Ne ɖɔktawo ɖo kpe edzi be no me dɔdzẽ le ŋuwò alo ame aɖe si te ɖe ŋuwò la, esesẽna be nàgblɔ vɔvɔ̃ kple dzimaɖitsitsi si nèsena le ɖokuiwò me la ɖe nyagbewo me. Le ɣeyiɣi ma ke me la, ne ɖɔktawo le nu ƒom tso dodokpɔ kple dɔdamɔnu vovovowo ŋu , ate ŋu asesẽ be míase nya mawo gɔme. Dodokpɔ ɖeka si nàse zi geɖee nye IHC dodokpɔ. Togbɔ be ŋkɔa aɖi nya sesẽ vie hã la, mègavɔ̃ o . Esia nye dodokpɔ vevi aɖe ŋutɔ si kpena ɖe wò ɖɔkta ŋu wòtiaa atike nyuitɔ kekeake na wò kansa. Egbea, míaƒo nu tso esia ŋu le mɔ bɔbɔe aɖe ŋutɔ nu, le mɔ si gɔme nàte ŋu ase nu.
Nukae nye IHC dodokpɔa ko?
Kpuie ko la, IHC (Immunohistochemistry) nye dodokpɔ tɔxɛ aɖe si dea dzesi wò kansa lãmenugbagbeviwo ƒe nɔnɔme tututu. Menye no me dɔdzẽwo katãe sɔ o. Kansa aɖewo zãa lãmetsi siwo le míaƒe ŋutilã me tsɔ tsina. Bubuwo nɔa te ɖe protein bubuwo dzi hafi tsina. Eyata ne ènya nya nusiwo tututu le kpekpem ɖe wò kansa ŋu be wòatsi ko la, wò ɖɔkta ate ŋu atɔ ŋku nu mawo ahada wo.
Nu eve koŋue IHC dodokpɔa dia:
1. Lãmetsiŋusẽ Xɔxɔlawo : Míaƒe ŋutilã wɔa lãmetsiŋusẽ siwo woyɔna be estrogen kple progesterone le dzɔdzɔme nu. Teƒe tɔxɛ aɖewo le no me dɔdzẽ ƒe lãmenugbagbevi aɖewo ŋu le woƒe anyime si woyɔna be lãmenugbagbevi siwo xɔa lãmetsi siwo me lãmetsi siawo ate ŋu abla ɖo. Ne lãmetsi siawo kpe ɖe wo nɔewo ŋu la, kansa lãmenugbagbeviwo xɔa dzesi be woatsi. Ne lãmetsiŋusẽxɔla siawo le wò kansa lãmenugbagbeviwo me la, woyɔnɛ be "lãmetsixɔla-positive."
2. HER2 protein: `(HER2)` nye protein bubu si kpena ɖe ame ŋu be woakpɔ lãmenugbagbeviwo ƒe tsitsi dzi. Ke hã, no me dɔdzẽ ƒe lãmenugbagbevi aɖewo wɔa `HER2` protein sia fũ akpa. Woyɔa esia be "HER2-positive". Esia hã nye susu si ta kansa la tsina kabakaba ɖo.
Dodokpɔ sia ƒe taɖodzinu vevitɔe nye be nànya nusiwo tututu le "nuɖuɖu" nam wò kansa, si fia be nusiwo le ewɔm be wòle tsitsim. Emegbe, míate ŋu ana atike si ana "nuɖuɖu" ma nadzudzɔ wò.
Aleke wowɔa IHC dodokpɔ siae?
Dodokpɔ sia bia be nàxɔ wò kansa lãmenugbagbeviwo ƒe kpɔɖeŋu . Zi geɖe la, wokpɔa esia tso lãkusi aɖe si woɖe le ŋutilã ƒe akpa aɖe ɖeɖe me tsɔ ɖo kpe edzi be kansa le ame ŋu alo le amekoko me be woaɖe kansa la ɖa.
Emegbe woɖoa lãkusi sia ɖe nudokpɔƒe, si fia be woɖoa nudokpɔƒe. Afimae nu dodzidzɔname aɖe dzɔna le:
- Dɔnyala siwo le dodokpɔxɔa me atsɔ atike tɔxɛ aɖe akpe ɖe wò kansa lãmenugbagbeviwo ƒe kpɔɖeŋu ŋu. Esia zãa protein ƒomevi aɖe si wowɔ etɔxɛe le dodokpɔxɔ me. Woyɔa esiawo be ``dɔlékuiwutikewo''.
