Pathology

Pathology yog ib feem ntawm cov kev pabcuam hauv chaw kuaj mob uas yog qhov tseem ceeb ntawm kev kuaj mob, thiab kwv yees seb qhov kev kho mob yuav ua li cas thiaj li tsim lub hauv paus rau kev tswj hwm.
 Cov qauv tau txais los ntawm lub chaw kuaj kab mob pathology tau kho cov ntaub so ntswg ua raws li kev npaj los ntawm cov txheej txheem uas pab peb txheeb xyuas cov ntaub so ntswg hauv qab lub tshuab tsom. Cov ntaub so ntswg kho kom raug thiab ua tiav tso cai cia cov ntaub so ntswg thiab siv cov ntaub so ntswg rau kev tshawb nrhiav ntxiv nrog rau Immuno histochemistry thiab kev tshawb fawb molecular.  Cov hom qauv tseem ceeb uas tau txais los ntawm lub chaw kuaj kab mob muaj xws li cov qauv loj dua ntawm tag nrho cov kab mob hauv nruab nrog cev lossis qhov chaw ntawm nws, uas raug tshem tawm thaum lub sijhawm phais. Cov ntaub so ntswg es tsis yog tag nrho cov kabmob raug tshem tawm raws li biopsies zoo li excision biopsies - cov ntaub so ntswg raug tshem tawm nrog lub scalpel (xws li kev txiav ntawm daim tawv nqaij rau qhov tsis txaus ntseeg mole), cov tub ntxhais biopsy- ib rab koob tau muab tso rau hauv qhov tsis txaus ntseeg kom tshem tawm cov tub ntxhais ntawm cov ntaub so ntswg. tuaj yeem kuaj xyuas nyob rau hauv lub microscope (xws li tshawb xyuas lub mis) thiab txawm tias kev kuaj mob pob txha rau kev kuaj mob / kuaj mob.  Rau kev kuaj mob tam sim ntawd thiab cov txheej txheem margin thaum lub sij hawm kev phais (kev ntsuam xyuas hauv kev ua haujlwm) ib ntus khov. Qhov no tso cai rau tus kws phais txiav txim siab txog qhov kev phais hauv kev ua haujlwm ua yeeb yam nws tus kheej.

Immuno histochemistry yog cov txheej txheem kuaj siv los kuaj xyuas cov antigens tshwj xeeb (cov protein) hauv cov ntaub so ntswg rau cov hlwb raws li kev paub txog antigen-antibody. Cov kws kho mob siv IHC los kuaj xyuas seb cov qog nqaij hlav zoo li cas lossis tsis zoo, txhawm rau txiav txim siab nws theem thiab qib, thiab txheeb xyuas hom cell thiab keeb kwm ntawm metastasis txhawm rau txhawm rau nrhiav qhov chaw ntawm cov qog thawj zaug. Peb ua Immuno histochemistry siv lub tshuab ua haujlwm tag nrho rau kev kuaj mob, ntau yam prognostic thiab kwv yees cov cim hauv kev mob qog noj ntshav. Peb muaj vaj huam sib luag tsim rau carcinomas, sarcomas thiab lymphomas. Peb cov tshuaj hormone receptor vaj huam sib luag muaj xws li Lymphoma Panel markers 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 thiab Non Lymphoma Panel markers 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), MP100, SYNAPTOPHYS, Calcitonin, THYROGlobulin, MART1,MYOD1, CK19, CDX2, BetACatenin, CD1a, AMACAR, ANNEXIN, ARGI NASE, CD56, HHV8, IgG4, IgG, EMA, PAX-8, PD-1, RCC, S100, SXAT -2, SOX-10, GFAP, IDH-11, ATRX, NF, OLIG-1, P2, P53, KI63, EBER -ISH, MLH-67, MSH-1, PMS-2, MSH-2, BRAF, D6, CKIT, DOG-240, E-cadherin, GRANZYME-B, HEP-1, IgG, IgG1, INI-4, RCC, SALL1, STAT-4, WT-6, FLI. Peb kuj ua ntau yam neuro-oncology immunohistochemistry panels rau nruab nrab paj hlwb hlav. Tsis tas li ntawd, peb lub chaw kuaj mob kuj tseem siv cov kev ntsuam xyuas xws li nyob rau hauv situ hybridization rau Epstein- Barr Virus, Microsatellite Instability Panel, BRAF test, PD-L1 testing (SP1 thiab SP142) uas ua lub luag haujlwm tseem ceeb hauv kev tswj tus neeg mob los ntawm kev siv tshuaj tiv thaiv kab mob.

