Kukosha kweHistopathology mukuongorora
Histopathology ndiyo nheyo huru yemishonga yemazuva ano, kunyanya mukuongorora zvirwere zvakasiyana-siyana. Izwi rekuti "histopathology" rinobva pamashoko ekuti "histo," zvichireva kuti tishu, "patho," zvichireva chirwere, uye "logy," zvichireva sainzi. Saka, histopathology ikudzidza kwekuchinja kwenyama yemuviri kunokonzerwa nemaitiro echirwere. Kuongororwa kwehistopathological kunoitwa nekutarisa zvikamu zvenyama pasi pemaikorosikopu mushure mekuitwa maitiro akatevedzana ekugadzirira. Kunyange zvazvo zvinganzwika sehunyanzvi, basa rayo nderechokwadi: mhedzisiro yehistopathological inowanzova ndiyo yekupedzisira inosarudza kuongororwa, kuronga kurapwa, uye kunyange kufanotaura kufambira mberi kwechirwere (kufanotaura).
Chii chinonzi kuongorora histopathology?
Kuongorora histopathological kuongorora nyama inotorwa mumuviri wemurwere nemaikorosikopu. Mienzaniso yenyama inowanzo wanikwa kuburikidza ne biopsy (kubviswa kwenyama diki), kubviswa kweronda rose), kana kubviswa kwenyama yakawanda. Maitiro ekuongorora anosanganisira kugadzirisa nyama (kazhinji uchishandisa formalin), kugadzirisa nyama kuita paraffin blocks, kuchekerera uchishandisa microtome, kuisa mavara (kazhinji ne hematoxylin-eosin/HE), uye kuongororwa nachiremba wezvirwere.
Pamusoro pekudhaya ganda, histopathology inogonawo kushandisa mamwe matekiniki akadai se immunohistochemistry (IHC) kuona mapuroteni chaiwo, mavara akakosha etupukanana, uye kuongorora mamorekuru enyama. Nekusanganiswa uku kwenzira, histopathology haingotsananguri "chimiro" chenyama chete asi inogonawo kujekesa hunhu hwemuviri hwechirwere chiripo.
Sei histopathology ichikosha zvakadaro?
Pane zvikonzero zvakawanda zvinoita kuti histopathology ive yakakosha pakuongorora nekurapa. Chekutanga, zvirwere zvakawanda zvine zviratidzo zvakafanana. Mapundu, kuzvimba, kana maronda mune dzimwe nhengo dzemuviri zvinogona kukonzerwa nehutachiona, zvirwere zve autoimmune, bundu risingakuvadzi, kana kenza. Kuongororwa kwekiriniki neradiological kunobatsira kuderedza mikana, asi kazhinji hazvikwani kusimbisa chirwere. Apa ndipo panowana mhinduro yakajeka nekuti inoongorora zvakananga shanduko pamasero nenyama.
Chechipiri, histopathology inobvumira kuongororwa kwehurwere. Semuenzaniso, mugomarara, vanachiremba vanoda ruzivo rwakadai serudzi rwegomarara, mwero wegomarara (kuyera), kudzika kwekupinda kwaro, kupindira kwetsinga dzeropa kana tsinga, uye mamiriro emucheto wekucheka kwegomarara. Zvese izvi zvinopesvedzera zvakanyanya sarudzo yekurapa (kuvhiyiwa, chemotherapy, radiotherapy, kurapwa kwakanangana) uye kufungidzira njodzi yekudzokazve kwegomarara.
Chechitatu, histopathology inoita basa guru pakusarudza mamwe marapirwo. Kazhinji, mhedzisiro ye biopsy ndiyo inoratidza kana murwere achida kuvhiyiwa kwakawanda, kurapwa kwakawedzerwa, kana kuongororwa kwakakwana. Pasina histopathology, sarudzo dzekiriniki dzinenge dzichingofungidzira.
Basa reHistopathology mukuongorora kenza
Nyaya inozivikanwa zvikuru ine chekuita nekuongorora kenza ndeye oncology. Kuongororwa kwekenza kwakasimba kunoda kusimbiswa kwekuongorora kenza. Izvi zvinodaro nekuti "kenza" harisi izwi rekuti "cancer" chete, asi boka guru rezvirwere zvine hunhu hwakasiyana. Mabundu maviri ari panzvimbo imwe anogona kuva nemarudzi akasiyana emasero, mhinduro kukurapa, uye fungidziro.
Semuenzaniso, mukenza yemazamu, histopathology haingobvumidze chete kuti chirwere ichi chine kenza asiwo inoongorora mhando dzakasiyana dzekenza, huwandu hwekenza, kupinda kwemasero eropa mumuviri, uye inoita mimwe miedzo yakaita seER, PR, uye HER2 immunohistochemistry. Ruzivo urwu runoratidza kana murwere achida kurapwa nemahormone, anti-HER2 therapy, kana kuti mishonga chaiyo yekurapa.
Mukenza yemapapu, histopathology inobatsira kusiyanisa adenocarcinoma, squamous cell carcinoma, kana mamwe marudzi. Musiyano uyu unokanganisa kurapwa uye bvunzo dzinotevera, dzakadai seEGFR, ALK, ROS1 mutations, uye mamwe mamorekuru ezviratidzo, izvo zvava kukosha munguva yekurapa kwakanyatsojeka.
