Ukubaluleka kwe-Histopathology ekuxilongweni
I-Histopathology iyinsika ebalulekile yezokwelapha zanamuhla, ikakhulukazi ekuxilongweni kwezifo ezahlukahlukene. Igama elithi "histopathology" livela kumagama athi "histo," okusho izicubu, "patho," okubhekisele esifweni, kanye nelithi "logy," okusho isayensi. Ngakho-ke, i-histopathology isifundo sezinguquko ezicutshini zomzimba ezibangelwa izinqubo zesifo. Ukuhlolwa kwe-Histopathological kwenziwa ngokubheka izingxenye zezicubu ngaphansi kwe-microscope ngemuva kokudlula uchungechunge lwezinqubo zokulungiselela. Nakuba kungase kuzwakale njengobuchwepheshe, indima yayo ingokoqobo kakhulu: imiphumela ye-histopathological ivame ukuba yisinqumo sokugcina sokuxilongwa, ukuhlela ukwelashwa, kanye nokubikezela ukuqhubeka kwesifo (isibikezelo).
Kuyini ukuhlolwa kwe-histopathology?
Ukuhlolwa kwe-histopathological ukuhlolwa kwezicubu nge-microscope ezithathwe emzimbeni wesiguli. Amasampula ezicubu ngokuvamile atholakala nge-biopsy (ukususwa kwengcezu encane yezicubu), ukususwa (ukususwa kwesilonda sonke), noma ukususwa ngokuhlinzwa (ukususwa kwenqwaba yezicubu). Inqubo yokuhlola ifaka phakathi ukulungiswa kwezicubu (ngokuvamile kusetshenziswa i-formalin), ukucubungula izicubu zibe amabhlogo e-paraffin, ukuhlukaniswa okuncane kusetshenziswa i-microtome, ukudaya (ngokuvamile nge-hematoxylin-eosin/HE), kanye nokuhlolwa ngudokotela wezifo.
Ngaphezu kokufaka umbala oyisisekelo, i-histopathology ingasebenzisa amasu engeziwe njenge-immunohistochemistry (IHC) ukuthola amaprotheni athile, amabala akhethekile ezilwanyane, kanye nokuhlolwa kwama-molecule ezicubu. Ngale nhlanganisela yezindlela, i-histopathology ayichazi nje kuphela "uhlobo" lwezicubu kodwa futhi ingacacisa izici zebhayoloji zesifo esiyisisekelo.
Kungani i-histopathology ibaluleke kangaka?
Kunezizathu eziningana ezenza ukuthi i-histopathology ibaluleke kakhulu ekuxilongweni nasekwelashweni. Okokuqala, izifo eziningi zinezimpawu ezifanayo. Amaqhubu, ukuvuvukala, noma izilonda ezithweni ezithile kungabangelwa ukutheleleka, izifo zokuzivikela komzimba, izimila ezingengozini, noma umdlavuza. Ukuhlolwa kwemitholampilo kanye ne-radiological kusiza ekunciphiseni amathuba, kodwa ngokuvamile akwanele ukuqinisekisa ukuxilongwa. Yilapho i-histopathology inikeza khona impendulo ecacile ngoba ihlola ngqo izinguquko ezingeni lamaseli nezicubu.
Okwesibili, i-histopathology ivumela ukuhlolwa kobucayi besifo. Isibonelo, kumdlavuza, odokotela badinga ulwazi olufana nohlobo lomdlavuza, izinga lomdlavuza (ukuhlolwa), ukujula kokungena, ukubandakanyeka kwemithambo yegazi noma kwemizwa, kanye nesimo semingcele yokuhlinzwa. Zonke lezi zinhlaka zithonya kakhulu ukukhetha ukwelashwa (ukuhlinzwa, i-chemotherapy, i-radiotherapy, ukwelashwa okuqondiwe) futhi zilinganisela ingozi yokuphinda kuvele.
