Madokotala akatsimikizira kuti inuyo kapena munthu amene muli naye pafupi ali ndi khansa ya m'mawere, zimakhala zovuta kufotokoza mantha ndi nkhawa zomwe mukumva. Nthawi yomweyo, madokotala akamalankhula za mayeso ndi njira zosiyanasiyana zochiritsira , zimakhala zovuta kumvetsetsa mawu amenewo. Mayeso amodzi omwe mumamva nthawi zambiri ndi mayeso a IHC. Ngakhale dzinalo lingamveke lovuta pang'ono, musachite mantha . Iyi ndi mayeso ofunikira kwambiri omwe amathandiza dokotala wanu kusankha chithandizo chabwino kwambiri cha khansa yanu. Lero, tikambirana izi m'njira yosavuta, m'njira yomwe mungamvetse.
Kodi mayeso a IHC ndi otani?
Mwachidule, IHC (Immunohistochemistry) ndi mayeso apadera omwe amazindikira mtundu weniweni wa maselo anu a khansa. Si khansa zonse za m'mawere zomwe zimafanana. Khansa zina zimagwiritsa ntchito mahomoni m'thupi lathu kuti zikule. Zina zimadalira mapuloteni ena kuti zikule. Choncho mukadziwa bwino zinthu zomwe zikuthandiza khansa yanu kukula, dokotala wanu amatha kuyang'ana zinthuzo ndikuzichiza.
Mayeso a IHC makamaka amayang'ana zinthu ziwiri:
1. Ma Hormone Receptors : Matupi athu amapanga mahomoni otchedwa estrogen ndi progesterone mwachibadwa. Maselo ena a khansa ya m'mawere ali ndi malo apadera pamwamba pawo otchedwa ma receptor komwe mahomoniwa amatha kumamatirana. Ma hormone awa akamamatirana, maselo a khansa amalandira chizindikiro choti akule. Ngati maselo anu a khansa ali ndi ma hormone receptors awa, amatchedwa "hormone receptor-positive."
2. Puloteni ya HER2: `(HER2)` ndi puloteni ina yomwe imathandiza kuwongolera kukula kwa maselo. Komabe, maselo ena a khansa ya m'mawere amapanga puloteni ya `HER2` yochuluka kwambiri. Izi zimatchedwa "HER2-positive". Ichi ndi chifukwa chake khansa imakula mofulumira.
Cholinga chachikulu cha mayesowa ndikupeza zinthu zenizeni zomwe "zikudyetsa" khansa yanu, kutanthauza kuti, zomwe zikuipangitsa kukula. Kenako, tikhoza kukupatsani mankhwala omwe angalepheretse "kudya" khansayo.
Kodi mayeso a IHC awa amachitika bwanji?
Kuyezetsa kumeneku kumafuna chitsanzo cha maselo anu a khansa . Izi nthawi zambiri zimapezeka kuchokera ku minofu yomwe imatengedwa panthawi yoyezetsa kuti atsimikizire kukhalapo kwa khansa kapena panthawi ya opaleshoni yochotsa khansayo.
Kenako chidutswa cha minofuchi chimatumizidwa ku labotale, kutanthauza ku labotale. Kumeneko, chinthu chosangalatsa kwambiri chimachitika:
- Akatswiri mu labu adzawonjezera mankhwala apadera ku chitsanzo cha maselo anu a khansa. Izi zimagwiritsa ntchito mtundu wa mapuloteni omwe amapangidwa mwapadera mu labu. Awa amatchedwa ``antibodies''.
- Ma `(antibodies)` awa adapangidwa kuti azingolumikizana ndi ma `(Estrogen)`, `( Progesterone )` kapena `(HER2)` receptors. Monga ngati bowo la kiyi lomwe limalowa mu kiyi.
- Ngati maselo anu a khansa ali ndi ma receptors awa, ma antibodies amenewo adzapita ndi kumamatira kwa iwo.
- Kenako, mankhwala ena akawonjezedwa pa izi, maselo omwe ali ndi ma antibodies omangiriridwa amasintha mtundu .
- Katswiri wa matenda , kapena katswiri wa mbiri ya zamoyo, amayang'ana minofuyo pansi pa maikulosikopu ndikuwerengera ngati pali maselo omwe asintha mtundu ndi kuchuluka kwa maselo omwe alipo.
Umu ndi momwe mungadziwire ngati khansa yanu ili ndi `HER2-positive`, `hormone receptor-positive`, kapena `zonse ziwiri zilibe`.
Kodi mukumvetsa bwanji zomwe zili mu lipoti la mayeso?
