Ukuhlolwa kokuxilonga kwenziwa elabhorethri ye-pathology ngodokotela abangochwepheshe nososayensi. Amasampula ezicubu kungabandakanya ukuhlolwa kwegazi kanye nama-tissue biopsies. Kwesinye isikhathi amasampula ezicubu kungase kudingeke ukuthi athunyelwe elabhorethri eyisipesheli esibhedlela esikhulu ukuze kwenziwe lokhu kuhlolwa.
Ukulinda imiphumela yalokhu kuhlola ngezinye izikhathi kungase kube isizathu sokuqala kokwelashwa ukubambezeleka. Kubaluleke kakhulu ukuthi odokotela babe nalo lonke ulwazi abaludingayo ukuze benze izinqumo ezingcono kakhulu zokwelashwa kwesiguli.
Kungani kwenziwa ukuhlolwa kokuxilonga?
Kunenqwaba yokuhlolwa okwenziwa ukuze kuqinisekiswe ukuxilongwa kwe-lymphoma. Kunodokotela abangochwepheshe asebethole ukuqeqeshwa okukhethekile kule ndawo ukuze bahumushe lokhu kuhlolwa ngegazi, ama-lymph nodes kanye namasampula omnkantsha ukuze kutholakale isifo.
Njengoba ososayensi beqonda kabanzi nge-lymphoma, kwakhiwa izivivinyo ezintsha nezibucayi ukwazisa odokotela mayelana nokuxilongwa. Kuya kubaluleka kakhulu ukuthi lokhu kuhlola kwenziwe ukuze baqonde uhlobo nokuziphatha kwe-lymphoma ngaphambi kokuthatha isinqumo ngokwelashwa okufanele kwesiguli.
Elebhu ye-pathology amasampula ezicubu azohlolwa eziningana ukuze kuhlukaniswe amaseli omdlavuza. Baphinde babheke ukuma kwabo, usayizi wabo kanye nendlela aqoqwe ngayo ngamasampula avela kuma-lymph nodes nomnkantsha wamathambo, ngokubheka ngaphansi kwesibonakhulu. Bazokwenza izivivinyo ezengeziwe ezifana ne-immunophenotyping, ukuhlaziywa kwe-cytogenetic kanye/noma izifundo zamangqamuzana ukuze bathole ulwazi olwengeziwe ukuze babonise ukuthi i-lymphoma ingase iziphathe kanjani.
Iyini i-Immunophenotyping?
I-Immunophenotyping inqubo esetshenziselwa ukuhlukanisa phakathi kwezinhlobo ezahlukene zamaseli. Isibonelo, umehluko phakathi kwe-lymphocyte evamile namaseli e-lymphoma. Lokhu ikwenza ngokuthola izinto ezincane ezihlonzayo, ezibizwa 'omaka' or ama-antigens ezivezwa kumaseli.
I-Immunophenotyping inikeza ulwazi ngezinhlobo ze ama-antigen itholakala ngaphakathi noma ngaphakathi amaseli amhlophe egazi (WBCs). Lokhu kuhlolwa kungasiza ukuxilonga nokukhomba izinhlobo ezithile ze-lymphoma. Kwezinye izimo, ulwazi lungabikezela ukuthi i-lymphoma inonya kangakanani noma ukuthi izosabela kanjani ekwelapheni. Ukuhlolwa kungenziwa ukuze kubonakale ukuthi ukwelashwa kube ngempumelelo kangakanani futhi kubhekwe noma yisiphi isifo esiyinsalela noma esiphindelelayo.
I-Immunophenotyping ingenziwa ngezindlela ezimbili. Lezi zihlanganisa ukuhlolwa okubizwa i-immunohistochemistry (IHC) noma i-cytometry yokugeleza.
I-Immunohistochemistry (IHC)
I-Immunophenotyping kungenziwa ngezindlela ezimbili. I-Immunohistochemistry (IHC), kulapho amabala afakwa khona kumaseli aku-slide. Bese zibhekwa ngaphansi kwesibonakhulu. Amabala azohlonza ama-antigen noma omaka abakhona kumaseli.
I-flow cytometry
Enye indlela yile ukugeleza kwe-cytometry. Kulokhu kuhlola isampula liyacutshungulwa futhi amasosha omzimba amakwe ngomaka be-fluorescent ayengeziwe. Lezi ama-antibodies namathisela kokuqondile ama-antigen lapho bekhona. Isampula ligeleza entweni ebizwa ngokuthi a ukugeleza kwe-cytometry lapho amaseli ngamanye ahlaziywa khona.
