Esimweni esishintsha njalo sokuxilonga kwezokwelapha,izinaliti ze-biopsyzidlala indima ebalulekile ekutholeni amasampula ezicubu ukuze kuhlolwe ngendlela efanele izifo, futhi ukukhethwa kwazo kuhlobene ngqo nokunemba kwe-biopsy, ukuphepha kanye nokuhlangenwe nakho kwesiguli. Okulandelayo ukuhlaziywa kwezinqubo ze-biopsy,izinhlobo zezinaliti ze-biopsy, izilinganiso zenaliti eziphakathi nendawo nezincane, kanye nezici zokukhetha ezibalulekile ukuze kuhlinzekwe isiqondiso esihlelekile somkhuba wezokwelapha.
1. Ukuqonda izinqubo ze-biopsy
Umgomo oyinhloko wenqubo ye-biopsy ukuthola isampula yezicubu esezingeni eliphezulu ukuze kucaciswe uhlobo lwesilonda noma ukuthuthukisa uhlelo lokwelashwa. Isidingo senalithi ye-biopsy siyahlukahluka kakhulu phakathi kwezimo ze-biopsy:
- Ukuxilongwa kwesimila: kudingeka ivolumu eyanele yezicubu ukusekela izigaba zezifo kanye nokuhlolwa kofuzo (isb., i-EGFR, izinguquko ze-ALK).
- Izifo zokuvuvukala: i-cytology iyadingeka ukuze kucaciswe uhlobo lwegciwane noma uhlobo lweseli lokuzivikela komzimba.
- Ukuhlolwa kwangaphambi kokuhlinzwa: ukutholwa kwesampula okusheshayo kuyadingeka ukuze kuqondiswe izindlela zokuhlinzwa (isb., ukuhlonza izinhlungu zebele ezingenabungozi nezinobuthi).
2. Izinhlobo zeizinaliti ze-biopsykanye nezicelo zemitholampilo
- Isimiso: Ukuthola ucezu lwesampula yezicubu ngokusika ngomshini.
- Izinzuzo:
Ukuthatha amasampula aphelele, afanelekela isimila esiqinile (isib., ibele, i-prostate) kanye ne-biopsy yezicubu zamathambo.
Usayizi wesampula wanele ukusekela i-immunohistochemistry kanye nokuhlolwa kwama-molecule.
- Ukulinganiselwa: ukulimala okukhulu, kudingeka ukuqonda izinkomba ngokucophelela.
(2) Inaliti Yokuhlola I-Fine Aspiration Biopsy
- Isimiso: Ukusetshenziswa kokumuncwa kwengcindezi engemihle ukuze kutholakale ukumiswa kweseli.
- Izinzuzo:
Akubuhlungu kangako, kufanelekile kuma-lymph node angaphezulu, izilonda ze-thyroid kanye namaphaphu.
Kulula ukwenza, kungathola ngokushesha ukumiswa kwamaseli.
Kulula ukwenza, kuvumela ukuxilongwa okusheshayo kwe-cytological.
- Imikhawulo: ukuqhekeka kwesampula, ukungakwazi ukuhlangabezana nezidingo zokuhlolwa kwe-histological.
(3) Inaliti Yokuhlola I-Vacuum-Assisted Biopsy (VAB)
- Isimiso: Ihlanganisa ukusika ngomshini kanye nokumunca ingcindezi engemihle ukuze kuthuthukiswe ukusebenza kahle kwesampula.
- Izinzuzo:
Amasampula amaningi angatholakala ngokubhoboza okukodwa, afanelekela i-foci yebele ene-microcalcified.
Kunciphisa ingozi yokubhoboza okuphindaphindiwe futhi kuthuthukisa ukubekezelelana kwesiguli.
(4) Inaliti Yokusika I-Biopsy
- Isimiso: Izicubu zinqunywa ngesihloko esinemiphetho noma ngensingo ejikelezayo.
- Izinhlobo:
Inaliti Enezimbobo: isib. Inaliti ye-Tru-Cut Biopsy, yezicubu ezithambile.
Inaliti Yokubhoboza Indandatho: isib. Inaliti Yokuhlola Umongo Wethambo, yezicubu zamathambo.
3. i-core needle biopsy vs ukufuthwa kwenaliti encane
| Isikhombisi | I-biopsy yenaliti eyinhloko | Ukufuthwa kwenaliti okuncane |
| Izinhlobo Zesampula | Isampula yezicubu ezihlutshiwe | Ukumiswa kweseli |
| Ukunemba kokuxilonga | Okuphezulu (i-histology) | Okuphakathi (i-cytology) |
| Izinga lokuhlukumezeka | Okukhulu | Okuncane |
| Isikhathi sokusebenza | Isikhathi eside | Okufushane |
| Izimo | Izimila eziqinile, izicubu zamathambo | Izilonda ezingaphandle, ama-lymph node |
4. Izinto eziyinhloko okufanele uzicabangele lapho ukhetha izinaliti ezifanele ze-biopsy
(1) Indawo okuqondiwe kuyo i-biopsy
- Izitho zomzimba ezingabalulekile (isb., i-thyroid, ibele): izinaliti ezincane noma izinaliti eziyinhloko ziyathandwa ukuze kulinganiswe izidingo zokulimala kanye nokuxilongwa.
- Izitho ezijulile (isb., isibindi, izinso): izinaliti ezinde ze-biopsy zikhethwa ukuqinisekisa ukujula kokungena.
