Ke hōʻoia nā kauka ua loaʻa iā ʻoe a i ʻole kekahi mea kokoke iā ʻoe ka maʻi ʻaʻai umauma, he mea paʻakikī ke hōʻike i ka makaʻu a me ka hopohopo āu e manaʻo ai. I ka manawa like, ke kamaʻilio nā kauka e pili ana i nā hoʻokolohua a me nā lāʻau lapaʻau like ʻole, hiki ke paʻakikī ke hoʻomaopopo i kēlā mau huaʻōlelo. ʻO kahi hoʻokolohua āu e lohe pinepine ai ʻo ia ka hoʻokolohua IHC. ʻOiai paha he paʻakikī iki ka inoa, mai makaʻu . He hoʻokolohua koʻikoʻi loa kēia e kōkua i kāu kauka e koho i ka lāʻau lapaʻau maikaʻi loa no kou maʻi ʻaʻai. I kēia lā, e kamaʻilio mākou e pili ana i kēia ma ke ʻano maʻalahi loa, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
He aha ka maʻalahi o ka hoʻāʻo IHC?
I ka ʻōlelo maʻalahi, ʻo IHC (Immunohistochemistry) kahi hoʻokolohua kūikawā e ʻike ai i ke ʻano pololei o kāu mau hunaola kanesa. ʻAʻole like nā kanesa umauma āpau. Hoʻohana kekahi mau kanesa i nā hormones i loko o ko mākou kino e ulu. Hilinaʻi kekahi i nā protein ʻē aʻe e ulu. No laila, ke ʻike pono ʻoe i nā mea e kōkua ana i kou kanesa e ulu, hiki i kāu kauka ke kuhikuhi i kēlā mau mea a mālama iā lākou.
ʻO ka hoʻāʻo IHC ke nānā nui nei i ʻelua mau mea:
1. Nā Mea Loaʻa Hormone : Hoʻopuka maoli ko mākou kino i nā hormones i kapa ʻia ʻo estrogen a me progesterone. Loaʻa i kekahi mau hunaola maʻi umauma nā wahi kūikawā ma ko lākou ʻili i kapa ʻia he mau mea loaʻa kahi e hiki ai i kēia mau hormones ke hoʻopili. Ke hoʻopili ʻia kēia mau hormones, loaʻa i nā hunaola maʻi kahi hōʻailona e ulu. Inā loaʻa i kāu mau hunaola maʻi kēia mau mea loaʻa hormone, ua kapa ʻia ʻo "hormone receptor-positive."
2. Pūmua HER2: ʻO `(HER2)` kekahi pūmua e kōkua ana i ka kaohi ʻana i ka ulu ʻana o nā pūnaewele. Eia nō naʻe, hana nui kekahi mau pūnaewele maʻi ʻaʻai umauma i kēia pūmua `HER2`. Ua kapa ʻia kēia he "HER2-positive". ʻO ia kekahi kumu e ulu wikiwiki ai ke kanesa.
ʻO ka pahuhopu nui o kēia hoʻāʻo ʻana, ʻo ia ke ʻike pono i nā mea e "hānai" nei i kāu maʻi ʻaʻai, ʻo ia hoʻi, ke kumu o kona ulu ʻana. A laila, hiki iā mākou ke hāʻawi iā ʻoe i ka lāʻau lapaʻau e hoʻōki i kēlā "hānai ʻana."
Pehea e hana ʻia ai kēia hoʻāʻo IHC?
Pono kēia hoʻāʻo i kahi hāpana o kāu mau hunaola kanesa . Loaʻa pinepine ʻia kēia mai kahi ʻāpana ʻiʻo i lawe ʻia i ka wā o kahi biopsy e hōʻoia i ke alo o ke kanesa a i ʻole i ka wā o ke ʻoki ʻana e wehe i ke kanesa.
A laila hoʻouna ʻia kēia ʻāpana ʻiʻo i ka hale hana, ʻo ia hoʻi, i ka hale hana. Ma laila, hana ʻia kekahi mea hoihoi loa:
- E hoʻohui nā poʻe loea ma ka lab i kahi kemika kūikawā i kāu hāpana cell cancer. Hoʻohana kēia i kahi ʻano protein i hana kūikawā ʻia ma ka lab. Ua kapa ʻia kēia mau mea he "antibodies".
