Sɛ nnuruyɛfo si so dua sɛ wo anaa obi a ɔbɛn wo wɔ nufu mu kokoram a, ɛyɛ den sɛ wobɛka ehu ne dadwen a wote no ho asɛm. Bere koro no ara mu no, sɛ nnuruyɛfo ka nhwehwɛmu ne ayaresa ahorow ho asɛm a , ebetumi ayɛ den sɛ yɛbɛte saa nsɛm no ase. Sɔhwɛ biako a wobɛtaa ate ne IHC sɔhwɛ. Ɛwom mpo sɛ ebia edin no bɛyɛ te sɛ nea ɛyɛ den kakra de, nanso nsuro . Eyi yɛ sɔhwɛ a ɛho hia yiye a ɛboa wo duruyɛfo ma ɔpaw ayaresa a eye sen biara ma wo kokoram. Ɛnnɛ, yɛbɛka eyi ho asɛm wɔ ɔkwan a ɛyɛ mmerɛw koraa so, wɔ ɔkwan a wubetumi ate ase so.
Dɛn ne IHC sɔhwɛ no tiawa?
Sɛ yɛbɛka no tiawa a, IHC (Immunohistochemistry) yɛ sɔhwɛ titiriw bi a ɛkyerɛ sɛnea wo kokoram nkwammoaa no te ankasa. Ɛnyɛ nufu mu kokoram nyinaa na ɛyɛ pɛ. Kokoram ahorow bi de hormone ahorow a ɛwɔ yɛn nipadua mu di dwuma ma enyin. Afoforo nso gyina protein afoforo so na ama anyin. Enti sɛ wuhu nneɛma a ɛreboa wo kokoram no yiye a, wo duruyɛfo betumi de n’ani asi saa nneɛma no so na wasa.
IHC sɔhwɛ no hwehwɛ nneɛma abien titiriw:
1. Hormone Receptors : Yɛn nipadua fi awosu mu yɛ hormone ahorow a wɔfrɛ no estrogen ne progesterone. Nufu mu kokoram nkwammoaa bi wɔ mmeae titiriw bi wɔ wɔn ani a wɔfrɛ no receptors a saa hormone ahorow yi tumi bata ho. Sɛ saa nkwaadɔm yi bata ho a, kokoram nkwammoaa no nya sɛnkyerɛnne bi sɛ enyin. Sɛ wo kokoram nkwammoaa no wɔ saa hormone receptors yi a, wɔfrɛ no "hormone receptor-positive."
2. HER2 protein: `(HER2)` yɛ protein foforo a ɛboa ma nkwammoaa nyin. Nanso, nufu mu kokoram nkwammoaa binom yɛ saa `HER2` protein yi pii dodo. Wɔfrɛ eyi "HER2-positive". Eyi nso yɛ ade a ɛma kokoram no nyin ntɛmntɛm.
Botae titiriw a ɛwɔ sɔhwɛ yi mu ne sɛ wubehu nneɛma pɔtee a ɛde "aduan" wo kokoram, kyerɛ sɛ, nea ɛma ɛrenyin. Afei, yebetumi ama wo nnuru a ɛbɛma saa "aduan" no agyae.
Ɔkwan bɛn so na wɔyɛ IHC sɔhwɛ yi?
Saa sɔhwɛ yi hwehwɛ sɛ wonya wo kokoram nkwammoaa no nhwɛsode . Wɔtaa nya eyi fi ntini bi a wɔfa bere a wɔreyɛ biopsy de akyerɛ sɛ kokoram bi wɔ hɔ anaa bere a wɔreyɛ oprehyɛn de ayi kokoram no afi hɔ no mu.
Afei wɔde saa ntini yi kɔ aduruyɛdan mu, kyerɛ sɛ, wɔde kɔ aduruyɛdan mu. Ɛhɔ no, biribi a ɛyɛ anigye paa si:
- Adwumayɛfo a wɔwɔ lab no de nnuru titiriw bi bɛka wo kokoram nkwammoaa nhwɛsode no ho. Eyi de protein bi a wɔayɛ no titiriw wɔ aduruyɛdan mu na edi dwuma. Wɔfrɛ eyinom ``antibody''.
