Pathology

I-Pathology ingesinye sezigaba ezingaphansi kwezinsizakalo zaselabhorethri okuyisona sici esiyinhloko sokuxilongwa, futhi sibikezela inkambo yomtholampilo okungenzeka ibe nayo ngaleyo ndlela yakhe insika yokuphatha.
 Izibonelo ezitholwe ilabhorethri ye-pathology zilungiswa ngokulungiswa kwezicubu kulandelwa ukulungiswa ngamasu asisiza ukuhlaziya izicubu ngaphansi kwesibonakhulu. Ithishu elungiswe kahle futhi ecutshungulwe ivumela ukugcinwa okufanele kwezicubu kanye nokusetshenziswa kwezicubu ukuze kwenziwe olunye uphenyo oluhlanganisa ne-Immuno histochemistry kanye nezifundo zamangqamuzana.  Izinhlobo eziyinhloko zezibonelo ezitholwe ilabhorethri ye-pathology zihlanganisa izibonelo ezinkulu zezitho eziphelele noma izingxenye zazo, ezikhishwa ngesikhathi sokuhlinzwa. Izicucu zezicubu esikhundleni sezitho eziphelele zisuswa njengama-biopsies afana nama-excision biopsies -izicubu zikhishwa nge-scalpel (isb. ukuhlinzwa kwesikhumba semvukuzane esolisayo), i-core biopsy- inaliti ishuthekwa esixukwini esisolisayo ukuze kukhishwe umongo wethishu leyo. ingahlolwa ngesibonakhulu (isb. ukuphenya isigaxa sebele) ngisho nokuhlolwa komnkantsha ngezinhloso zesiteji/zokuxilongwa.  Ukuze uthole ukuxilongwa ngokushesha kanye nesimo se-margin ngesikhathi sokuhlinzwa (ukuhlolwa kokuhlinzwa) ingxenye eqandisiwe iyenziwa. Lokhu kuvumela udokotela ohlinzayo ukuba anqume izinga lokuhlinzwa endaweni yeshashalazi ngokwayo.

I-Immuno histochemistry iyindlela yaselabhorethri esetshenziselwa ukuthola ama-antigen athile (amaprotheni) ezicutshini zamaseli asekelwe ekuboneni i-antigen-antibody. Izazi zezifo zisebenzisa i-IHC ukuxilonga uma isimila siyingozi noma siyingozi, ukucacisa isigaba saso kanye nebanga, kanye nokuhlonza uhlobo lweseli nomsuka we-metastasis ukuze kutholwe indawo yesimila esiyinhloko. Senza i-Immuno histochemistry sisebenzisa inkundla ezenzakalelayo esebenza ngokugcwele yokuxilonga, izimpawu ezihlukahlukene zokubikezela kanye nezibikezelo ku-pathology yomdlavuza. Sinamaphaneli aklanyelwe umdlavuza, ama-sarcoma nama-lymphomas. Iphaneli yethu yokwamukela amahomoni iyatholakala njengezimpawu ze-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 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,100GRONIG 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 futhi amaphaneli abanzi we-neuro-oncology immunohistochemistry kumathumba esistimu yezinzwa emaphakathi. Ngaphezu kwalokho, ilabhorethri yethu iphinde isebenzise izivivinyo ezifana ne-in situ hybridization ye-Epstein- Barr Virus, Iphaneli Yokungaqini Kwe-Microsatellite, ukuhlolwa kwe-BRAF, ukuhlolwa kwe-PD-L1 (SP1 kanye ne-SP142) okudlala indima ebalulekile ekwenzeni ukuphathwa kwesiguli kube ngokwakho nge-immunotherapy ehlosiwe.

Izinqubo zokulangazelela inaliti eziqondiswa yi-ultrasound: Uketshezi nezicucu ezincane kakhulu zezicubu (amangqamuzana ngamanye kunamaqembu amangqamuzana, isb. ngaphakathi koketshezi olusuka ephashini) kungatholakala ukufukamela inaliti. Lokhu kwenziwa kusetshenziswa inaliti ezacile kunaleyo esetshenziswa ku-core biopsy, kodwa ngendlela efanayo. Lolu hlobo lwento ngokuvamile luwuketshezi kunokuba luqine, futhi luthunyelwa nge-cytology kune-histology. I-Cytology ihilela ukulungiswa kwamaslayidi kanye nokubika ngezifo zabesifazane (Pap smear) kanye namasampula angewona awe-gynecological (uketshezi lomzimba noketshezi lwe-cerebrospinal). Senza i-Liquid Based Cytology sisebenzisa inqubo ye-semi-automated ukuze sidale ukusabalala okufanayo kwamaseli e-epithelial okusenza sikwazi ukunikeza imiphumela eyanelisa kakhulu. Siphinde futhi sisebenzise ama-cell blocks njengesengezo esijwayelekile kuma-cytological smear ezenzelwe ukuhlola uketshezi. Lawa mabhulokhi amaseli angaphinde asetshenziselwe izifundo ze-immunohistochemistry kanye ne-molecular.

