Hoʻoponopono

ʻO ka Pathology kekahi o nā ʻāpana ma lalo o nā lawelawe hoʻokolohua ʻo ia ka mea nui e hoʻoholo ai i ka hōʻailona, ​​​​a wānana i ke ʻano o ka hana lapaʻau e hiki mai ana a pēlā e hoʻokumu ai i ke kihi no ka hoʻokele.
 Hoʻopaʻa ʻia nā ʻiʻo i loaʻa i ka hale hana pathology a ukali ʻia e ka hoʻomākaukau ʻana e nā ʻano hana e kōkua iā mākou e kālailai i nā ʻiʻo ma lalo o ka microscope. ʻO kahi ʻiʻo i hoʻopaʻa pono ʻia a hana ʻia e ʻae i ka mālama pono ʻana i nā ʻiʻo a me ka hoʻohana ʻana i nā ʻiʻo no nā noiʻi hou aʻe e pili ana i ka Immuno histochemistry a me nā haʻawina molekala.  ʻO nā ʻano nui o nā ʻiʻo i loaʻa i ka hale hana pathology e komo pū ana me nā ʻiʻo nui aʻe o nā ʻāpana a i ʻole nā ​​​​ʻāpana o ia mea, i lawe ʻia i ka wā o nā hana ʻoki. ʻO nā ʻāpana o ka ʻiʻo ma mua o nā ʻāpana holoʻokoʻa i lawe ʻia ma ke ʻano he biopsies e like me ka excision biopsies - wehe ʻia ka ʻiʻo me ka scalpel (e laʻa me ka ʻili excision no kahi mole kānalua), kahi biopsy koʻikoʻi - hoʻokomo ʻia kahi nila i loko o kahi puʻupuʻu kānalua e wehe i kahi koʻikoʻi o ka ʻiʻo hiki ke nānā ʻia ma lalo o ka microscope (e laʻa me ka noiʻi ʻana i kahi puʻupuʻu umauma) a me ka hoʻokolokolo ʻana i ka iwi iwi no nā kumu staging/diagnostic.  No ka ʻike koke ʻana a me ke kūlana margin i ka wā o ke kaʻina hana (loiloi intra-operative) hana ʻia kahi ʻāpana hau. ʻAe kēia i ke kauka lapaʻau e hoʻoholo i ka nui o ke ʻoki ʻana ma ka hale hana ponoʻī.

ʻO ka Immuno histochemistry kahi ʻenehana hoʻokolohua i hoʻohana ʻia e ʻike i nā antigens kikoʻī (protein) i loko o nā ʻiʻo no nā cell e pili ana i ka ʻike ʻana o ka antigen-antibody. Hoʻohana nā pathologists i ka IHC e ʻike inā he benign a malignant paha kahi tumor, e hoʻoholo i kona kahua a me kona ʻano, a e ʻike i ke ʻano cell a me ke kumu o kahi metastasis i mea e loaʻa ai ke kahua o ka tumor mua. Hana mākou i ka Immuno histochemistry me ka hoʻohana ʻana i kahi kahua piha piha no ka diagnostic, nā māka prognostic a me nā predictive like ʻole i ka pathology cancer. Loaʻa iā mākou nā panela i hoʻolālā ʻia no nā carcinomas, sarcomas a me nā lymphomas. Loaʻa kā mākou panela receptor hormone ma ke ʻano he mau māka Lymphoma Panel CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD15, CD20, CD21, CD23, CD30, CD43, CD56, CD68, CD79a, CD138, LCA, LMP, BCL2, BCL6, MUM-1, Oct-2, BOB -1, CYCLIND1, CD138, KAPPA, LAMBDA, c- Myc, ALK a me nā māka Non Lymphoma Panel ALKD5F3, CD31, CD34, CD99, CK,CK(HMW), CK7, CK20, CK5/6, CK8/18, EMA, GATA-3, Glypican – 3, GCDFP-15, SMA, MSA, PSA, PSAP, PLAP, VIMENTIN, DESMIN, HMB45, HER2NEU, CA125,CALDESMON, ,INHIBIN ALPHA,CALRETININ, BEREP4, TTF, GCDFP15, CKIT, CEA(Monoclonal), CEA (polyclonal), SYNAPTOPHYSIN, CHROMOGRANIN, S100, MPO, CALCITONIN, THYROGLOBULIN, MART1,MYOD1,CK19,CDX2,BETACATENIN,CD1a,AMACAR,ANNEXIN,ARGI NASE,CD56,HHV8,IgG4,IgG, EMA, PAX-8, PD-1,RCC, S100,SAT-B2,SOX-10, SOX-11, GFAP, IDH-1, ATRX, NF, OLIG-2, P53, P63, KI67, EBER-ISH, MLH-1, MSH-2, PMS-2, ʻO MSH-6,BRAF, D240, CKIT, DOG-1, E-cadherin, GRANZYME-B, HEP-1, IgG, IgG4, INI-1, RCC, SALL4, STAT-6,WT-1, FLI. Hana pū mākou i nā panela immunohistochemistry neuro-oncology nui no nā ʻōpū o ka ʻōnaehana nerve waena. Eia kekahi, hoʻohana pū kā mākou keʻena hoʻokolohua i nā hoʻokolohua e like me ka hybridization in situ no Epstein-Barr Virus, Microsatellite Instability Panel, BRAF testing, PD-L1 testing (SP142 a me SP263) nona ke kuleana koʻikoʻi i ka hoʻopilikino ʻana i ka hoʻokele maʻi ma o ka immunotherapy i kuhikuhi ʻia.

