IGazi leGazi eliMbi loMntu (FOB) iSixhobo sokuVavanya ngokukhawuleza
Intshayelelo
Umhlaza we-Colorectal ngowona mhlaza ufunyaniswayo kwaye ungoyena nobangela wokufa komhlaza eUnited States.Ukuvavanyelwa umhlaza webala mhlawumbi kunyusa ukubhaqwa komhlaza kwangethuba, ke ngoko kunciphisa ukusweleka.
Iimvavanyo ze-FOB zangaphambili ezifumanekayo kwezorhwebo zasebenzisa uvavanyo lwe-guaiac, olufuna uthintelo olukhethekileyo lokutya ukuze kuncitshiswe iziphumo ezingezizo eziqinisekileyo nezingeyonyani.Isixhobo soVavanyo oluKhawulezayo lwe-FOB (Iindle) zenzelwe ngokukodwa ukubona i-hemoglobin yomntu kwiisampulu ze-fecal usebenzisa iindlela ze-Immunochemical, eziphucule ngokukodwa ukuchongwa kwesisu esisezantsi.ukuphazamiseka, kubandakanywa umhlaza we-colorectal kunye ne-adenomas.
Umgaqo
Isixhobo soVavanyo oluKhawulezayo lwe-FOB (Iindle) senzelwe ukufumanisa i-hemoglobin yomntu ngokutolika okubonakalayo kophuhliso lombala kumgca wangaphakathi.I-membrane yayingashukumi kunye ne-anti-human hemoglobin antibodies kwindawo yovavanyo.Ngexesha lovavanyo, umzekelo uvumelekile ukuba usabele nge-anti-human hemoglobin antibodies enemibala ye-colloidal conjugates yegolide, eyayifakwe ngaphambili kwisampulu yovavanyo.Emva koko umxube uhamba kwi-membrane ngesenzo se-capillary, kwaye udibanise nama-reagents kwi-membrane.Ukuba bekukho i-hemoglobin yabantu eyaneleyo kwisampulu, ibhendi enemibala iya kuvela kwindawo yovavanyo yenwebu.Ubukho beli bhanti elinemibala libonisa umphumo omuhle, ngelixa ukungabikho kwawo kubonisa umphumo ombi.Ukubonakala kwebhanti enemibala kwindawo yokulawula isebenza njengolawulo lwenkqubo.Oku kubonisa ukuba umthamo ofanelekileyo we-specimen wongeziwe kwaye i-membrane wicking yenzeke.
Amacandelo eKit
| Imicu yovavanyo epakishwe ngokuzimeleyo | Umcu ngamnye uqulethe i-conjugates enemibala kunye nee-reagents ezisebenzayo ezisasazwe kwangaphambili kwiindawo ezihambelanayo. |
| Isampulu ityhubhu yodilution ene-buffer | 0.1 M I-Phosphate buffered saline (PBS) kunye ne-preservative |
| Faka iphakheji | Ngomyalelo wokusebenza. |
Izinto Eziyimfuneko Kodwa Ezingabonelelwanga
| Isingxobo sokuqokelelwa kwesampuli | Ukuze kusetyenziswe imizekelo yokuqokelela. |
| Isibali-xesha | Ukusetyenziswa kwexesha. |
| Centrifuge | Kunyango lwemizekelo ekhethekileyo. |
Ukulumkela
★ Ukusetyenziswa koxilongo lwe-in vitro kuphela.
★ Ungasebenzisi emva komhla wokuphelelwa oboniswe kwiphakheji.Musa ukulusebenzisa uvavanyo ukuba isingxobo sefoyile saso sonakalisiwe.Musa ukuphinda usebenzise iimvavanyo.
★ Le khithi iqulethe iimveliso zemvelaphi yezilwanyana.Ulwazi oluqinisekisiweyo lwemvelaphi kunye / okanye ubume bococeko lwezilwanyana aluqinisekisi ngokupheleleyo ukungabikho kwee-agent ze-pathogenic ezihambisayo.Kuyacetyiswa ke ngoko ukuba ezi mveliso ziphathwe njengenokosulela, kwaye ziphathwe ngokuqwalasela imiqathango yokhuseleko yesiqhelo (ungagilisi okanye ukusezele umoya).
