About tests and laboratory tests
Is conducting several tests and laboratory tests designed to detect the presence of cancer cells, and then rated the event of illness following the diagnosis of tumors, both in order to identify the degree of tumor classification in its class (Grading), or classification phase
(Staging), determine how much cancerous tissue located the body, and its position and how he moved from place of origin to other places and members, in order to arrange appropriate treatment plans and as soon as possible, as is the use of these tests periodically during the stages of the processors.
And there is a wide range of these tests and examinations and tests, which are made according to the type of tumor is diagnosed, start analyzes different blood and chemicals the body, and take pictures of physical hitting it multiple, through the operations of an osteotomy surgery (biopsy) in order to extract a biopsy of the tumor tissue surgically, to be examined under a microscope in order to determine its type and its properties and the manifestation of vital tissues, analyzes, and ending with cellular genes and chromosomes of cells count and biochemistry.
And is, of course, make many of these tests and analysis on a regular basis while receiving treatment and after its completion, to monitor the development of the disease, and to investigate and monitor the path of processors used, and the behavior of tumors towards it and its effectiveness and side effects, and monitor developments to the situation a whole, as well to the potential impacts on the effectiveness of the vital organs in the body.
It should be noted that some of these tests are painful, and is the use of methods of anesthesia different and treatment of pain by direct commissioned, but it is still important to always remove the fears of the child and reassure him, and is the best means to achieve that teach him and give him sufficient information about the examination to be conducted ahead of schedule well in advance, and psychologically prepared to remove his fears, and it is useful to explain every step of the procedure in detail and use of medical photographs or graphics, and visit the operating room and doctors conversation, the domestication of the situation as a whole.
In the following paragraphs we review a simplified explanation of the usual tests and analysis
Imaging studies
And are these tests take pictures physically different internal and a number of ways, in order to gain a clear picture about the changes of tissues within the body and the extent of the tumors, and their positions, if any, and extent of spread, and in general are not like these tests are painful for the child, but some machines may frighten one way or another, such as an MRI, which issued the magnetic noises.
Vascular Planning (Angiography)
This type of imaging using X-rays to take pictures of radiation of different vessels and capillaries and to show the variations or changes in organ vital nearby, for example, may indicate the presence of coronary obstruction, or change its location to the tumor, and use of this type in particular at the cases of kidney tumors , with which to determine the blood vessels that feed the tumor tissue, which helps the surgeon to plan the surgery, and is making this imaging after injection of a certain type of pigments in one artery to flow through the circulatory system, which shows the blood vessels are clearly in X-rays, which are taken at different angles and for several times.
Planning Ultrasound (Ultrasonography)
Is the use of sound waves in this type of photography, and so to create different images of the internal organs of the body, where when the emission of sound waves and a collision with tissue and organs of the body, bounce composed echo has a specific computer in order of Onsagah to be a clear picture of the organ or tissue, and varies usually recoil resulting from tissue tumor is clearly higher than fabrics of sound, which can distinguish tumors, and emit ultrasound of a tool similar to the lens works as a converter of energy, and the doctor put ointment a special connector for power on the skin placement is to be filmed, and then will move the adapter energy in several directions, to get the different images appear clearly on the computer screen, and as this process is painful for the child of course.
Planning tomography (CT scan - computerized tomography scan)
Is in this type of planning take photos central cross-sectional members and tissues of the body, and the guidance package of X-rays on the body, and the computer installation images to appear clear and give precise details in the images of multiple sections of the subject of photography, and then give details specific about the changes placement and extent of growth and throw and the kind and size and place flour, and in most cases is infusion of a specific type of dyes, characterized by appearance and clear under the X-ray, before starting a layout, and may take the imaging process from 30 to 90 minutes, where lies the child is fixed and the machine, planning to pass back and forth around the body to capture images of different, and this is imaging one of the most important types of planning in cases of tumors that arise placements accurate and sensitive, such as the kidney, it is also useful in finding the movement of cells tumor placements tion to other sites, and planning is a spiral (helical scanning) that works very quickly, the most important recent developments, where they are shooting at high speed during the injection of the dye, which shows it is clear when passing through the blood vessels, and this technique is very useful in kidney tumors In particular, where it appears the flow of blood altogether clearly permit the disclosure of very small tumors.