Nā kaʻina hana hoʻohemo nila maikaʻi maʻamau a me ke alakaʻi ʻana o ka ultrasound: Hiki ke loaʻa kahi hoʻohemo nila maikaʻi i ka wai a me nā ʻāpana liʻiliʻi loa o ka ʻiʻo (nā cell pākahi ma mua o nā hui o nā cell, e laʻa me loko o ka wai mai ka māmā). Hana ʻia kēia me ka hoʻohana ʻana i kahi nila lahilahi ma mua o ka mea i hoʻohana ʻia i loko o kahi biopsy koʻikoʻi, akā me kahi ʻano hana like. ʻO kēia ʻano mea he wai maʻamau ma mua o ka paʻa, a waiho ʻia no ka cytology ma mua o ka histology. Pili ka Cytology i ka hoʻomākaukau ʻana i nā slide a me ka hōʻike ʻana i nā gynecological (Pap smears) a me nā laʻana gynecological ʻole (nā wai o ke kino a me ka wai cerebrospinal). Hana mākou i ka Liquid Based Cytology me ka hoʻohana ʻana i kahi kaʻina hana semi-automated e hana i kahi pālahalaha like o nā cell epithelial e hiki ai iā mākou ke hāʻawi i nā hopena ʻoluʻolu loa. Hoʻohana pū mākou i nā poloka cell ma ke ʻano he mea hoʻohui maʻamau i nā smears cytological maʻamau i hana ʻia no ka hoʻokolokolo wai. A laila hiki ke hoʻohana hou ʻia kēia mau poloka cell no ka immunohistochemistry a me nā haʻawina molecular.

He keʻena e kālele ana i ke koko a me nā maʻi kanesa e pili ana i ke koko e helu ana ma kahi o 10% o nā maʻi kanesa āpau. Hoʻomaka ia i ka iwi iwi ʻo ia ke kumu nui o ka hana ʻana o ke koko a hoʻopilikia i ka hana ʻana a me ka hana o nā hunaola koko. Hana ʻia ke koko i ʻekolu ʻano o nā hunaola: nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo a me nā Platelets. I ka hihia o ka maʻi kanesa, ua hoʻopau ʻia ke kaʻina hana hana koko ma muli o ka ulu ʻana o kahi ʻano hunaola koko ʻē. ʻO nā ʻano like ʻole:  Leukemia: Hoʻokumu ʻia kēia e ka hana wikiwiki ʻana o nā hunaola koko ʻē i loko o ka iwi iwi e hoʻopilikia ai i ka hiki o ka iwi iwi ke hana i nā hunaola koko ʻulaʻula a me nā platelets.  Lymphoma: He ʻano maʻi kanesa koko kēia e hoʻopilikia ai i ka ʻōnaehana lymphatic nona ke kuleana no ka hana ʻana i nā lymphocytes (kahi ʻano hunaola koko keʻokeʻo e hakakā nei i ka maʻi) a no ka wehe ʻana i nā wai keu mai ke kino. ʻO ka ulu ʻole ʻana o kēia mau lymphocytes ʻē ke kumu o ka lymphoma e laha ana i nā lymph nodes a me nā ʻiʻo ʻē aʻe.  Myeloma: ʻO ia ke ʻano o ka maʻi kanesa koko e hoʻopilikia ai i nā hunaola plasma (nā hunaola koko keʻokeʻo e kuleana no ka hana ʻana i nā antibodies e hakakā ana i nā maʻi i loko o ke kino), e hopena ana i kahi ʻōnaehana pale nāwaliwali.

