Uma odokotela beqinisekisa ukuthi wena noma umuntu oseduze nawe unomdlavuza webele, kunzima ukusho ngamazwi ukwesaba nokukhathazeka okuzwayo. Ngesikhathi esifanayo, lapho odokotela bekhuluma ngezivivinyo ezahlukene kanye nokwelashwa , kungaba nzima ukuqonda lawo magama. Ukuhlolwa okukodwa ozokuzwa kaningi ukuhlolwa kwe-IHC. Ngisho noma igama lingase lizwakale liyinkimbinkimbi kancane, ungesabi . Lokhu ukuhlolwa okubaluleke kakhulu okusiza udokotela wakho ukuthi akhethe ukwelashwa okungcono kakhulu komdlavuza wakho. Namuhla, sizokhuluma ngalokhu ngendlela elula kakhulu, ngendlela ongayiqonda.
Iyini nje i-IHC test?
Kalula nje, i-IHC (Immunohistochemistry) ukuhlolwa okukhethekile okuhlonza uhlobo oluqondile lwamaseli akho omdlavuza. Akuwona wonke umdlavuza webele ofanayo. Eminye imidlavuza isebenzisa ama-hormone emizimbeni yethu ukuze ikhule. Eminye incike kwamanye amaprotheni ukuze ikhule. Ngakho-ke uma usuwazi kahle ukuthi yiziphi izici ezisiza umdlavuza wakho ukuba ukhule, udokotela wakho angaziqondisa lezo zici futhi azelaphe.
Ukuhlolwa kwe-IHC kubheka izinto ezimbili ikakhulukazi:
1. Ama-Hormone Receptors : Imizimba yethu ikhiqiza ngokwemvelo ama-hormone abizwa ngokuthi i-estrogen ne-progesterone. Amanye amangqamuzana omdlavuza webele anezindawo ezikhethekile ebusweni bawo ezibizwa ngokuthi ama-receptor lapho la ma-hormone anganamathela khona. Uma la ma-hormone enamathela, amangqamuzana omdlavuza athola isignali yokukhula. Uma amangqamuzana akho omdlavuza enala ma-hormone receptors, abizwa ngokuthi "i-hormone receptor-positive."
2. Iphrotheni ye-HER2: `(HER2)` ingenye iphrotheni esiza ukulawula ukukhula kwamaseli. Kodwa-ke, amanye amangqamuzana omdlavuza webele akhiqiza kakhulu le phrotheni ye-`HER2`. Lokhu kubizwa ngokuthi "i-HER2-positive". Lesi futhi yisizathu esenza umdlavuza ukhule ngokushesha.
Umgomo oyinhloko walolu vivinyo ukuthola ukuthi yiziphi ngempela izinto "eziphakela" umdlavuza wakho, okungukuthi, yini ebangela ukuba ukhule. Ngemuva kwalokho, singakunikeza imithi ezomisa lokho "kuphakela".
Kwenziwa kanjani lokhu kuhlolwa kwe-IHC?
Lokhu kuhlolwa kudinga isampula yamaseli akho omdlavuza . Lokhu kuvame ukutholakala esicutshini esithathwe ngesikhathi sokuhlolwa kwezicubu ukuqinisekisa ukuthi umdlavuza ukhona noma ngesikhathi sokuhlinzwa ukuze kususwe umdlavuza.
Ngemuva kwalokho lesi siqephu sethishu sithunyelwa elabhorethri, okungukuthi, elabhorethri. Lapho, kwenzeka okuthile okuthakazelisayo kakhulu:
- Ochwepheshe abase-lab bazofaka ikhemikhali ekhethekile esampula yakho yamaseli omdlavuza. Lokhu kusebenzisa uhlobo lweprotheni olwenziwe ngokukhethekile e-lab. Lawa abizwa ngokuthi "ama-antibodies".
- Lawa `(ama-antibodies)` aklanyelwe ukunamathela kuphela kuma-receptor e-`(Estrogen)`, `( Progesterone )` noma `(HER2)`. Njengembobo yokhiye efanela ukhiye.
- Uma amangqamuzana akho omdlavuza enalezi zitho zokwamukela, lawo ma-antibodies azonamathela kuwo.
- Ngemuva kwalokho, uma kufakwa elinye ikhemikhali kulokhu, amaseli anama-antibodies anamathele ashintsha umbala .
- Isazi sezifo , noma isazi se-histologist, sibheka izicubu ngaphansi kwe-microscope bese sibala ukuthi ngabe kukhona yini amangqamuzana ashintshe umbala nokuthi mangaki akhona.
Lena yindlela ongathola ngayo ukuthi umdlavuza wakho 'une-HER2-positive', 'une-hormone receptor', noma 'une-kokubili-negative'.
Ukuqonda kanjani okusembikweni wokuhlolwa?