I-flow cytometry ikala inombolo namaphesenti amaseli kusampula yegazi nezici zeseli ezifana nosayizi, umumo kanye nokuba khona kwama-biomarker endaweni yeseli. I-Flow cytometry ingakwazi futhi ukubona amazinga asele esifo ngemva kokwelashwa. Lokhu kusiza udokotela ukuthi abone ukubuya kwesifo futhi aqale kabusha ukwelashwa njengoba kudingeka.
I-Immunohistochemistry (IHC)
- Izingcezu ezizacile zesampula ye-biopsy (noma izingqimba ezincane zoketshezi) ziphathwa ngamasethi amasosha omzimba abona izimpawu ezihlukene ezitholakala ezinhlotsheni ezahlukene ze-lymphoma noma amaseli e-leukemic kanye nama-lymphocyte avamile.
- Isazi sezifo sihlola amaslayidi ngaphansi kwesibonakhulu ukuze sibheke ukushintsha kombala okwenzekayo lapho i-antibody inamathela kumaka.
- Isazi sezifo sihlonza futhi sibale inani lamaseli agqanyiswe ngombala (okusho ukuthi alungile kumaka) ngamasosha omzimba ahlukene.
I-flow cytometry
- Amaseli asuka kusampula ye-biopsy afakwa kusixazululo esiwuketshezi futhi aphathwe ngamasethi amasosha omzimba abona ama-antigen ahlukene atholakala ezinhlotsheni ezihlukene zamaseli e-lymphoma.
- Ingxube ye-cell-antibody ijovwa entweni ebizwa ngokuthi i-flow cytometer. Lo mshini usebenzisa imishayo ye-laser ukuzwa imibala eyahlukene amangqamuzana ayikhiphayo kumasosha omzimba ahlukene anamathele kuwo. Lolu lwazi lulinganiswa futhi luhlaziywe ngekhompiyutha futhi luhunyushwe udokotela wezifo.
Kuyini ukuhlaziywa kwe-cytogenetic?
Ama-Chromosomes ziqukethe izakhi zofuzo ezihlanganisa imicu emide ye-DNA. Amaseli omuntu anempilo anamapheya angama-23 ama-chromosome. Ama-Chromosome ahlukaniswe abe izifunda ezimbili ezibizwa ngokuthi 'izingalo', ezibizwa ngokuthi p (ingalo emfushane) kanye no-q (ingalo ende). Amanye ama-lymphoma nezinye izinhlobo zomdlavuza zinama-chromosome amaningi kakhulu noma ambalwa kakhulu noma anama-chromosome anesakhiwo esingavamile. Ngokuvamile ama-chromosomes ziphukile futhi zixhunywe kabusha (ukuthutha), ukuze izingcezu zechromosome zixhunywe ngokungalungile okuholela ekusebenziseni amasignali okukhula kwesimila.
In i-cytogenetic ukuhlaziywa, ama-chromosome avela kumangqamuzana omdlavuza ahlolwa ngesibonakhulu ukuze kubhekwe ukuthi awekho yini ama-chromosome ambalwa kakhulu noma amaningi kakhulu. Ngokuvamile kuthatha amasonto amabili kuya kwamathathu ukuthola imiphumela ekuhlolweni kwe-cytogenetic ngoba inani elanele lamaseli omdlavuza kufanele likhuliswe elabhorethri ukuze kutholwe izakhi zofuzo ezanele zokuhlaziywa.
Imiphumela ye ukuhlaziywa kwe-cytogenetic kungasiza futhi ukuhlukanisa phakathi izinhlobo ezahlukene of i-non-Hodgkin lymphoma noma usizo ekwenzeni izinqumo zokwelashwa.
Yiziphi izinhlobo ze-chromosomal abnormalities?
Olunye uhlobo lokungajwayelekile kwe-chromosomal olutholakala kwezinye izinhlobo ze-lymphoma lubizwa ukuthutha, okwenzeka lapho ingxenye ye-chromosome iphuma endaweni yayo evamile futhi inamathela kwenye i-chromosome.
Olunye uhlobo lokungajwayelekile kwe-chromosomal lubizwa ngokuthi a ukususa, okwenzeka lapho ingxenye ye-chromosome ingekho. Lokhu kubhaliwe, isibonelo njenge-del(17p), kuphawula ukuthi kube khona ukususwa engalweni emfushane ye-chromosome 17.
