Imwe nzira yekunzwisisa zviri nani maranoma ekuongorora uye kukonzerwa kwehutano urongwa ndeyekuverenga rondedzero yako yehuranoma pathology, iyo inotumirwa kunechiremba wako uye ine zivo inokosha zvakadai sechinhu chaiyo chetachiona chako. Iyi ndiyo chikamu chokutanga chezvinyorwa zvinyorwa zvingakubatsira kuti udzidze chirongwa chemagetsi mumishumo iyi.
Kuongororwa Maonero
Kana chironda chinoshushikana kana mole chinowanikwa panguva yaunenge uchiongorora ganda , chiremba wako mukuru wekuchirapa kana dermatologist achatora sopimen biopsy yechiremba (chiremba anoongorora tsvina uye mvura inoshandiswa kurwara zvirwere kuitira kuti vabatsire pakuita zvirongwa zvekurapa ) kuongorora pasi microscope.
Kana nyanzvi yehutano inowana maswere anouraya (kenza) mu biopsy, chiremba wako wekuchiremba chiremba anogona kuronga dzimwe mimwe miedzo - lymph node, ropa, urini uye zviratidzo zvekufungidzira - kuti uone kana kenza haina kupararira kana kwete. Iyi miedzo inobatsira chirwere chekuongorora chirwere chekuongorora nzvimbo, kupararira, uye shato yemaranoma. Chirwere chechirwere chinoratidzira chiremba wako wekunyanya kutarisira mushure mekuongorora zviitiko zvekuedza nekugadzira danga rekenza. Vose, vanoona maitiro ekurapa akakodzera zvakanyanya pamamiriro ako.
Mitotic Rate
Rondedzero yako yehutano ine ruzivo, zvakadai semarara, danho, Clark , Blowlow thickness , ulceration (inowanikwa apo maranoma anoputika nepakati peganda) uye mitotic (MR).
Nhamba yakakura yemitoti inobatanidzawo nehuwandu hwekuve neine positive sentinel lymph node biopsy.
IMM inotaridzirwa nekutsvaga chiremera chekunyadziswa (chekuvhiyiwa) chinokonzerwa ne microscope uye nokuverenga nhamba yemasero anoratidza mitosis , zvinonzwisisika zvinozivikanwa zvekuparadzanisa masero.
Kazhinji kazhinji, MR inonzi ichine chimwe chezvikamu zvitatu (kunyange zvazvo dzimwe nguva inorondedzerwa senhamba inoenderera mberi, isina chimiro):
- pasi pe-1 pamakiromita emakiromita
- 1 kusvika ku 4 pamakiromita emakiromita
- mukuru kudarika 4 pamakiromita emakiromita
Izvo zvakakwirira mitotic kuverenga, kunyanya chirwere chacho chinofanirwa kuparadzaniswa (kupararira). Izvo zvine musoro ndezvokuti kana mamwe masero ari kugovana, zvinowanzoita kuti vapinde muropa kana lymphatic midziyo uye saka vakapararira pamuviri.
Kutsvakurudza kwakaratidza kuti maitiro ekupona kwevarwere vane chirwere chesepanamendi uye mitotic chiyero che 0 per square millimita gumi nemaviri apo yevarwere vane mitotic yakawanda kupfuura 6 pamakiromita emakiromita. Uyewo, 4% chete yezvipembenene nevadzidzisi veMR reur (vadzoka) vakaenzaniswa ne24% yevaya vane MR. Iyo mitotic inogona kubatsirawo kufanotaura kana wako sentinel lymph node biopsy ichava yakanaka kana kwete.
Ari Kuenzanisa MR Zvakakodzera?
Kubvira kuma1990, zvidzidzo zvakawanda zvakatsigira kuti mitotic chiyero inokosha yekufananidzira kwezviitiko kune varwere vane melanoma, kunyange zvazvo dzimwe nharo dziripo. Nharo mbiri dziri pasi pekukakavadzana: 1) MR azvimiririra kune mamwe anofungidzira zvinhu ? uye 2) kana zvisina, kuyera MR kunobatsira nguva uye mari?
Kunyange zvazvo MR asina rutivi rwemamiriro ezvinhu epanguva ino ye melanoma, tsvakurudzo yakaratidza kuti iyo inonyanya kukosha kufungidzira kupfuura kuonda, iyo ine basa rinokosha pakutsvaga. Vamwe vanachiremba, zvisinei, vanotenda kuti mitotic chiyero hachisi chekuzvimiririra chirevo nokuti chakanyatsobatana nechirwere (Breslow) kuwanda uye kuonda. Semuenzaniso, American Academy of Dermatology inotaura kuti MR inofanira kunge yakasarudzwa mumashoko ekunyora . Kune rumwe rutivi, National Comprehensive Cancer Center inokurudzira kuti MR inofanira kuziviswa nezvezviremera zvose muchitemiti I kuvaviri varwere.
Kunyange zvakadaro, dzimwe nyanzvi dzinopikisa kuti kuenzanisa MR kunofanira kungoitwa muzvikoro zvikuru (yunivhesiti) kuchipatara zvirongwa zvekutsvakurudza mune ramangwana. Kana iyo MR isingabatanidzwi mushumo wehutano hwako, iva nechokwadi chekubvunza chiremba wako pamusoro pekufunga kwake.
Mhedziso
Nguva dzose unokumbira kopi yerondedzero yako yehutano. Verengai uye mubvunze chiremba wenyu mibvunzo pamusoro payo. Usanonoka kuwana pfungwa yechipiri pamusoro pekuongororwa kubva kune imwe nyanzvi, yakadai sedermatopathologist. Murwere ane ruzivo murwere ane simba, uye murwere ane simba anokwanisa kuita sarudzo dziri nani dzinotungamirira kumigumisiro yakanaka.
Zvimwe pamusoro peKutsanangura Kwazvo Musoro Wenyu weMaranoma Pathology
Sources:
Melanoma. National Comprehensive Cancer Network. V1.2009.
Kunzwisisa Kuongorora Kanzira: Ganda Melanoma. College of American Pathologists.
Attis MG, Vollmer RT. "Mitotic rate mu melanoma: kuongororazve." Am J Clin Pathol 2007 127 (3), 380-4.
Barnhill RL, Katzen J, Spatz A, Fine J, Berwick M. "kukosha kwemitotic chiyero sechirevo chechirwere chinonzi melanoma." J Cutan Pathol 2005 32 268-273.