Magnetic resonance imaging (MRI magnetic resonance imaging)
Submit a planning MRI feature photography places the body can not be photographed using the types of other planning, and here is the use of radio waves, built-field magnetic cardboard instead of x-rays, where the body tissues to absorb energy from radio waves, and then fired format varies depending on the type of tissue or organ and by type of disease, and the computer translated the form of energy feedback from the tissues to the detailed pictures of the members of the body, and provides this type of planning, more detailed images than those planning tomography or ultrasound, for example, can memorize pictures from inside the bone was able to determine where tumors small near these bones, or by which to determine the extent of the tumor to major blood vessels adjacent to the College at the cases of kidney tumors, and in some cases, special dye is injected prior to initiate this type of photography, to draw pictures more accurate and detailed.
On the other hand may seem a MRI magnetic disturbing for children, in particular, where lies the child firmly on the bed and entered into a kind of room circular length of the body, and during the operation of MRI, which may continue for a period ranging from 15 to 90 minutes, heard the child up and banging sounds like regular pulse, which may cause fear, and requires reassurance.
X-ray
Are often capture x-rays-ray chest and abdominal cavity at the initial assessment of the situation, and is the X-rays normal useful in identifying tumors of bone and lung tumors expanding tissue soft, but it does not present an image anatomical clear that assist in the planning of treatment, and are useful in tumors of bone In particular, in which most of these tumors are clearly images of X-rays, it appears the bone when the position of the tumor fragile than solid, and may show the tumor on the body piercing bone, or show the mass enlarged on position patient can look extended to the tissues adjacent to, such as muscle , and in most cases be able radiologist to determine whether the tumor is cancerous than just his appearance in X, and the other of the usual capture x-rays X-fact-the transmission of tumor cells to the area of the chest or lymph nodes or lung, as is done x-rays of the chest area and the bones on a regular basis when cases of leukemia to assess the situation, as they may indicate the existence of any mass or swelling chest, for example, or explain any changes to bone.
Planning bone (Bone scan)
When you make a layout of the bones is intravenous injection of small amounts of chemical compounds especially low radiation, accumulate turn in the positions affected by cancer (or other causes such as fractures), and the special cameras and detectors of radiation show these positions very clearly, and this way add to it sediments show small bones of the cancerous tissue, can help in the detection of secondary tumors in transition to the bone, and of course the radiation levels are low and the vehicles used are not harmful to the body.
Planning radioactive isotopes (Radioisotope scanning)
You use this type of CT scan in order to examine the vital organs, especially brain, liver, kidneys and bones, and is has a recruitment property radiological some radioactive material is not harmful, where it is injected into the body or ingested, and then a special survey investigated the sites gathered These materials, which allows the doctor to identify the subject of the tumor, and of course the child will not consist of any radioactivity during the test or after it ends.
Planning tomography stream of positive electrons (Positron emission tomography (PET) scan)
And use of this imaging is usually to examine brain tumors, and that injection of low-dose radiation is vital, such as glucose, and shows the planning rate of consumption of tumor cells of sugar as an energy source, and compares a rate of consumption of brain cells other, and in general, consume brain tumors of grades High high levels of sugar more than healthy brain cells (hyper metabolism hyper-metabolism), while consuming tumors of the lower rates of less than (lack of metabolic hypo-metabolism), also used this chart to assess the response of tumors to different treatments.
