Munzvimbo inogara ichichinja yekuongorora kwekurapa,biopsy tsonovanoita basa rakakosha mukuwana matishu samples kuti anyatso ongorora pathological, uye kusarudzwa kwavo kwakanangana nekurongeka kwebiopsy, kuchengetedzeka uye ruzivo rwemurwere. Izvi zvinotevera ongororo yebiopsy maitiro,mhando dzebiopsy tsono, core-to-fine tsono ratios, uye zvakakosha kusarudza zvinhu kuti zvipe hutungamiri hwakarongeka hwekuita kwekliniki.
1. Kunzwisisa maitiro ebiopsy
Chinangwa chepakati chemaitiro ebiopsy kutora sampuli yemhando yepamusoro yekujekesa chimiro cheronda kana kugadzira chirongwa chekurapa. Kudiwa kwetsono yebiopsy kunosiyana zvakanyanya pakati pezviitiko zvebiopsy:
- Tumor diagnostic: yakakwana tishu vhoriyamu inodiwa kutsigira pathologic staging uye genetic test (semuenzaniso, EGFR, ALK mutations).
- Zvirwere zvinoputika: cytology inotarisirwa kujekesa pathogen kana immune cell type.
- Preoperative yekuongorora: kukurumidza kutora sampuli kunodiwa kutungamira mapuroteni ekuvhiya (semuenzaniso, kuzivikanwa kwemazamu asina kunaka uye akashata mazamu).
2. Mhando dzebiopsy tsonouye kliniki zvikumbiro
-Sisimboti: Kuwana chidimbu chetishu sampuro nemechani yekucheka.
- Zvakanakira:
Yakazara sampling, yakakodzera bundu rakasimba (semuenzaniso, zamu, prostate) uye bone tishu biopsy.
Saizi yemuenzaniso inokwana kutsigira immunohistochemistry uye molecular test.
- Miganhu: kukuvara kwakakura, inoda kunyatso nzwisisa zvinongedzo.
(2) Fine Aspiration Biopsy Tsono
-Nheyo: Kushandiswa kweiyo yakaipa kusveta kusveta kuti uwane kumiswa kwesero.
- Zvakanakira:
Kusanyanya kushungurudza, kwakakodzera kune epamusoro lymph nodes, thyroid uye mapapu maronda.
Zviri nyore kuita, zvinogona kukurumidza kuwana kumiswa kwesero.
Zviri nyore kuita, zvinobvumira kukurumidza cytological kuongororwa.
- Mitemo: kupatsanurwa kwemuenzaniso, kusakwanisa kuzadzisa zvinodiwa zve histological bvunzo.
(3) Vacuum-Assisted Biopsy Tsono (VAB)
-Nheyo: Inosanganisa kucheka kwemechini uye kudzvinyirirwa kwakashata kuti uvandudze hunyanzvi hwesampling.
- Zvakanakira:
Masampuli akawanda anogona kuwanikwa mune imwe puncture, yakakodzera yezamu microcalcified foci.
Inoderedza njodzi yekudzokorora puncture uye inovandudza kushivirira kwemurwere.
(4) Kucheka Biopsy Tsono
- Nheyo: Matishu anochekwa nemuromo wakachekwa kana blade inotenderera.
- Mhando:
Tsono Yakakandwa: semuenzaniso Tru-Cut Biopsy Tsono, yetishu nyoro.
Ring Drill Tsono: eg Bone Marrow Biopsy Tsono, yebhonzo tishu.
3. core tsono biopsy vs yakanaka tsono aspiration
| Indicator | Core tsono biopsy | Fine tsono aspiration |
| Sample Types | Strip tissue sample | Kumiswa kwesero |
| Diagnostic kururama | High (histology) | Pakati (cytology) |
| Degree of trauma | Zvikuru | Mudiki |
| Operation nguva | Yakareba | Mupfupi |
| Scenarios | Mamota akasimba, mapfupa emapfupa | Maronda epamusoro, lymph nodes |
4. Zvinhu zvikuru zvekufunga nezvazvo pakusarudza zvakakodzera biopsy tsono
(1) Biopsy yakananga nzvimbo
-Nhengo dzepamusoro (semuenzaniso, thyroid, zamu): tsono dzakanaka kana tsono dzepakati dzinosarudzwa kuenzanisa kukuvara uye kuongororwa zvinodiwa.
- Mitezo yakadzika (semuenzaniso, chiropa, itsvo): tsono refu dzepakati biopsy dzinofarirwa kuve nechokwadi chekudzika kwekupinda.
- Bone tissue: tsono dzekuboora mhete (semuenzaniso tsono dzebiopsy yemwongo) dzinofanira kushandiswa kudzivirira kupatsanuka kwetishu.
