KuPathology

I-Pathology lelinye lamacandelo aphantsi kweenkonzo zaselabhoratri engoyena mlawuli uphambili woxilongo, kwaye iqikelela ngekhosi enokubakho yezonyango ngokwenza oko isisiseko solawulo.
 Iisampulu ezifunyenwe yilabhoratri ye-pathology zilungiswa ngokulungiswa kwezicubu ezilandelwa kukulungiswa ngobuchule obusinceda ukuba sihlalutye izicubu phantsi kwe-microscope. Isihlunu esilungisiweyo nesilungisiweyo sivumela ukugcinwa ngokufanelekileyo kweethishu kunye nokusetyenziswa kwethishu kuphando olongezelelweyo olubandakanya i-Immuno histochemistry kunye nezifundo zemolekyuli.  Iintlobo eziphambili zesampulu ezifunyenwe yilabhoratri ye-pathology ziquka imizekelo emikhulu yamalungu onke okanye amalungu awo, athi asuswe ngexesha lotyando. Iingceba zeethishu endaweni yokuba amalungu aphelele asuswe njengee-biopsies ezifana ne-excision biopsies-izicubu zisuswa nge-scalpel (umzekelo, ukuhluthwa kwesikhumba kwi-mole ekrokrayo), i-core biopsy-inaliti ifakelwe kubunzima obukrokrekayo ukususa umbindi wethishu ekuthi. inokuhlolwa ngemakroskopu (umz. ukuphanda iqhuma lebele) kunye noxilongo lomongo wethambo ngeenjongo zokuxilonga.  Ukukhangela uxilongo olukhawulezileyo kunye nobume bomda ngexesha lenkqubo yotyando (uvavanyo lotyando) icandelo lomkhenkce liyenziwa. Oku kuvumela ugqirha wotyando ukuba agqibe ngobungakanani botyando kwindawo yotyando ngokwalo.

I-Immuno histochemistry yindlela yaselabhoratri esetyenziselwa ukufumanisa ii-antigens ezithile (iiprotheyini) kwiithishu zeeseli ezisekelwe ekuqaphelisweni kwe-antigen-antibody. Iingcali ze-pathologists zisebenzisa i-IHC ukuxilonga ukuba i-tumor inobungozi okanye iyingozi, ukumisela inqanaba kunye nebakala, kunye nokuchonga uhlobo lweseli kunye nemvelaphi ye-metastasis ukuze ufumane indawo ye-tumor yokuqala. Senza i-Immuno histochemistry sisebenzisa iqonga elizisebenzelayo ngokupheleleyo lokuxilonga, iimpawu ezahlukeneyo zokuxela kwangaphambili kunye nokuxela kwangaphambili kwisifo somhlaza. Sineephaneli ezenzelwe i-carcinomas, sarcomas kunye ne-lymphomas. Iphaneli yethu ye-hormone receptor iyafumaneka njengeLymphoma 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 and 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, I-PSAP,PLAP, VIMENTIN, DESMIN, HMB45, HER2NEU, CA125,CALDESMON, ,INHIBIN ALPHA,CALRETININ, BEREP4, TTF, GCDFP15, CKIT, CEA(Monoclonal), CEA (polyclonal), SYNAPTOPHY, MPOSINGROM,100GRONIM CALCITONIN, THYROGLOBULIN, MART1,MYOD1,CK19,CDX2,BETACATENIN,CD1a,AMACAR,ANNEXIN,ARGI NASE,CD56,HHV8,IgG4,IgG,EMA,PAX-8, PD-1,RCC,S100,SOX-B -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. Senza kwakhona iiphaneli ze-neuro-oncology immunohistochemistry ezibanzi kwii-central nervous system tumors. Ukongeza, ilabhoratri yethu ikwasebenzisa iimvavanyo ezifana ne-situ hybridization ye-Epstein- Barr Virus, iPaneli yokuZinzisa kweMicrosatellite, uvavanyo lwe-BRAF, uvavanyo lwe-PD-L1 (SP1 kunye ne-SP142) ezidlala indima ebalulekileyo ekwenzeni ulawulo lwesigulane ngonyango olujoliswe kuko.

Inkqubo yesiqhelo kunye ne-ultrasound ekhokelwayo yeenkqubo zokufunxa inaliti: Ulwelo kunye namaqhekeza amancinci kakhulu ezithishu (iiseli zomntu ngamnye kunamaqela eeseli, umz. ngaphakathi kolwelo olusuka kumphunga) zinokufumaneka ukuphefumla ngenaliti. Oku kwenziwa kusetyenziswa inaliti encinci kunaleyo isetyenziswa kwi-core biopsy, kodwa ngobuchule obufanayo. Olu hlobo lwemathiriyeli ludla ngokuba lulwelo kunokuba luqine, kwaye lungeniswa kwi-cytology kune-histology. I-Cytology ibandakanya ukulungiswa kwezilayidi kunye nokunika ingxelo nge-gynecology (Pap smears) kunye neesampulu ezingezizo ezesifazana (ulwelo lomzimba kunye nolwelo lwe-cerebrospinal). Senza i-Liquid Based Cytology sisebenzisa inkqubo ye-semi-automated ukwenza ukusabalalisa okufanayo kweeseli ze-epithelial ezisenza sikwazi ukubonelela ngeziphumo ezanelisayo kakhulu. Sikwasebenzisa ii-cell blocks njengesiqhelo esidibanisa ne-cytological smears yesiqhelo eyenzelwe uviwo lwe-fluid. Ezi bhloko zeeseli zinokuphinda zisetyenziswe kwi-immunohistochemistry kunye nezifundo zemolekyuli.

