Histopathology Dhiyabhorosi Dhiyabhorosi uye Zvirongwa Zvokufungidzira
Histopathology ndiko kuongorora kwemashupu kubva mumuviri uri pasi microscope kuti uone zviratidzo uye maitiro ezvirwere. Histology ndeyekudzidza kwemasukisi, uye hutachiona ndiko kuongorora zvirwere.
Saka kutorwa pamwechete histopathology chaizvoizvo zvinoreva kuongorora kwemasukisi sekune zvirwere. Rondedzero yezvinyorwa zvepfungwa inotsanangura mhuka dzakatumirwa kuti dziongororwe uye izvo zvinoitwa nekenza sezviri pasi pe microscope .
Rondedzero yezvematongerwo enyika dzimwe nguva inonzi ripoti ye biopsy kana mushumo wehutano.
Mharidzo yeApeptatology
Mumwe chiremba anoongorora uyo anoongorora pasi pe microscope anonzi Pathologist. Mhando iyo inodzidzwa inouya kubva pane bhiopsy kana chirongwa chinoporesa umo samuenzaniso wezvigunwe zveshungu zvinosarudzwa uye zvinotumirwa ku laboratory. Iko zvino inoshandiswa nekuchekwa muzvikamu zvakateteka zvikuru (zvinonzi zvikamu), zvakasvibiswa uye zvichiongororwa pasi microscopes kuti ijekese tsanangudzo yemasero ari mumatomu. Kune dzimwe zvirwere, chiremba anovhiya anogona kuwana mhando yezvinyorwa zvinotsanangurwa zvakakurumidza kuburikidza nekushandiswa kwezvikamu zvakaoma. Zvikamu zvakatsva kana zvimedu zvinoshandiswa zvishoma mu lymphoma, zvisinei, nemhaka yezvinetso mukududzira uye sampuli. Mune lymphomas, lymph nodes ndiwo maitiro anonyanya kuongororwa muhutano hwake. Kwemhando dzakawanda dzekenza yeropa, mafupa emapfupa anokwana anogonawo kudiwa kuti ave nechokwadi chekuongorora.
Zvikamu zveNhoroondo
Zvinyorwa zvake zvemapurisa pamusoro pezvipembenene zvepabonde rekuvhiya zviri kuramba zvichiwedzera. Dzinogona kusanganisira:
- Kubwinya kwechimiro chechimiro chakabatanidzwa
- Special stains
- Maitiro emakemikari
- Mimwe miedzo
Maitiro emakemikari anotaura kukwanisa kuongorora masero nemasukisi pamatomu-molecular, ari pamwero weprotein, receptors , uye mazamu anonyora zvinhu izvi.
Kududzira Mharidzo
Zvakawanda zvezviwanikwa kubva pakunongororwa kwemasumbu zvakabatanidzwa nekufananidzira. Zviratidzo zvekufananidzira zvinogona kusanganisira chiremera chepamusoro uye chiyero chekupararira, uye kana kwete kana kenza yakabviswa nechepakati yemasero ane utano akaipoteredza, kana kana kune uchapupu kuti kenza yakapararira kupfuura iyo yakabviswa.
Kuronga maitiro kunopesana zvichienderana nemhando yekenza iri kuvharwa, asi kazhinji masero anotsvaga zvichienderana nekusava kwemaitiro aripo pasi pe microscope, neBanga 1 matumire ari kutarisa kutarisa uye yeBlasi 4 zvirume zvinoratidza kusakanganisika. Chirwere chepamusoro-grade, zvino, inowanzo imwe iyo masero ane zvimwe zvisiri izvo. Kuchengeta hakusi kufanana nekugadzira. Kutarisa kune zvakawanda zvinoita nekenza kenza inowanikwa mumuviri uye kuti yakapararira zvakadini.
Zvinyorwa Zvitsanangudzo uye Mamwe Matanho Okuenzanisa
Mukuwedzera kune hutano hwake, mamwe maitiro anogona kushandiswa kuongorora kuvapo kwekenza mumatumbu, kusanganisira yakanaka yenzano aspiration cytology, uye imwe yemaitiro aya inogona kushandiswa zvakanyanya muzvirongwa zvehutano pasi rose. Leukemias uye lymphomas zvinoratidzwa zvichibatanidza maitiro avo-kuti masero anotarisa sei (morphology), mararamiro avo kana kuti mapuroteni epasi anogona kuonekwa achishandisa masero anorophenotype), maune enzyme anokwanisa kuita kuti mamwe maitiro emakemikari aitike (cytochemistry), uye kuchinja kwavo kwechromosomal (karyotype).
Kakawanda kacho mune lymphomas uye mamwe makondombera , imwe nzira inonzi immunohistochemistry inoshandiswa kubatsira kutarisa tumarara, chirwere uye kurapwa. Immunohistochemistry inosanganisira kushandisa ma antibodies kunamatira kune mamwe mavara kana zviratidzo kune kunze kwekenza masero.
Izvi zvinoratidza kuti ma antibodies anoomerera kune kazhinji ane "CD" muzita ravo, iyo inomirira masango ekusiyanisa. Semuenzaniso, CD23 neCD5 vane michina microscopic iyo, kana iripo mumasero ekenza, inogona kutsigira pfungwa yokuti chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL) inogona kuongororwa. Izvozvi zviratidzo zvinowanikwawo mune dzimwe mhirizhonga, zvisinei, saka vanachiremba vanoshandisa nzira yekugadzirisa zvichienderana nehupenyu hunozivikanwa uye izvo zvinozivikanwa pamusoro pezvakaipa zvakasiyana siyana uye "maitiro" avo eCD.
Mumwe muenzaniso weCCD marker iCD20, inowanikwa mune dzimwe lymphomas asi isipo kune vamwe. Kuparadzanisa larrge B cell lymphoma, kana DLBCL, inowanzoita lymphoma inosanganiswa neCD20 marker.
Kune samupa rakapiwa remakemukari eukemia kana lymphoma, zviratidzo zvinogona kuongororwa uchishandiswa boka rose remasikirwo anonamatira kune akasiyana-siyana, ane maitiro akanaka uye asina kunaka, akavakwa.
Zvidzidzo zvema molecular uye chromosomal zvinogona kuitwa kutarisa maitiro ekugadzirisa mararamiro uye kushanduka kwakananga kuma chromosomes. Dzimwe nguva inowanikwa kana kubviswa mazai emagetsi anobatanidzwa kune ruzivo pamusoro pekutsvaga. Somuenzaniso, mune chronic lymphocytic leukemia, kana CLL, chikamu chechromosome chakarasika, uye kazhinji kanguva chakarasika pamwe chete nayo geni rinobatsira kupedza kenza. Kubvisa 17p kunowanika munenge 3 kusvika ku10 muzana yevanhu vane CLL, zvakakwana. 17p deletion CLL isiri ye CLL yakaoma kubata; vanhu vane 17p deletion CLL vanowanzova zvakaoma kurapa nemakemikari anowanzogadzirwa.
Sources:
Ho C, Rodig SJ. Immunohistochemical markers mu lymphoid malignancies: Mapuroteni correlates ekuchinja kwema molecular. Seminari muDaagnostic Pathology . 2015. 32 (5): 381-91.
Zvinyorwa zvake zvekunyorwa kwake: Mazano ekurapa kenza. NeDerek C Allen. Springer Science & Business Media, Jun 29, 2013.
> Taylor J, Xiao W uye Abdel-Wahab O. Chirwere uye kusarudzwa kwehematologic malignancies pamusana peiyo genetics. Ropa . 2017 Jul 27; 130 (4): 410-423.