Munguva yakapfuura, varwere vakanga vasingawanzofariri zvinyorwa zvinotsanangura kenza yavo. Asi mazuva iwayo, ndinoonga, maenda. Vanhu vazhinji varikumbira makopi ehutano hwavo hwezvechiremba, uye dzimwe nzvimbo dzekenza dzinopa hovha yevarwere iyo zvinhu zvose kubva pahudhiology zvinosvika kumairabhu zvinogona kuwanika paIndaneti. Asi pane zvose izvi, ruzivo rwemapapu rwemapapu runyorwa runogona kuva rumwe rwezvinonyanya kuoma kukurudzira semunhu akaisa.
Saka ini ndichaedza kutsanangura imwe yemashoko ekurapa kuti ikubatsire kunzwisisa mutauro wako.
Chii Chaicho Chiitiko chePathology?
Rondedzero yehutano ndiyo tsanangudzo yakanyorwa yekenza yako nechirwere chechirwere, mushure mekuongorora hutundu hutorwa kubva mumuviri wako kuburikidza ne biopsy kana chirwere. Pane kungova hongu kana kuti kwete kana mushumo (iyo chirwere?) Iyi mishumo inogona kutakura ruzivo rwakanyanya ruzhinji runobatsira chiremba wako kuti anzwisise kutora kwako asi nzira yakanakisisa yekurapa zvakare. Izvozvo zvakati, maitiro ehutachiona haashandisi ari oga asi pane akabatanidzwa nehupenyu, kuongorora mumuviri, zvidzidzo zvehudhiology, uye mabhizinesi ekudzidza kuti awane mufananidzo wakanakisisa wekenza yako.
Zvinyorwa zvishoma zvinobatsira zvisati zvaenderera mberi. Chimwe ndechokuti kenza yese yakasiyana. Kana pakanga pane vanhu makumi matatu nematatu vane mukenza wemapapu mune imwe imba, paizova nemhando 30 yemhando yemukenza yemapapu. Mushumo wehutano ndeimwe yezvishandiso zvinoshandiswa kunzwisisa munhu wako wekenza.
Imwe pfungwa inokosha ndeyokuti kunyange zvazvo zvakajairika kuti uwane pfungwa dzechipiri (uye zvichida yechitatu kana kupfuura) pamusoro pekenza yako, kuverenga kwechipiri kwenyaya yako yehutano kunogona kukanganwa. Kuwana maonero echipiri pamusoro pehupenyu hwako kunogona kuva chinhu chakakosha sekutora pfungwa yechipiri pane kurapa kwako.
Zita, Zuva, uye Chipatara Mashoko
Rondedzero yako yehutano inotanga kusanganisira zita rako, uye mamwe mashoko ekutanga uyewo zvichida kuongororwa uye zviratidzo zvinogona kuitika iwe wave uchitarisana nayo.
Specimen
Izwi rokuti specimen rinonzwika rinotyisa, asi rinoreva zvinoshandiswa muenzaniso wezvisikwa izvo chiremba, chirembai, kana mumwe chiremba anobvisa. Ichi chikamu chinofananidza nzvimbo mumuviri kubva pane samuti yakatorwa. Apo shanduro inowanikwa uye inogamuchirwa nedhipatimendi rehutachiona inoongororwa mumatanho mashoma.
Macroscopic Assessment (inonziwo Gross Examination)
Sezvo "macro" zvinoreva kureba, uye "zvakakomba" mumagariro ezvokurapa zvinoreva kuonekwa kune ziso rakashama, kuongorora uku kunoreva izvo chiremba anoona kuburikidza nokutarisa mhando yako yemaitiro pasina kushandisa microscope-mufananidzo mukuru mukati. Inogona kusanganisira zviyero, uremu hwechirwere, uye mamwe maitiro akaita sevara uye kusagadzikana. Mamwe mapundu anonyatsojeka (semufananidzo uri pamusoro apa unoratidza) asi dzimwe nguva hapana kuipa kunowanikwa kusvikira danho rinotevera raitwa.