- Ua hoʻolālā ʻia kēia mau `(antibodies)` e hoʻopili wale i nā mea loaʻa `(Estrogen)`, `( Progesterone )` a i ʻole `(HER2)`. E like me kahi puka kī e kūpono i kahi kī.
- Inā loaʻa i kāu mau hunaola kanesa kēia mau mea loaʻa, e hele kēlā mau antibodies a pipili iā lākou.
- A laila, ke hoʻohui ʻia kekahi kemika ʻē aʻe i kēia, e loli ke kala o nā pūnaewele i hoʻopili ʻia me nā antibodies.
- Nānā kekahi pathologist , a histologist paha, i nā ʻiʻo ma lalo o kahi microscope a helu inā he mau cell i loli ke kala a me ka nui o lākou.
Penei e hiki ai iā ʻoe ke ʻike pono inā he 'HER2-positive' kou maʻi kanesa, 'hormone receptor-positive', a i ʻole 'both-negative'.
Pehea ʻoe e maopopo ai i ka mea i loko o ka hōʻike hoʻāʻo?
Ke loaʻa iā ʻoe kāu hōʻike hoʻāʻo IHC, hiki ke hopohopo iki ke ʻike i nā helu a me nā huaʻōlelo ma luna. Akā ʻo ka mea nui loa, ʻo ia ke noho pū me kāu kauka a kamaʻilio maopopo e pili ana i nā mea āpau i loko o ka hōʻike . Eia ke ʻano o ka hōʻike pinepine ʻana i nā hopena:
Nā hopena HER2
ʻO ka maʻamau, hāʻawi ʻia nā hopena `HER2` ma ke ʻano he helu.
| Hopena | Manaʻo |
|---|---|
| 0 a i ʻole 1+ | ʻO ke ʻano kēia, he HER2-negative kou maʻi kanesa. ʻO ke ʻano kēia, ʻaʻohe o nā mea loaʻa HER2 i nā hunaola kanesa a i ʻole he haʻahaʻa loa ko lākou pae. |
| 2+ | He kūlana "palena" a i ʻole indeterminate kēia. ʻAʻole hiki ke ʻōlelo maopopo inā he HER2-positive a maikaʻi ʻole paha ka puʻupuʻu. I kēlā mau hihia, hiki i ke kauka ke paipai i kahi hoʻāʻo ʻoi aku ka maopopo, i kapa ʻia he hoʻāʻo FISH (Fluorescence In Situ Hybridization). |
| 3+ | ʻO ke ʻano kēia he HER2-positive kou maʻi kanesa. ʻO ke ʻano kēia he nui loa nā mea loaʻa HER2 i loko o nā hunaola kanesa. |
Nā Hualoaʻa Hormone Receptor (ER/PR).
Hiki ke hōʻike ʻia kēia mau hopena ma nā ʻano he nui:
- Ma ke ʻano he pakeneka (0% - 100%): ʻO ka pakeneka o 100 mau hunaola kanesa i loaʻa nā mea loaʻa hormone.
- ʻO ka helu mai 0 a 3: ʻo 0 ke ʻano ʻaʻohe mea loaʻa. Hōʻike ʻo 1, 2, a me 3 i nā mea loaʻa haʻahaʻa, waena, a me ke kiʻekiʻe.
- He "helu Allred" (0-8): ʻO ke kiʻekiʻe o kēia helu, ʻo ka nui o ka helu o nā mea loaʻa a me ko lākou maopopo.
- "Poʻe maikaʻi" a i ʻole "Nānā ʻole": ʻO ke ʻano o "Poʻe maikaʻi" he mau mea loaʻa. ʻOiai inā he kakaikahi a hiki i ka 1% o nā mea loaʻa, ua manaʻo ʻia he "Poʻe maikaʻi." No laila, he mea nui e ʻike i ka pakeneka a i ʻole ka helu.