Surgical osteotomy (Biopsy)
Although the tests soundtracks of various types could clearly confirm the presence of a cancerous tumor, but the only way to ascertain conclusively, and then distinguish the type of tumor and its properties vital to be precise, is to make osteotomy surgery, which aims to extract a biopsy of the tumor tissue to be tested experimentally, and adopt the ways to reach the tumor tissue and extract the sample several factors, notably the location of the tumor and the patient's age, experience and medical skills, where they can avoid the proper planning for the position of osteotomy and technology to any complications later, and reduces the number of surgeries during the treatments, and, of course, after the osteotomy is performed using local anesthesia or sedation full, with local anesthesia is injected the drug directly into the tissue above the position of the tumor, while the anesthesia is injected the drug one of the veins, or is inhaled even sense the body loses during the whole process.
And there are two ways to extract the tumor tissue sample, either surgery open integrated access to the position of the tumor, or extract a small sample using a needle is inserted through the skin into the tumor mass.
Surgical osteotomy
Than usual to target osteotomy surgery with surgery open, remove the part of the tumor tissue and carrying out tests on the spot and quickly by a specialist knowledge of the disease (doctor who specializes in diagnosing diseases of the results of laboratory tests), and when proven precancerous tumor is, based next step position and size, the small in size, and is concentrated in the position available and easily accessible, the surgeon a process known Balkhoza Alastisala (excisional biopsy) of trying to eradicate the entire tumor mass, (as the lymph nodes adjacent to and available for eradication may be removed and checked to make sure the extent of transmission of tumor cells to them), but that the tumor is large and difficult to remove, be sufficient for the surgeon to draw a sample with known Balkhoza Aldaa (incisional biopsy).
Osteotomy needle
In the absence of appropriate osteotomy surgical open for one reason or another method is used less comprehensive and complex, known Balkhoza needle (needle biopsy), usually after local anesthesia of the skin and sometimes anesthesia full, and there are two types of the osteotomy from the trader held later, osteotomy needle traditional and called a biopsy mass (Core biopsy), using a needle of relatively large is its implantation directly into the tumor to extract a sample cylinder be enough for all the tests, with a diameter of about 1.5 mm and length about 12.5 mm, and is features in no need for surgery and without anesthesia complete in some cases, the disadvantages lies in the small sample, and lack of access to the tumor mass correctly in some cases, which requires a re-osteotomy.
And know how the latest Bkhoza or aspiration needle capillary (Fine needle aspiration), using a needle so fine to withdraw a small amount of tumor tissue, and the doctor can placement-targeted oversized and perceived under the skin, suspected of being the shot, or a position deep within the body and is perceived by abroad, using X-ray CT (CT scan) to ensure the accuracy of direction toward the tumor mass, and the misdeeds of this method lies in the small sample size, which requires appropriate medical provides possibilities to extract the largest amount of information, analyzes how the lowest of the tumor tissue.
Bone marrow biopsy (Bone marrow biopsy)
Or extraction of bone marrow (Bone marrow aspiration),
And targets of this type of osteotomy to draw a sample of tissue from the bone marrow for examination under a microscope, in order to investigate how the presence or movement of tumor cells different to the bone marrow, especially when cases of lymphomas, and, of course, is this type of osteotomy periodically and particularly when tumors blood, both to determine the type and extent of the tumor focus spinal tumor cells, or monitor the development of the disease during the therapeutic sessions.
And the usual draw a sample bone from hip bone back where there is the bone just under the skin, and contains large quantities of bone marrow, and is the osteotomy that lay the child lying on his face, and may be placed beneath a pillow suitable for raising the level of the body, or by putting both sides of the curved , and the doctor determine the appropriate position of clouds and disinfected, and then use the appropriate anesthesia, either topically or short-term anesthesia, and then inserts a needle withdrawal, which is not much different from the normal needle, through the skin to where the bone marrow, and the withdrawal of sample in the form of cylindrical needle 1.5 mm in diameter and length of approximately 12.5 millimeters, and do not take this process is usually more than five minutes, and the sample is examined under the microscope after the dyed material particular.
