Lub luag haujlwm tseem ceeb ntawm Mis Biopsy hauv Histological Molecular Subtyping

https://www.mayoclinic.org/tests-procedures/breast-biopsy/about/pac-20384812

Lub mis biopsycov txheej txheem tau ntev dhau los ntawm qhov yooj yim ntawm "kev kuaj mob"; lawv yog lub rooj vag tseem ceeb rau kev kho tus kheej precision. Nyob rau hauv lub tswv yim niaj hnub ntawm kev tswj mob qog noj ntshav ntawm lub mis, ob peb cov qauv me me tau txais los ntawm kev sib tsoo muaj cov ntaub ntawv muaj txiaj ntsig uas txiav txim siab tus neeg mob lub neej zoo. Kab lus no yuav tshawb nrhiav qhov tob npaum li cas cov txheej txheem ntawm lub mis biopsy, los ntawm qib siab - cov qauv sau zoo, txhawb nqa kev tshuaj ntsuam xyuas kab mob thiab kev txiav txim siab kho mob tom ntej.

Sample Quality: Lub Pob Zeb ntawm Kev Tshawb Nrhiav Molecular

Txawm hais tias nws yog immunohistochemical kuaj ntawm cov tshuaj hormone receptors (ER / PR) thiab HER2 raws li txoj cai, lossis cov noob qhia profileing siv Oncotype DX thiab MammaPrint, cov kev cai nruj yuav tsum tau muab tso rau ntawm kev ncaj ncees, ncua sij hawm kho, thiab cov qog cell ntawm cov ntaub so ntswg kuaj. Hauv cov txheej txheem biopsy ntawm lub mis, cov ntaub so ntswg uas tau siv 14G los yog cov kab uas loj dua cov koob zoo dua ua tau raws li cov kev cai no piv rau cov qauv cytological tau los ntawm kev nplua - koob aspiration.

* Kev Tiv Thaiv Tus Kheej: Cov koob txhaj tshuaj tseem ceeb khaws cov qauv qub ntawm cov ducts mammary, pab cov kws kho mob sib txawv ntawm cov kab mob carcinoma nyob rau hauv situ thiab invasive carcinoma, uas yog ib qho tseem ceeb rau kev txiav txim siab txog kev kho mob (xws li seb puas tsim nyog axillary lymph node dissection).

* Cov qog nqaij hlav ntau: kom tau txais cov txiaj ntsig kev kuaj pom muaj txiaj ntsig zoo, qhov feem pua ​​​​ntawm cov qog hlwb hauv cov qauv feem ntau yuav tsum tau mus txog qib (piv txwv li, 20%-30%). Vacuum-assisted biopsy (VAB) systems, vim lawv cov qauv loj dua, feem ntau muab cov qauv nrog cov qog cell ntau dua, ua rau lawv tshwj xeeb tshaj yog rau cov qog nqaij hlav heterogeneous.

Cov kev siv yav tom ntej ntawm koob tsim hauv Molecular Analysis

Cov txheej txheem ntawm lub mis biopsy Advanced tau pib xav txog cov kev xav tau ntawm downstream molecular tsom xam:

• 1. RNase/DNase-kev kho dawb: Qee qhov siab -kawg siv cov koob siv tshwj xeeb ntim thiab ua cov txheej txheem kom tsis txhob muaj exogenous nuclease paug thiab tiv thaiv RNA kev ncaj ncees, uas yog ib qho tseem ceeb rau cov qauv uas yuav tsum tau RNA sequencing los yog gene chip tsom xam.
• 2. Cov ntaub so ntswg preservation tov compatibility: Cov khoom siv koob (tshwj xeeb tshaj yog cov ntaub ntawv polymer) yuav tsum xyuas kom meej tias nws tsis chemically react nrog formalin los yog lwm yam ntaub so ntswg fixatives kom tsis txhob cuam tshuam cov antigen retrieval txheej txheem tom ntej.
• 3. Kev tuav pov hwm tus cim: Hauv lub tshuab nqus tsev- pab biopsy, qee lub tshuab tuaj yeem tso cov titanium clip (kos npe) ua ntej tshem koob. Qhov no tsis yog tsuas yog kos npe rau ntawm qhov chaw biopsy rau kev phais phais tom ntej, tab sis kuj tseem tuaj yeem pab kho kev sib koom ua ke yav tom ntej los ntawm kev thauj cov tshuaj lossis cov sensors mus rau titanium clip nto.

Biopsy Strategies hauv Cov Ntaub Ntawv Tshwj Xeeb

Rau qee hom mob qog noj ntshav mis, xws li mob qog noj ntshav mis lossis Paget tus kab mob, kev siv cov txheej txheem ntawm lub mis biopsy yog qhov tseem ceeb tshwj xeeb. Nyob rau hauv cov ntaub ntawv no, ntau punctures tej zaum yuav tsim nyog los xyuas kom meej cov qog nqaij hlav txaus. Tsis tas li ntawd, kev ua biopsy ua ntej kev kho neoadjuvant (chemotherapy/targeted therapy) los tsim kom muaj cov qauv hauv qab molecular typing yog irreplaceable rau kev soj ntsuam kev kho mob (xws li, PCR, pathological teb ua tiav).

Kev Sib Txuas thiab Kev Sib Tw ntawm Liquid Biopsy

Thaum cov ntaub so ntswg biopsy tseem yog tus qauv kub, kua biopsy (cov qog qog DNA, ctDNA) tau tsim sai heev hauv xyoo tas los no. Txawm li cas los xij, cov txheej txheem kho mob tam sim no tseem hais ntxiv tias tsis muaj cov kua dej biopsy tuaj yeem hloov cov txheej txheem ntawm lub mis biopsy rau kev kuaj pom tseeb thiab kev ntaus ntawv molecular. Cov ntaub so ntswg biopsy muab cov ntaub ntawv ntawm qhov chaw heterogeneity ntawm cov qog, thaum cov kua biopsy qhia txog ntau qhov kev hloov pauv hauv cov qog thoob plaws hauv lub cev. Kev sib xyaw ua ke ob qho tib si yog qhov kev sib tw yav tom ntej.

Hauv kev xaus, lub mis biopsy yog qhov pib ntawm cov tshuaj niaj hnub precision hauv kev mob qog noj ntshav mis. Txhua qhov biopsy zoo li kos cov kev tswj xyuas tseem ceeb ntawm tus neeg mob "lub neej daim ntawv qhia." Yog li ntawd, cov kws kho mob yuav tsum muaj "kev saib xyuas" thaum xaiv cov koob tshuaj biopsy thiab cov txheej txheem, txiav txim siab tsis yog qhov kev kuaj mob tam sim no nkaus xwb tab sis kuj tseem xav tau kev kho mob rau ob peb xyoos tom ntej no. High-cov qauv kuaj pom zoo yog qhov khoom plig zoo tshaj plaws rau cov kws kho mob thiab kws kho mob oncologist.