• Kuphephe ukungcoliseka ngokunqamlezayo kwesampulu ngokusebenzisa isikhongozeli esitsha sokuqokelelwa kwesampulu kumzekelo ngamnye ofunyenweyo.
★ Funda inkqubo yonke ngononophelo phambi kokwenza naluphi na uvavanyo.
★ Sukutya, usele okanye utshaye kwindawo apho imizekelo neekiti ziphathwa khona.Phatha yonke imizekelo ngokungathi inee-arhente ezosulelayo.Qwalasela izilumkiso ezimiselweyo malunga nobungozi be-microbiological kuyo yonke inkqubo kwaye ulandele iinkqubo ezisemgangathweni zokulahla ngokufanelekileyo iisampulu.Nxiba iimpahla ezikhuselayo ezifana needyasi zaselabhoratri, iiglavu ezilahlwayo kunye nokhuseleko lwamehlo xa imizekelo ivavanywa.
★ ISaline eBuffered iqulethe iazide yesodium enokuthi idibane nelothe okanye imibhobho yobhedu yenze i azides zentsimbi ezinokuba nokudubula.Xa ulahla i-buffered saline okanye iisampulu ezitsaliweyo, soloko ugungxulwa ngobuninzi bamanzi ukuthintela ukwakheka kwe-azide.
★ Musa ukutshintshiselana okanye udibanise ii-reagents ezivela kwiindawo ezahlukeneyo.
★ Ukufuma kunye nobushushu bunokuchaphazela kakubi iziphumo.
★ Izinto zokuvavanya ezisetyenzisiweyo kufuneka zilahlwe ngokuhambelana nemimiselo yendawo, urhulumente kunye / okanye i-federal.
Ukugcinwa kunye nokuzinza
✽ Ikhithi kufuneka igcinwe kwi-2-30°C de kube ngumhla wokuphelelwa kwexesha uprintwe kwisingxobo esivaliweyo.
✽ Uvavanyo maluhlale kwisingxobo esitywiniweyo de lusetyenziswe.
✽ Musa ukuba ngumkhenkce.
✽ Kufuneka kuthatyathwe inkathalo ukukhusela amalungu ale khithi ekosulelweni.Musa ukusebenzisa ukuba kukho ubungqina bokungcoliseka kwe-microbial okanye imvula.Ungcoliseko lwebhayoloji lwezixhobo zokukhupha, izikhongozeli okanye iirejenti kunokukhokelela kwiziphumo ezingezizo.
Ukuqokelelwa komfanekiso kunye noGcino
Isixhobo soVavanyo oluKhawulezayo lwe-FOB (Iindle) senzelwe kuphela ukusetyenziswa neesampulu zelindle lomntu.
✔ Izigulana akufuneki ziqokelele iisampulu ngexesha okanye kwisithuba seentsuku ezi-3 zokuya exesheni, ukuba zopha i-hemorrhoids, igazi emchameni, okanye xa ziye zahluzeka xa zihambisa amathumbu.
✔ Utywala, iasprini kunye namanye amayeza athathwe ngokugqithisileyo anokubangela ukucaphuka kwesisu okukhokelela ekopheni ngokwemimoya.Ezo zinto kufuneka ziyekwe ubuncinane kwiiyure ezingama-48 phambi kovavanyo.
✔ Akukho zithintelo zokutya ziyimfuneko phambi kovavanyo.
✔ Yenza uvavanyo ngoko nangoko emva kokuqokelelwa komfanekiso.Musa ukushiya imizekelo kwiqondo lobushushu begumbi ixesha elide.Imizekelo ingagcinwa kwi-2-8 ° C ukuya kwiiyure ezingama-72.
✔ Zisa iisampulu kwiqondo lobushushu legumbi ngaphambi kovavanyo.
✔ Pakisha imizekelo ngokuhambelana nemigaqo esebenzayo yokuthutha i-etiological agents, xa kufuneka zithunyelwe.
Inkqubo
Zisa iimvavanyo, imizekelo, isithinteli kunye/okanye nolawulo kwiqondo lobushushu begumbi (15-30°C) phambi kokusetyenziswa.
1.Ukuqokelelwa kwesampuli kunye nonyango lwangaphambili:
1)Sebenzisa isikhongozeli sokuqokelelwa komzekelo ukuqokelelwa kwesampulu.Iziphumo ezilungileyo ziya kufumaneka ukuba uvavanyo lwenziwa kwiiyure ze-6 emva kokuqokelela.
