Hana ʻia nā hoʻokolohua diagnostic i loko o ka hale hana pathology e nā kauka loea a me nā ʻepekema. Eia kekahi laʻana hiki ke hoʻokomo i nā hoʻokolohua koko a me nā biopsies kiko. I kekahi manawa pono paha e hoʻouna ʻia nā laʻana kiko i kahi keʻena loea ma kahi haukapila nui aʻe no kēia mau hoʻāʻo.
ʻO ke kali ʻana i nā hopena o kēia mau hoʻāʻo ʻana paha ke kumu o ka hoʻomaka ʻana o ka mālama ʻana. He mea nui loa i nā kauka nā ʻike a pau e pono ai lākou e hana i nā hoʻoholo lapaʻau maikaʻi loa no ka mea maʻi.
No ke aha i hana ʻia ai nā hoʻokolohua diagnostic?
Aia kekahi mau ho'āʻo i hana ʻia e hōʻoia i ka ʻike o ka lymphoma. Aia nā kauka kūikawā i hoʻomaʻamaʻa kūikawā ma kēia wahi no ka wehewehe ʻana i kēia mau hoʻāʻo mai ke koko, lymph nodes a me nā laʻana o ka iwi iwi e ʻike ai i ka maʻi.
E like me ka hoʻomaopopo ʻana o ka poʻe ʻepekema e pili ana i ka lymphoma, ua hana ʻia nā hoʻokolohua hou a ʻoi aku ka maʻalahi e hoʻomaopopo i nā kauka e pili ana i ka maʻi maʻi. Ke lilo nei i mea koʻikoʻi no ka hana ʻana i kēia mau hoʻokolohua no laila e hoʻomaopopo lākou i ke ʻano a me ke ʻano o ka lymphoma ma mua o ka hoʻoholo ʻana i ka lāʻau kūpono no ka mea maʻi.
I loko o ke keʻena pathology, e hoʻāʻo ʻia nā ʻano kikoʻī no ka hoʻokaʻawale ʻana i nā maʻi kanesa. Nānā pū lākou i ko lākou ʻano, ko lākou nui a me ke ʻano o ka hui ʻia ʻana i loko o nā laʻana mai nā ʻōpū lymph a me nā iwi iwi, ma ka nānā ʻana ma lalo o ka microscope. E hana lākou i nā hoʻokolohua hou aʻe e like me ka immunophenotyping, cytogenetic analysis a/a i ʻole molecular study no ka ʻike ʻana i ka ʻike hou aku e hōʻike ai i ke ʻano o ka lymphoma.
He aha ka Immunophenotyping?
Immunophenotyping he kaʻina hana e hoʻokaʻawale i waena o nā ʻano pūnaewele like ʻole. No ka laʻana, ka ʻokoʻa ma waena o nā lymphocytes maʻamau a me nā cell lymphoma. Hana ia i kēia ma ka ʻike ʻana i nā mea ʻike liʻiliʻi, i kapa ʻia 'mea hoailona' or 'antigens' i hōʻikeʻia ma nā pūnaewele.
Hāʻawi ka Immunophenotyping i ka ʻike e pili ana i nā ʻano o antigens loaʻa ma loko a i ʻole ke koko keʻokeʻo (WBCs). Hiki i kēia ho'āʻo ke kōkua i ka ʻike a ʻike i nā ʻano lymphoma kikoʻī. I kekahi mau hihia, hiki i ka ʻike ke wānana i ke ʻano koʻikoʻi o ka lymphoma a i ʻole ka pane ʻana i ka lāʻau lapaʻau. Hiki ke hana ʻia ka hoʻāʻo ʻana no ka ʻike ʻana i ka maikaʻi o ka mālama ʻana a me ka ʻimi ʻana i ke koena a i ʻole ka maʻi hou.
Hiki ke hana ʻia ka Immunophenotyping ma nā ʻano ʻelua. ʻO kēia mau mea he ho'āʻo i kapaʻia immunohistochemistry (IHC) a i ʻole flow cytometry.
Immunohistochemistry (IHC)
Immunophenotyping hiki ke hana ʻia ma nā ʻano ʻelua. Immunohistochemistry (IHC), ʻo ia kahi e hoʻopili ʻia ai nā stains i nā cell ma luna o kahi paheʻe. A laila nānā ʻia lākou ma lalo o ka microscope. E ʻike nā ʻili i nā antigens a i ʻole nā mea hōʻailona i loaʻa ma nā cell.
Kahe cytometry
ʻO ke ala ʻē aʻe kahe cytometry. Ma kēia hoʻāʻo ʻana ua hoʻoponopono ʻia ka hāpana a hoʻohui ʻia nā antibodies i hoʻopaʻa ʻia me nā māka fluorescent. ʻO kēia mau mea nā pūʻali hoʻopili i kahi kikoʻī antigens i ko lakou noho ana. Kahe ka hāpana ma kekahi mea hana i kapa ʻia a kahe cytometry kahi e kālailai ʻia ai nā pūnana pākahi.