- Wotrɔ asi le `(dɔlékuiwutikewo)` siawo ŋu be woalé ɖe `(Estrogen)`, `( Progesterone )` alo `(HER2)` xɔlawo ko ŋu. Abe safui ƒe do si sɔ na safui ene.
- Ne dɔlékuiwutike siawo le wò kansa lãmenugbagbeviwo me la, dɔlékuiwutike mawo ayi aɖalé ɖe wo ŋu.
- Emegbe ne wotsɔ atike bubu kpe ɖe esia ŋu la, lãmenugbagbevi siwo ŋu dɔlékuiwutikewo kpe ɖo la ƒe amadede trɔna .
- Dɔléleŋutinunyala , alo lãmenugbagbeviŋutinunyala, léa ŋku ɖe lãkusia ŋu le nusuekpɔmɔ̃ me eye wòxlẽa ne lãmenugbagbevi aɖewo li siwo ƒe amadede trɔ eye wosɔ gbɔ.
Aleae nàwɔ anya nenye be wò kansa nye `HER2-positive`, `hormone receptor-positive`, alo `both-negative`.
Aleke nèse nusi le dodokpɔa ƒe nyatakakaa me gɔmee?
Ne èxɔ wò IHC dodokpɔ ŋuti nyatakaka la, ate ŋu ado vɔvɔ̃ na wò vie be nàkpɔ xexlẽdzesiwo kple nya siwo le edzi. Gake nu vevitɔe nye be nànɔ anyi kple wò ɖɔkta aƒo nu tso nusianu si le nyatakakaa me ŋu eme nakɔ . Alesi wogblɔa emetsonuwo zi geɖee nye esi:
HER2 ƒe emetsonuwo
Zi geɖe la, wonaa `HER2` ƒe emetsonuwo abe xexlẽdzesi ene.
| Metsonu | Gɔmeɖeɖe |
|---|---|
| 0 alo 1+ | Esia fia be wò kansa nye HER2-negative . Esia fia be HER2 xɔla mele kansa lãmenugbagbeviwo si o alo woƒe agbɔsɔsɔ le sue ŋutɔ. |
| 2+ ƒe xexlẽme | Esia nye "liƒo" alo nɔnɔme si womeɖo ɖi o . Manya wɔ be woagblɔe kple kakaɖedzi nenye be dɔdzẽa nye HER2-positive alo negative o. Le nɔnɔme mawo me la, ɖɔkta ate ŋu aɖo aɖaŋu be woawɔ dodokpɔ si ŋu kakaɖedzi le wu, si woyɔna be FISH dodokpɔ (Fluorescence In Situ Hybridization). |
| 3+ ƒe xexlẽme | Esia fia be wò kansa nye HER2-positive . Esia fia be HER2 xɔla geɖe le kansa lãmenugbagbeviwo me akpa. |
Lãmetsiŋusẽ Xɔla (ER/PR) ƒe Emetsonuwo
Woate ŋu agblɔ emetsonu siawo le mɔ vovovowo nu:
- Abe alafa memamã ene (0% - 100%): Kansa lãmenugbagbevi 100 siwo si lãmetsiŋusẽ ƒe xɔlawo le ƒe alafa memamã.
- Xexlẽdzesi si tso 0 va ɖo 3: 0 fia be xɔla aɖeke meli o. 1, 2, kple 3 fia be xɔla siwo le bɔbɔe, le titina, kple esiwo le kɔkɔm.
- An "Allred score" (0-8): Zi alesi dzesi sia loloe la, zi nenemae xɔlawo ƒe xexlẽme kple woƒe eme kɔna.
- "Positive" alo "Negative": "Positive" fia be xɔlawo li. Ne xɔlawo ƒe xexlẽme mede 1% o hã la, wobua eŋu kokoko be enye "Nu Nyui." Eyata ele vevie be nànya alafa memamã alo dzesi si woxɔ.
Ɣeaɖewoɣi la, emetsonuwo ate ŋu anye esiwo mesɔ o. Ne ɖikeke aɖe le mewò la, mègahe ɖe megbe gbeɖe be yeabia tso wò ɖɔkta si be wòana ``dɔléleŋutinunyala`` bubu nado nyatakakaa kpɔ alo agbugbɔ dodokpɔa awɔ o.
