Yuav Ua Li Cas Nyeem Daim Ntawv Qhia Pathology Ntawm Kab Mob Siab

Thaum lawv tau txaisdaim ntawv qhia pathology,cov neeg mob feem ntau tsis nkag siab txog nws cov ntsiab lus, tab sis lawv mob siab rau paub tias lawv qhov xwm txheej zoo li cas, yog li ntawd lawv yuav niaj hnub caum tus kws kho mob los sab laj ...... ntau zaus. Niaj hnub no, cov kws tshaj lij yuav pab koj txheeb xyuas qhov twg yog cov ntsiab lus tseem ceeb tshaj plaws nyob rau hauvkab mobqhiantawm daim siab mob cancer uas tsim nyog mloog.

1. Hom qog hlwb.

2. Tus naj npawb thiab qhov loj ntawm cov qog.

3. degree ntawm qog sib txawv.

4. mob qog noj ntshav.

5. Microvascular ntxeem tau (MVI).

6. satellite nodes.

7. phais npoo.

8. Lymph node metastasis.

Cov yam ntxwv saum toj no tuaj yeem siv los pab kwv yees qhov yuav tshwm sim ntawm cov qog loj hlob thiab kev sib kis, tab sis qhov muaj qhov pheej hmoo siab tsis zoo kiag li rov tshwm sim los yog kev loj hlob sai sai, thiab tsis muaj qhov tsis muaj qhov pheej hmoo siab txhais tau tias kev ceev faj tuaj yeem so. .

Rau cov ntsiab lus saum toj no, cov lus nug muaj xws li.

1. Dab tsi yog hepatocellular carcinoma, cholangiocellular carcinoma, mixed cell carcinoma, thiab metastatic carcinoma?

Covdaim siabNws yog tsim los ntawm ntau cov ntaub so ntswg sib txawv, suav nrog hepatocytes, bile duct cells, vascular epithelial cells, thiab lwm yam. Hepatocellular carcinoma yog ib lo lus sib sau ua ke thiab daim ntawv qhia txog kab mob yuav piav qhia txog hom cell uas cov qog tuaj, thaum cov qog malignant ntawm txawv keeb kwm muaj zoo heev. Qhov sib txawv ntawm kev kho mob tshwm sim, txoj kev kho mob, thiab kev kwv yees, subdivided rau hauv:

(1). hepatocellular carcinoma: cov qog los ntawm hepatocytes, thiab feem ntau zoo beam hom, coarse beam type, pseudo glandular duct type, thiab donut type, etc. Tumors of hepatocellular origin account for most hepatocellular carcinomas.

(2). Cholangiocarcinoma: Cov qog nqaij hlav los ntawm cov kab mob hauv cov ducts hauv lub cevdaim siab, thiab adenocarcinoma yog feem ntau.

(3). Mixed cell carcinoma: cov qog muaj ob qho tib si hepatocellular thiab bile duct cell Cheebtsam.

(4). Hepatic metastases: Cov qog tsim los ntawm cov qog nqaij hlav malignant uas tshwm sim sab nrauddaim siabthiab kis mus raudaim siablos ntawm cov ntshav ntws thiab lwm txoj hauv kev, thiab hom kab mob tshwj xeeb muaj feem cuam tshuam rau hom kab mob extrahepatic. Hom ntau homdaim siabmetastases nyob rau hauv cov qog nqaij hlav hauv plab yog lub siab metastases.

Raws li kev tshawb fawb cuam tshuam,cistanche, tseem hu ua Suav kab ntsig fungus, yog ib hom tshuaj suav tshuaj suav zoo uas tau siv ntau pua xyoo rautxhim khodaim siabmuaj nuj nqithiabtiv thaivdaim siab mob. Cistanche yog nplua nuj nyob rau hauv bioactive compounds xws li polysaccharides, cordycepin, thiab adenosine, uas tau pom tias muaj hepatoprotective zog.

Cistanchetau pom tias txo qhov mob, oxidative kev nyuaj siab, thiab apoptosis hauvdaim siabhlwb. Cov teebmeem no ntseeg tau tias yog vim muaj cov tshuaj antioxidant thiab tiv thaiv kev mob ntawm nws cov tshuaj bioactive. Los ntawm kev txo qhov mob thiab oxidative kev nyuaj siab, cistanche pab txhim kho daim siab ua haujlwm thiab tiv thaiv daim siab puas.

Ntxiv nrog rau nws cov antioxidant thiab anti-inflammatory teebmeem,cistanchekuj tau pom tias muaj cov teebmeem immunomodulatory. Los ntawm kev hloov kho lub cev tiv thaiv kab mob, cistanche pab txo qhov mob thiabtiv thaivdaim siabkev puas tsuajtshwm sim los ntawm kev tiv thaiv kab mob.

