Abasawo bwe bakakasa nti ggwe oba omuntu ali ku lusegere alina kookolo w’amabeere, kizibu okuteeka mu bigambo okutya n’okweraliikirira kw’owulira. Mu kiseera kye kimu, abasawo bwe boogera ku kukebera n’obujjanjabi obw’enjawulo , kiyinza okuba ekizibu okutegeera ebigambo ebyo. Ekigezo ekimu ky’ogenda okutera okuwulira kwe kukebera kwa IHC. Wadde ng’erinnya eryo liyinza okuwulikika nga lizibu katono, totya . Kino kigezo kikulu nnyo ekiyamba omusawo wo okulonda eddagala erisinga obulungi eri kookolo wo. Leero, tugenda kwogera ku nsonga eno mu ngeri ennyangu ennyo, mu ngeri gy’osobola okutegeera.
Ekigezo kya IHC kye ki mu ngeri ennyangu?
Mu ngeri ennyangu, IHC (Immunohistochemistry) kigezo kya njawulo ekizuula obutonde bwennyini obw’obutoffaali bwo obwa kookolo. Kookolo w’amabeere yenna si y’emu. Kookolo ezimu zikozesa obusimu mu mibiri gyaffe okukula. Ebirala byesigamye ku puloteyina endala okukula. Kale bw’omala okumanya ensonga ki eziyamba kookolo wo okukula, omusawo asobola okutunuulira ensonga ezo n’azijjanjaba.
Okugezesebwa kwa IHC okusinga kunoonya bintu bibiri:
1. Ebikwata obusimu : Emibiri gyaffe mu butonde gikola obusimu obuyitibwa estrogen ne progesterone. Obutoffaali obumu obwa kookolo w’amabeere bulina ebifo eby’enjawulo ku ngulu bwabwo ebiyitibwa receptors obusimu buno mwe busobola okwegatta. Obusimu buno bwe bukwatagana, obutoffaali bwa kookolo bufuna akabonero okukula. Singa obutoffaali bwo obwa kookolo buba n'obusimu buno obukwata obusimu, buyitibwa "hormone receptor-positive."
2. Puloteeni ya HER2: `(HER2)` ye puloteyina endala eyamba okufuga okukula kw’obutoffaali. Wabula obutoffaali obumu obwa kookolo w’amabeere bukola ekisusse ku puloteyina eno eya `HER2`. Kino kiyitibwa "HER2-positive". Eno era y’ensonga lwaki kookolo akula mangu.
Ekigendererwa ekikulu eky'okukebera kuno kwe kuzuula ensonga ki ddala ezi "giriisa" kookolo wo, kwe kugamba, kiki ekimuleetera okukula. Olwo, tusobola okukuwa eddagala erijja okukomya "okuliisa" okwo.
Okukebera kuno okwa IHC kukolebwa kutya?
Okukebera kuno kwetaaga sampuli y'obutoffaali bwo obwa kookolo . Kino kitera okufunibwa okuva mu kitundu ky’omubiri ekiggiddwa mu kiseera ky’okukebera kookolo okukakasa nti waliwo kookolo oba nga balongoosebwa okuggyawo kookolo.
Olwo ekitundu kino eky’omubiri ne kisindikibwa mu laboratory, kwe kugamba, mu lab. Eyo, waliwo ekintu ekinyuvu ennyo ekibaawo:
- Abakugu mu laabu bajja kwongera eddagala ery’enjawulo mu sampuli yo ey’obutoffaali bwa kookolo. Kino kikozesa ekika kya puloteyina ekikolebwa mu ngeri ey’enjawulo mu laabu. Bino biyitibwa ``antibodies''.
- `(antibodies)` zino zikoleddwa okwekwata ku `(Estrogen)`, `( Progesterone )` oba `(HER2)` receptors zokka. Nga ekituli ky’ekisumuluzo ekituuka ku kisumuluzo.
- Singa obutoffaali bwo obwa kookolo buba n’ebikwata bino, obuziyiza obwo bujja kugenda bunywerere ku byo.
- Oluvannyuma, eddagala eddala bwe lyongerwa ku kino, obutoffaali obulina obusimu obuziyiza endwadde bukyuka langi .
- Omukugu mu by’endwadde , oba omukugu mu by’ebitundu by’omubiri, atunuulira ekitundu ekyo ng’akozesa microscope n’abala oba waliwo obutoffaali bwonna obukyuse langi n’obungi bwe buli.
Eno y’engeri gy’oyinza okuzuulamu ddala oba kookolo wo `HER2-positive`, `hormone receptor-positive`, oba `both negative`.
Otegeera otya ebiri mu lipoota y’okugezesebwa?