(2) Murwere-zvakananga zvinhu
- Zera uye bumbiro: vana kana varwere vasina simba vanofanira kusarudza tsono yakaonda (semuenzaniso, 20G) kuderedza matambudziko.
- Coagulation basa: varwere vane coagulation kusagadzikana vanoda kudzivirira coarse tsono (semuenzaniso, 16G) kuderedza njodzi yekubuda ropa.
- Mamiriro epfungwa: Varwere vanonetseka vanogona kusarudza vacuum-yakabatsira biopsy tsono kupfupisa nguva yekuvhiya.
(3) Tissue density uye nzvimbo
- Dense tishu (semuenzaniso, prostate, chiropa): sarudza biopsy tsono ine simba rekucheka rakasimba (semuenzaniso, 18G yakatsvetwa tsono).
- Mitsipa yeropa yevavakidzani / tsinga: ultrasound / CT-inotungamirirwa kushanda inodiwa kuti usarudze inokura yakanyorwa biopsy tsono.
(4) Kukura kwetsono uye kureba
-Kusarudzwa kwezvimiro:
Tsono yakanaka (20-22G): ye cytology kana maronda epamusoro.
Coarse tsono (14-18G): inokodzera histological kuongororwa kana maronda akadzika.
-Kureba kusarudzwa: kunotemerwa nekudzika kwekubaya (semuenzaniso mapapu biopsy inoda kuva ≥15cm).
(5) Tsono zano rekugadzira
- Beveled tsono tip: yakakodzera kune zvinyoro zvinyoro kuderedza kuramba.
-Three-yakapetwa muromo: inoshanda kune pfupa tishu, kuwedzera kupinda.
-Kumaka: tsono dzinotungamirwa neMRI dzinofanirwa kunyorwa netitanium alloy.
(6) Kuenderana nemaitiro ekufungidzira
- Ultrasound kutungamira: Biopsy tsono dzine mhete dzinokura dzinoda kusarudzwa.
- CT / MRI kutungamira: isiri-magnetic kana yakaderera artifact zvinhu (semuenzaniso, titanium alloy) inofanira kusarudzwa.
(7) Sample extraction mechanism
- Mechanical kucheka: inoshanda kune akasimba mabundu ane yakazara sampling.
-Negative pressure suction: yakakodzera cytological bvunzo, iri nyore kushanda.
- Vacuum-inobatsirwa: inoshanda kune akawanda-saiti sampling, inosimudzira kushanda zvakanaka.
(8) Kunyaradzwa nemurwere uye kuchengeteka
- Kudzora kurwadziwa: tsono yakanaka haina kushungurudza uye inoshivirira kune varwere.
- Kudzivirirwa kwekukanganisa: dzivisa kudzokorora kubaya netsono gobvu, kuderedza njodzi yepneumothorax uye kubuda ropa.
(9) Mutengo uye kuwanikwa
- Mutengo-kushanda: zvizere otomatiki biopsy tsono (semuenzaniso, TSK) inodhura, asi ine yakakwira sampling yekubudirira.
-Inishuwarenzi yekurapa inovharwa: inoda kusarudza zvigadzirwa mukati meiyo yekudzorera chiyero zvinoenderana nemitemo yemuno.
5. Mhedziso
Kusarudzwa kwebiopsy tsonoinoda kuongororwa kwakadzama kwechimiro chechironda, chimiro chemurwere, mamiriro ehunyanzvi uye mamiriro ehupfumi. Mukuita kwekiriniki, zvinotevera zvinofanirwa kuteverwa:
1. kunyatsoenderana: sarudza rudzi rwetsono zvinoenderana nenzvimbo yakanangwa yebiopsy (semuenzaniso 14G grooved tsono yezamu, 20G tsono yakanaka yethyroid).
2. Koshesa kuchengetedzwa: dzivirira tsono dzakakora dzevarwere vane coagulation disorders, uye shanda pasi pemufananidzo wekutungamirirwa kwezvironda zvevascular zviri pedyo.
3. Kubudirira uye kunyaradza: vacuum-assisted biopsy tsono inogona kuvandudza kushanda zvakanaka, uye tsono dzakanaka dzinogona kuderedza kurwadziwa kwemurwere.
Kuburikidza nesainzi kusarudzwa kwetsono dzebiopsy, iko kurongeka kwekuongorora kunogona kuvandudzwa zvakanyanya, njodzi yematambudziko inogona kuderedzwa, uye pakupedzisira mushonga wakasarudzika unogona kuitika.
Nguva yekutumira: May-19-2025