Nyem qhov no rau qhov twg Kuv Yuav Yuav Cistanche Rau Kev Tiv Thaiv Mob Siab

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Cistanche kuj tau pom tias muaj cov teebmeem los tiv thaiv fibrotic.Daim siabfibrosis yog ib qho teeb meem ntawmmob ntevdaim siabkab mob, thiab nws thiaj li tuaj yeem ua rau cirrhosis thiabdaim siabua tsis tiav. Cistanche pab txo cov tsub zuj zuj ntawm extracellular matrix proteins nyob rau hauv lubdaim siab, uas yog ib kauj ruam tseem ceeb ntawm txoj kev loj hlob ntawmdaim siabfibrosis.

Hauv kev xaus, cistanche yog ib qho tseem ceeb tshuaj suav tshuaj uas tau pom tias muaj ntau yam txiaj ntsig raudaim siab mob. Nws cov antioxidant, tiv thaiv kev mob, immunomodulatory, thiab anti-fibrotic zog ua rau nws yog ib qho zoo tagnrho tshuaj rau kev tiv thaiv thiab kev kho mob.kab mob siab.

2. Tus naj npawb thiab qhov loj ntawm cov qog tseem ceeb npaum li cas?

Tus naj npawb thiab qhov loj ntawm cov qog uas raug kaw tuaj yeem cuam tshuam qhov hnyav ntawm cov kab mob intrahepatic thiab tseem cuam tshuam rau cov qog thaum ntxov mus rau nruab nrab. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias tus naj npawb thiab qhov loj ntawm cov qog qhia los ntawm preoperative CT lossis MRI tej zaum yuav txawv ntawm cov uas tau piav qhia hauv daim ntawv qhia pathology.

3. Kev sib txawv txhais li cas?

Kev sib txawv yog qib ntawm malignancy ntawm cov qog hlwb, uas yog txiav txim los ntawm tus kws kho mob los ntawm kev soj ntsuam qhov txawv txav ntawm cov qog hlwb nyob rau hauv lub microscope.

Mob qog noj ntshavtuaj yeem muab faib ua 3 qib: sib txawv heev, sib txawv me ntsis, lossis tsis zoo sib txawv. Tsis tas li ntawd, nws tseem tuaj yeem muab faib thoob ntiaj teb rau qib I, II, III, thiab IV raws li Edmondson-Steiner qhov kev faib tawm ntawm qhov zoo mus rau qhov tsis zoo.

Kev sib txawv heev txhais tau hais tias cov qog hlwb zoo ib yam li cov hlwb ib txwm, thaum hypodifferentiated txhais tau hais tias cov qog hlwb tshwm sim ntau dua qub thiab savage, yog li cov qog hypodifferentiated feem ntau loj hlob los yog kis tau sai dua.

4. Qhov mob qog noj ntshav yog dab tsi?

Yog tias cov qog nqaij hlav nkag mus rau hauv cov hlab ntsha los yog cov kab mob hauv cov hlab ntsha thiab loj hlob thaum lub qog loj zuj zus mus rau qee qhov, cov qog tuaj yeem pom hauv cov ducts los ntawm qhov muag liab qab hauv CT, MRI, lossis cov qauv phais, hu ua cancer thrombus.

Ib zaug tusmor invades cov hlab ntsha los yog cov kua tsib ducts tsim cov qog nqaij hlav cancer, nws txhais tau hais tias cov qog hlwb tau yooj yim kis mus rau lwm qhov chaw hauv lub cev.daim siablos yog nyob deb ntawm lub cev los ntawm cov ntshav khiav los yog cov kua tsib. Txawm hais tias cov qog pom thiab cov thrombus raug phais raug tshem tawm, tseem muaj cov qog hlwb twb pub dawb rau hauv lub cev thiab qhov kev pheej hmoo ntawm rov tshwm sim tom qab phais yog siab. Txawm li cas los xij, qhov no tsis txhais hais tias cov qog tau kis tau los yog kho tsis tau. Qhov kev pheej hmoo ntawm kev rov tshwm sim tuaj yeem txo qis rau qee qhov los ntawm kev kho tom qab kev kho mob ntxiv.

5. Microvascular cancer embolism (MVI) yog dab tsi?

MVI hais txog kev cuam tshuam ntawm cov hlab ntsha uas pom ntawm qhov muag liab qab, thaum MVI feem ntau yog hais txog qhov loj ntawm cov qog nqaij hlav cancer tsis pom ntawm qhov muag liab qab tab sis pom hauv lumen ntawm cov hlab ntsha me me hauv qab lub tshuab tsom; MVI qhia tias cov qog nqaij hlav me me tau nkag mus rau cov hlab ntsha me me thiab cov neeg mob muaj kev pheej hmoo siab dua tom qab phais.