Kahe cytometry ana i ka helu a me ka pākēneka o nā pūnaewele i loko o kahi hāpana koko a me nā hiʻohiʻona pūnaewele e like me ka nui, ke ʻano a me ka loaʻa ʻana o nā biomarkers ma ka ʻili o ke kelepona. Hiki i ka Flow cytometry ke ʻike i ke koena o ka maʻi ma hope o ka mālama ʻana. Kōkua kēia i ke kauka e ʻike i ka hoʻi hou ʻana o ka maʻi a hoʻomaka hou i ka mālama ʻana inā pono.
Immunohistochemistry (IHC)
- Hana ʻia nā ʻāpana lahilahi o ka laʻana biopsy (a i ʻole nā ʻāpana lahilahi o ka wai) me nā pūʻulu o nā antibodies e ʻike i nā hōʻailona like ʻole i loaʻa i nā ʻano lymphoma a i ʻole leukemic cell a me nā lymphocytes maʻamau.
- Nānā ka pathologist i nā paheʻe ma lalo o kahi microscope e nānā i ka hoʻololi ʻana o ka waihoʻoluʻu ʻike ʻia i ka wā e pili ana ka antibody i ka māka.
- Hoʻomaopopo a helu ʻia ka heluna o nā cell i hōʻike ʻia e ke kala (ʻo ia hoʻi, maikaʻi lākou no ka marker) me kēlā me kēia ʻano antibodies.
Kahe cytometry
- Hoʻokomo ʻia nā pūnaewele mai ka laʻana biopsy i loko o kahi hoʻonā wai a mālama ʻia me nā pūʻulu o nā antibodies e ʻike i nā antigens like ʻole i loaʻa i nā ʻano like ʻole o nā pūnaewele lymphoma.
- Hoʻokomo ʻia ka hui pūlima-antibody i loko o kahi mea hana i kapa ʻia ʻo flow cytometer. Hoʻohana kēia mīkini i nā kukuna laser e ʻike i nā kala like ʻole e hoʻokuʻu ʻia e nā cell mai nā antibodies like ʻole i pili iā lākou. Hoʻopili ʻia kēia ʻike e ke kamepiula a unuhi ʻia e kahi pathologist.
He aha ka cytogenetic analysis?
Nā Chromosomea loaʻa nā genes i loaʻa nā kaula lōʻihi o DNA. He 23 mau chromosomes ke kino kanaka ola kino. Ua māhele ʻia nā Chromosome i ʻelua mau ʻāpana i kapa ʻia ʻo 'lima', i kapa ʻia ʻo p (ka lima pōkole) a me q (ka lima lōʻihi). ʻO kekahi mau lymphomas a me nā ʻano maʻi maʻi ʻē aʻe he nui a liʻiliʻi paha nā chromosomes a i ʻole he mau chromosomes me kahi ʻano ʻano like ʻole. ʻO ka mea maʻamau nā chromosomes ua haki a pili hou (nā unuhi), no laila ua kuhi hewa ʻia nā ʻāpana chromosome e alakaʻi ana i ka hoʻōla ʻana i nā hōʻailona ulu ulu.
In cytogenetic Ka Ikepili, nānā ʻia nā chromosomes mai nā maʻi maʻi maʻi ma lalo o kahi microscope e ʻike ai ʻaʻole he ʻuʻuku a nui loa paha nā chromosomes. ʻElua a ʻekolu mau pule e loaʻa ai nā hopena mai ka hoʻāʻo cytogenetic no ka mea pono e hoʻonui ʻia ka nui o nā maʻi maʻi maʻi i loko o ka hale hoʻokolohua e loaʻa ai ka nui o nā mea genetic no ka nānā ʻana.
Nā hopena o ka ka nānā ʻana o ka cytogenetic hiki ke kōkua i ka ʻokoʻa ma waena nāʻano likeʻole of Non-Hodgkin lymphoma a i ʻole kōkua i ka hoʻoholo ʻana i ka lāʻau lapaʻau.
He aha nā ʻano o nā chromosomal abnormalities?
Ua kapa ʻia kekahi ʻano o ka chromosomal abnormality i loaʻa i kekahi mau ʻano lymphoma unuhi, ka mea i hana ʻia i ka wā e hemo ai kekahi hapa o ka chromosome mai kona wahi maʻamau a pili i kekahi chromosome.
ʻO kekahi ʻano like ʻole o ka chromosomal i kapa ʻia a kāpae, e hana ana ke nalo kekahi hapa o ka chromosome. Ua kākau ʻia kēia, no ka laʻana e like me del(17p), me ka ʻike ʻana aia kahi holoi ʻana i ka lima pōkole o ka chromosome 17.