2) Khulula kwaye ususe isifakeli setyhubhu yedilution.Qaphela ukuba ungachithi okanye utshize isisombululo esivela kumbhobho.Qokelela imizekelo ngokufaka intonga yofakelo ubuncinane kwiindawo ezi-3 ezahlukeneyo zelindle ukuze uqokelele malunga ne-50 mg yelindle (elilingana ne-1/4 yeertyisi).
3）Buyisela isifakeli kwityhubhu kwaye usijije ikepusi ngokuqinileyo.Qaphela ukuba ungaphuli incam yetyhubhu yokudibanisa.
4)Vuthulula ityhubhu yokuqokelelwa komzekelo ngamandla ukuxuba umfuziselo kunye nesithinteli sokutsalwa.Iisampuli ezilungiselelwe kwityhubhu yokuqokelela i-specimen ingagcinwa kwiinyanga ezi-6 kwi--20 ° C ukuba ayivavanywanga kwiyure eli-1 emva kokulungiselela.
2.Uvavanyo
1) Susa uvavanyo kwingxowa yalo evaliweyo, kwaye uyibeke kwindawo ecocekileyo, esemgangathweni.Faka ileyibheli yovavanyo ngesigulana okanye ngesazisi solawulo.Ukufumana iziphumo ezingcono, uvavanyo kufuneka lwenziwe kwiyure enye.
2) Ukusebenzisa isiqwenga sephepha le-tissue, phula incam yombhobho we-dilution.Bamba ityhubhu ngokuthe nkqo kwaye ukhuphe amathontsi e-3 esisombululo kwi-specimen well (S) yesixhobo sovavanyo.
Kuphephe ukubambisa amaqamza omoya kwiqula elingumzekelo (S), kwaye musa ukulahla nasiphi na isisombululo kwifestile yokuphonononga.
Njengoko uvavanyo luqala ukusebenza, uya kubona umbala uhamba kwi-membrane.
3.Lindela amabhanti anemibala avele.Isiphumo kufuneka sifundwe ngemizuzu emi-5.Musa ukutolika umphumo emva kwemizuzu eyi-10.
Ukutolikwa kweziPhumo
IZIPHUMO EZINYO: 
| * Ibhendi enemibala ibonakala kwingingqi yebhanti yolawulo (C) kwaye enye ibhendi enemibala ibonakala kwindawo ye-T band. |
| IZIPHUMO EZINGAMBI:
| Ibhendi enye enemibala ibonakala kwingingqi yebhanti yolawulo (C).Akukho bhendi ivela kummandla webhendi yovavanyo (T). |
| IZIPHUMO EZINGAVUMI:
| Ibhendi yolawulo ayibonakali.Iziphumo zalo naluphi na uvavanyo olungakhange luvelise ibhendi yolawulo ngexesha lokufunda elichaziweyo mazichithwe.Nceda ujonge inkqubo kwaye uphinde ngovavanyo olutsha.Ukuba ingxaki iyaqhubeka, yeka ukusebenzisa ikhithi ngoko nangoko kwaye uqhagamshelane nomsasazi wakho wendawo. |
Phawula
1. Ubunzulu bombala kwingingqi yovavanyo (T) bunokwahluka ngokuxhomekeka kugxininiso lwezinto ezijoliswe kuzo ezikhoyo kumzekelo.Ngoko ke, nawuphi na umthunzi wombala kummandla wovavanyo kufuneka uthathwe njengento enhle.Ngaphandle koko, inqanaba lezinto alinakumiselwa ngolu vavanyo lomgangatho.
2.I-specimen enganelanga umthamo, inkqubo yokusebenza engachanekanga, okanye ukwenza iimvavanyo eziphelelwe lixesha zizona zizathu ezinokwenzeka zokungaphumeleli kwebhendi yolawulo.
Ulawulo lwemeko
★ Ulawulo lwenkqubo lwangaphakathi lubandakanyiwe kuvavanyo.Ibhendi enemibala ebonakala kummandla wolawulo (C) ithathwa njengolawulo olulungileyo lwangaphakathi.Iqinisekisa umthamo owaneleyo wesampuli kunye nobuchule benkqubo obuchanekileyo.