- Wɔayɛ saa `(antibody)` yi sɛ ɛbɛbata `(Estrogen)`, `( Progesterone )` anaa `(HER2)` agyefo nkutoo ho. Te sɛ safe tokuru a ɛfata safe.
- Sɛ wo kokoram nkwammoaa no wɔ saa ntini ahorow yi a, saa nnuru a ɛko tia nyarewa no bɛkɔ akɔbata ho.
- Afei sɛ wɔde nnuru foforo ka eyi ho a, nkwammoaa a wɔde nnuru a ekum ɔyare mmoawa abata ho no kɔla sesa .
- Ɔyare ho ɔbenfo , anaa nipadua mu nkwaadɔm ho ɔbenfo de afiri a wɔde hwɛ nneɛma nketenkete hwɛ ntini no na ɔkan sɛ ebia nkwammoaa bi wɔ hɔ a ne kɔla asesa ne dodow a ɛwɔ hɔ anaa.
Eyi ne ɔkwan a wobɛfa so ahu pɛpɛɛpɛ sɛ ebia wo kokoram no yɛ `HER2-positive`, `hormone receptor-positive`, anaa `both-negative`.
Wote nea ɛwɔ sɔhwɛ amanneɛbɔ no mu ase dɛn?
Sɛ wo nsa ka wo IHC sɔhwɛ amanneɛbɔ a, ebetumi ayɛ hu kakra sɛ wubehu nɔma ne nsɛmfua a ɛwɔ so no. Nanso nea ɛho hia sen biara ne sɛ wo ne wo duruyɛfo bɛtra ase abɔ biribiara a ɛwɔ amanneɛbɔ no mu ho nkɔmmɔ pefee . Sɛnea wɔtaa bɔ nea efi mu ba no ho amanneɛ ni:
HER2 a efi mu ba
`HER2` aba no , wɔtaa de ma sɛ nɔma.
| Nsunsuansoɔ | Kyerɛ |
|---|---|
| 0 anaa 1+ na ɛyɛ | Eyi kyerɛ sɛ wo kokoram no yɛ HER2-negative . Eyi kyerɛ sɛ kokoram nkwammoaa no nni HER2 agyefo anaasɛ wɔn dodow sua koraa. |
| 2+ na ɛwɔ hɔ | Eyi yɛ "borderline" anaasɛ tebea a wontumi nsi ho gyinae . Ɛrentumi nyɛ yiye sɛ yɛbɛka no pen sɛ ebia akisikuru no wɔ HER2 anaasɛ ɛnyɛ papa. Wɔ tebea horow a ɛtete saa mu no, ebia oduruyɛfo no bɛkamfo nhwehwɛmu a ɛyɛ pintinn kɛse a wɔfrɛ no FISH sɔhwɛ (Fluorescence In Situ Hybridization) akyerɛ. |
| 3+ na ɛwɔ hɔ | Eyi kyerɛ sɛ wo kokoram no wɔ HER2 . Eyi kyerɛ sɛ kokoram nkwammoaa no wɔ HER2 agyefo pii dodo. |
Nea Efi Hormone Receptor (ER/PR) mu bae
Wobetumi abɔ nea afi mu aba yi ho amanneɛ wɔ akwan horow pii so:
- Sɛ́ ɔha biara mu nkyem (0% - 100%): Ɔha biara mu nkyem 100 a ɛwɔ kokoram nkwammoaa 100 a ɛwɔ hormone receptors.
- Nnɔmba a efi 0 kosi 3: 0 kyerɛ sɛ wonni agyefo biara. 1, 2, ne 3 kyerɛ sɛ agyefo a ɛba fam, mfinimfini, ne nea ɛkorɔn.
- "Allred nkontabuo" (0-8): Dodow a saa nkontabuo yi kɔ soro no, dodoɔ no ara na agyefoɔ dodoɔ ne wɔn mu pefeeyɛ yɛ kɛseɛ.
- "Positive" anaa "Negative": "Positive" kyerɛ sɛ agyefo wɔ hɔ. Sɛ mpo agyefoɔ no sua te sɛ 1% a, wɔda so ara bu no sɛ "Positive." Enti, ɛho hia sɛ wuhu ɔha biara mu nkyem anaa nkontaa a wonya.