Histopathology muzvirwere zvinotapukira uye zvinoputika
Kunyangwe zvichiwanzobatanidzwa nekenza, histopathology inokoshawo muzvirwere zvinotapukira uye zvinozvimba kwenguva refu. Semuenzaniso, muTB, kuoneka kwegranulomas ine caseous necrosis kunogona kuva chiratidzo chakasimba. Muzvirwere zvefungus, vanachiremba vanogona kushandisa mavara akakosha akadai sePAS kana GMS kuratidza maumbirwo efungus munyama.
Pamusoro pezvirwere, zvirwere zvakawanda zve autoimmune uye zvirwere zvekuzvimba zvinoda kusimbiswa kwenyama. Semuenzaniso, muhepatitis isingaperi, biopsy yechiropa inogona kuongorora huwandu hwekuzvimba uye fibrosis, izvo zvakakosha pakuona fungidziro uye kudiwa kwekurapwa. Muzvirwere zvemudumbu zvakaita seulcerative colitis kana chirwere cheCrohn, histopathology inobatsira kusiyanisa rudzi rwekuzvimba, kuongorora mashandiro echirwere, uye kutarisa njodzi yekuchinja kwechirwere usati watanga kenza.
Kuongorora kubudirira kwekurapa uye mafambiro echirwere
Kuongororwa kwemapfupa hakungoshandiswi pakutanga chete kuti pave nechirwere asi kunogonawo kuita basa guru mukuongorora mushure mekurapwa. Muzviitiko zvemapundu anorapwa nechemotherapy kana radiotherapy vasati vavhiyiwa (neoadjuvant), nyama dzakabviswa nekuvhiyiwa dzinogona kuongororwa kuti dzione kuti bundu racho rinopindura sei pakurapwa. Kana nzvimbo yebundu ikafa kana kudzokera shure kwemasero, mhinduro yacho inowedzera kuva nani.
Mune zvimwe zviitiko, histopathology inoshandiswawo kuongorora kudzoka kana shanduko muhunhu hwechirwere. Semuenzaniso, ronda reganda raimbova risina njodzi rinogona kudonha kana kuva nekenza; kuongororwazve kwenyama kuchasarudza matanho anotevera.
Kurongeka kwekuongorora: kushandira pamwe pakati pevanachiremba nevanoongorora zvirwere
Kururama kwekuongorora histopathology kunonyanya kukonzerwa nemhando yemuenzaniso uye ruzivo rwekiriniki rwunoenderana nawo. Vanachiremba vezvirwere vanoda data rakadai senzvimbo yechironda, saizi, zvakawanikwa neX-ray, nhoroondo yezvekurapa, uye marapirwo ekare. Pasina ruzivo urwu, kududzira kunogona kuoma. Uyezve, nzira dzisina kunyorwa zvakanaka dzebiopsy dzinogonawo kupa mhedziso dzisingaratidzi mamiriro chaiwo ezvinhu.
Saka, histopathology inofanira kunge iri chikamu chenzira yekurapa ine hunyanzvi hwakawanda. Zvipatara zvakawanda zvinoshandisa maforamu ekukurukurirana nyaya, akadai semabhodhi egomarara, uko vanachiremba vekuvhiya, vanachiremba vekenza, vanachiremba ve radiology, uye vanachiremba vezvirwere vanoungana kuti vakurukure zvabuda muongororo kuti vaone kurapa kwakanakisa.
Matambudziko nekufambira mberi mukudzidza kwehistopathology yemazuva ano
Maitiro ekuongorora histopathology anosangana nematambudziko akati wandei, akadai sekuganhurirwa kwesampuro, kusiyana kwekuongorora pakati pevaongorori, uye nguva refu yekugadzirisa mune dzimwe nguva. Zvisinei, kufambira mberi kwetekinoroji kuri kuramba kuchivandudza mhando nekukasira kwekuongorora. Semuenzaniso, pathology yedhijitari inobvumira masiraidhi ematishu kuti atariswe mumifananidzo yedhijitari yepamusoro inogona kuongororwa, kuchengetwa, uye kutariswa kure. Unyanzvi hwekugadzira huri kutotanga kushandiswa kubatsira kuona mapatani chaiwo, kuverenga zviratidzo zvekupararira, kana kuongorora nzvimbo dzegomarara nenzira yakatwasuka.
Uyezve, kubatanidzwa kwehistopathology nekuongorora kwemolecular kunoita kuti kuongororwa kwechirwere kuve kwakazara. Iye zvino, vanachiremba havangodi chete kuziva kuti "ikenza here kana kuti kwete," asiwo "rudzii rwekenza, ine shanduko dzipi, uye kuti ndeipi nzira yekurapa inoshanda zvakanyanya." Histopathology inopa mukana wemibvunzo iyi yese.
Mhedziso
Histopathology inoita basa guru mukuongorora chirwere nekuti inopa humbowo hwakananga hwekuchinja kwemasero nenyama kunokonzerwa nechirwere. Inobatsira kusiyanisa zvirwere zvakafanana mukiriniki, kuona rudzi uye mwero wegomarara remamota, kuongorora kuoma kwekuzvimba kana hutachiona, uye inoshanda sehwaro hwekuronga kurapwa kwakakodzera. Munguva yekurapa kwakanyatsojeka, histopathology iri kuwedzera kugadzirwa nerutsigiro rwe immunohistochemistry, kuongororwa kwemamorekuru, uye digitalization, zvichiita kuti isangova chishandiso chekuongorora chete asiwo kambasi huru mukuona gwara rekurapa kwemurwere. Nokudaro, kunzwisisa nekushandisa histopathology zvakanaka kwakakosha mukuvandudza kururama kwekuongorora uye kunaka kwehutano hwese.