★ Ulawulo lwangaphandle alubonelelwanga nale khithi.Kucetyiswa ukuba ulawulo oluqinisekileyo nolungalunganga luvavanywe njengenkqubo efanelekileyo yaselabhoratri yokuqinisekisa inkqubo yovavanyo kunye nokuqinisekisa ukusebenza kakuhle kovavanyo.
Imida yoVavanyo
1.Isixhobo soVavanyo oluKhawulezayo seFOB (Iindle) sesosetyenziso lobuchwephesha kwi-vitro, kwaye kufuneka sisetyenziselwe ukufumanisa umgangatho we-hemoglobin yomntu kuphela.
2. Ubukho begazi ezindleleni bunokuba ngenxa yezizathu ezininzi, ngaphandle kokuphuma kwegazi, njenge-hemorrhoid, igazi kumchamo okanye isisu esibuhlungu.
3.Iziphumo ezibi azikukhupheli ngaphandle ukopha kuba ezinye iipolyps kunye nomhlaza wengingqi ye-colorectal inokopha rhoqo okanye hayi kwaphela.Ukongeza, igazi alinakuhanjiswa ngokufanayo kwiisampulu zefecal.Iipolyps ze-colorectal kwisigaba sokuqala zisenokungopha.
4.Umchamo kunye nokuhlanjululwa okugqithisileyo kwesampulu ngamanzi aphuma kwisitya sendlu yangasese kunokubangela iziphumo zovavanyo olugwenxa.
5.Olu vavanyo lunokuba lubuthathaka kakhulu ekubhaqeni ukopha kwe-gi ephezulu kuba igazi liyancipha njengoko lidlula kwi-gi track.
6.Konke ukopha kwe-colorectal akunakuba ngenxa ye-polyps ye-precancerous okanye umhlaza.Njengazo zonke iimvavanyo zokuxilonga, uxilongo oluqinisekisiweyo kufuneka lwenziwe kuphela ngugqirha emva kokuba zonke iziphumo zeklinikhi kunye nelebhu ziye zavavanywa.
Iimpawu zokuSebenza
Itheyibhile: Uvavanyo oluKhawulezayo lwe-FOB vs. Olunye uvavanyo oluFumaneka ngokuKhawuleza ngokuRhweba
| Uvakalelo olunxulumeneyo:95.3% (92.5% -97.3%)* Iinkcukacha Ngokuhambelanayo:99.1% (98.4%-99.6%)* Isivumelwano sisonke:98.2% (97.3%-98.8%)* *95% iThutyana lokuzithemba | FOB Rapid Test | ||||
| + | - | Iyonke | |||
| Okunye RT | + | 325 | 9 | 334 | |
| - | 16 | 1024 | 1040 | ||
| 341 | 1033 | 1374 | |||
A. Uvakalelo lokuHlalutya
Isampuli equkethe i-hemoglobin yomntu ekugxininiseni elingana okanye ngaphezulu kwe-25 ng / ml ivelisa umphumo omuhle.Kwezinye iimeko isampulu equlethe i-hemoglobin yomntu kwindawo engaphantsi kwe-25 ng/ml nayo inokuvavanywa ukuba unayo.
Ihuku okanye isiphumo seProzone:
Isampulu equlathe phezulu njenge-1 mg/ml i-hemoglobin isenokuvavanya ukuba unayo.Iimvavanyo azibonisi i-Hook okanye i-Prozone Effect ukuya kwi-maximal ebonwayo yoxinzelelo lwe-physiological (1 mg / ml).Ngaloo ndlela, uluhlu olusebenzayo luyi-25 ng / ml ukuya kwi-1 mg / ml.
B. Ucazululo Olucacileyo:
Uvavanyo luthe ngqo kwi-hemoglobin yomntu kwaye alubonisi nakuphi na ukusabela kwi-cross-reaction kunye ne-hemoglobin evela kwi-bovine, ihagu, ihashe kunye neegusha zoxinzelelo ukuya kwi-1 mg/ml.
IHemoglobin esuka kumvundla kunye nepolecat inokubangela ukuhlangana.
Uvavanyo kwakhona alubonisi nakuphi na ukusabela komnqamlezo ngebhilirubin, ivithamin C kunye ne-horse radish peroxidase.
