Nws tuaj yeem hais qhia qhov xwm txheej ntawm neoplasm hauv lub cev vim muaj cov tsos mob ntawm cov tsos mob thiab hluav taws xob, tab sis txhawm rau txiav txim siab nws txoj kev koom tes hauv histogenetic yog ua tau tsuas yog los ntawm kev txheeb xyuas morphological ntawm kev kuaj mob. Lub luag haujlwm tseem ceeb ntawm qhov kev kuaj mob no yog kuaj xyuas ob zaug ntawm kev kuaj mob oncological txhawm rau paub meej tias nws thiab xaiv cov kev kho mob zoo.
Morphological pov thawj
Tau hnov thawj zaug los ntawm tus kws kho mob txog qhov xav tau kev kuaj mob morphological, ntau tus tsis paub tias nws yog dab tsi thiab nws yog dab tsi.
Kev Tshawb Fawb yog ib qho kev kawm tseem ceeb, tsis muaj qhov tsis tuaj yeem txiav txim siab txog kev nqis tes ua ntxiv. Kev txheeb xyuas morphological yog cov txheej txheem kho mob uas pab paub meej lossis tsis lees paub qhov kev kuaj mob oncological. Txhawm rau ua qhov kev tshawb fawb, koj yuav tsum tau txais cov khoom siv. Nws txoj kev xaiv tsuas yog nyob ntawm thaj chaw ntawm kev kawm. Tom qab kev kawm, tus kws kho mob tshwj xeeb, nyob ntawm qhov tshwm sim, txiav txim siab ntxiv kev kho mob tactics, uastej zaum yuav yog conservative los yog phais. Tsuas yog tom qab kev pom zoo morphological tuaj yeem npaj kho kom txaus. Indications rau kev txheeb xyuas yog volumetric formations los yog diffuse hloov nyob rau hauv lub cev los yog nws cov qauv. Txhawm rau ua qhov kev tshawb fawb morphological, cov ntaub so ntswg kuaj tau ua raws li hauv qab no:
- nrog cov qog nqaij hlav tawv nqaij, khawb thiab smears-imprints;
- nrog rau qhov ntiav ntiav nodular formations, ib qho puncture yog ua;
- yog tias nws tsis tuaj yeem ua qhov puncture, kev kuaj ntshav yog ua nrog cov qauv ntawm cov ntaub so ntswg;
- Tom qab kev sim ua tsis tiav ntawm kev txheeb xyuas los ntawm txhua txoj hauv kev tau teev tseg saum toj no, qhib kev kuaj ntshav tau ua tiav.
Morphological pov thawj ntawm kev kuaj mob yog xyaum tsis txawv ntawm cytological puncture. Txhawm rau nqa cov khoom siv rau kev tshawb fawb, ua ntej, ib tus neeg tau txais tshuaj loog ntawm cov ntaub so ntswg thiab tawv nqaij, tom qab ntawd ua ib qho kev txiav me me ntawm daim tawv nqaij, los ntawm kev siv cov cuab yeej tshwj xeeb nkag rau hauv cov ntaub so ntswg thiab ncaj qha mus rau hauv cov ntaub so ntswg. Txhua qhov kev ua tom ntej ncaj qha nyob ntawm lub cuab yeej siv.
Kev Tshawb Fawb
Qhov kev xaiv tus qauv rau kev txheeb xyuas histological ntawm kev kuaj mob yog kev sau ntawm cov ntu thinnest ntawm cov ntaub so ntswg biopsy rau kev kuaj mob tom ntej. Ua tsaug rau lawv, cov ntaub ntawv tseem ceeb hais txog qhov muaj pes tsawg leeg ntawm cov qog tau txais.
Kev tshuaj xyuas morphological ntawm cov qog yog ua raws li hauv qab no:
- histochemistry;
- immunohistochemistry;
- immunofluorescence;
- immunoenzymatictsom xam.
Txawm hais tias txoj kev twg yog xaiv rau txoj kev tshawb no, lub hom phiaj ntawm kev txheeb xyuas tsis yog tsuas yog txiav txim siab hom qog, tab sis kuj ntsuas kev hloov pauv ntawm tes. Raws li cov txiaj ntsig ntawm txoj kev tshawb fawb, nws tuaj yeem ua tau kom raug txiav txim siab thiab xaiv txoj kev kho mob.
Histochemical kev tshawb fawb
Nrog kev pab ntawm cov txheej txheem histochemical, koj tuaj yeem tau txais cov ntaub ntawv tseem ceeb ntawm kev ua haujlwm ntawm kev kawm, nws hom thiab histogenesis. Txoj kev no tso cai rau koj los kuaj xyuas kom raug thiab daws qhov teeb meem ntawm nws qhov sib txawv.
Thaum pov tseg ntawm histochemistry yog ntau cov tshuaj tiv thaiv uas pab txhawm rau txheeb xyuas cov chav sib txawv ntawm cov tshuaj.
Immunohistochemistry
IHC yog cov txheej txheem kev yees duab uas pab nrhiav cov tshuaj hauv cov ntaub so ntswg npaj. Txoj kev no yog ua raws li lub hauv paus ntsiab lus ntawm cov yam ntxwv ntawm kev sib cuam tshuam ntawm antigens nrog cov tshuaj tiv thaiv uas tau txais los ntawm ib txoj kev tshwj xeeb.