Isebe eligxile kwigazi kunye nomhlaza onxulumene negazi elithatha malunga ne-10% yazo zonke ii-cancer. Isuka kumongo wethambo owona mthombo wemveliso yegazi kwaye ichaphazela ukuveliswa kunye nokusebenza kweeseli zegazi. Igazi lenziwe ziintlobo ezintathu zeeseli: Iiseli ezibomvu zegazi, iiseli ezimhlophe zegazi kunye neePlatelets. Kwimeko yomhlaza, inkqubo yokuvelisa igazi iyaphazamiseka ngenxa yokukhula kohlobo olungaqhelekanga lweseli yegazi. Iindidi ezahlukeneyo ziquka:  I-Leukemia: Oku kubangelwa ukuveliswa ngokukhawuleza kweeseli zegazi ezingaqhelekanga kumongo wethambo nto leyo echaphazela amandla omongo wokuvelisa iiseli ezibomvu zegazi kunye neeplatelet.  I-Lymphoma: Olu luhlobo lomhlaza wegazi ochaphazela inkqubo ye-lymphatic enoxanduva lokuvelisa i-lymphocytes (uhlobo lweseli emhlophe yegazi elwa nosulelo) kunye nokukhupha ulwelo olugqithisileyo emzimbeni. Ukukhula okungalawulekiyo kwezi lymphocytes ezingaqhelekanga kubangela i-lymphoma esasazeka kwii-lymph nodes kunye nezinye izicubu.  I-Myeloma: Luhlobo lomhlaza wegazi ochaphazela iiseli ze-plasma (iiseli ezimhlophe zegazi ezijongene nokuveliswa kwezifo ezilwa nezifo emzimbeni), okubangelwa ubuthathaka bomzimba.

I-oncology ye-Haemato ixhotyiswe ngemeko yobugcisa Umatshini we-Flow Cytometry ojonga izinto ezithile (iziphawuli / izilwa-buhlungu) okanye kwiiseli ezinceda ukuchonga ukuba zeziphi iintlobo zeeseli. Olu vavanyo lunokusetyenziselwa ukubona ukuba ii-lymphocytes kwisampulu yegazi zineeseli ze-CLL. Ngokukwanjalo i-Cytometry ingasetyenziselwa ukukhangela iiseli ezimhlophe ezingaqhelekanga ezibizwa ngokuba kuqhushumbo nokuba kumongo wethambo okanye egazini leperipheral. Olu qhushumbo xa lufunyenwe ngamanani amakhulu egazini leperipheral okanye umongo wethambo lubizwa ngokuba yi-acute leukemia. I-Flow Cytometry ikwavumela ukuchongwa kweentlobo ezahlukeneyo ze-leukemia. Emva kokonyango, ukuhamba kwe-Cytometry kungasetyenziselwa ukuvavanya ukuba ukuqhuma kusekho okanye kupheliswe ngokupheleleyo yi-chemotherapy. Oku kubizwa ngokuba kukufunyanwa kwesifo esincinci sentsalela okanye i-MRD. I-Flow Cytometry inokuxilonga i-Classical Hodgkin Lymphoma kwii-Lymph Nodes ezinovakalelo oluphezulu kunye neenkcukacha ezithile kunye nezinye ii-Non -Hodgkin lymphomas apho uvavanyo lokuhlola lunokwenziwa ukufumanisa ukuba i-lymphoma ikhona okanye ayikho. I-Flow Cytometry isetyenziselwa i-Immuno phenotyping yeentlobo ezahlukeneyo zesampulu, kubandakanya igazi elipheleleyo, umongo wethambo, ulwelo lwe-serous cavity, ulwelo lwe-cerebrospinal, umchamo, kunye nezicubu eziqinileyo. Kwi-Flow Cytometry, isampuli yeeseli ezivela kwi-biopsy, i-cytology specimen, okanye isampuli yegazi iphathwa nge-antibodies ekhethekileyo. I-antibody nganye inamathela kuphela kwiintlobo ezithile zeeseli ezinee-antigens ezihambelana nayo. Ngokwesiqhelo, konke okufunekayo ukuchonga uhlobo oluthile lweseli kukwenza i-antibody ye-monoclonal ukuze iqaphele loo seli. Emva koko idayi ye-fluorescent idityaniswe kwi-antibody, kwaye i-Cytometry ejikelezayo inokufumana zonke iiseli ezijoliswe kuzo i-antibody. Iiseli ke zigqithiselwa phambi komqadi welaser ukuvelisa iiploti zedatha eziluncedo ukuze icytometrist enobuchule itolike. Iphaneli yeAcute Leukemia Panel- B-Lymphoid Markers & Acute Myeloid Leukemia Panel B-Lymphoid Markers ibandakanya iCD10, CD19, CD20, CD22, Nuclear TDT T- Lymphoid kunye neNK Markers CD1a, CD 2, CD3, CD4, CD5, CD7, CD8, CD56 Iimpawu zeMyeloid CD13, CD15, CD16,CD33, I-CD117 Monocytic Markers CD4, CD11b, CD14, CD64 Cytoplasmic Markers – MPO, CD79a kunye neCD3 Non-Lineage markers CD34, HLADR, CD45, Myeloma Panel 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 control, Viability idayi, Stem count amaso.