Cov MVI me me no tuaj yeem muab faib rau ntau qhov chaw nyob ib sab ntawm lub qog, thiab kev tshuaj xyuas microscopic tsuas tuaj yeem coj mus kuaj los ntawm ntau qhov chaw rau kev soj ntsuam, thiab qhov kev kuaj pom yuav raug cuam tshuam yog tias qhov ntsuas tsis tiav. Raws li kev txheeb cais, qhov tshwm sim ntawm MVI hauvdaim siabmob qog noj ntshavyog 15 feem pua ​​~ 57.1 feem pua.

6. Puas yog satellite nodule yog qog?

Satellite nodules kuj tau piav qhia tias yog sub foci, thiab raws li lub npe qhia, lawv feem ntau yog cov qog nqaij hlav me me pom ntawm qhov muag liab qab lossis microscopically hauv qhov qub.daim siabcov ntaub so ntswg nyob ib ncig ntawm lub ntsiab loj qog. Nws tau xav tias satellite nodules los ntawm MVI thiab tuaj yeem kuaj tau thaum MVI thiab satellite nodules tsis yooj yim cais.

Lub xub ntiag ntawm satellite nodules qhia tau hais tias cov qog pib kis mus rau sab nraud, uas yuav ua rau kev phais tsis tiav ntawm tag nrho cov qog; Yog li ntawd, satellite nodules kuj tseem cuam tshuam nrog kev rov ua haujlwm tom qab.

7. Nws txhais li cas yog kuv daim ntawv qhia hais txog MVI thiab satellite nodes?

Cov txiaj ntsig no qhia seb tus neeg mob puas muaj feem yuav rov qab ua dua tshiab. Feem ntau cov kab mob hepatocellular carcinoma tshwm sim hauv 2 xyoos tom qab kev phais, thiab rau cov neeg mob uas muaj kev pheej hmoo siab, cov kws kho mob tuaj yeem teem sijhawm soj ntsuam kom ze dua. Nyob rau hauv rooj plaub uas tsis muaj hmoo rov tshwm sim, cov qog tseem tuaj yeem tswj tau zoo thiab tus neeg mob qhov kev mob tshwm sim tuaj yeem txhim kho los ntawm kev tshawb pom ntxov thiab kho raws sijhawm.

8. Qhov kev txiav tawm yog dab tsi? Qhov zoo txiav ntug txhais li cas?

Txhawm rau tshem tawm cov qog kom huv li sai tau, tus kws phais yuav tshem tawm cov qog thiab ib puag ncigdaim siabcov ntaub so ntswg ua ke ntawm ib qho kev ncua deb ntawm lub qog. Tus kws kho mob ntxiv tshuaj xyuas cov hnoos qeev kom paub meej tias puas muaj cov qog qog nyob hauv lub cevdaim siabcov ntaub so ntswg ntawm qhov chaw txiav. Yog tias cov qog nqaij hlav pom ntawm ntug txiav, lossis yog tias qhov txiav ntug yog qhov zoo, nws txhais tau hais tias tseem yuav muaj qog nyob hauvdaim siabuas tsis tau txiav kom huv si.

Feem ntau, tus kws phais yuav xyuas kom meej cov npoo kom txaus thiaj li ua tiav cov qog nqaij hlav radical. Tsuas yog nyob rau hauv ob peb kis yuav muaj ib tug zoo txiav ntug, xws li thaum lub qog invasion yog li ntawd nws kim heev thiab ntau heev uas cov qog tsis tuaj yeem raug tshem tawm tag nrho; los yog thaum cov qog muaj ze ze rau cov hlab ntsha tseem ceeb nyob ib puag ncig cov hlab ntsha, cov kua tsib, thiab lwm yam ntaub so ntswg kom txaus txiav ntug tsis tuaj yeem lav tau txhawm rau tiv thaiv cov ducts thiab cov kabmob tseem ceeb. Nyob rau hauv cov ntaub ntawv ntawm qhov zoo txiav paj, cov neeg mob yuav tsum sib txuas lus nrog lawv cov kws kho mob thiab xav txog kev rov qab kho cov kev xaiv.

9. Yuav ua li cas thiaj paub seb puas muaj metastasis hauv cov qog ntshav?

Txawm hais tias muaj metastasis hauv cov qog ntshav qog ntshav yog qhov tseem ceeb cuam tshuam rau cov qog nqaij hlav, ntawm cov qog ntshav qog ntshav yog qhov tseem ceeb dua.

Lymph node metastasis yog tsis tshua muaj nyob rau hauv hepatocellular carcinoma, thiab lymph nodes tej zaum yuav tsis muaj nyob rau hauv resected specimen. Piv txwv li,daim siabmob qog noj ntshavntawm cov kua tsib cell keeb kwm muaj feem yuav muaj lymph node metastasis. Tus kws phais yuav tshem tawm cov chaw tshwj xeeb lossis cov qog ntshav qog ntshav siab thiab xa mus rau tus kws kho mob kom txiav txim siab seb puas muaj metastasis.