Kungani isiguli singase sidinge ukuhlolwa okwengeziwe kofuzo?
Odokotela bangase ba-ode ukuhlolwa kofuzo okwengeziwe ukuze baqinisekise imiphumela yokuhlolwa kwe-cytogenetic noma ukuthola ulwazi lwethu olunemininingwane eminingi mayelana nezinhlobo zomonakalo olwazini lofuzo lwamaseli e-lymphoma.
Izinhlobo zokuhlolwa kofuzo okwengeziwe
I-Fluorescence in situ hybridization (INHLANZI)
- I-FISH isebenzisa amakhemikhali e-fluorescent ukuze inamathisele ngokuqondile ezingxenyeni ezithile zama-chromosome ukuze ibonise ukuba khona kokuguqulwa nokunye okungavamile okukhulu.
- I-FISH inikeza abacwaningi indlela yokubona ngeso lengqondo futhi benze imephu impahla yofuzo kumaseli omuntu ngamunye, okuhlanganisa ufuzo oluthile noma izingxenye ezithile zofuzo. Lokhu kungase kusetshenziselwe ukuqonda izinhlobonhlobo zokungajwayelekile kwe-chromosomal nokunye ukuguqulwa kofuzo.
- INHLANZI ingenziwa ngegazi, ama-lymph nodes, noma amasampula omnkantsha, futhi imiphumela yokuhlolwa ivamise ukutholakala ezinsukwini ezimbalwa (ngokushesha kunokuhlolwa kwe-cytogenetic).
I-Polymerase chain reaction (PCR)
- I-PCR ukuhlola okusetshenziselwa ukukala izakhi zofuzo ezithile (okungukuthi, i-DNA) ezingakwazi ukubonakala ngesibonakhulu.
- Ukuhlolwa kwe-PCR kungenziwa enanini elincane kakhulu lamaseli, futhi ngokuvamile kuthatha cishe isonto elilodwa ukuthola le miphumela.
Ukulandelana kwe-DNA
- Okunye okungavamile ekukhuleni kwesimila kwenzeka ngenxa yoshintsho ekulandelaneni kofuzo oluthile noma isethi yofuzo.
- Lokhu okutholakele kungasiza ukuchaza uhlobo lwesimila, ukunquma ukubikezela, noma kube nomthelela ekukhethweni kokwelashwa.
- Isakhi sofuzo esingasodwana singase silandelane noma iphaneli yezakhi zofuzo ezaziwayo zingalandelana ngesikhathi esisodwa.
Isiguli sizoyithola kanjani imiphumela yaso?
Lokhu ukuhlola okukhethekile okwenziwa kuphela kumalabhorethri athile. I-hematologist izothola imiphumela futhi ayihumushe ngayo yonke eminye imiphumela yokuhlolwa. Lokhu kuhlola kungase kuthathe isikhashana ukubuya futhi okunye ukuhlola kungathatha izinsuku ezimbalwa kanti okunye kungathatha amaviki.
Kubalulekile ukuthola olunye lwalolu lwazi ngaphambi kokuthi ukwelashwa kuqale ukuze kuqinisekiswe ukuthi isiguli ngasinye sinikezwa ukwelashwa okufanele. Kubalulekile ukuthi iziguli zazi ukuthi ukutolika ukuhlolwa kokuxilongwa kufanele kwenziwe phakathi kukadokotela nesiguli.
Usho ukuthini umbiko?
Ezinye iziguli zithanda ukubukeza imibiko yazo ebhaliwe; lapho wenza kanjalo, kubalulekile ukuba isiguli sibuyekeze ngokucophelela lokho okutholwe nodokotela waso. Lokhu kungenxa yokuthi ngokuvamile udokotela uhumusha imiphumela eminingi evela ekuhlolweni okuhlukene ukuze enze ukuxilonga unolwazi.
Lesi isibonelo sezinye zezimpawu ze-CD zezinhlobo ezahlukene ze-non-Hodgkin lymphoma odokotela abazibhekayo ukuze babone ukuthi i-lymphoma ixilongwa kanjani, bheka ithebula elingezansi:
Qaphela: Olunye lwezimpawu eziwusizo zokuxilongwa kwe-Hodgkin lymphoma yi-CD30
