali chosaopsa chingakhale chosalimba kapena choipa; kuyang'ananso minofu kudzatsimikizira njira zotsatirazi.
Kulondola kwa matenda: mgwirizano pakati pa asing'anga ndi akatswiri a matenda
Kulondola kwa histopathology kumakhudzidwa kwambiri ndi ubwino wa zitsanzo ndi chidziwitso chachipatala chomwe chikugwirizana nacho. Akatswiri a matenda amafunikira deta monga malo a zilonda, kukula kwake, zomwe zapezeka pa x-ray, mbiri yake yachipatala, ndi njira zochiritsira zam'mbuyomu. Popanda chidziwitsochi, kutanthauzira kungakhale kovuta kwambiri. Kuphatikiza apo, njira zochepa zodziwira matenda zimathanso kupanga mfundo zomwe sizikuwonetsa momwe zinthu zilili.
Chifukwa chake, histopathology iyenera kukhala gawo la njira zosiyanasiyana. Zipatala zambiri zimagwiritsa ntchito ma forum okambirana nkhani, monga ma board a zotupa, komwe madokotala ochita opaleshoni, madokotala a khansa, akatswiri a radiology, ndi akatswiri a matenda amasonkhana kuti akambirane zotsatira za mayeso kuti adziwe chithandizo chabwino kwambiri.
Mavuto ndi chitukuko mu histopathology yamakono
Machitidwe a histopathology amakumana ndi mavuto angapo, monga zoletsa zitsanzo, kusiyanasiyana kwa kutanthauzira pakati pa ofufuza, komanso nthawi yayitali yogwiritsira ntchito nthawi zina. Komabe, kupita patsogolo kwaukadaulo kukupitilizabe kukonza ubwino ndi liwiro la matenda. Mwachitsanzo, matenda a digito amalola kuti ma slide a minofu azitha kujambulidwa m'zithunzi zapamwamba za digito zomwe zitha kusanthulidwa, kusungidwa, ndikufunsidwa patali. Luntha lochita kupanga likuyamba kugwiritsidwa ntchito pothandiza kuzindikira mapangidwe enaake, kuwerengera kuchuluka kwa zizindikiro, kapena kuwunika madera otupa moyenera.
Kuphatikiza apo, kuphatikiza kwa histopathology ndi mayeso a molecular kumapangitsa kuti matenda azitha kufalikira mosavuta. Tsopano, madokotala samangofuna kudziwa "kodi ndi khansa kapena ayi," komanso "kodi ndi khansa yamtundu wanji, kusintha kwa majini komwe ili nako, komanso chithandizo chomwe chili chothandiza kwambiri." Histopathology imapereka njira yopezera mayankho a mafunso onsewa.
Mapeto
Histopathology imagwira ntchito yofunika kwambiri pozindikira matenda chifukwa imapereka umboni wolunjika wa kusintha kwa maselo ndi minofu komwe kumachitika chifukwa cha matenda. Imathandiza kusiyanitsa matenda ofanana ndi azachipatala, kudziwa mtundu ndi kuchuluka kwa khansa ya zotupa, kuwunika kuopsa kwa kutupa kapena matenda, komanso kukhala maziko okonzekera chithandizo choyenera. Munthawi ya mankhwala olondola, histopathology ikupangidwa kwambiri mothandizidwa ndi immunohistochemistry, mayeso a molekyulu, ndi digito, zomwe zimapangitsa kuti ikhale chida chodziwira matenda komanso njira yofunika kwambiri yodziwira komwe wodwala akuyenera kulandira chithandizo. Chifukwa chake, kumvetsetsa bwino ndi kugwiritsa ntchito histopathology ndikofunikira kwambiri pakukweza kulondola kwa matenda komanso mtundu wonse wa chisamaliro chaumoyo.
