Kwimeko ehlala itshintsha yokuxilongwa kwezonyango,iinaliti ze-biopsyzidlala indima ebalulekileyo ekufumaneni iisampulu zezicubu ukuze zihlolwe ngokuchanekileyo ngezifo, kwaye ukukhethwa kwazo kunxulumene ngokuthe ngqo nokuchaneka kwe-biopsy, ukhuseleko kunye namava esigulana. Oku kulandelayo luhlalutyo lweenkqubo ze-biopsy,iintlobo zeenaliti ze-biopsy, umlinganiselo weenaliti eziphakathi ukuya kwezincinci, kunye nezinto ezibalulekileyo zokukhetha ukubonelela ngesikhokelo esicwangcisiweyo sokwenziwa kweklinikhi.
1. Ukuqonda iinkqubo ze-biopsy
Injongo ephambili yenkqubo ye-biopsy kukufumana isampuli yezicubu ezisemgangathweni ophezulu ukuze kucaciswe uhlobo lwesilonda okanye ukuphuhlisa isicwangciso sonyango. Imfuneko yenaliti ye-biopsy yahluka kakhulu phakathi kweemeko ze-biopsy:
- Ukuxilongwa kwethumba: kufuneka umthamo owaneleyo wezicubu ukuxhasa ukubekwa kwesifo kunye novavanyo lwemfuza (umz., i-EGFR, utshintsho lwe-ALK).
- Izifo ezibangelwa kukudumba: i-cytology iyadingeka ukuze kucaciswe uhlobo lwe-pathogen okanye i-immune cell.
- Uvavanyo lwangaphambi kotyando: ukufunyanwa kwesampulu ngokukhawuleza kuyafuneka ukuze kukhokelwe iindlela zotyando (umz., ukuchonga amabele angenabungozi nanobungozi).
2. Iintlobo zeiinaliti ze-biopsykunye nezicelo zeklinikhi
- Umgaqo: Ukufumana umcu wesampuli yethishu ngokusika ngomatshini.
- Iingenelo:
Isampuli epheleleyo, efanelekileyo kwi-tumor eqinileyo (umz., ibele, i-prostate) kunye ne-biopsy yezicubu zamathambo.
Ubungakanani besampulu buyanele ukuxhasa uvavanyo lwe-immunohistochemistry kunye ne-molecular.
- Imida: ukwenzakala okukhulu, kufuneka uqonde ngokucacileyo izalathiso.
(2) Inaliti ye-Fine Aspiration Biopsy
- Umgaqo: Ukusetyenziswa komoya otyhafisayo ukuze kufunyanwe ukumiswa kweseli.
- Iingenelo:
Ayibuhlungu kangako, ifanelekile kwi-lymph nodes ezingaphezulu, izilonda ze-thyroid kunye nemiphunga.
Kulula ukuyenza, inokufumana ngokukhawuleza ii-suspensions zeseli.
Kulula ukuyenza, ivumela ukuxilongwa ngokukhawuleza kwe-cytological.
- Imida: ukuqhekeka kwesampulu, ukungakwazi ukuhlangabezana neemfuno zovavanyo lwe-histologic.
(3) Inaliti yeBiopsy encediswa yiVacuum (VAB)
- Umgaqo: Idibanisa ukusika ngoomatshini kunye nokufunxwa koxinzelelo olungalunganga ukuphucula ukusebenza kakuhle kwesampulu.
- Iingenelo:
Iisampuli ezininzi zingafunyanwa ngokubhoboza kube kanye, ezifanelekileyo kwi-foci yebele ene-microcalcified.
Inciphisa umngcipheko wokubhobozwa kwakhona kwaye iphucula ukunyamezela kwesigulana.
(4) Inaliti yokusika i-Biopsy
- Umgaqo: Izicubu zinqunyulwa ngencam enemiqolo okanye incam ejikelezayo.
- Iintlobo:
Inaliti eneembobo: umz. Inaliti ye-Tru-Cut Biopsy, yezicubu ezithambileyo.
Inaliti yokubhola ngeRing: umz. Inaliti yeBone Marrow Biopsy, yezicubu zethambo.
3. i-core needle biopsy vs i-fine needle aspiration
| Isalathisi | I-biopsy yenaliti engundoqo | Ukufunxwa kwenaliti encinci |
| Iintlobo zeSampulu | Isampulu yethishu ehlutyiweyo | Ukumiswa kweseli |
| Ukuchaneka kokuxilongwa | Iphezulu (i-histology) | Phakathi (i-cytology) |
| Ubungakanani bokwenzakala | Enkulu | Encinci |
| Ixesha lokusebenza | Ixesha elide | Mfutshane |
| Iziganeko | Iithumba eziqinileyo, izicubu zamathambo | Izilonda ezingaphezulu, ii-lymph nodes |
4. Izinto eziphambili ekufuneka ziqwalaselwe xa ukhetha iinaliti ezifanelekileyo ze-biopsy
(1) Indawo ekujoliswe kuyo yiBiopsy
- Izitho zomzimba ezingasentla (umz., i-thyroid, ibele): iinaliti ezincinci okanye iinaliti eziphambili zikhethwa ukulinganisela iimfuno zokulimala kunye nokuxilongwa.
- Izitho ezinzulu (umz., isibindi, izintso): iinaliti ze-biopsy ezinde zikhethwa ukuqinisekisa ubunzulu bokungena.