Aleke IHC me tsonu kpɔa ŋusẽ ɖe wò atikewɔwɔ dzii?
Esiae nye akpa vevitɔ kekeake. Wò kansaŋutinunyala anɔ te ɖe IHC dodokpɔa me tsonu dzi atso nya me le atikewɔwɔ ƒe ɖoɖo nyuitɔ kekeake ŋu na wò.
| Kansa ƒomevi (si wotu ɖe IHC ƒe emetsonuwo dzi) . | Atikewɔwɔ siwo sɔ ɖe enu |
|---|---|
| HER2-dɔlékui le ame ŋu | Atikewɔwɔ si woɖo taɖodzinu na, si tɔa ŋku HER2 protein la, wɔa dɔ ŋutɔ na ƒomevi sia. |
| HER2-vɔ̃ɖi | Esia ƒomevi ate ŋu adzi blewu wu kansa si me HER2 le. Atike siwo woɖo ɖe HER2 ŋu mewɔa dɔ na ƒomevi sia o. Eyata wò ɖɔkta ate ŋu atia atikewɔmɔnu bubuwo, abe atikewɔmɔnu alo lãmetsiŋusẽtike ene. |
| Lãmetsiŋusẽ ƒe xɔla-positive (ER+ kple/alo PR+) . | Lãmetsiŋusẽ ƒe atikewɔwɔ wɔa dɔ ŋutɔ na kansa sia ƒomevi. Atike siawo ɖea estrogen ƒe agbɔsɔsɔ dzi kpɔtɔna le ŋutilã me alo xea mɔ na kansa lãmenugbagbeviwo be woagaxɔ estrogen o. |
| Lãmetsiŋusẽ ƒe xɔla-negative | Zi geɖe la, kansa siawo tsina kabakaba. Lãmetsiŋusẽtikewo mate ŋu akpɔ ŋusẽ ɖe esia dzi o. Eyata ehiã be woawɔ atike bubuwo abe atikewɔmɔnu ene. |
| Etɔ̃-nu nyuiwo | Esia fia be esiawo katã nye nu nyuiwo: `(Estrogen), `(Progesterone), kple `HER2.` Woate ŋu ana lãmetsiŋusẽtike kple atikewɔwɔ si woɖo ɖe HER2 siaa ame siawo. |
| Etɔ̃-negative | Esia fia be nu etɔ̃awo katã nye nu gbegblẽ. Zi geɖe la, amesiawo tsina kabakaba. Esi wònye be lãmetsiŋusẽ alo HER2 ƒe atikewɔwɔwo mewɔa dɔ na esia o ta la, nuwo abe amekoko, atikewɔmɔnu, kple keklẽŋusẽ koŋue wozãna. |
Gbedasi si Wotsɔ Yi Aƒeme
- IHC dodokpɔ nye dodokpɔ vevi aɖe ŋutɔ si wozãna le no me dɔdzẽ dada ƒe ɖoɖowɔwɔ me. Mègana ŋkɔa nado vɔvɔ̃ na wò o.
- Esia koŋue afia nenye be wò kansa nɔ te ɖe lãmetsiŋusẽ dzi (ER/PR nyui) eye wònɔ te ɖe HER2 protein dzi (HER2 nyui).
- Wò ɖɔkta anɔ te ɖe dodokpɔ sia me tsonu dzi atia atike si awɔ dɔ nyuie wu na wò, eye eƒe nugbegblẽ le ame ŋu ʋɛ wu.
- Ne èxɔ wò dodokpɔ ŋuti nyatakaka la, bia tso wò ɖɔkta si be wòaɖe nya kple xexlẽdzesi ɖesiaɖe si le eme la me ale be nàse egɔme nyuie. Mègavɔ̃ gbeɖe be yeabia nya o.
- Ne mèka ɖe emetsonuwo dzi o la, ƒo nu kple wò ɖɔkta tso nukpɔsusu evelia xɔxɔ alo dodokpɔa gbugbɔgawɔ ŋu. Ele vevie be nàwɔ akpa vevi aɖe le nyametsotso wɔwɔ le wò lãmesẽ ŋu me.
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