C. Ukuchaza ngokuthe ngqo kwezonyango:
Le miba ilandelayo engahambelaniyo nomhlaza inokubangela igazi kwiisampulu zelindle:
1) Intsimbi
Ukongezwa kokutya ngentsimbi kukhokelela ekukhululweni kwegazi kwikholoni.I-ayina ngokwayo ayihambisani novavanyo.
2) Acetylsalicylic acid
I-ASA yeyona ngxubevange kumachiza amaninzi okulwa yintloko (umzekelo, i-Aspirin® evela e-Bayer), kwaye ngamanye amaxesha isetyenziswa endaweni ye-macumar njengesihlambululi segazi.Phantse kusoloko kukho izixa zegazi ezincinci kakhulu kwiisampulu zelindle kwimeko yabantu abasempilweni.Oku kungaphantsi kakhulu kobuntununtunu bovavanyo lwethu kwaye akunanto yakwenza nomhlaza okanye nawuphi na umcimbi onzulu.Ukuba isigulana sithatha i-diluters yegazi ukopha kunokuba nzima kakhulu.Ngoko ke ukunqunyulwa kovavanyo kunokufikelelwa.
3) I-Coumarin
I-Coumarines isetyenziswa njengamachiza (umz. i-Macumar®) ekuthinteleni ukuhlaselwa yintliziyo, ngokuchasene ne-thrombosis kunye ne-stroke.Ngokufana ne-ASA, iicumarines ziludidi lwegazi.Phantse kusoloko kukho izixa zegazi ezincinci kakhulu kwiisampulu zelindle kwimeko yabantu abasempilweni.Oku kungaphantsi kakhulu kobuntununtunu bovavanyo kwaye akunanto yakwenza nomhlaza okanye nawuphi na umcimbi onzulu.Ukuba isigulana sithatha i-diluters yegazi, ukopha kunokuba nzima kakhulu.Ngoko ke ukunqunyulwa kovavanyo kunokufikelelwa.
4) I-Hemorrhoids
I-Hemorrhoids inokopha.Ke ngoko isampulu yelindle inokungcoliswa ligazi elingadityaniswanga nomhlaza.
5) Ixesha lenyanga
Izixa ezincinci zegazi elikhutshiweyo ngenxa yexesha labasetyhini lisenokungcolisa isampulu yelindle.Eli ligazi elingadityaniswanga nomhlaza.
6) Iisampuli zomchamo
Izifo ezininzi zinokubangela igazi kwiisampuli zomchamo.Ukunqanda ukufunyanwa kwegazi elinxulumene nomchamo, isampulu yesitulo akufuneki idibane nomchamo.
Iimbekiselo zoncwadi
1.Dam, JV, njl.el.;uVavanyo lweGazi leNcinci kuMhlaza woMbala;UVimba woNyango lwangaphakathi;(1995) 155:2389-2402.
2.Ukusuka, DJ et.el.;UkuHlolwa okuPhuculweyo kuMhlaza weMbala ngokuFumana i-Immunological of Occult Blood;Ijenali yezoNyango yaseBritani;(1988) 296:1092-1094.
3.Lieberman, D.;Uvavanyo / iModeli yokuFumana kwangethuba kuMhlaza oMbala, Kutheni iSkrini?I-Cancer Supplement;(1994) 74(7):2023-2027.
4.Miller, AB;I-Epidemiological Perspective kwi-Cancer Screening;I-Clinical Biochemistry (1995) 28 (1): 41-48.
5.Ransohoff, DF kunye neLang, CA;Ukuphucula uvavanyo lwe-Fecal Occult-Blood;INew England Journal of Medicine;(1996) 334 (3):189-190.
6.Screening for Colorectal Cancer-United States, 1992-1993, kunye neZikhokelo eziNtsha;INgxelo yeVeki yokuHamba nokuFa;(1995) 45 (5): 107-110.
7.St.John, DJB, et al.;UVavanyo loVavanyo lweGazi olutsha lwe-Occult ukuze kubonwe i-Colorectal Neoplasia;I-Gastroenterology;(1993) 104:1661-1668.
8.Yamamoto M., Nakama H., Uhlalutyo lweendleko ze-immunochemical occult blood screening for colorectal cancer phakathi kweendlela ezintathu zesampulu ye-fecal: Hepatogastroenterology, 2000 Mar-Apr, 47 (32) 396-399.
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