I kekahi manawa hiki ke hewa nā hopena. Inā he kānalua kou, mai kānalua e noi i kāu kauka e nānā hou ʻia ka hōʻike e kekahi "pathologist" ʻē aʻe a i ʻole e hana hou i ka hoʻāʻo.
Pehea e pili ai nā hopena IHC i kāu lāʻau lapaʻau?
ʻO kēia ka ʻāpana koʻikoʻi loa. Na kāu kauka maʻi kanesa e hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa nāu ma muli o nā hopena o ka hoʻāʻo IHC.
| ʻAno maʻi kanesa (ma muli o nā hopena IHC) | Nā lāʻau lapaʻau kūpono |
|---|---|
| HER2-maikaʻi | He kūpono loa ka lāʻau lapaʻau i hoʻolālā ʻia, kahi e hoʻolālā ana i ka protein HER2, no kēia ʻano. |
| HER2-maikaʻi ʻole | Hiki i kēia ʻano ke ulu lohi ma mua o ke kanesa HER2-positive. ʻAʻole hana nā lāʻau lapaʻau i kuhikuhi ʻia iā HER2 no kēia ʻano. No laila e koho paha kāu kauka i nā lāʻau lapaʻau ʻē aʻe, e like me ka chemotherapy a i ʻole ka hormone therapy. |
| Hormone receptor-positive (ER+ a me/a i ʻole PR+) | He kūpono loa ka lāʻau lapaʻau hormone no kēia ʻano maʻi kanesa. Hoʻohaʻahaʻa kēia mau lāʻau i ka pae o ka estrogen i loko o ke kino a pale paha i ka loaʻa ʻana o ka estrogen i nā hunaola kanesa. |
| ʻAʻole loaʻa ka hormone receptor | ʻO ka maʻamau, ulu koke kēia mau maʻi kanesa. ʻAʻole hiki i nā lāʻau lapaʻau hormone ke hoʻopilikia i kēia. No laila, pono nā lāʻau lapaʻau ʻē aʻe, e like me ka chemotherapy. |
| ʻEkolu-maikaʻi | ʻO ke ʻano kēia, ua maikaʻi kēia mau mea ʻekolu: `(Estrogen), `(Progesterone), a me `HER2.` Hiki ke hāʻawi ʻia i kēia poʻe i ka lāʻau hormonal a me ka lāʻau i kuhikuhi ʻia i ka HER2. |
| ʻEkolu-maikaʻi ʻole | ʻO ke ʻano kēia, he maikaʻi ʻole nā kumu ʻekolu. Ulu koke kēia mau mea. ʻOiai ʻaʻole hana nā lāʻau lapaʻau hormonal a i ʻole HER2-targeted no kēia, hoʻohana nui ʻia nā mea e like me ke ʻoki ʻana, chemotherapy, a me ka radiation. |
Leka Lawe-Home
- He hoʻāʻo koʻikoʻi loa ka hoʻāʻo IHC i hoʻohana ʻia i ka hoʻolālā ʻana i ka mālama ʻana i ka maʻi ʻaʻai umauma. Mai hopohopo i ka inoa.
- ʻO kēia ka mea nui e hoʻoholo ai inā pili kou maʻi ʻaʻai i ka hormone (ER/PR maikaʻi) a me HER2 protein-dependent (HER2 maikaʻi).
- Ma muli o nā hopena o kēia hoʻokolohua, e hiki i kāu kauka ke koho i ka lāʻau lapaʻau kūpono loa nāu, me nā hopena ʻaoʻao liʻiliʻi loa.
- Ke loaʻa iā ʻoe kāu hōʻike hoʻāʻo, e noi i kāu kauka e wehewehe i kēlā me kēia huaʻōlelo a me nā helu i loko i maopopo iā ʻoe. Mai makaʻu e nīnau.
- Inā kānalua ʻoe i nā hopena, e kamaʻilio me kāu kauka e pili ana i ka loaʻa ʻana o kahi manaʻo ʻelua a i ʻole e hana hou i ka hoʻāʻo. He mea nui e lawe ʻoe i kahi kuleana ikaika i ka hoʻoholo ʻana e pili ana i kou olakino.
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