Mukalandira lipoti lanu la mayeso a IHC, zingakhale zoopsa pang'ono kuona manambala ndi mawu omwe ali pamenepo. Koma chofunika kwambiri ndikukhala pansi ndi dokotala wanu ndikukambirana momveka bwino za chilichonse chomwe chili mu lipotilo . Umu ndi momwe zotsatira zake nthawi zambiri zimanenedwera:
Zotsatira za HER2
Zotsatira za `HER2` nthawi zambiri zimaperekedwa ngati nambala.
| Zotsatira | Tanthauzo |
|---|---|
| 0 kapena 1+ | Izi zikutanthauza kuti khansa yanu ili ndi HER2 negative . Izi zikutanthauza kuti maselo a khansa alibe ma HER2 receptors kapena ali ndi milingo yochepa kwambiri. |
| 2+ | Uwu ndi mkhalidwe wa "malire" kapena wosatsimikizika . Sizotheka kunena motsimikiza ngati chotupacho chili ndi HER2-positive kapena negative. Pazochitika zotere, dokotala angakulimbikitseni mayeso otsimikizika kwambiri, otchedwa FISH test (Fluorescence In Situ Hybridization). |
| 3+ | Izi zikutanthauza kuti khansa yanu ili ndi HER2-positive . Izi zikutanthauza kuti maselo a khansa ali ndi ma HER2 receptors ambiri. |
Zotsatira za Hormone Receptor (ER/PR).
Zotsatirazi zitha kufotokozedwa m'njira zingapo:
- Monga peresenti (0% - 100%): Chiwerengero cha maselo 100 a khansa omwe ali ndi ma hormone receptors.
- Nambala kuyambira 0 mpaka 3: 0 imatanthauza kuti palibe ma receptor. 1, 2, ndi 3 imasonyeza ma receptor otsika, apakati, ndi apamwamba, motsatana.
- "Chiwerengero cha Allred" (0-8): Chiŵerengerochi chikakhala chachikulu, chiwerengero cha ma receptor ndi kumveka bwino kwawo zimakhala zazikulu.
- "Zabwino" kapena "Zoipa": "Zabwino" zikutanthauza kuti pali ma receptor. Ngakhale kuti pali ma receptor ochepa ngati 1%, amaonedwabe kuti ndi "Zabwino." Chifukwa chake, ndikofunikira kudziwa kuchuluka kapena chigoli.
Nthawi zina zotsatira zake zingakhale zolakwika. Ngati muli ndi kukayikira kulikonse, musazengereze kupempha dokotala wanu kuti lipotilo liwunikidwenso ndi "katswiri wina wa matenda" kapena kuti mubwerezenso mayesowo.
Kodi zotsatira za IHC zimakhudza bwanji chithandizo chanu?
Ili ndiye gawo lofunika kwambiri. Dokotala wanu wa khansa adzakukonzerani njira yabwino kwambiri yochizira matenda anu kutengera zotsatira za mayeso a IHC.
| Mtundu wa khansa (kutengera zotsatira za IHC) | Mankhwala ogwirizana |
|---|---|
| HER2-positive | Chithandizo cholunjika, chomwe chimayang'ana mapuloteni a HER2, ndi chothandiza kwambiri pamtunduwu. |
| HER2-negative | Mtundu uwu ukhoza kukula pang'onopang'ono kuposa khansa ya HER2. Mankhwala omwe amagwiritsidwa ntchito ndi HER2 sagwira ntchito pa mtundu uwu. Choncho dokotala wanu angasankhe njira zina zochiritsira, monga chemotherapy kapena hormone therapy. |
| Hormone receptor-positive (ER+ ndi/kapena PR+) | Mankhwala a mahomoni ndi othandiza kwambiri pa khansa yamtunduwu. Mankhwalawa amachepetsa kuchuluka kwa estrogen m'thupi kapena kuletsa maselo a khansa kuti asalandire estrogen. |
| Cholandirira cha mahomoni | Khansa zimenezi nthawi zambiri zimakula mofulumira. Mankhwala a mahomoni sangakhudze izi. Chifukwa chake, njira zina zochiritsira, monga chemotherapy, zimafunika. |
| Zabwino katatu | Izi zikutanthauza kuti zonse zitatuzi ndi zabwino: `(Estrogen), `(Progesterone), ndi `HER2.` Anthu awa akhoza kupatsidwa chithandizo cha mahomoni komanso chithandizo cholunjika ku HER2. |
| Zoipa zitatu | Izi zikutanthauza kuti zinthu zitatu zonsezi ndi zoipa. Izi nthawi zambiri zimakula mofulumira. Popeza mankhwala a mahomoni kapena HER2-target sagwira ntchito pa izi, zinthu monga opaleshoni, chemotherapy, ndi radiation zimagwiritsidwa ntchito kwambiri. |
Uthenga Wopita Nawo Kunyumba
- Mayeso a IHC ndi mayeso ofunikira kwambiri omwe amagwiritsidwa ntchito pokonzekera chithandizo cha khansa ya m'mawere. Musachite mantha ndi dzinalo.
- Izi makamaka zimatsimikizira ngati khansa yanu imadalira mahomoni (ER/PR positive) ndi HER2 protein-dependent (HER2 positive).
- Kutengera ndi zotsatira za mayesowa, dokotala wanu adzatha kusankha chithandizo choyenera kwambiri kwa inu, ndi zotsatirapo zochepa kwambiri.
- Mukalandira lipoti lanu la mayeso, funsani dokotala wanu kuti akufotokozereni mawu ndi manambala onse omwe ali mmenemo kuti mumvetse bwino. Musamaope kufunsa mafunso.
- Ngati simukudziwa bwino za zotsatira zake, lankhulani ndi dokotala wanu kuti akuuzeninso kapena kubwerezanso mayesowo. Ndikofunikira kuti mutenge nawo mbali popanga zisankho zokhudzana ndi thanzi lanu.
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