Kubvunzurudza kweChina
Mushure mekutarisa muenzaniso wezvisikwa zvenyu, vana pathologist vanowanzotora zvimedu zviduku izvo ivo vanozozviongorora pasi pe microscope. Izvi dzimwe nguva dzakanyanyisa (kuitira kuti zvidimbure maronda acho zvishoma kwazvo) uye inogona kubatwa nedhayi chaiyo kana zvimwe zvinhu zvisati zvaiswa pane slide. (Izvi zvinogona kutora nguva uye chikonzero chimwe chete chiremba wako haazove nemigumisiro apo iwe wakamirira nekutya.) Pane zvikamu zvakakosha zvezvikamu zvinobva kune iyi yekuongorora:
- Kumhanyira mumashure - Chimwe chinhu chinowanzozivikanwa ndechokuita maronda margins (kana kuvhara margins.) Izvi zvinoreva kuti kana kwete yose yekenza yakabviswa, uye kana yose yakabviswa, kurega kure nekutsvaga kwaiva nehupi hwekenza. Somuenzaniso, mushumo unogona kutaura kuti chironda chacho chakawedzerwa kusvika ku 1.2 cm kubva mumuganhu wekuvhiya.
- Tumor Grade - Tumorori inogona kuve yakarongedzwa nekumarara gorosi. Zviri nyore kuti chiremera chechikamu chekutanga chichange chisina kunyanyisa, uye chirwere chechikamu chechitatu chingava chinotyisa. Nemukenza wemapapu, mutauriri wako unogona kunge uine mazwi akafanana zvakasiyana-siyana, asinganyatsosiyaniswi, kana asina kufanirwa. Zvipembenene zvakanyatsosiyaniswa zvinowanzokura zvishoma, asi zvisingaverengeki zvisingabatsiri zvinowedzera kukura zvakanyanya. Mukuwedzera pane kuonekwa kwemaitiro emukenza, vanachipatara vanotarisa zvinhu zvakawanda kuti vaone kusuruvara kwechiremera. Izvi zvinosanganisira zvinhu zvakadai sekuita mitotic (kuti masero emukenza anokurumidza kuonekwa sei achiparadzanisa) paanosarudza chikamu chemuviri.
- Rudzi rwekenza - Nemukenza wemapapu, pane 2 maitiro makuru. Makana-maduku emakristini emapapu emapapu anotora anenge 80 muzana emakirini emapapu uye masero ane unhu huri pasi pe microscope. Dzimba duku dzekenza mapapu emapapu dzinoumba zvizhinji zvezvasara uye dzine maitiro akasiyana pasi pe microscope. Madiki-maduku emakristini emapapu emapapu anowedzera kugoverwa kuva adenocarcinomas , huru cell carcinomas , uye squamous cell carcinomas zvichienderana nerudzi rwekero kenza inotangira, kuoneka pasi pe microscope, uyewo maitiro ekuraira anotarisa mamwe mavara (ona pasi apa .) Kuvhiringidzika kwevanhu vazhinji pavanotarisa rondedzero yavo yehutano ndeyekuti matumire haagadziri zvakakwana muchikamu chimwe chete kana chimwe. Semuenzaniso, mushumo unogona kutaura kuti tumarara isiri duku duku rekenza yemapapu uye mamwe maitiro emukenza mutsva wemapapu.
- In Situ vs Infiltrating / Invasive - Chimwe chinyorwa chaunogona kuona pamushumo wako ndechokuti tumarara iri mu situ kana kuti inopinda kana kuti inopisa. In situ rinotsanangura kenza iyo inongowanikwa mumasero mawakatanga. Masayendisiti akawanda anofunga kuti aya ari masevi anononoka pane masero anouraya. Kanzera yemaperembudzi inowanikwa pane ino danga inofungidzirwa sendima 0. Chizhinji chenguva nemukenza wemapapu chironda chinotsanangurwa sechichipinda kana chisingaiti. Izvi zvinoreva kuti tumarara yakapararira kupfuura mhuka iyo yakatanga mukati uye ine simba rokupararira (metastasize) kune dzimwe nhengo dzomuviri. Vanachiremba vanogonawo kucherechedza chimwe chinhu chinonzi chinonzi angiolymphatic invasion. Izvi zvinotsanangura kana chirwere ichi chakapinda mumisasa yeropa iri pedyo uye / kana midziyo ye lymphatic.