Immunofluorescence
Txoj kev tshawb fawb yog ua raws li qhov rhiab heev ntawm fluorescence microscopy thiab qhov tshwj xeeb ntawm cov tshuaj tiv thaiv kab mob. Nyob rau hauv tus txheej txheem ntawm nws cov kev siv, cov qog nqaij hlav yog cim nrog ib tug tshwj xeeb zas xim, uas yuav pab tau tus kws kho mob txiav txim kom meej qhov kev kuaj mob. Ib qho tshwj xeeb ntawm txoj kev no yog nws qhov yooj yim thiab yuav tsum tau siv qhov tsawg kawg nkaus ntawm cov khoom uas tau kawm.
ELISA
Txoj kev kuaj mob muaj qhov cuam tshuam siab thiab tso cai rau koj los teeb tsa qhov tsawg kawg nkaus ntawm cov khoom. Nyob rau hauv niaj hnub diagnostic txoj kev, nws yog nrog kev pab los ntawm txoj kev no uas lub localization ntawm antigen yog txiav txim. Kev tsom xam siv cov enzymes tshwj xeeb los kuaj mob qog noj ntshav.
Txawm hais tias xaiv cov txheej txheem, lub hom phiaj ntawm kev tshawb fawb morphological yog los txiav txim seb hom qog thiab ntsuas qhov hloov pauv ntawm cov cellular. Nws tuaj yeem hais tau yooj yim hais tias kev txheeb xyuas morphological yog qhov kev txiav txim siab ntawm hom qog thiab nws tsis saib xyuas rau qhov kev xaiv raug ntawm kev kho mob.
Txoj kev kom tau txais cov khoom siv rau kev tshawb fawb morphological
Rau kev txheeb xyuas morphological ntawm kev kuaj mob, nws yog qhov tsim nyog kom tau txais cov khoom siv. Koj tuaj yeem ua qhov no hauv cov hauv qab no:
- Trepan biopsy - yog suav tias yog ib qho ntawm cov txheej txheem zoo tshaj plaws, txawm tias nws muaj qee yam tsis zoo. Txhawm rau nqa cov khoom siv, cov koob tshwj xeeb nrog cov txheej txheem txiav sab hauv yog siv. Nrog lawv cov kev pab, ib kem ntawm cov ntaub so ntswg yog tau los ntawm cov qog. Txoj kev no tso cai rau kev txheeb xyuas morphological ntawm lub mis, prostate, ntsws, siab, txha nraub qaum thiab lymph nodes.
- Incisional biopsy yog txoj kev nrov tshaj plaws uas tau ua nrog lub scalpel, uas siv cov khoom los ntawm qhov chaw ntawm qhov tsis txaus ntseeg, raws li qhov chaw ntawm cov qog. Nyob rau hauv rooj plaub no, nws yog ib qho tsim nyog yuav tau ua qhov no sab nraum cov cheeb tsam ntawm edema, necrosis thiab hemorrhage ntawm granulation ntaub so ntswg.
- Excisional biopsy - qhov tseem ceeb ntawm txoj kev no yog kev tshem tawm tag nrho ntawm cov qog. Txoj kev no tsuas yog siv tau yog tias qhov neoplasm me me. Hauv qhov no, txoj kev no yog qhov zoo tshaj plaws, vim nws muaj ob qho kev kuaj mob thiab kho tus nqi.
Kev xaiv ntawm txoj kev tshawb xyuas morphological yog txiav txim los ntawm tus kws kho mob tuaj koom, nyob ntawm qhov tshwj xeeb ntawm qhov xwm txheej.
Ib ntu ntawm kev hloov pauv morphological
Qhov kev txheeb xyuas morphological ntawm kev kuaj mob yog dab tsi, thiab qhov kev hloov pauv tshwm sim hauv cov txheej txheem ntawm kev mob qog noj ntshav, tsis muaj coob tus neeg paub. Hmoov tsis zoo, feem ntau, tib neeg nyiam cov ntaub ntawv no tsuas yog thaum lawv ntsib teeb meem.
Oncology mus dhau qee theem hauv cov txheej txheem ntawm kev txhim kho, thiab raws li kev txheeb xyuas morphological, tus kws kho mob tuaj yeem soj ntsuam qhov sib txawv ntawm kev loj hlob. Kev pov thawj tuaj yeem pom cov ntaub so ntswg hloov pauv hauv qab no:
- diffuse thiab focal hyperplasia - cov txheej txheem tsis txaus ntshai thiab thim rov qab;
- metaplasia yog ib qho benign neoplasm;
- dysplasia - kev loj hlob precancerous;
- cancer in situ - pre-invasive cancer lesion;
- microinvasion;
- mob qog noj ntshav nrog metastasis.
Lub sijhawm lub sijhawm nruab nrab ntawm cov theem teev tseg yog tus kheej thiab hauv txhua kis tuaj yeem sib txawv ntawm ob peb lub hlis mus rau kaum xyoo.
Lub luag haujlwm tseem ceeb ntawm kev kuaj mob morphological yog tsim kom muaj cov ntaub so ntswg ntawm tus qog. Tib lub sijhawm, nws nthuav tawmTsis tsuas yog nws lub xub ntiag thiab ntau yam, tab sis kuj tseem muaj cov qib ntawm atypia ntawm tes thiab kev ua txhaum ntawm cov ntaub so ntswg raug soj ntsuam scrupulously. Feem ntau, morphological pov thawj ntawm cov thyroid caj pas, lub mis, prostate, daim siab, ob lub raum thiab txha nraub qaum yog nqa tawm. Tus txheej txheem ntawm kev tshawb fawb nyob rau hauv txhua rooj plaub yog txiav txim ib tug zuj zus.