- Izicubu zethambo: iinaliti zokubhoboza iringi (umz. iinaliti ze-bone marrow biopsy) mazisetyenziswe ukunqanda ukuqhekeka kwezicubu.
(2) Izinto ezichaphazela isigulana
- Ubudala kunye nokwakheka: abantwana okanye izigulane ezibuthathaka kufuneka zikhethe inaliti encinci (umz., 20G) ukunciphisa iingxaki.
- Umsebenzi wokujiya: izigulane ezineengxaki zokujiya kufuneka ziphephe iinaliti ezirhabaxa (umz., 16G) ukuze kuncitshiswe umngcipheko wokopha.
- Imeko yengqondo: Izigulana ezixhalabileyo zinokukhetha iinaliti ze-biopsy ezincediswa yi-vacuum ukuze zinciphise ixesha lotyando.
(3) Uxinano lwezicubu kunye nendawo ezikuyo
- Izicwili ezixineneyo (umz., iprostate, isibindi): khetha inaliti ye-biopsy enamandla okusika aqinileyo (umz., inaliti enemingxuma eyi-18G).
- Imithambo yegazi/imithambo-luvo ekufutshane: kufuneka utyando olukhokelwa yi-ultrasound/CT ukuze kukhethwe inaliti ye-biopsy ebhalwe ngendlela yophuhliso.
(4) Ubungakanani benaliti kunye nobude bayo
- Ukhetho lweenkcukacha:
Inaliti encinci (20-22G): ye-cytology okanye izilonda ezingaphezulu.
Inaliti erhabaxa (14-18G): ifanelekile kuvavanyo lwe-histologic okanye kwizilonda ezinzulu.
- Ukukhetha ubude: kuxhomekeka kubunzulu bokubhoboza (umz. i-biopsy yemiphunga kufuneka ibe yi-≥15cm).
(5) Uyilo lwencam yenaliti
- Incam yenaliti egobileyo: ifanelekile kwizicubu ezithambileyo ukunciphisa ukumelana.
- Incam enamacala amathathu: isebenza kwizicubu zethambo, ukuphucula ukungena.
- Ukuphawula: Iinaliti ze-biopsy ezikhokelwa yi-MRI mazibhalwe nge-titanium alloy.
(6) Ukuhambelana neendlela zokuthatha imifanekiso
- Isikhokelo se-ultrasound: Kufuneka kukhethwe iinaliti ze-biopsy ezineendandatho ezikhulayo.
- Isikhokelo se-CT/MRI: kufuneka kukhethwe izinto ezingezizo zemagnethi okanye eziphantsi (umz., i-titanium alloy).
(7) Indlela yokukhupha isampuli
- Ukusika ngoomatshini: kusebenza kwiithumba eziqinileyo kunye nesampuli epheleleyo.
- Ukufunxwa koxinzelelo olungalunganga: ifanelekile kuvavanyo lwe-cytological, kulula ukuyisebenzisa.
- Incediswa yi-vacuum: iyasebenza kwiisampulu ezininzi, nto leyo ephucula ukusebenza kakuhle.
(8) Intuthuzelo nokhuseleko lwesigulana
- Ukulawula iintlungu: inaliti encinci ayibuhlungu kakhulu kwaye iyakwazi ukunyamezeleka kwizigulana.
- Ukuthintela iingxaki: kuphephe ukubhoboza okuphindaphindiweyo ngenaliti etyebileyo, kunciphisa umngcipheko we-pneumothorax kunye nokopha.
(9) Ixabiso kunye nokufikeleleka
- Ukusebenza kakuhle kweendleko: iinaliti ze-biopsy ezizenzekelayo ngokupheleleyo (umz., i-TSK) zibiza kakhulu, kodwa zinezinga eliphezulu lempumelelo yesampulu.
- Umshuwalense wezonyango: kufuneka bakhethe iimveliso ezikwinqanaba lokubuyiselwa imali ngokwemigaqo-nkqubo yasekuhlaleni.
5. Isiphelo
Ukukhethwa kweiinaliti ze-biopsyifuna uvavanyo olupheleleyo lohlobo lwesilonda, imeko yesigulana, iimeko zobugcisa kunye neemeko zoqoqosho. Kwimisebenzi yezonyango, le migaqo ilandelayo kufuneka ilandelwe:
1. Ukuhambelana ngokuchanekileyo: khetha uhlobo lwenaliti ngokwendawo ekujoliswe kuyo kwi-biopsy (umz. inaliti enemiqolo eyi-14G yebele, inaliti encinci eyi-20G ye-thyroid).
2. Beka ukhuseleko phambili: phepha iinaliti eziqinileyo kwizigulana ezineengxaki zokujiya kwegazi, kwaye usebenze phantsi kolwalathiso lomfanekiso kwizilonda zemithambo yegazi ezikufutshane.
3. Ukusebenza kakuhle kunye nentuthuzelo: iinaliti ze-biopsy ezincediswa yi-vacuum zinokuphucula ukusebenza kakuhle, kwaye iinaliti ezincinci zinokunciphisa iintlungu zesigulana.
Ngokusebenzisa ukhetho lwesayensi lweenaliti ze-biopsy, ukuchaneka kokuxilongwa kunokuphuculwa kakhulu, umngcipheko weengxaki unokuncipha, kwaye ekugqibeleni unyango oluchanekileyo lomntu ngamnye lunokuphunyezwa.
Ixesha leposi: Meyi-19-2025