Spinal tap (Lumbar puncture)
This process aims to draw a sample of cerebrospinal fluid (cerebrospinal fluid CSF) surrounding the brain and spinal cord, in order to examine under the microscope and to investigate the presence of cancer cells, (as they used injection vaginalis to chemotherapy drugs directly into the brain and spinal cord, and please Jump to Page chemotherapy for more details on the injection NA), and is the drainage that lay the child on one side with the inclusion of the knees put a bypass, or sitting hunched forward, and the doctor sterilized the lower back after you select the appropriate place, and then uses the anesthesia local or general anesthesia a short-term, and then enter the needle cavity between the two paragraphs of the lumbar spine where there is cerebrospinal fluid, which begins to flow through the needle without the need to withdraw, and are collecting a small amount adequate for the analysis and testing various, which include measuring the levels of glucose and Add some protein to investigate the presence of tumor cells by microscopic examination.
Blood tests
Analysis features of tumor (Tumor markers)
Or analysis of implications of cancer, and targeting this group of tests investigating and the search for compounds chemical certain proportion of its concentration in different body fluids when there are cancer cells, in addition to other substances and secretions produced by tumor cells, which accompanies the development of some tumors increase of calcium or by blood proteins or hormones, in addition to the high percentage of some enzymes, serum, and although these tests may help in the initial diagnosis of cancer, but it is not an indication conclusive, of course, as they may show the same data at the emergence of infections or exposure to some types of infection, or the emergence of benign tumors, and in turn utilized in the investigation of the development of tumors and how to respond to the treatments, as close as the focus of these signs are usually normal rates when the size of the tumor is small in cases of solid tumors, but when inflation rises, or when the emergence of tumor secondary tumors, while at low rates and return to normal after treatment, this is a positive indication of the treatment, while the increased rates may indicate that the failure of treatment, or the emergence of secondary tumors other placements.
Complete blood count (CBC)
Aims to analyze the census total blood conduct a census of blood cells and their components, from red and white cells and platelets and blood roe and the various offshoots.
White blood cells (white blood cells)
Are counted white blood cells, a sample of blood in this census, in order to investigate the presence of a particular type of tumor cells is mature and the abnormal, which indicates its presence in numbers is a regular on the existence of leukemia in cases of tumors of blood, as well as to explore the impact of treatments, which are white blood cells of the most important components of the system immune to the body, and are protected from different types of infection, and the alien, on the other hand the treatments tumors of different frustrated bone marrow and low rates in blood, which increases the risk of infection easily, so it is important to conduct the census periodically, the treatments are delayed or modified if it is shown a population decline, and until the return rates to normal levels again.
Hemoglobin (Hemoglobin)
Or Roe is the most important compounds of red blood cells and carry oxygen to the tissues of the body, and lead to the emergence of low rates of anemia, which in turn may appear as a result of the effects of treatments, or may appear as a sign of the return of cancer in tumors of blood.
Sludge blood (Hematocrit)
Defines count sludge blood ratio between blood plasma and red blood cells, which determines its effectiveness, and also shows a population decline in the presence of anemia with blood.
Neutral total cell count (Absolute neutrophil count ANC)
And also called the enumeration of neutrophils (neutrophils) total white blood cells, and is an important measure of the ability of the body to fight infection, and is by measuring the ratio between the population of these cells and the census total leukocyte, and in general the value of more than 1000 means that the ability of the body Child resistant to infection close to normal limits.
Platelet count (Platelet count)
The platelet composition of clots and to close the subject of bleeding at the time of cuttings or wound tissue, a decrease in population blood as a side effect when the child receives treatment, may fall because of the presence of an infection, and the decline may indicate the presence of leukemia in children in particular, and lead shortage to ease the bleeding.
(Please go to chemotherapy and blood cell count for more thorough details.)
Chemical analysis of blood
Is performed several other tests to measure the rates of many of the chemicals and salts in blood, and determine the effectiveness of the functions of the liver and kidneys, and conducted these tests on a regular basis to investigate the general state of health of the patient, and the effect of treatments received.