No ke aha e makemake ai ka mea maʻi i nā hoʻokolohua genetic hou?
Hiki i nā kauka ke kauoha i nā hoʻokolohua genetic hou e hōʻoia i nā hopena o nā hoʻokolohua cytogenetic a i ʻole e ʻimi i kā mākou ʻike kikoʻī e pili ana i nā ʻano o ka pōʻino i ka ʻike genetic o nā pūnaewele lymphoma.
Nā ʻano hoʻokolohua genetic hou
ʻO ka hoʻoheheʻe ʻia ʻana o ka fluorescence in situ hybridization (FISH)
- Hoʻohana ʻo FISH i nā kemika fluorescent e hoʻopili pono i kekahi mau ʻāpana o nā chromosomes e hōʻike i ka hele ʻana o nā translocations a me nā mea ʻino ʻē aʻe.
- Hāʻawi ʻo FISH i nā mea noiʻi i kahi ala e nānā ai a palapala ʻia nā mea genetic i loko o nā keena o ke kanaka, me nā genes kikoʻī a i ʻole nā ʻāpana o nā genes. Hiki ke hoʻohana ʻia kēia no ka hoʻomaopopo ʻana i nā ʻano like ʻole o ka chromosomal a me nā hoʻololi ʻē aʻe.
- Hiki ke hana ʻia ka FISH ma ke koko, lymph nodes, a i ʻole ka iwi iwi, a loaʻa mau nā hopena hōʻike i loko o kekahi mau lā (ʻoi aku ka wikiwiki ma mua o ka hoʻāʻo cytogenetic).
Ka hopena o ke kaulahao polymerase (PCR)
- ʻO ka PCR kahi hoʻāʻo i hoʻohana ʻia e ana i nā genes kikoʻī (ʻo ia hoʻi, DNA) ʻaʻole hiki ke ʻike ʻia ma lalo o kahi microscope.
- Hiki ke hana ʻia nā hoʻokolohua PCR ma kahi liʻiliʻi loa o nā cell, a ma kahi o hoʻokahi pule e loaʻa ai kēia mau hopena.
Hoʻokaʻina DNA
- Hiki mai kekahi mau mea ʻino i ka ulu ʻana o ka maʻi maʻi ma muli o ka hoʻololi ʻana i ke kaʻina o kahi ʻano kikoʻī a i ʻole nā genes
- Hiki i kēia mau ʻike ke kōkua i ka wehewehe ʻana i ke ʻano o ka puʻupuʻu, e hoʻoholo i ka wānana, a i ʻole ka hoʻololi ʻana i ka koho lapaʻau.
- Hiki ke hoʻokaʻina ʻia kekahi ʻano genes a i ʻole kahi papa o nā gene koʻikoʻi i ʻike ʻia i ka manawa hoʻokahi.
Pehea e loaʻa ai i ka mea maʻi ko lākou hopena?
He mau ho'āʻo kūikawā loa kēia i hana ʻia ma kekahi mau laboratories. E loaʻa i ka haematologist nā hopena a wehewehe i kēia me nā hopena hoʻokolohua ʻē aʻe. He manawa liʻiliʻi paha kēia mau hoʻāʻo e hoʻi mai a hiki i kekahi mau hoʻāʻo ke lawe i kekahi mau lā a hiki i kekahi ke lawe i nā pule.
He mea nui ka loaʻa ʻana o kekahi o kēia ʻike ma mua o ka hoʻomaka ʻana o ka mālama ʻana e hōʻoia i ka hāʻawi ʻia ʻana o ka lāʻau kūpono no kēlā me kēia maʻi. He mea nui i ka poʻe maʻi ke ʻike pono e hana ʻia ka wehewehe ʻana i nā hoʻokolohua diagnostic ma waena o ke kauka a me ka mea maʻi.
He aha ka manaʻo o ka hōʻike?
Makemake kekahi mau maʻi e nānā i kā lākou mau hōʻike i kākau ʻia; i ka wā e hana ai pēlā, he mea nui i ka mea maʻi e nānā pono i nā ʻike me kā lākou kauka. ʻO kēia ke kumu no ka unuhi pinepine ʻana o ke kauka i nā hopena he nui mai nā hoʻokolohua like ʻole e hana i kahi hōʻailona ʻike.
He laʻana kēia o nā hōʻailona CD no nā ʻano lymphoma non-Hodgkin like ʻole a nā kauka e nānā ai e ʻike i ke ʻano o ka maʻi lymphoma, e ʻike i ka papa ma lalo.
'Ōlelo Aʻo: ʻO CD30 kekahi o nā hōʻailona kūpono no ka hōʻoia ʻana i ka lymphoma Hodgkin