- Lymph node kupinda - Kana wakambovhiyiwa kubvisa tsvina yako, lymph nodes ingadai yakabviswa kuti ione kana iine kenza (positive) kana isingararami (isina.) Izvi zvicharatidzwa mumushumo nemashoko akadai sokuti lymph nodes dzakanga dziri pedyo nechirwere, kana kuti zvakanyanya kure, uye dzinogona kutora chikamu chikuru mukurapa wako oncologist anokurudzira.
- Kusangana - Dzimwe nguva danho rinopiwa sechikamu chehupenyu hwehutano hwako. Kuti uwane shanho, vanachipatara vanotarisa kusanganiswa kwechiremera chekukura, lymph node kupinda, uye kana kwete kana chirwere chacho chakapararira kune dzimwe nhengo dzomuviri (mastasizedzed.) Pane nzira shomanana dzenzira yako ingarondedzerwa. Chero-duku kemukirini yemapapu yemapapu inogoverwa muzvikamu zvina zvekutanga . Kuti uone matanho aya vanachiremba vanoshandisa chimwe chinhu chinonzi TNM staging . Nechigadziriro iyi T inomirira chiremera chemuviri, N inomirira kuvapo uye nhamba yemakiromodhi akanaka, uye M inomira kumagetsi ekure. Nekenza kaduku kemapapu memapapu pane zvikamu zviviri chete: nzvimbo yakadzika uye zvishoma .
Mapuroteni / Gene Markers
Pane humwe huongorori humwe hutachiwana hunogona kuita pahutachiona hwako kuti ubatsire kuziva kuti ndeipi yemapapu emapapu iyo, kana kuti chirwere chako chiri chaizvoizvo kenza yakasimuka mune imwe chikamu chemuviri wako ndokupararira kumapapu ako. Mienzaniso miviri yeiyi inosanganisira TTF-1, p63, CD56, uye chromogranin.
Molecular Profiling
Munguva pfupi yapfuura, kufambira mberi kwakaitika mukurapwa kwekenza yemapapu kuburikidza nokunzwisiswa kwezvinhu zvakasiyana-siyana zvemashoko anokonzera "kukura" kukura kwekenza. Kune vamwe vanhu, kunyanya vanhu vane adenocarcinoma, vanotarisira kurapwa kunowanika kurapa chirwere chinowanzova nemigumisiro shoma pane yakasarudzwa chemotherapy. Kuchinja kwemazuva ano kwakaitwa kune EGFR , KRAS, ROS1 , uye ALK . Iko zvino inokurudzirwa kuti vanhu vane musero musingaiti masero memapapu emapapu vanoongororwa nekuda kwekuchinja uku-asi kuongorora kwechangobva kuitika kwakaratidza kuti 60 chete muzana yevana oncologist vari kuita saizvozvo.
Kuziva
Chikamu chekupedzisira chehutano hwehutano ndechekuongororwa umo mutachiona anotsanangura muchidimbu zvitsva. Izvi zvinowanzosanganisira rudzi rwekenza, yegorosi (kuti yakasiyana sei,) ingave chero lymph nodes yaiva yakanaka, uye danho.
Nhanho Inotevera
Kana iwe uchangobva kuudzwa kuti une kenza yemapapu, tarisa matanho aya ekutanga kutora , funga nezvechipiri pfungwa , uye nguva dzose bvunza mibvunzo yakawanda. Usambofunga kuti iwe uri kutora nguva yako yakawanda yechiremba-kuti 'chii chaanobhadhara. Kana mibvunzo yako isingagoni kupindurwa zvakakwana, tsvaga chiremba anokwanisa kupindura.
Sources:
National Cancer Institute. FactSheet. Repentance Reports. Updated 09/23/10.