Analysis of cellular
And is a set of tests used in particular in the diagnosis and classification of tumors of blood and lymphatic tumors, and some of solid tumors such as the tumors of Ewing, and the purpose of this analysis to study the changes DNA of the cells tumor, and the changes and exchanges in the types of chromosomes, genetic as well to detect cancer cells, using Ddiat exotic particles (Antibodies), making it possible to determine the type of tumor and its properties vital, and planning for the processors of different, in addition to predict how effective treatment is expected and how to respond to the processors, and conducted these tests on the cells of the samples extracted from bone marrow marrow and cerebrospinal fluid, and lymph nodes and blood samples, tissue biopsies and tumors, and investigate whether abnormal changes in the size of these cells or their behavior or phenotypic characteristics under the microscope.
And we will take in the following paragraphs at the cellular analysis of cases of leukemia is an example to illustrate these tests:
Analysis of cellular chemistry (Cytochemistry)
After that is installed on a sample of cells from microscope slides, are dyed with different types of dyes that are attracted to a specific type of chemicals found only certain types of tumor cells Allokimah, for example, uses a specific type of pigment granules makes the most of spinal leukemia cells appear in the form of patches black under the microscope, but they do not occur any change to the color cell leukemia lymphoma.
Census successive cell (Flow cytometry)
And use this technique sometimes to examine cell samples of blood and bone marrow and lymph nodes, and is accurate in determining the type of cell leukemia or lymphoma Allahoddgkin, and are addressing the cell types of special Ddiat particles (Antibodies), which are attracted to specific types of tumor cells, and is passed to the beam of a laser beam, it contained a sample of any of these cells, the laser descendants ... pending in a different color, and then the computer measured and analyzed carefully, and use this test also to estimate the amount of DNA in cells Allokimah, and then estimate the likely behavior, for example, the acute lymphatic leukemia cells with a high content of DNA, more than 16% above the average, more sensitive to chemotherapy drugs.
Chemistry analysis of immune cell (Immunocytochemistry)
And like the way this test cell enumeration, as it is processed cells from bone marrow biopsy is a special kind of particle Ddiat laboratory, but instead of using lasers and computers in the audit, is processed so that the cells change color of some kind, and color changes can be scrutinized under the microscope accurately, and this is the way the census, such as cell useful for distinguishing between different types of cells and leukemia cells of other tumors.
Analysis of cellular genes (Cytogenetics)
Human cells contain 46 chromosomes natural (chromosomes and are pieces of DNA and proteins that control the life cycle and cell metabolism), and in some types of leukemia, Part of one chromosome with part of a different chromosome, known as the exchange of bonds of chromosomes (Translocation ), and the fact it is usually possible for such exchanges under a microscope, and helps distinguish them identify the different types of leukemia or lymphoma, either spinal, in addition to some types of leukemia Bouklayaha there is a larger number of chromosomes above the normal number, and distinguish them Palmrdod help to predict therapeutic For example, acute lymphatic leukemia cells, which shows the number of 50 chromosomes are more susceptible to chemotherapy, while those that contain fewer than 46 chromosomes, they are more resistant to chemical drugs.
Molecular genetic analysis (Molecular genetic studies)
There are certain substances known Bmtlkiet generators counter, or recipients variant (antigen receptors), lies on the outer surface of cells, nodes, and these recipients an active role in launching the interactions of the immune system to various foreign objects and types of infection, and present cell lymphoma regular large number of recipients that help in the interaction of the body to resist many types of infection, and as the leukemia lymphoma, for example arise in the beginning than just a cell lymph abnormal one, therefore, present in all cells Allokimah when the patient the same recipients of antigen, and is a laboratory analysis of a series of DNA (which include information Palmtlkiet each cell), a proven way to diagnose leukemia and lymphoma classification, because each subtype of receptors different from other properties, and generally this analysis is complicated and expensive and is not necessary when most of the cases.