Uma uthola umbiko wakho wokuhlolwa kwe-IHC, kungaba yinto eyethusayo ukubona izinombolo namagama akuwo. Kodwa into ebaluleke kakhulu ukuhlala phansi nodokotela wakho nixoxe ngokucacile ngakho konke okubikiwe . Nansi indlela imiphumela evame ukubikwa ngayo:
Imiphumela ye-HER2
Imiphumela ye -`HER2` ivame ukunikezwa njengenombolo.
| Umphumela | Incazelo |
|---|---|
| 0 noma 1+ | Lokhu kusho ukuthi umdlavuza wakho awunayo i-HER2 . Lokhu kusho ukuthi amangqamuzana omdlavuza awanawo ama-receptor e-HER2 noma anamazinga aphansi kakhulu awo. |
| 2+ | Lesi yisimo "esingenamingcele" noma esingacaci . Akunakwenzeka ukusho ngokuqinisekile ukuthi isimila sine-HER2-positive noma singesihle. Ezimweni ezinjalo, udokotela angase atuse ukuhlolwa okucacile, okubizwa ngokuthi ukuhlolwa kwe-FISH (Fluorescence In Situ Hybridization). |
| 3+ | Lokhu kusho ukuthi umdlavuza wakho une -HER2-positive . Lokhu kusho ukuthi amangqamuzana omdlavuza anama-receptor amaningi kakhulu e-HER2. |
Imiphumela ye-Hormone Receptor (ER/PR).
Le miphumela ingabikwa ngezindlela eziningana:
- Njengephesenti (0% - 100%): Iphesenti lamaseli omdlavuza ayi-100 anama-hormone receptors.
- Inombolo kusukela ku-0 kuya ku-3: 0 isho ukuthi azikho izitho zokwamukela. 1, 2, no-3 zisho izitho zokwamukela eziphansi, eziphakathi nendawo, neziphezulu, ngokulandelana.
- "Isikolo se-Allred" (0-8): Uma lesi sikolo siphezulu, inani lama-receptor kanye nokucaca kwawo kuyanda.
- "Okuhle" noma "Okubi": "Okuhle" kusho ukuthi kukhona ama-receptor. Ngisho noma kukhona ama-receptor ambalwa njenge-1%, kusabhekwa "Okuhle." Ngakho-ke, kubalulekile ukwazi iphesenti noma amaphuzu.
Ngezinye izikhathi imiphumela ingaba yiphutha. Uma unokungabaza, ungalokothi unqikaze ukucela udokotela wakho ukuba aphinde ahlolwe umbiko ngomunye "udokotela wezifo" noma aphinde ahlolwe.
Imiphumela ye-IHC ikuthinta kanjani ukwelashwa kwakho?
Lena yingxenye ebaluleke kakhulu. Udokotela wakho womdlavuza uzonquma uhlelo lokwelashwa olungcono kakhulu ngokusekelwe emiphumeleni yokuhlolwa kwe-IHC.
| Uhlobo lomdlavuza (ngokusekelwe emiphumeleni ye-IHC) | Ukwelashwa okuhambisanayo |
|---|---|
| I-HER2-positive | Ukwelashwa okuqondiwe, okuqondiswe kuphrotheni ye-HER2, kusebenza kahle kakhulu kulolu hlobo. |
| I-HER2-negative | Lolu hlobo lungakhula kancane kunomdlavuza one-HER2. Imithi eqondiswe ku-HER2 ayisebenzi kulolu hlobo. Ngakho udokotela wakho angakhetha ezinye izindlela zokwelapha, njengokwelashwa ngamakhemikhali noma ngama-hormone. |
| I-hormone receptor-positive (ER+ kanye/noma PR+) | Ukwelashwa ngama-hormone kusebenza kahle kakhulu kulolu hlobo lomdlavuza. Le mithi yehlisa izinga le-estrogen emzimbeni noma ivimbele amangqamuzana omdlavuza ekutholeni i-estrogen. |
| I-hormone receptor-negative | Lezi zinhlanza zivame ukukhula ngokushesha. Ukwelashwa ngama-hormone akukwazi ukukuthinta lokhu. Ngakho-ke, kudingeka ezinye izindlela zokwelapha, njenge-chemotherapy. |
| Okuphindwe kathathu okuhle | Lokhu kusho ukuthi zonke lezi ezintathu zinhle: `(I-Estrogen), `(I-Progesterone), kanye `I-HER2.` Laba bantu banganikwa kokubili ukwelashwa ngama-hormone kanye nokwelashwa okuqondiswe ku-HER2. |
| Okuphindwe kathathu okungekuhle | Lokhu kusho ukuthi zonke lezi zinto ezintathu azilungile. Lezi zivame ukukhula ngokushesha. Njengoba izindlela zokwelapha eziqondiswe kuma-hormone noma ama-HER2 zingasebenzi kulokhu, izinto ezifana nokuhlinzwa, i-chemotherapy, kanye nemisebe zisetshenziswa kakhulu. |
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlolwa kwe-IHC kuwukuhlolwa okubaluleke kakhulu okusetshenziswa ekuhleleni ukwelashwa komdlavuza webele. Ungesabi igama.
- Lokhu kunquma kakhulu ukuthi umdlavuza wakho uncike kuma-hormone (ER/PR positive) kanye nokuthi uncike kuma-protein e-HER2 (HER2 positive).
- Ngokusekelwe emiphumeleni yalolu vivinyo, udokotela wakho uzokwazi ukukhetha ukwelashwa okusebenzayo kakhulu kuwe, nemiphumela emibi embalwa kakhulu.
- Uma uthola umbiko wakho wokuhlolwa, cela udokotela wakho ukuthi akuchazele wonke amagama nezinombolo ezikuwo ukuze uwuqonde kahle. Ungesabi ukubuza imibuzo.
- Uma ungaqiniseki ngemiphumela, khuluma nodokotela wakho mayelana nokuthola umbono wesibili noma ukuphinda ukuhlolwa. Kubalulekile ukuthi uthathe indima ebalulekile ekwenzeni izinqumo mayelana nempilo yakho.
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