Ɛtɔ mmere bi a, nea efi mu ba no betumi ayɛ nea ɛnteɛ. Sɛ w'adwene mu yɛ wo naa a, ntwentwɛn wo nan ase da sɛ wobɛka akyerɛ wo duruyɛfo sɛ ɔmma ``yare ho ɔbenfo`` foforo nhwehwɛ amanneɛbɔ no mu bio anaasɛ ɔnsan nyɛ nhwehwɛmu no bio.
Ɔkwan bɛn so na nea efi IHC mu ba no ka w’ayaresa no?
Eyi ne ɔfã a ɛho hia sen biara. Wo kokoram ho ɔyaresafo no begyina nea ebefi IHC nhwehwɛmu no mu aba so akyerɛ ayaresa nhyehyɛe a eye sen biara ama wo.
| Kokoram su (a egyina nea efii IHC mu bae so) . | Ayaresa ahorow a ɛne ne ho hyia |
|---|---|
| HER2-a ɛyɛ papa | Ayaresa a wɔde wɔn ani asi so a wɔde wɔn ani si HER2 protein so no tu mpɔn yiye ma saa ɔkwan yi. |
| HER2-a ɛyɛ bɔne | Ebia saa kokoram yi benyin brɛoo asen kokoram a ɛwɔ HER2. Nnuru a wɔde asi HER2 so no nyɛ adwuma mma saa ɔkwan yi. Enti wo duruyɛfo betumi apaw ayaresa afoforo te sɛ nnuru a wɔde sa yare anaa hormone ayaresa. |
| Hormone receptor-a ɛyɛ papa (ER + ne/anaasɛ PR +) . | Hormone ayaresa tu mpɔn yiye ma kokoram a ɛte sɛɛ. Saa nnuru yi ma estrogen dodow a ɛwɔ nipadua no mu no so tew anaasɛ esiw kokoram nkwammoaa no kwan sɛ ennya estrogen. |
| Hormone receptor-a ɛnyɛ papa | Mpɛn pii no, saa kokoram ahorow yi nyin ntɛmntɛm. Hormone ayaresa ntumi nka eyi. Enti, ayaresa afoforo te sɛ nnuru a wɔde sa yare ho hia. |
| Nneɛma abiɛsa a ɛyɛ papa | Eyi kyerɛ sɛ eyinom abiɛsa nyinaa yɛ papa: `(Estrogen), `(Progesterone), ne `HER2.` Wobetumi ama saa nkurɔfo yi hormone ayaresa ne ayaresa a wɔde asi HER2 so nyinaa. |
| Mmiɛnsa-asɛmmɔne | Eyi kyerɛ sɛ nneɛma abiɛsa no nyinaa yɛ nea enye. Eyinom taa nyin ntɛmntɛm. Esiane sɛ nnuru a wɔde sa hormone anaa HER2 a wɔde wɔn ani asi so no nyɛ adwuma mma eyi nti, wɔde nneɛma te sɛ oprehyɛn, nnuru a wɔde sa yare, ne mframa a wɔde ma titiriw na edi dwuma. |
Nkrasɛm a Wɔde Kɔ Fie
- IHC sɔhwɛ no yɛ sɔhwɛ a ɛho hia yiye a wɔde di dwuma wɔ nufu mu kokoram ayaresa nhyehyɛe mu. Mma edin no mmɔ wo hu.
- Eyi titiriw na ɛkyerɛ sɛ ebia wo kokoram no gyina hormone so (ER/PR positive) na egyina HER2 protein so (HER2 positive).
- Wo duruyɛfo no begyina nea ebefi sɔhwɛ yi mu aba so apaw ayaresa a etu mpɔn sen biara ama wo, a nea ebefi mu aba kakraa bi na ɛbɛba.
- Sɛ wo nsa ka wo nhwehwɛmu amanneɛbɔ a, ka kyerɛ wo duruyɛfo no ma ɔnkyerɛkyerɛ asɛmfua ne nɔma biara a ɛwɔ mu no mu sɛnea ɛbɛyɛ a wobɛte ase yiye. Nsuro da sɛ wubebisa nsɛm.
- Sɛ wunnim nea ebefi mu aba no yiye a, wo ne wo duruyɛfo nkasa mfa nnya adwene a ɛto so abien anaasɛ wobɛsan ayɛ nhwehwɛmu no bio. Ɛho hia sɛ wudi dwuma denneennen wɔ w’akwahosan ho gyinaesi mu.
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