Okwesithathu, i-histopathology idlala indima ebalulekile ekunqumeni ukwelashwa okwengeziwe. Ezimweni eziningi, imiphumela ye-biopsy inquma ukuthi isiguli sidinga ukuhlinzwa okubanzi, ukwelashwa okwengeziwe, noma ukuqapha okwanele. Ngaphandle kwe-histopathology, izinqumo zezokwelapha ziwukuqagela kakhulu.
Indima ye-histopathology ekuxilongweni komdlavuza
Insimu eyaziwa kakhulu ehlobene ne-histopathology yi-oncology. Cishe zonke izifo zomdlavuza eziqinile zidinga ukuqinisekiswa kwe-histopathological. Lokhu kungenxa yokuthi igama elithi "umdlavuza" alilona nje igama elijwayelekile, kodwa kunalokho liyiqembu elikhulu lezifo ezinezici ezahlukene. Izimila ezimbili endaweni efanayo zingaba nezinhlobo zamaseli ezihlukene kakhulu, impendulo ekwelashweni, kanye nokubikezela.
Isibonelo, kumdlavuza webele, i-histopathology ayiqinisekisi nje kuphela umdlavuza kodwa futhi ihlola izinhlobo ezincane, izinga le-histological, ukuhlasela kwama-lymph node, futhi yenza izivivinyo ezengeziwe ezifana ne-ER, PR, kanye ne-HER2 immunohistochemistry. Lolu lwazi lunquma ukuthi isiguli sidinga ukwelashwa ngamahomoni, ukwelashwa okuqondiswe ku-anti-HER2, noma inhlanganisela ethile ye-chemotherapy.
Kumdlavuza wamaphaphu, i-histopathology isiza ukuhlukanisa i-adenocarcinoma, i-squamous cell carcinoma, noma ezinye izinhlobo. Lokhu kuhlukanisa kuthonya ukwelashwa kanye nokuhlolwa okulandelayo, njenge-EGFR, ALK, ROS1 mutations, kanye nezinye izimpawu zama-molecule, ezibaluleke kakhulu manje enkathini yezokwelapha ngokunemba.
I-Histopathology ezifweni ezithathelwanayo nezivuvukalayo
Nakuba kuvame ukuhlotshaniswa nomdlavuza, i-histopathology ibalulekile nasezifweni ezingapheli ezithathelwanayo nezivuvukalayo. Esifweni sofuba, isibonelo, ukubonakala kwama-granuloma ane-caseous necrosis kungaba yinkomba enamandla. Ezifweni zesikhunta, odokotela bezifo bangasebenzisa amabala akhethekile njenge-PAS noma i-GMS ukukhombisa izakhiwo zesikhunta ezicutshini.
Ngaphezu kokutheleleka, izifo eziningi zokuzivikela komzimba kanye nezinkinga zokuvuvukala zidinga ukuqinisekiswa kwezicubu. Isibonelo, ku-hepatitis engapheli, i-biopsy yesibindi ingahlola izinga lokuvuvukala kanye ne-fibrosis, okubalulekile ekunqumeni ukubikezela kanye nesidingo sokwelashwa. Ezifweni zamathumbu ezifana ne-ulcerative colitis noma isifo sikaCrohn, i-histopathology isiza ukuhlukanisa uhlobo lokuvuvukala, ukuhlola umsebenzi wesifo, kanye nokuqapha ingozi yezinguquko ezingaphambi komdlavuza.
Ukuhlola impumelelo yokwelashwa kanye nenkambo yesifo
I-Histopathology ayisetshenziswa nje kuphela ekuqaleni ukuthola ukuxilongwa kodwa futhi ingadlala indima ekuhlolweni kwangemva kokwelashwa. Ezimweni zezimila eziphathwe nge-chemotherapy noma nge-radiotherapy ngaphambi kokuhlinzwa (neoadjuvant), izicubu ezisusiwe ngokuhlinzwa zingahlolwa ukuze kutholakale impendulo yesimila ekwelashweni. Uma indawo yesimila inkulu ehlangabezana nokufa noma ukuhlehla kweseli, kulapho impendulo iba ngcono khona, ngokuvamile.