- Izicubu zethambo: izinaliti zokubhoboza indandatho (isb. izinaliti ze-bone marrow biopsy) kumele zisetshenziswe ukugwema ukuqhekeka kwezicubu.
(2) Izici eziqondene nesiguli
- Ubudala kanye nokwakheka: izingane noma iziguli ezibuthakathaka kufanele zikhethe inalithi encane (isb., 20G) ukuze kuncishiswe izinkinga.
- Umsebenzi wokubopha: iziguli ezinezinkinga zokubopha zidinga ukugwema izinaliti eziqinile (isib. 16G) ukuze kuncishiswe ingozi yokopha.
- Isimo sengqondo: Iziguli ezikhathazekile zingase zithande izinaliti ze-biopsy ezisizwa yi-vacuum ukuze zinciphise isikhathi sokuhlinzwa.
(3) Ubuningi bezicubu nendawo yazo
- Izicubu eziminyene (isib., i-prostate, isibindi): khetha inalithi ye-biopsy enamandla okusika aqinile (isib., inalithi enezikhala engu-18G).
- Imithambo yegazi/izinzwa eziseduze: ukuhlinzwa okuqondiswa yi-ultrasound/CT kuyadingeka ukuze kukhethwe inaliti ye-biopsy ebhalwe ngendlela yokuthuthukiswa.
(4) Usayizi wenaliti nobude
- Ukukhetha imininingwane:
Inaliti encane (20-22G): ye-cytology noma izilonda ezingaphezulu.
Inaliti eqinile (14-18G): ifanele ukuhlolwa kwe-histologic noma izilonda ezijulile.
- Ukukhetha ubude: kunqunywa ukujula kokubhoboza (isb. i-biopsy yamaphaphu idinga ukuba ≥15cm).
(5) Umklamo wesiciko senaliti
- Isihloko senaliti esigobekile: sifanele izicubu ezithambile ukunciphisa ukumelana.
- Iphuzu elinamacala amathathu: lisebenza ezicutshini zethambo, ukuze kuthuthukiswe ukungena.
- Ukumaka: Izinaliti ze-biopsy eziqondiswa yi-MRI kufanele zifakwe ilebula nge-titanium alloy.
(6) Ukuhambisana nezindlela zokuthatha izithombe
- Isiqondiso se-Ultrasound: Izinaliti ze-Biopsy ezinezindandatho ezikhulayo zidinga ukukhethwa.
- Isiqondiso se-CT/MRI: kufanele kukhethwe izinto zokwenziwa ezingezona ezikagesi noma eziphansi (isb., i-titanium alloy).
(7) Indlela yokukhipha isampula
- Ukusika ngomshini: kusebenza kuma-tumors aqinile kanye nesampula ephelele.
- Ukumuncwa kwengcindezi okungekuhle: kufanelekile ukuhlolwa kwe-cytological, kulula ukuyisebenzisa.
- Kusizwa yi-vacuum: kusebenza ekuthathweni kwamasampula ezindaweni eziningi, okuthuthukisa ukusebenza kahle.
(8) Induduzo nokuphepha kwesiguli
- Ukulawula ubuhlungu: inaliti encane ayibuhlungu kakhulu futhi ibekezeleleka kalula ezigulini.
- Ukuvimbela izinkinga: gwema ukubhoboza okuphindaphindiwe ngenaliti ejiyile, nciphisa ingozi ye-pneumothorax kanye nokopha.
(9) Izindleko kanye nokufinyeleleka
- Ukusebenza kahle kwezindleko: izinaliti ze-biopsy ezizenzakalelayo ngokuphelele (isib. i-TSK) zibiza kakhulu, kodwa zinezinga eliphezulu lempumelelo yokuthatha amasampula.
- Umshwalense wezokwelapha: isidingo sokukhetha imikhiqizo engaphakathi kobubanzi bokubuyiselwa kwemali ngokwezinqubomgomo zendawo.
5. Isiphetho
Ukukhethwa kweizinaliti ze-biopsykudinga ukuhlolwa okuphelele kohlobo lwesilonda, isimo sesiguli, izimo zobuchwepheshe kanye nezici zezomnotho. Ekwelashweni, kufanele kulandelwe izimiso ezilandelayo:
1. Ukufanisa okunembile: khetha uhlobo lwenaliti ngokuya ngendawo okuqondiswe kuyo i-biopsy (isb. inaliti enemiphetho engu-14G yebele, inaliti encane engu-20G ye-thyroid).
2. Beka phambili ukuphepha: gwema izinaliti ezijiyile zeziguli ezinezinkinga zokubopha ama-coagulation, bese usebenza ngaphansi kwesiqondiso sesithombe sezilonda zemithambo yegazi eziseduze.
3. Ukusebenza kahle kanye nenduduzo: izinaliti ze-biopsy ezisizwa yi-vacuum zingathuthukisa ukusebenza kahle, kanti izinaliti ezincane zinganciphisa ubuhlungu besiguli.
Ngokukhethwa kwesayensi kwezinaliti ze-biopsy, ukunemba kokuxilonga kungathuthukiswa kakhulu, ingozi yezinkinga ingancishiswa, futhi ekugcineni umuthi oqondile womuntu ngamunye ungatholakala.
Isikhathi sokuthunyelwe: Meyi-19-2025