Kwimeko ehlala iguquka yoxilongo lwezonyango,iinaliti ze-biopsyzidlala indima ebalulekileyo ekufumaneni iisampulu zethishu zovavanyo oluchanekileyo lwe-pathological, kwaye ukhetho lwazo luhambelana ngokuthe ngqo nokuchaneka kwe-biopsy, ukhuseleko kunye namava esigulane. Oku kulandelayo luhlalutyo lweenkqubo ze-biopsy,iintlobo zeenaliti ze-biopsy, i-core-to-fine needle ratios, kunye nezinto eziphambili zokukhetha ukubonelela ngesikhokelo esicwangcisiweyo sokwenza unyango.
1. Ukuqonda iinkqubo ze-biopsy
Injongo ephambili yenkqubo ye-biopsy kukufumana isampuli ye-tissue yekhwalithi ephezulu ukucacisa uhlobo lwesilonda okanye ukuphuhlisa isicwangciso sonyango. Isidingo senaliti ye-biopsy sihluka kakhulu phakathi kweemeko ze-biopsy:
- Ukuxilongwa kwe-tumor: umthamo owaneleyo we-tissue uyafuneka ukuxhasa i-pathologic staging kunye novavanyo lwemfuza (umzekelo, i-EGFR, ukuguqulwa kwe-ALK).
- Izifo ezivuthayo: i-cytology iyadingeka ukucacisa i-pathogen okanye uhlobo lwe-immune cell cell.
- Uvandlakanyo lwangaphambi kotyando: ukufunyanwa kwesampulu ekhawulezileyo kuyafuneka ukukhokela iiprothokholi zotyando (umzekelo, ukuchongwa kobunzima bebele obunobungozi kunye nobubi).
2. Iintlobo zeiinaliti ze-biopsykunye nezicelo zeklinikhi
- Umgaqo: Ukufumana umcu wesampulu yethishu ngokusikwa ngoomatshini.
- Izinto eziluncedo:
Iisampulu epheleleyo, ilungele ithumba elomeleleyo (umzekelo, ibele, idlala lengqula) kunye ne-bone tissue biopsy.
Ubungakanani besampuli banele ukuxhasa i-immunohistochemistry kunye novavanyo lwe-molecular.
- Unyino: umonzakalo omkhulu, kufuneka ubambe ngokungqongqo izikhombisi.
(2) I-Fine Aspiration Biopsy Inaliti
- Umgaqo: Ukusetyenziswa koxinzelelo olubi lokufunxa ukufumana ukumiswa kweeseli.
- Izinto eziluncedo:
Ukwenzakala okuncinci, okufanelekileyo kwii-lymph nodes ezingaphezulu, i-thyroid kunye nezilonda zemiphunga.
Kulula ukwenza, kunokukhawuleza ukufumana ukumiswa kweeseli.
Kulula ukwenza, ivumela ukuxilongwa ngokukhawuleza kwe-cytological.
- Unyino: ulwahlulo lwesampulu, alukwazi ukuhlangabezana neemfuno zoviwo lwe-histology.
(3) Inaliti yeBiopsy eNceda ngeVacuum (VAB)
-Umgaqo: Udibanisa ukusika koomatshini kunye nokufunxa uxinzelelo olubi ukuze kuphuculwe ukusebenza kakuhle kwesampulu.
- Izinto eziluncedo:
Iisampuli ezininzi zinokufumaneka kwi-puncture enye, efanelekileyo kwi-foci ye-breast microcalcified.
Yehlisa umngcipheko wokuphinda uhlatywe kwaye iphucula ukunyamezela kwesigulane.
(4) Ukusika inaliti yeBiopsy
- Umgaqo: Izicubu zisikwa ngencam egobileyo okanye iblade ejikelezayo.
- Iintlobo:
Inaliti eSlotyolweyo: umz. Inaliti ye-Tru-Cut Biopsy, yeethishu ezithambileyo.
Inaliti yokuBomba iRingi: umz. Inaliti yeBone Marrow Biopsy, eyenzelwe ithambo lethambo.
3. inaliti engundoqo ye-biopsy vs i-finenaliti aspiration
| Isalathisi | I-biopsy yenaliti engundoqo | Ukufuna inaliti entle |
| Iintlobo zeesampuli | Isampulu yethishu | Ukumiswa kweeseli |
| Ukuchaneka koxilongo | Phezulu (i-histology) | Phakathi (i-cytology) |
| Iqondo lokwenzakala | Enkulu | Encinci |
| Ixesha lokusebenza | Ixesha elide | Mfutshane |
| Iimeko | Amathumba aqinileyo, izicubu zethambo | Izilonda eziphezulu, i-lymph nodes |
4. Izinto eziphambili ekufuneka ziqwalaselwe xa ukhetha iinaliti ezifanelekileyo ze-biopsy
(1) Indawo ekujoliswe kuyo ngeBiopsy
- Amalungu angaphezulu (umzekelo, idlala lengqula, ibele): iinaliti ezicolekileyo okanye iinaliti ezingundoqo zikhethwa ukulungelelanisa ukwenzakala kunye neemfuno zokuxilonga.
- Amalungu anzulu (umzekelo, isibindi, izintso): iinaliti ze-biopsy ezide zikhethwa ukuqinisekisa ubunzulu bokungena.