Umnyango ogxile egazini kanye nomdlavuza ohlobene negazi owenza cishe u-10% wawo wonke umdlavuza. Isuka emnkantsheni okuwumthombo oyinhloko wokukhiqizwa kwegazi futhi ithinta ukukhiqizwa nokusebenza kwamangqamuzana egazi. Igazi lakhiwe izinhlobo ezintathu zamangqamuzana: Amangqamuzana egazi abomvu, amangqamuzana amhlophe egazi kanye namaPlatelets. Uma kunomdlavuza, inqubo yokukhiqizwa kwegazi iyaphazamiseka ngenxa yokukhula kohlobo lwengqamuzana legazi olungavamile. Izinhlobo ezahlukene zihlanganisa:  I-leukemia: Lokhu kubangelwa ukukhiqizwa ngokushesha kwamangqamuzana egazi angavamile emnkantsheni wethambo okwenza umnkantsha ukhiqize amangqamuzana egazi abomvu namaplatelet.  I-Lymphoma: Lolu wuhlobo lomdlavuza wegazi oluthinta uhlelo lwe-lymphatic olubhekele ukukhiqiza ama-lymphocyte (uhlobo lwamangqamuzana amhlophe egazi alwa nezifo) kanye nokukhipha uketshezi oluningi emzimbeni. Ukukhula okungalawuleki kwalawa ma-lymphocyte angavamile kubangela i-lymphoma esabalele kuma-lymph nodes nezinye izicubu.  I-Myeloma: Iwuhlobo lomdlavuza wegazi othinta amangqamuzana e-plasma (amangqamuzana amhlophe egazi abhekele ukukhiqizwa kwamasosha omzimba alwa nezifo emzimbeni), okuholela ekwakhekeni kwamasosha omzimba.

I-Haemato oncology ifakwe umshini wobuciko we-Flow Cytometry obheka izinto ezithile (omaka/amasosha omzimba) kumaseli noma kumaseli asiza ukukhomba ukuthi ayizinhlobo zini zamaseli. Lokhu kuhlola kungasetshenziswa ukubona ukuthi ama-lymphocyte esampula yegazi anamaseli e-CLL. Ukugeleza okufanayo I-Cytometry ingasetshenziswa ukuthola amangqamuzana amhlophe angajwayelekile abizwa ngokuthi ukuqhuma kumnkantsha wethambo noma egazini le-peripheral. Lokhu kuqhuma uma kutholakala ngobuningi egazini le-peripheral noma umnkantsha kubizwa ngokuthi i-acute leukemia. I-Flow Cytometry iphinde inikeze amandla ukuhlonza izinhlobo ezahlukene ze-leukemia. Ngemva kokwelashwa, i-flow Cytometry ingasetshenziswa ukuhlola ukuthi ukuqhuma kusekhona yini noma kuqedwe ngokuphelele ngamakhemikhali. Lokhu kubizwa ngokuthi ukutholwa kwesifo esincane esiyinsalela noma i-MRD. I-Flow Cytometry ingakwazi ukuxilonga i-Classical Hodgkin Lymphoma kuma-Lymph Nodes ngokuzwela okuphezulu nokucacile kanye namanye ama-Non -Hodgkin lymphomas lapho kungenziwa ukuhlolwa kokuhlolwa ukuze kutholakale ukuthi i-lymphoma ikhona noma cha. I-Flow Cytometry isetshenziselwa i-Immuno phenotyping yezinhlobonhlobo zezibonelo, okuhlanganisa igazi lonke, umnkantsha, uketshezi lwe-serous cavity, uketshezi lwe-cerebrospinal, umchamo, nezicubu eziqinile. Ku-Flow Cytometry, isampula lamaseli asuka ku-biopsy, i-cytology specimen, noma isampula yegazi iphathwa ngama-antibodies akhethekile. I-antibody ngayinye inamathela kuphela ezinhlotsheni ezithile zamaseli anama-antigen ahambisana nawo. Imvamisa, okudingekayo nje ukukhomba uhlobo oluthile lweseli ukwenza i-monoclonal antibody ukuze ibone lelo seli. Bese udayi we-fluorescent unamathiselwe ku-antibody, futhi i-Cytometry egelezayo ingathola wonke amaseli i-antibody eqondiswe kuwo. Amaseli abe esedluliswa phambi kwe-laser beam ukuze akhiqize iziza zedatha eziwusizo ukuze i-cytometrist enekhono ayihumushe. I-Acute Leukemia Panel- B-Lymphoid Markers & Acute Myeloid Leukemia Panel B-Lymphoid Markers ihlanganisa i-CD10, CD19, CD20, CD22, Nuclear TDT T- Lymphoid kanye ne-NK Markers CD1a, CD 2, CD3, CD4, CD5, CD7, CD8, CD56 Izimpawu ze-Myeloid CD13, CD15, CD16,CD33, I-CD117 Monocytic Markers CD4, CD11b, CD14, CD64 Cytoplasmic Markers – MPO, CD79a kanye 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 udayi, Stem count ubuhlalu.