Kwezinye izimo, i-histopathology isetshenziswa futhi ukuqapha ukubuya noma izinguquko esimweni sesifo. Isibonelo, isilonda sesikhumba esasingenangozi singaba yi-dysplastic noma sibe yi-malignant; ukuhlolwa kabusha kwezicubu kuzonquma izinyathelo ezilandelayo.
Ukunemba kokuxilonga: ukubambisana phakathi kodokotela kanye nodokotela bezifo
Ukunemba kwe-histopathology kuthonywa kakhulu yikhwalithi yesampula kanye nolwazi lomtholampilo oluhambisana nayo. Odokotela bezifo badinga idatha efana nendawo yezilonda, usayizi, okutholakele nge-radiological, umlando wezokwelapha, kanye nokwelashwa kwangaphambilini. Ngaphandle kwalolu lwazi, ukuhumusha kungaba nzima kakhulu. Ngaphezu kwalokho, amasu e-biopsy angameleli kangako angaveza neziphetho ezingabonisi isimo sangempela.
Ngakho-ke, i-histopathology kufanele ibe yingxenye yendlela ehlanganisa imikhakha eminingi. Izibhedlela eziningi zisebenzisa amaforamu okuxoxisana ngamacala, njengamabhodi omdlavuza, lapho odokotela abahlinzayo, odokotela be-oncologist, odokotela be-radiology, kanye nodokotela be-pathologist behlangana khona ukuze baxoxe ngemiphumela yokuhlolwa ukuze bathole ukwelashwa okungcono kakhulu.
Izinselele kanye nentuthuko ku-histopathology yesimanje
Imikhuba ye-Histopathology ibhekene nezinselele eziningana, njengokulinganiselwa kwamasampula, ukuhlukahluka kokuhumusha phakathi kwabahloli, kanye nezikhathi zokucubungula ezinde ezimweni ezithile. Kodwa-ke, intuthuko yezobuchwepheshe iyaqhubeka nokuthuthukisa ikhwalithi kanye nesivinini sokuxilonga. I-pathology yedijithali, isibonelo, ivumela amaslayidi ezicubu ukuthi askeniwe abe izithombe zedijithali ezisezingeni eliphezulu ezingahlaziywa, zigcinwe, futhi zibuzwe kude. Ubuhlakani bokwenziwa sebuqala ngisho nokusetshenziswa ukusiza ukuthola amaphethini athile, ukubala izinkomba zokwanda, noma ukuhlola izindawo zesimila ngobuqotho.
Ngaphezu kwalokho, ukuhlanganiswa kwe-histopathology nokuhlolwa kwama-molecular kwenza ukuxilongwa kube okuphelele. Manje, odokotela abafuni nje ukwazi ukuthi "umdlavuza noma cha," kodwa futhi "uhlobo luni lomdlavuza, yiziphi izinguquko onazo, nokuthi yikuphi ukwelashwa okusebenza kahle kakhulu." I-Histopathology inikeza isango layo yonke le mibuzo.
Isiphetho
I-Histopathology idlala indima ebalulekile ekuxilongweni ngoba inikeza ubufakazi obuqondile bezinguquko zamaseli nezicubu ezibangelwa yisifo. Isiza ukuhlukanisa izifo ezifanayo ngokwemitholampilo, inqume uhlobo kanye nezinga lomdlavuza wezimila, ihlole ubukhali bokuvuvukala noma ukutheleleka, futhi isebenza njengesisekelo sokuhlela ukwelashwa okufanele. Esikhathini somuthi onembile, i-histopathology iyathuthukiswa ngokusekelwa yi-immunohistochemistry, ukuhlolwa kwama-molecular, kanye ne-digitalization, okwenza kungabi ithuluzi lokuxilonga kuphela kodwa futhi kube yikhampasi ebalulekile ekunqumeni indlela yokwelashwa kwesiguli. Ngakho-ke, ukuqonda kahle kanye nokusetshenziswa kwe-histopathology kuyisihluthulelo sokuthuthukisa ukunemba kokuxilonga kanye nekhwalithi iyonke yokunakekelwa kwempilo.