- Iinaliti zethambo: iinaliti zokubhoboza iiringi (umz. iinaliti zomongo wethambo) kufuneka zisetyenziswe ukunqanda ukuqhekeka kwezicubu.
(2) Imiba ethile yesigulana
- Ubudala kunye nomgaqo-siseko: abantwana okanye izigulane ezibuthathaka kufuneka zikhethe inaliti encinci (umzekelo, i-20G) ukunciphisa iingxaki.
- Umsebenzi we-Coagulation: izigulane ezinokuphazamiseka kwe-coagulation kufuneka ziphephe iinaliti ezirhabaxa (umzekelo, i-16G) ukunciphisa umngcipheko wokuphuma kwegazi.
- Isimo sengqondo: Izigulane ezixhalabileyo zinokukhetha iinaliti ze-vacuum-assisted biopsy ukunciphisa ixesha lokusebenza.
(3) Ubuninzi bezicubu kunye nendawo
- Izicubu ezixineneyo (umzekelo, idlala lengqula, isibindi): khetha inaliti ye-biopsy enamandla anamandla okusika (umzekelo, inaliti efakwe i-18G).
- Imithambo yegazi / imithambo yegazi engummelwane: I-ultrasound / i-CT-guided operation iyadingeka ukukhetha inaliti ye-biopsy ebhalwe ngophuhliso.
(4) Ubungakanani benaliti kunye nobude
-Ukhetho lokuchongwa:
Inaliti entle (20-22G): kwi-cytology okanye izilonda ezingaphezulu.
Inaliti erhabaxa (14-18G): ilungele uvavanyo lwe-histological okanye izilonda ezinzulu.
- Ukukhetha ubude: kumiselwa bubunzulu bokugqobhoza (umzekelo, i-lung biopsy kufuneka ibe yi-≥15cm).
(5) Uyilo lwencam yenaliti
- Incapha yenaliti edibeneyo: ilungele izihlunu ezithambileyo zokunciphisa ukuxhathisa.
- Ingcebiso enemigangatho emithathu: esebenzayo kwithambo lethambo, ukuphucula ukungena.
- Ukumakisha: Iinaliti ze-biopsy ezikhokelwa yi-MRI kufuneka zibhalwe nge-titanium alloy.
(6) Ukuhambelana neendlela zokucinga
- Isikhokelo se-Ultrasound: Iinaliti ze-Biopsy ezineendandatho eziphuhlisayo kufuneka zikhethwe.
- Isikhokelo se-CT / MRI: i-non-magnetic okanye i-artifact material ephantsi (umzekelo, i-titanium alloy) kufuneka ikhethwe.
(7) Isampulu yokukhutshwa kwesixhobo
- Ukusika oomatshini: kusebenza kumathumba aqinileyo kunye neesampuli ezipheleleyo.
- Ukufunxa uxinzelelo olubi: ilungele uvavanyo lwe-cytological, kulula ukuyisebenzisa.
- Uncedo lwevacuum: lusebenza kwisampulu yeendawo ezininzi, ukwandisa ukusebenza kakuhle.
(8) Ukuthuthuzela ngomonde nokhuseleko
- Ukulawulwa kweentlungu: inaliti ecikizekileyo ayibuhlungu kwaye inyamezeleka ngakumbi kwizigulane.
Uthintelo lwengxaki: kunqanda ukugqojozwa ngokuphindaphindiweyo ngenaliti engqindilili, yehlisa umngcipheko wepneumothorax kunye nokopha.
(9) Iindleko kunye nokufikeleleka
- Ukusebenza kakuhle kweendleko: iinaliti ze-biopsy ezizenzekelayo (umzekelo, i-TSK) zibiza kakhulu, kodwa zinezinga eliphezulu lempumelelo yesampuli.
- I-inshorensi yonyango: kufuneka ukhethe iimveliso ngaphakathi kwendawo yembuyekezo ngokwemigaqo-nkqubo yendawo.
5. Isiphelo
Ukhetho lweiinaliti ze-biopsykufuna uvavanyo olubanzi lwemeko yesilonda, imeko yesigulane, iimeko zobugcisa kunye nezoqoqosho. Kwinkqubo yeklinikhi, le migaqo ilandelayo kufuneka ilandelwe:
1. ukuhambelana ngokuchanekileyo: khetha uhlobo lwenaliti ngokwendawo ekujoliswe kuyo ye-biopsy (umzekelo, inaliti ye-14G ye-grooved yebele, i-20G inaliti ecocekileyo ye-thyroid).
2. Lubeke phambili ukhuseleko: zithintele iinaliti ezityebileyo kwizigulana ezinokuphazamiseka kwe-coagulation, kwaye usebenze phantsi kwesikhokelo somfanekiso wezilonda ezikufutshane nemithambo.
3. Ukusebenza kunye nokuthuthuzela: iinaliti ze-biopsy ezincediswa nge-vacuum zinokuphucula ukusebenza kakuhle, kwaye iinaliti ezintle zinokunciphisa intlungu yesigulane.
Ngokhetho lwesayensi lweenaliti ze-biopsy, ukuchaneka koxilongo kunokuphuculwa kakhulu, umngcipheko weengxaki unokuncitshiswa, kwaye ekugqibeleni iyeza elichanekileyo linokufezekiswa.
Ixesha lokuposa: May-19-2025