Ua lako ʻia ka Haemato oncology me ka mīkini Flow Cytometry hou loa e nānā ana i kekahi mau mea (nā māka/antibodies) ma luna a i loko o nā cell e kōkua i ka ʻike ʻana i nā ʻano cell. Hiki ke hoʻohana ʻia kēia hoʻāʻo e ʻike inā loaʻa i nā lymphocytes i loko o kahi hāpana koko nā cell CLL. Pēlā nō, hiki ke hoʻohana ʻia ka flow Cytometry no ka ʻike ʻana i nā cell keʻokeʻo ʻē aʻe i kapa ʻia he blasts i loko o ka iwi iwi a i ʻole ke koko peripheral. ʻO kēia mau blasts i ka wā e loaʻa ai i nā helu nui i loko o ke koko peripheral a i ʻole ka iwi iwi iwi ua kapa ʻia ʻo leukemia acute. Hiki i ka Flow Cytometry ke ʻike i nā ʻano leukemia like ʻole. Ma hope o ka mālama ʻana, hiki ke hoʻohana ʻia ka flow Cytometry e loiloi inā aia mau nā blasts a i ʻole i hoʻopau loa ʻia e ka chemotherapy. Ua kapa ʻia kēia ʻo ka ʻike ʻana i ka maʻi koena liʻiliʻi a i ʻole MRD. Hiki i ka Flow Cytometry ke ʻike i ka Classical Hodgkin Lymphoma ma Lymph Nodes me ke kiʻekiʻe o ka naʻau a me ka kikoʻī me nā lymphomas Non-Hodgkin ʻē aʻe kahi e hiki ai ke hana i kahi hoʻāʻo screening e hoʻoholo ai inā aia ka lymphoma a ʻaʻole paha. Hoʻohana ʻia ʻo Flow Cytometry no ka Immuno phenotyping o nā ʻano specimens like ʻole, me ke koko holoʻokoʻa, ka iwi iwi, nā wai serous cavity, ka wai cerebrospinal, ka mimi, a me nā ʻiʻo paʻa. I loko o Flow Cytometry, ua mālama ʻia kahi laʻana o nā cell mai kahi biopsy, specimen cytology, a i ʻole ka specimen koko me nā antibodies kūikawā. Hoʻopili wale kēlā me kēia antibody i kekahi mau ʻano cell i loaʻa nā antigens e kūpono me ia. ʻO ka maʻamau, ʻo ka mea wale nō e pono ai e ʻike i kahi ʻano cell kikoʻī, ʻo ia ka hana ʻana i kahi antibody monoclonal e ʻike i kēlā cell. A laila hoʻopili ʻia kahi dye fluorescent i ka antibody, a hiki i ka flow Cytometry ke loaʻa nā cell āpau a ka antibody e kuhikuhi ai. A laila hoʻouna ʻia nā cell i mua o kahi kukuna laser e hana i nā kiʻi ʻikepili pono no kahi cytometrist akamai e wehewehe. ʻO ka Panel Leukemia Akute- Nā Māka B-Lymphoid & Acute Myeloid Leukemia Panel ʻO nā Māka B-Lymphoid e komo pū me CD10, CD19, CD20, CD22, Nuclear TDT T- Lymphoid a me NK Nā Māka CD1a, CD 2, CD3, CD4, CD5, CD7, CD8, CD56 Nā Māka Myeloid CD13, CD15, CD16,CD33, CD117 Nā Māka Monocytic CD4, CD11b, CD14, CD64 Nā Māka Cytoplasmic - MPO, CD79a a me CD3 Nā Māka Kūikawā ʻole CD34, HLADR, CD45, Myeloma Panel Cyto Kappa, cyto Lambda, CD56, CD10, CD38, CD138, CD19, CD28, CD20 & CD45, Chronic B Lymph proliferative Disorder Panel Kappa, Lambda, CD38, CD10, CD11c, CD19, CD5, CD20, CD103, CD180, CD200, IgM, CD43, CD21, CD3, CD16, CD56, CD7, CD8, CD4, TCR g/d, FMC7, CD23 & CD45, CD34+ Helu ʻana o nā pūnaewele kumu CD34, Kaohi Iso clonic, Wai hoʻoluʻu ola, Nā momi helu kumu.