It is possible to suggest the nature of a neoplasm in the body due to clinical and radiological symptoms, but to determine its histogenetic affiliation is possible only due to morphological verification of the diagnosis. The main task of such diagnostics is to recheck the oncological diagnosis in order to confirm it and select an effective course of chemotherapy.
Morphological verification
Having heard for the first time from a doctor about the need for morphological diagnostics, many have no idea what it is and what it is for.
Verification is an important study, without which it is impossible to decide on further actions. Morphological verification is a medical procedure that helps confirm or refute an oncological diagnosis. To conduct research, you need to get the material. His choice mainly depends on the localization of education. After the study, the specialist, depending on the result, determines further treatment tactics, whichmay be conservative or surgical. Only after morphological confirmation can adequate treatment be planned. Indications for verification are volumetric formations or diffuse changes in the organ or its structures. To conduct a morphological study, tissue sampling is carried out as follows:
- with superficial ulcerative tumors, scrapings and smears-imprints are taken;
- with shallowly placed nodular formations, a puncture is performed;
- if it is impossible to take a puncture, a biopsy is performed with the sampling of a tissue site;
- After unsuccessful attempts at verification by all the methods listed above, an open biopsy is performed.
Morphological verification of the diagnosis is practically no different from cytological puncture. To take material for research, first, a person is given anesthesia of the soft tissues and skin, after which a small skin incision is made, through which a special instrument is introduced into the soft tissues and directly into the tumor tissue. All subsequent actions directly depend on the device used.
Verification methods
The standard option for histological verification of the diagnosis is the collection of the thinnest sections of biopsy tissues for subsequent microscopic examination. Thanks to them, useful information about the composition of the tumor is obtained.
Morphological verification of the tumor is carried out in the following ways:
- histochemistry;
- immunohistochemistry;
- immunofluorescence;
- immunoenzymaticanalysis.
Regardless of which method is chosen for the study, the purpose of verification is not only to determine the type of tumor, but also to evaluate cellular modifications. According to the results of the study, it becomes possible to accurately make a decision and choose a treatment strategy.
Histochemical study
With the help of histochemical technique, you can get valuable information about the functional activity of education, its type and histogenesis. This method allows you to accurately diagnose and resolve the issue of its differential.
At the disposal of histochemistry are numerous reactions that assist in the identification of different classes of substances.
Immunohistochemistry
IHC is an imaging technique that helps locate substances in tissue section preparations. This method is based on the principle of the characteristic interaction of antigens with antibodies obtained by a special method.
Immunofluorescence
The research method is based on the sensitivity of fluorescence microscopy and the specificity of the immunological reaction. In the process of its implementation, the tumor tissue is marked with a special dye, which helps the doctor to accurately determine the diagnosis. A feature of this method is its simplicity and the need to use the minimum amount of material being studied.
ELISA
The diagnostic method has a high susceptibility and allows you to set the minimum amount of the substance. In modern diagnostic methods, it is with the help of this method that the localization of the antigen is determined. The analysis uses special enzymes to detect cancer.
Regardless of the chosen technique, the goal of any morphological study is to accurately determine the type of tumor and evaluate changes at the cellular level. It can be said in simple terms that morphological verification is the determination of the type of tumor and its neglect for the correct choice of treatment tactics.
Methods for obtaining material for morphological research
For morphological verification of the diagnosis, it is necessary to obtain material. You can do this in the following ways:
- Trepan biopsy - is considered one of the most effective procedures, despite the fact that it has certain disadvantages. To take the material, special needles with internal cutting mechanisms are used. With their help, a column of tissue is obtained from the tumor. This method allows for morphological verification of the breast, prostate, lung, liver, spine and lymph nodes.
- Incisional biopsy is the most popular method that is performed with a scalpel, which takes material from the center of suspicious areas, along the periphery of the tumor. In this case, it is imperative to do this outside the zones of edema, necrosis and hemorrhage of the granulation tissue.
- Excisional biopsy - the essence of this method is the complete radical removal of the tumor. This method is applicable only if the neoplasm is small. In this case, this method is most preferable, as it has both diagnostic and therapeutic value.
The choice of the method of morphological verification is determined by the attending physician, depending on the specifics of the situation.
Sequence of morphological changes
What is morphological verification of the diagnosis, and in what sequence changes occur in the process of cancer development, not many people know. Unfortunately, for the most part, people become interested in such information only when they encounter a problem.
Oncology goes through certain stages in the process of development, and as a result of morphological verification, the doctor can observe different nuances of development. Verification may reveal the following tissue changes:
- diffuse and focal hyperplasia - the process is not dangerous and reversible;
- metaplasia is a benign neoplasm;
- dysplasia - precancerous growth;
- cancer in situ - pre-invasive cancer lesion;
- microinvasion;
- Advanced cancer with metastasis.
The time intervals between the listed stages are individual and in each case can vary from several months to decades.
The main task of morphological diagnostics is to establish the tissue identity of the tumor. At the same time, it revealsnot only its presence and variety, but also the degree of atypia of the cell and the violation of tissue structures are scrupulously assessed. Most often, morphological verification of the thyroid gland, breast, prostate, liver, kidneys and spine is carried out. The method of conducting research in each individual case is determined individually.