Daim ntawv qhia txog kab mob muaj xws li qhov loj thiab qhov chaw ntawm cov qog nqaij hlav tshem tawm, piv txwv li para portal, paracolic, thiab lwm yam. Cov qog ntshav qog ntshav tau qhia raws li ib feem yooj yim, piv txwv li, 3/12, qhov twg tus denominator ntawm 12 txhais tau tias 12 lymph nodes. cov nodes tau kuaj xyuas thiab tus lej ntawm 3 txhais tau hais tias 3 ntawm cov qog nqaij hlav muaj metastases.

10. Cov lus tshaj tawm hais txog daim siab fibrosis thiab cirrhotic nodes txhais li cas?

Feem ntaudaim siabCov qog nqaij hlav muaj feem cuam tshuam nrog tus kab mob siab, nrog rau tus kab mob siab B thiab C tus account rau feem ntau ntawm cov neeg mob. Cov kab mob siab ntev ua rau rov ua mob thiab kho cov txheej txheem hauv lub cevdaim siab, ua rau fibrosis thiab qeeb hardening ntawm covdaim siab, tsim intrahepatic nodules ntawm ntau qhov sib txawv, txheej txheem uas feem ntau kav ntev txog 20 xyoo. Qee qhov cirrhotic nodules tuaj yeem ua malignant thiab tsimdaim siabmob qog noj ntshav. Yog li ntawd, cov neeg mob uas muaj mob qog noj ntshav feem ntau nrog mob cirrhosis. Cirrhosis tuaj yeem cuam tshuam rau lub cev physiological ntawm lub siab.

Rau cov neeg mob uas muaj kab mob siab, daim ntawv qhia pathology tseem yuav piav qhia txog qib ntawm kev ua haujlwm ntawm tus kab mob siab thiab qib ntawmdaim siabfibrosis, muab qhab nia ntawm me me mus rau nruab nrab raws li G{{0}} mus rau G4 thiab S0 rau S4, feem. Cov kev tshawb pom no qhia tias cov neeg mob yuav tsum txhawj xeeb txog kev hloov pauv hauv daim siab ua haujlwm.

11. Dab tsi yog qhov heterogeneous hyperplastic nodules thiab intraepithelial neoplasia uas tau hais hauv tsab ntawv ceeb toom?

Kev tsim ntawm hepatocellular carcinoma yog ib qho txheej txheem ntawm kev hloov pauv ntawm cov cell ntawm ib txwm mus rau qhov txawv txav, uas tshwm sim nws tus kheej hauv cov ntaub ntawv tshwj xeeb ntawm ntau theem, thiab cov ntaub ntawv no tuaj yeem hu ua cov kab mob precancerous. Daim ntawv tshaj tawm yuav piav qhia txog ntau yam morphologies pom. Yog tias qhov kev kuaj mob ntawm malignancy twb tau meej lawm, cov neeg mob tsis tas yuav tsum tau them nyiaj ntau rau cov kab mob precancerous.

12. Cov kev xeem tshwj xeeb, xws li AFP, CD34, CK19, thiab CD10 yog dab tsi?

Ntxiv nrog rau kev soj ntsuam cov qauv morphological ntawm cov qog hlwb los ntawm qhov muag liab qab thiab lub tshuab tsom, cov kws kho mob yuav tsum tau siv cov cim qog tshwj xeeb los pab rau kev kuaj mob.daim siabmob qog noj ntshav, hu ua immunohistochemical tests. Cov cim no feem ntau yog siv los kuaj xyuas lub hauv paus ntawm cov qog thiab yog li ntawd tsuas yog rau tus kws kho mob cov ntaub ntawv siv thiab cov neeg mob feem ntau tsis tas yuav paub txog lawv.

Ib lo lus ceeb toom: Muaj tsawg zaus uas hom qog nyuaj los txiav txim siab los ntawm kev kuaj niaj hnub, cov cim tshuaj tiv thaiv kab mob ntxiv yuav tsum tau siv los piav qhia qhov kev kuaj mob. Ua qhov kev sim tshuaj immunohistochemical ntxiv yuav xav tau tus nqi ntxiv rau tus neeg mob thiab tseem tuaj yeem ncua sijhawm tso tawm daim ntawv qhia txog kab mob.

Hauv kev xaus, daim ntawv qhia pathology yog cov ntaub ntawv tseem ceeb heev rau cov neeg mob hauv kev kuaj mob thiab kho cov qog, nco ntsoov khaws nws kom raug thiab nkag siab cov ntsiab lus tseem ceeb hauv daim ntawv qhia pathology kuj pab txhawb cov neeg mob thiab kws kho mob kom sib txuas lus lawv tus mob, npaj kev kho mob thiab ua raws. .

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