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simsivnesTan asocirebuli serologiuri markerebi

simsivnesTan asocirebuli serologiuri markerebi. Tbilisi 2014. კლინიკო-დიაგნოსტიკური ლაბორატორია. laboratoria amkvidrebs profesiuli saqmianobis umaRles standartebs da moqmedebs mxolod pacientis interesebis Sesabamisad . aRWurvilia uaxlesi mRalteqnologiuri diagnostikuri aparaturiT

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simsivnesTan asocirebuli serologiuri markerebi

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  1. simsivnesTanasocirebuliserologiurimarkerebi Tbilisi 2014

  2. კლინიკო-დიაგნოსტიკური ლაბორატორია • laboratoriaamkvidrebsprofesiulisaqmianobisumaRlesstandartebs da moqmedebsmxolodpacientisinteresebisSesabamisad. • aRWurviliauaxlesimRalteqnologiuridiagnostikuriaparaturiT • laboratoriaSimuSaobenmaRalikvalifikaciisspecialistebi, maTSorismecnierebaTaakademuridoqtorebi • laboratoriaSisruldebasxvadasxva tipis uzustesihematologiuri, koagulaciuri, bioqimiuri, imunologiurikvlevebi

  3. laboratoriaSixorcieldebaSemdegiimunologiurigamokvlevebi: • farisebrijirkvlishormonebi: T3, T4, FT3, FT4, TSH, Anti-TG, Anti-TPO • sasqesohormonebi: PRL, E2, LH, FSH, TESTO, FTESTO, PROG, 17-OH-PROG, DHEA-S • onko-markerebi: CEA, CA-125, CA-15-3, CA-19-9, PSA, FPSA, AFP, HCG, BAP, SCC, S100, HE4, ROMA • infeqciuridaavadebebi: HBsAg, HCV, HIV • HSV IgG/IgM; CMV IgG/IgM; TOXO IgG/IgM; Chlam Tr. IgG/IgM • sxvadasxva: Insulin, C-Peptide, Cortisolda a.S.

  4. gardaimisa, rom laboratoriaSiyoveldRiuradxorcieldebaSidalaboratoriulixarisxiskontroli, igiCarTuliagarexarisxiskontrolissaerTaSorisoprogramaSi – RIQAS (External Quality Assessment (EQA) Program) Randox, UK, romlisaxalicikliiwyeba 2013 wlisianvridanlaboratoriagaerTianebulia 3 programaSi:Monthly Immunology programmeMonthly Coagulation programme Monthly Clinical Chemistry programmelaboratoriaregistrirebuliakompaniissaitze, yovelTviuradigzavnebaSedegebiinternetiT da ramdenimedReSimiviRebTstatistikuraddamuSavebulSedegebs.

  5. simsivnesTanasocirebuliserologiurimarkerebi markerebi – nivTierebebia, romelTakoncentraciamatulobssxvadasxvabiologiursiTxeebSi (sisxli, Sardi, kistisSigTavsi, asciturisiTxe da a.S.) onkologiuridaavadebebismqonepacientebSi.

  6. simsivnesTanasocirebuliserologiurimarkerebi om-s diagnostikuriRirebulebaganisazRvrebamaTispecifiurobiTa da mgrZnobelobiT. • mgrZnobeloba – onkologiurpacientebSirealuraddadebiTiSedegissixSire, gamosaxuliprocentSi. • specifiuroba – janmrTel da keaTilTvisebianidaavadebebismqoneadamianebSirealuraduaryofiTiSedegissixSire, gamosaxuliprocentSi. • om iTvlebaidealurad, Tumisispecifiuroba da mgrZnobelobaSeadgenas 100%.

  7. klasifikacia • lokalizaciismixedviT - specifiuroba da informatiuloba • biologiuri – qimiuristruqtura, ujredulifunqcia, embriogenezi • simsivnesTanasocirebuliglikoproteinebi (CA-125, CA-19-9, CA-15-3, CA-72-4, CA-242 da a.S.) • fermentebi(PSA, NSE) • citokinebi (IL-6, IL-10, EGF (epidermalurizrdisfaqtori) • mwvavefaziscilebi(feritini, CRP)

  8. sxvadasxvalokaciisSedarebiTinformatiuliom

  9. sxvadasxvalokaciisSedarebiTinformatiuliom

  10. serologiurionkomarkeriCA-125 • CA-125 - maRalmolekulurimucinisglikoproteinuriepitopia, romelicmiekuTvnebaonkofetaluricilebisklass • normisfarglebijanmrTeliqalebisaTvis: < 35 U/ml • mismomatebasganapirobebsavTvisebianiaxalwarmonaqmnebi: sakvercxis, sarZevejirkvlis, endometriozissimsivne, filtvisadenokarcinoma, kuWqveSajirkvlis, hepatocelularulisimsivne, metastaziRviZlSi. • serozuli tipis sakvercxissimsivnisdrosCA-125-isdiagnostikuri mgrZnobelobavarirebs 42% -dan (I-II stadia) 99%-mde (IV stadia) • CA-125-is mgrZnobelobasisxlSisakvercxisserozuli tipis kibosrecidivisdrosaRemateba 90%-s.

  11. serologiurionkomarkeriHE4 • HE4 miekuTvnebaproteinazebis inhibitors • mJavaglikoproteiniaoTxidisupfiduribmiT da 25 kdaltonimasiT • HE4 eqspresirdebareproduqtiuliorganoebis, zedasasunTqigzebis da kuWqveSajirkvlisnormalurepiTelSi. cilismomatebuliwarmoqmnaZiriTadadgamovleniliasakvercxisa da endometriumissimsivnis, iSviaTadfiltvisadenokarcinomisgavrcelebuliformisdros. • kvlevebmaaCvenes, rom orimarkerisHE4 da CA-125 erToblivigansazRvramniSvnelovnadzrdismaTdiagnostikurRirebulebassakvercxissimsivnisaRmoCenisadreulstadiaze da mciremenjisavTvisebiani da keTilTvisebianiwarmonaqmnebisdiferencialurdiagnostikaSi.

  12. serologiurionkomarkeriHE4 • HE4 da CA-125 –is kombinirebuligansazRvramniSvnelovnadzustadgansazRvravsavTvisebianiwarmonaqmnisarsebobas, vidrenebismierisxvamarkericalkeaRebuli an romelimesxvamarkerTankombinaciaSi • mecnierebismierSemuSavebuliasakvercxisavTvisebianisimsivnisganviTarebisgansazRvrisalgoriTmi – Risk of Ovarian Malignancy Algorithm – ROMA – post- da premenopauzismqoneqalebSisakvercxisepiTelurisimsivnisganviTarebisriskisSesafaseblad. • algoriTmiiTvaliswinebsHE4 da CA-125 –is koncentraciisgansazRvrassisxlSi, asevepacientismenopauzisstatuss. is saSualebasiZlevagaiTvalossakvercxisepiTelurisimsivnisaRmoCenisalbaToba.

  13. sakvercxissimsivne sakvercxissimsivnisdReisaTvisSedarebiTSeswavliliserologiuri om

  14. individualuri da kombinirebulisimsivnurimarkerebismgrZnobeloba 90%-ianispecifiurobisdros

  15. siaxle! pirveladsaqarTveloSiTbilisisonkologiuridispanserislaboratoriaSisruldebasakvercxisavTvisebianobisriskisalgoriTmis (ROMA) gamoTvla • ROMA – Risk of Ovarian Malignancy Algorithm – gamoiyeneba pre- da postnopauzismqoneqalebSisakvercxisepiTelurisim-sivnisganviTarebisriskisSesafaseblad • algoriTmisaSualebasiZlevaganisazRvrossakvercxisepiTelurisimsivnisavTvise-bianobisxarisxi • kvlevasruldebakompania “Fujirebio Diagnostics, Inc” (Sweden) – warmoebuliumaRlesixarisxis test-sistemebiT • TiToeulpacientsutardebaorikvleva: CA-125 da HE4 • miRebuliSedegebimuSavdebaspecialuriprogramissaSualebiT • algoriTmiiTvaliswinebsCA-125 daHE4-is koncentraciassisxlSi, asevepacientismeno-pauzisstatuss • premenopauza: dabaliriski <13 maRaliriski >13 • postmenopauza: dabaliriski <28 maRaliriski >28

