Types/bone/bone-fact-sheet

Ka maʻi ʻaʻai iwi mua

He aha nā puʻupuʻu iwi?

Hiki ke ulu i kekahi mau ʻano tumole ʻokoʻa i nā iwi: nā iwi iwi mua, mai loko mai o ka iwi a hiki ke hōʻino (cancerous) a i ʻole benign (ʻaʻole cancerous), a me nā tumastatic metorsatic (tumors e hoʻomohala ʻia mai nā hunaola maʻi ʻaʻai i hana i nā wahi ʻē aʻe o ke kino a a laila hohola i ka iwi). ʻOi aku ka maʻi maʻamau o nā iwi iwi ʻino mua. Hiki ke ulu a ʻoki nā ʻano iwi ʻelua i nā iwi iwi olakino maikaʻi, akā ʻaʻole hoʻolaha pinepine nā kūpuna benign ʻole a luku paha i nā iwi o ka iwi a ʻaʻole mea weliweli i ke ola.

Hoʻokomo ʻia nā maʻi ʻōiwi ʻōiwi i ka mahele ākea o nā maʻi ʻino i kapa ʻia ʻo sarcomas. (ʻO nā sarcomas-palupalu-sarcomas e hoʻomaka i ka mākala, momona, nāʻiʻo fibrous, nā kīʻaha koko, a i ʻole nā ​​mea kākoʻo ʻē aʻe o ke kino, me nā sarcoma synovial - ʻaʻole i kamaʻilio ʻia i kēia pepa ʻoiaʻiʻo.)

ʻAʻohe laha ka maʻi ʻaʻai iwi mua. ʻOi aku ka helu ma lalo o 1% o nā maʻi ʻaʻai hou āpau i ʻike ʻia. I ka makahiki 2018, 3,450 mau hihia hou o ka maʻi ʻaʻa iwi mua e ʻike ʻia ma United States (1).

Ka maʻi ʻaʻai e metastasize (pālahalaha ʻia) i nā iwi mai nā ʻāpana ʻē aʻe o ke kino i kapa ʻia he kanesa iwi metastatic (a i ʻole kekona) a kuhikuhi ʻia e ka mea a me nā aʻa a kahi i hoʻomaka ai - e laʻa me ka maʻi ʻaʻai umauma i metastasize i ka iwi. . I ka poʻe mākua, ʻo nā maʻi ʻōpū i metastasize i ka iwi ka mea maʻamau ma mua o ka maʻi ʻaʻai iwi mua. ʻO kahi laʻana, i ka hopena o 2008, ua koho ʻia 280,000 mau mākua i nā makahiki 18-64 i ka United States e noho nei me ka maʻi ʻaʻai metastatic i nā iwi (2).

ʻOiai ʻo ka hapanui o nā ʻano maʻi ʻaʻai e hiki ke hoʻolaha aku i ka iwi, ʻo ka metastasis iwi ka mea like me kekahi mau maʻi maʻi maʻi, e like me nā maʻi umauma a me nā maʻi ʻalaki. Hiki i nā tumors metastatic i ka iwi ke hana i nā haki, ʻeha, a me nā kiʻekiʻe kiʻekiʻe o ka calcium i loko o ke koko, kahi ʻano i kapa ʻia ʻo hypercalcemia.

He aha nā ʻano ʻokoʻa o ka maʻi ʻaʻai iwi mua?

ʻO nā ʻano o ka maʻi ʻaʻa iwi mua e wehewehe ʻia e nā hunaola i loko o ka iwi e hoʻāla iā lākou.

Osteosarcoma

Kū mai ʻo Osteosarcoma mai nā hunaola hana iwi i kapa ʻia he osteoblasts i kaʻiʻo osteoid (ka iwi iwi ʻole). Kū pinepine kēia tumo i ka lima kokoke i ka poʻohiwi a i ka wāwae kokoke i ke kuli i nā keiki, ʻōpio, a me nā ʻōpio ʻōpio (3) akā hiki ke hana i kekahi iwi, keu hoʻi i nā ʻelemākule. Piʻi pinepine ia a pālahalaha aku i nā ʻāpana ʻē aʻe o ke kino, me nā akemāmā. ʻOi aku ka makaʻu o ka osteosarcoma ma waena o nā keiki a me nā ʻōpio ma ka makahiki 10 a 19. ʻOi aku ka nui o nā kāne ma mua o nā wahine e hoʻomohala i ka osteosarcoma. Ma waena o nā keiki, ʻoi aku ka nui o ka osteosarcoma i ka poʻe ʻeleʻele a me nā lāhui / lāhui ʻē aʻe ma mua o ka poʻe keʻokeʻo, akā i waena o nā poʻe mākua ka mea maʻamau i nā keʻokeʻo ma mua o nā lāhui / lāhui ʻē aʻe.

Chondrosarcoma

Hoʻomaka ka Chondrosarcoma i kaʻiʻo cartilaginous. ʻO ka cartilage kahi ʻano o nā mea hoʻopili e uhi i nā wēlau o nā iwi a laina i nā hono. Hana pinepine ʻo Chondrosarcoma i ka pelvis, ka wāwae kiʻekiʻe, a me ka poʻohiwi a ulu mālie, ