Ongororo dzekuongorora dzinoitwa murabhoritari yezvirwere navanachiremba vane hunyanzvi uye masayendisiti. Zvinyorwa zvinyama inogona kusanganisira kuongororwa ropa uye biopsies yenyama. Dzimwe nguva masamples ematishu angangoda kuendeswa kune nyanzvi murabhoritari kuchipatara chikuru kuti ongororo idzi dziitwe.
Kumirira mhedzisiro yedzimwe dzebvunzo idzi dzimwe nguva kungave chikonzero chekuti kurapwa kunonoke. Zvakakosha kuti vanachiremba vave neruzivo rwese rwavanoda kuti vaite sarudzo dzekurapa dzemurwere.
Sei ongororo dzekuongorora dzichiitwa?
Kune huwandu hwemiedzo inoitwa kusimbisa kuongororwa kwe lymphoma. Kune vana chiremba vane mazvikokota vakaita dzidziso yakakosha munzvimbo iyi kuti vaturike ongororo idzi kubva muropa, malymph nodes nemasampure emwongo wekuona chirwere.
Sezvo masayendisiti anonzwisisa zvakawanda nezve lymphoma, mitsva uye yakanyanya kujeka bvunzo iri kugadzirwa kuzivisa vanachiremba nezve chirwere ichi. Zviri kuwedzera kukosha kuti bvunzo idzi dziitwe kuitira kuti vanzwisise mhando nemaitiro eiyo lymphoma vasati vafunga nezve kurapwa kwakakodzera kumurwere.
Mupathology lab masampuli ematishu anozoitwa akati wandei bvunzo kurongedza masero egomarara. Vanotarisawo chimiro chavo, hukuru hwavo uye kuti vakaiswa sei mumasamples kubva kumalymph nodes uye bone marrow, nekutarisa pasi pemaikorosikopu. Vachaita mimwe miedzo yakadai se immunophenotyping, cytogenetic analysis uye / kana zvidzidzo zvema molecular kuti vawane mamwe mashoko ekuratidza kuti lymphoma inogona kuita sei.
Chii chinonzi Immunophenotyping?
Immunophenotyping inzira inoshandiswa kusiyanisa marudzi akasiyana emasero. Semuenzaniso, musiyano pakati peyakajairika lymphocytes uye lymphoma masero. Inoita izvi nekuona zvinhu zvidiki zvinozivisa, zvinonzi 'zvicherechedzo' or 'antigens' izvo zvinoratidzwa pamaseru.
Immunophenotyping inopa ruzivo rwemhando dze maantigen inowanikwa mukati kana mukati masero machena eropa (WBCs). Uyu muedzo unogona kubatsira kuongorora uye kuziva mamwe marudzi e-lymphoma. Mune zvimwe zviitiko, ruzivo runogona kufanotaura kuti lymphoma ine utsinye sei kana kuti ichapindura sei kurapwa. Kuongororwa kunogona kuitwa kuona kuti kurapa kwave kwakanaka sei uye kutsvaga chero chirwere chasara kana chisingaperi.
Immunophenotyping inogona kuitwa nenzira mbiri. Izvi zvinosanganisira bvunzo inonzi immunohistochemistry (IHC) kana kuyerera cytometry.
Immunohistochemistry (IHC)
Immunophenotyping inogona kuitwa nenzira mbiri. Immunohistochemistry (IHC), apa ndipo panoiswa mavara kumaseru ari pane siraidhi. Vanobva vatariswa pasi pemaikorosikopu. Iwo mavara anozivisa maantigen kana mamaki aripo pamaseru.
Kuyerera cytometry
Imwe nzira ndeye kuyerera kwe cytometry. Muyedzo iyi sampu inogadziriswa uye masoja ekudzivirira chirwere akaiswa machira efluorescent anowedzerwa. Izvi antibodies batanidza kune chaiyo maantigen kana varipo. Muenzaniso unoyerera nemudziyo unonzi a kuyerera kwe cytometry uko masero ega ega anoongororwa.
Kuyerera cytometry inoyera nhamba uye muzana yemasero muropa sampuli uye sero maitiro senge saizi, chimiro uye kuvapo kwemabiomarker pane cell cell. Flow cytometry inogonawo kuona mazinga akasara echirwere mushure mekurapwa. Izvi zvinobatsira chiremba kuona kudzoka kwechirwere uye kutangazve kurapwa sezvinodiwa.
Immunohistochemistry (IHC)
- Zvimedu zvitete zvemuenzaniso webiopsy (kana kuti zvidimbu zvitete zvemvura) zvinorapwa nemasoja emasoja ekudzivirira chirwere anocherekedza mavara akasiyana anowanikwa mumhando dzakasiyana dze lymphoma kana leukemic masero uye akajairika lymphocytes.
- The pathologist anoongorora masiraidhi pasi pemaikorosikopu kuti atarise shanduko yeruvara inooneka inoitika kana masoja ekudzivirira chirwere anonamira pane chinomaka.
- Chiremba anoona nekuverengera huwandu hwemasero anotaridzwa nemuvara (zvichireva kuti akanaka kune chicherechedzo) nerimwe nerimwe remasoja ekudzivirira chirwere.
Kuyerera cytometry
- Masero anobva mumuenzaniso webiopsy anoiswa mumhinduro yemvura uye anorapwa nemasoja ekudzivirira chirwere anoziva maantigen akasiyana anowanikwa mumhando dzakasiyana dzemaseru elymphoma.
- Musanganiswa we cell-antibody unobaiwa muchiridzwa chinonzi flow cytometer. Muchina uyu unoshandisa matanda elaser kuona mavara akasiyana anoburitswa nemasero kubva kune akasiyana masoja ekudzivirira chirwere anonamirwa paari. Mashoko aya anoyerwa nekuongororwa nekombuta odudzirwa nenyanzvi yezvirwere.
Chii chinonzi cytogenetic analysis?
Chromosomes dzine majini anoumba tambo refu dzeDNA. Masero emunhu ane hutano ane mapeya makumi maviri nematatu emakromosomes. MaChromosomes akakamurwa kuita matunhu maviri anonzi 'maoko', anodaidzwa kuti p (ruwoko rupfupi) uye q (ruoko rurefu). Mamwe ma lymphomas nemamwe marudzi egomarara ane makromosome akawandisa kana mashoma kana ane machromosome ane chimiro chisina kujairika. Kazhinji kazhinji okutodza dzakaputsika uye dzakabatanidzwa zvakare (translocations), kuitira kuti zvidimbu zvechromosome zvibatanidzwe zvisiri izvo zvinotungamira ku activation yebundu kukura masaini.
In cytogenetic ongororo, machromosome anobva kumasero ekenza anoongororwa pasi pemaikorosikopu kuti aone kuti hapana makromosome mashoma here kana kuti akawandisa. Zvinowanzotora mavhiki maviri kusvika matatu kuwana mhinduro kubva kucytogenetic test nekuti huwandu hwakakwana hwemaseru egomarara hunofanirwa kukura murabhoritari kuti uwane genetic material yakakwana yekuongororwa.
Mhedzisiro yeiyo cytogenetic kuongorora inogonawo kubatsira kusiyanisa pakati marudzi akasiyana of isiri-Hodgkin lymphoma kana kubatsira mukuita sarudzo dzekurapa.
Ndeapi marudzi echromosomal abnormalities?
Imwe mhando yechromosomal abnormality inowanikwa mune mamwe marudzi e-lymphoma inonzi translocation, iyo inoitika kana chikamu chechromosome chikabuda kubva panzvimbo yachiri yenguva dzose chobva chanamatira kune imwe chromosome.