  16. markerebiskvleva da masalisaReba • om-s SemcvelobassisxlSigansazRvravenradioimunuri, imunofermentuli da qemiluminescentulimeTodebiT. • zustiSedegebismisaRebadZaliandidimniSvnelobaaqvssakvlevimasalissworadaRebas da Senaxvas. • ZiriTadisakvlevimasalaaSrati, romelicmiiRebauzmodaRebulivenurisisxlidan. hemolizurinimuSebissaanalizodgamoyenebaaraarekomendirebuli.

  17. sisxlisSegrovebasaanalizod SearCieTsisxlisasaRebiadgili moamzadeTyvelasaWironivTi da gaikeTeTxelTaTmani daawereTsinjaraspacientissaidentifikacionomeri (TuaseTiarsebobs) an saxeli da gvari moargeTpacientsJguti

  18. sisxlisSegrovebasaanalizod daamuSaveTspirtiTsisxlisaRebisadgili daafiqsireTkani da dabalkuTxianidaxriTSeiyvaneTnemsivenaSi aiReTsisxlisinjaraSie.w.Clot Activator (SratismisaRebad) JgutiundamoixsnasrogorckisisxlisnakadiwamovasinjaraSi gamoiReTnemsivenidan da daaWireTpunqciisadgilas SeamowmeTpunqciisadgilidaakariTleikoplastiri gamoyenebulinemsigadaagdeT

  19. sisxlisSegrovebasaanalizod aRebulisisxlinazadgadaatrialeT 5-6-jer sisxlis da SededebisaqtivatorisSerevisaTvis moixseniTxelTaTmanebi da daibaneTxelebi sinjarebimoaTavseTStativSivertikalurpoziciaSi da daayovneToTaxistemperaturaze minimum 30wT

  20. sisxlisSegrovebasaanalizod SratisgamosayofadsinjarebidaacentrifugeT 10 wT 1300g oTaxistemperaturispirobebSi. TuarmoxdaSratissruladgamoyofa, saWiroakidevdamatebiTdacentrifugeba6-8wT analizisaTvisSratiundagadataniliqnaspasterispipetiT an avtomaturipipetiT 1.5-2ml-ian ependorfSi da SevinaxoTmacivarSi (4-8C). SeniSvna: yovelinimuSisaTvisundagamoviyenoTaxalipipeti an pipetiswveri

  21. sisxlisSegrovebasaanalizod • transportireba: • yvelanimuSimisiaRebisa da momzadebisSemdegundagadavagzavnoTTbilisisonkologiuridispanserislaboratoriaSi. • yvelasinjs Tan undaaxldesSesabamisiganacxadi, sadacaRniSnuliiqnebamasalisaRebisTariRi, pacientissaxeli, gvari, asaki da menopauzisstatusi. asevemasalisgamogzavnisTariRi. M • masala transportirdebasamedicinosinjebistransportirebisaTvisgankuTvnilispecialuriTermoCanTebiT (2-8C) • TiToeulisinjimowmdeba da dadasturdebalaboratoriaSimiRebisTanave. saTanadoidentifikaciisarmqonepirveladisinjebilaboratoriismierarmiiReba da SesabamisadardamuSavdeba!

  22. Sedegad, andeTTqvenijanmrTelobapacientis da misukanmdgomiojaxiswinaSeudidesipasuxismgeblobismqoneprofesionalebs!

  23. didimadloba!

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