Cov txheej txheem niaj hnub thiab ultrasound coj cov txheej txheem zoo koob aspiration: Cov kua dej thiab cov ntaub so ntswg me me (cov tib neeg lub hlwb es tsis yog pab pawg ntawm cov hlwb, xws li cov kua dej los ntawm ib ncig ntawm lub ntsws) tuaj yeem tau txais ib rab koob zoo. Qhov no yog ua los ntawm kev siv rab koob thinner dua li uas siv rau hauv cov tub ntxhais biopsy, tab sis nrog cov txheej txheem zoo sib xws. Cov khoom no feem ntau yog kua ntau dua li cov khoom, thiab xa mus rau cytology es tsis yog histology. Cytology suav nrog kev npaj cov swb thiab qhia txog gynecological (Pap smears) thiab cov qauv uas tsis yog gynecological (cov kua hauv lub cev thiab cov kua cerebrospinal). Peb ua Liquid Based Cytology siv cov txheej txheem semi-automated los tsim kev sib kis ntawm cov hlwb epithelial uas ua rau peb muab cov txiaj ntsig zoo siab. Peb kuj siv cell blocks raws li niaj hnub txuas mus rau ib txwm cytological smears ua rau cov kua dej. Cov blocks ntawm tes no tuaj yeem siv ntxiv rau kev siv tshuaj tiv thaiv kab mob thiab kev tshawb fawb molecular.

Ib chav haujlwm uas tsom mus rau cov ntshav thiab cov qog nqaij hlav hauv ntshav uas suav txog kwv yees li 10% ntawm tag nrho cov qog nqaij hlav. Nws tshwm sim hauv cov pob txha pob txha uas yog lub hauv paus tseem ceeb ntawm cov ntshav tsim tawm thiab cuam tshuam rau kev tsim thiab ua haujlwm ntawm cov qe ntshav. Cov ntshav yog tsim los ntawm peb hom hlwb: cov qe ntshav liab, cov qe ntshav dawb thiab Platelets. Nyob rau hauv cov ntaub ntawv ntawm mob qog noj ntshav, cov ntshav ntau lawm yog cuam tshuam vim kev loj hlob ntawm ib qho txawv txav ntawm cov ntshav cell. Muaj ntau hom muaj xws li:  Leukemia: Qhov no yog tshwm sim los ntawm kev tsim cov qe ntshav tsis zoo hauv cov pob txha uas cuam tshuam rau cov pob txha lub peev xwm tsim cov qe ntshav liab thiab platelets.  Lymphoma: Qhov no yog hom mob qog noj ntshav uas cuam tshuam rau cov kab mob lymphatic uas yog lub luag haujlwm tsim cov lymphocytes (ib hom ntshav dawb uas tiv thaiv kab mob) thiab tshem tawm cov kua dej ntau dhau ntawm lub cev. Kev loj hlob tsis tuaj yeem ntawm cov lymphocytes txawv txav ua rau lymphoma uas kis mus rau cov qog nqaij hlav thiab lwm yam ntaub so ntswg.  Myeloma: Nws yog hom mob qog noj ntshav uas cuam tshuam rau cov ntshav plasma (cov qe ntshav dawb ua lub luag haujlwm rau kev tsim cov kab mob tiv thaiv kab mob hauv lub cev), ua rau lub cev tsis muaj zog.