Imwe mhando yechromosomal abnormality inonzi a kubviswa, izvo zvinoitika kana chikamu chekromosome chisipo. Izvi zvakanyorwa, semuenzaniso se del(17p), tichiona kuti pane kudzima muruwoko rwupfupi rwekromosome 17.
Nei murwere angada kumwe kuongorora magene?
Vanachiremba vanogona kuraira mamwe ma genetic test kuti vasimbise mhedzisiro ye cytogenetic bvunzo kana kuwana yedu yakadzama ruzivo nezve marudzi ekukuvadza kune ruzivo rweiyo genetic ye lymphoma masero.
Mhando dzekuwedzera genetic tests
Fluorescence in situ hybridization (FISH)
- FISH inoshandisa kemikari yefluorescent kunyatsobatanidza kune zvimwe zvikamu zvemakromosomes kuratidza kuvepo kwekufambiswa uye zvimwe zvakakura zvisingaite.
- FISH inopa vaongorori nzira yekuona uye mepu yemajini mumasero emunhu, kusanganisira chaiwo majini kana zvikamu zvemajini. Izvi zvinogona kushandiswa kunzwisisa zvakasiyana siyana zvechromosomal abnormalities uye mamwe genetic mutations.
- HOVE inogona kuitwa paropa, lymph nodes, kana mapfupa emapfupa, uye mhinduro dzebvunzo dzinowanzo kuwanikwa mukati memazuva mashoma (nekukurumidza kupfuura cytogenetic test).
Polymerase chain reaction (PCR)
- PCR bvunzo inoshandiswa kuyera majini chaiwo (kureva, DNA) asingaonekwe nemaikorosikopu.
- PCR bvunzo dzinogona kuitwa pahuwandu hudiki hwemasero, uye kazhinji zvinotora svondo rimwechete kuti uwane mhinduro idzi.
DNA kutevedzana
- Kumwe kusajairika mukukura kwebundu kunoitika nekuda kweshanduko mukutevedzana kwejini kana seti yemajini.
- Izvi zvakawanikwa zvinogona kubatsira kutsanangura rudzi rwebundu, kuona prognosis, kana kukanganisa sarudzo yekurapa.
- Jeni rega rega rinogona kutevedzana kana pani yeanozivikanwa akakosha majini anogona kutevedzana panguva imwe chete.
Murwere achawana sei mhedzisiro yavo?
Idzi bvunzo dzehunyanzvi dzinoitwa chete kune mamwe marabhoritari. Hematologist inowana zvabuda uye nekududzira izvi nemamwe ese emamwe mhedzisiro yebvunzo. Miyedzo iyi inogona kutora nguva diki kudzoka uye mimwe bvunzo inogona kutora mazuva mashoma uye imwe inogona kutora mavhiki.
Zvakakosha kuti uwane rumwe ruzivo urwu kurapwa kusati kwatanga kuona kuti kurapwa kwakakodzera kuri kupihwa kumurwere wega. Zvakakosha kuti varwere vazive kuti kududzira ongororo dzekuongorora dzinofanirwa kuitwa pakati pachiremba nemurwere.
Mushumo unorevei?
Vamwe varwere vanofarira kuongorora zvinyorwa zvavo zvakanyorwa; pakuita kudaro, zvakakosha kuti murwere anyatsoongorora zvakawanikwa nachiremba wavo. Izvi zvinodaro nekuti kazhinji chiremba anoturikira mibairo mizhinji kubva mukuyedzwa kwakasiyana kuti aite kuongororwa ane ruzivo.
Uyu muenzaniso wemamwe maCD marker emhando dzakasiyana dzenon-Hodgkin lymphomas dzinotariswa navanachiremba kuti vaone kuti chirwere che lymphoma chii, ona tafura iri pasi apa:
Cherechedzo: Chimwe chezviratidzo zvinobatsira zvekuongororwa Hodgkin lymphoma iCD30