Bw’ofuna lipoota yo ey’okukebera kwa IHC, kiyinza okukutiisa katono okulaba ennamba n’ebigambo ebigiriko. Naye ekisinga obukulu kwe kutuula n'omusawo wo n'oyogera bulungi ku buli kimu ekiri mu lipoota . Laba engeri ebyavaamu gye bitera okuloopebwa:
Ebivudde mu HER2
Ebivudde mu `HER2` bitera okuweebwa nga namba.
| Alizaati | Okutegeeza |
|---|---|
| 0 oba 1+ | Kino kitegeeza nti kookolo wo alina HER2-negative . Kino kitegeeza nti obutoffaali bwa kookolo tebulina bikwata bya HER2 oba bulina emiwendo gyabyo emitono ennyo. |
| 2+ | Eno mbeera ya "ensalo" oba etategeerekeka . Tekisoboka kwogera bulungi oba ekizimba kirimu HER2-positive oba negative. Mu mbeera ng’ezo, omusawo ayinza okukuwa amagezi okukozesa okukebera okukakafu, okuyitibwa okukebera kwa FISH (Fluorescence In Situ Hybridization). |
| 3+ | Kino kitegeeza nti kookolo wo alina HER2-positive . Kino kitegeeza nti obutoffaali bwa kookolo bulina ebirungo ebikwata HER2 bingi nnyo. |
Ebivudde mu kukwata obusimu (ER/PR).
Ebivuddemu bino bisobola okuloopebwa mu ngeri eziwerako:
- Nga ebitundu ku kikumi (0% - 100%): Ebitundu ku kikumi eby’obutoffaali bwa kookolo 100 obulina ebikwata obusimu.
- Ennamba okuva ku 0 okutuuka ku 3: 0 kitegeeza nti tewali bikwata. 1, 2, ne 3 ziraga ebikwata ku bikwata ebya wansi, ebya wakati, n’ebya waggulu.
- An "Allred score" (0-8): Obukodyo buno gye bukoma okuba obunene, omuwendo gw'ebikwata n'obutangaavu bwabyo gye bukoma okuba obunene.
- "Positive" oba "Negative": "Positive" kitegeeza nti waliwo ebikwata. Ne bwe wabaawo ebitundu ebitono nga 1% eby'ebikwata, kikyatwalibwa nga "Positive." N’olwekyo, kikulu okumanya ebitundu oba obubonero.
Oluusi ebivaamu biyinza okuba ebikyamu. Bwoba olina okubuusabuusa kwonna, tolwawo kusaba musawo wo okuddamu okwekebejjebwa lipoota ``omusawo w'endwadde`` omulala oba okuddamu okukeberebwa.
Ebivudde mu IHC bikwata bitya ku bujjanjabi bwo?
Kino kye kitundu ekisinga obukulu. Omusawo wo ow’obulwadde bwa kkansa ajja kukusalawo enteekateeka y’obujjanjabi esinga obulungi gy’oli okusinziira ku bivudde mu kukeberebwa kwa IHC.
| Ekika kya kookolo (okusinziira ku bivudde mu IHC) . | Enzijanjaba ezikwatagana |
|---|---|
| HER2-positive | Obujjanjabi obugendereddwamu, obugenderera puloteyina ya HER2, bukola nnyo ku kika kino. |
| HER2-obuzibu | Ekika kino kiyinza okukula mpola okusinga kookolo alina HER2. Eddagala erigendereddwamu HER2 terikola ku kika kino. N’olwekyo omusawo wo ayinza okulonda obujjanjabi obulala, gamba ng’obujjanjabi bw’eddagala oba obusimu. |
| Obusimu obukwata obusimu (ER+ ne/oba PR+) . | Obujjanjabi bwa hormone bukola nnyo ku kookolo ow’ekika kino. Eddagala lino likendeeza ku muwendo gwa estrogen mu mubiri oba liziyiza obutoffaali bwa kookolo okufuna estrogen. |
| Obusimu obukwata obusimu-negative | Kookolo ono atera okukula mangu. Obujjanjabi bw’obusimu tebusobola kukosa kino. N’olwekyo, obujjanjabi obulala, gamba ng’okujjanjaba eddagala, bwetaagibwa. |
| Emirundi esatu-positive | Kino kitegeeza nti bino byonna ebisatu biba birungi: `(Estrogen), `(Progesterone), ne `HER2.` Abantu bano basobola okuweebwa obujjanjabi obw’obusimu n’obujjanjabi obugendereddwamu HER2. |
| Emirundi esatu-negative | Kino kitegeeza nti ensonga zonsatule zitali nnungi. Bino bitera okukula amangu. Okuva obujjanjabi obugendereddwamu obusimu oba HER2 bwe butakola ku kino, ebintu ng’okulongoosa, obujjanjabi bw’eddagala, n’obusannyalazo bye bisinga kukozesebwa. |
Obubaka Obutwala Awaka
- Ekigezo kya IHC kigezo kikulu nnyo ekikozesebwa mu nteekateeka y’obujjanjabi bwa kookolo w’amabeere. Totiisibwatiisibwa linnya.
- Kino okusinga kye kisalawo oba kookolo wo yeesigamye ku busimu (ER/PR positive) ne HER2 protein-dependent (HER2 positive).
- Okusinziira ku bivudde mu kukeberebwa kuno, omusawo wo ajja kusobola okulonda obujjanjabi obusinga okukukolera, ng’obuzibu butono.
- Bw’ofuna lipoota yo ey’okukeberebwa, saba omusawo akunnyonnyole buli kigambo na nnamba ezirimu osobole okukitegeera obulungi. Totya kubuuza bibuuzo.
- Bw’oba tokakasa bivuddemu, yogerako n’omusawo wo ku ky’okufuna endowooza eyookubiri oba okuddamu okukeberebwa. Kikulu okukola ennyo mu kusalawo ku bulamu bwo.
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