Haemato oncology yog nruab nrog lub xeev ntawm kev kos duab Flow Cytometry tshuab uas saib rau qee yam khoom (cov cim / cov tshuaj tiv thaiv) ntawm lossis hauv cov hlwb uas pab txheeb xyuas seb hom cell lawv yog dab tsi. Qhov kev sim no tuaj yeem siv los saib seb cov lymphocytes hauv cov qauv ntshav muaj CLL cov hlwb. Ib yam li ntawd, Cytometry tuaj yeem siv los kuaj xyuas cov qe ntshav dawb hu ua blasts nyob rau hauv cov pob txha pob txha lossis cov ntshav peripheral. Cov blasts no thaum pom muaj coob nyob rau hauv cov ntshav peripheral los yog cov pob txha pob txha hu ua mob leukemia. Flow Cytometry tseem ua kom paub txog ntau hom kab mob leukemia. Tom qab kev kho mob, ntws Cytometry tuaj yeem siv los ntsuam xyuas seb cov blasts tseem nyob lossis tshem tawm tag nrho los ntawm kev siv tshuaj khomob. Qhov no yog hu ua kev kuaj pom tus kab mob tsawg tsawg lossis MRD. Flow Cytometry tuaj yeem kuaj xyuas Classical Hodgkin Lymphoma hauv Lymph Nodes uas muaj qhov rhiab heev thiab qhov tshwj xeeb nrog rau lwm cov Non-Hodgkin lymphomas qhov kev ntsuam xyuas tuaj yeem ua tiav los txiav txim seb cov qog ntshav qab zib puas muaj lossis tsis muaj. Flow Cytometry yog siv rau Immuno phenotyping ntawm ntau yam qauv, suav nrog tag nrho cov ntshav, pob txha pob txha, cov kua dej hauv cov kab noj hniav, cov kua cerebrospinal, cov zis, thiab cov ntaub so ntswg. Hauv Flow Cytometry, ib qho piv txwv ntawm cov hlwb los ntawm kev kuaj ntshav biopsy, cytology specimen, lossis cov ntshav kuaj tau kho nrog cov tshuaj tiv thaiv tshwj xeeb. Txhua cov tshuaj tiv thaiv tsuas yog nyob rau qee hom hlwb uas muaj cov antigens uas haum nrog nws. Feem ntau, txhua yam nws yuav siv los txheeb xyuas ib hom ntawm tes yog los tsim cov tshuaj tiv thaiv kab mob monoclonal kom paub txog lub cell. Tom qab ntawd cov xim fluorescent txuas nrog cov tshuaj tiv thaiv kab mob, thiab ntws Cytometry tuaj yeem pom txhua lub hlwb uas cov tshuaj tiv thaiv lub hom phiaj. Cov hlwb ces dhau mus rau pem hauv ntej ntawm lub teeb laser los tsim cov ntaub ntawv muaj txiaj ntsig rau tus kws tshaj lij cytometrist los txhais. Acute Leukemia Panel- B-Lymphoid Markers & Acute Myeloid Leukemia Panel B-Lymphoid Markers suav nrog CD10, CD19, CD20, CD22, Nuclear TDT T- Lymphoid thiab NK Markers CD1a, CD 2, CD3, CD4, CD5, CD7, CD8, CD56 Myeloid Markers CD13, CD15, CD16, CD33, CD117 Monocytic Markers CD4, CD11b, CD14, CD64 Cytoplasmic Markers - MPO, CD79a thiab CD3 Tsis-Lineage cov cim tshwj xeeb CD34, HLADR, CD45, Myeloma Vaj Huam Sib Luag Cyto Kappa, cyto Lambda, CD56, CD10, CD38, CD138, CD19 & CD28, Chronic B Lymph proliferative Disorder Panel Kappa, Lambda, CD20, CD45, CD38c, CD10, CD11, CD19, CD5, CD20, CD103, IgM, CD180, CD200, CD43, CD21, CD3, CD16, CD56, CD7, TCR g/d, FMC8, CD4 & CD7, CD23+ Stem cell enumeration CD45, Iso clonic tswj, Viability zas, qia suav hlaws.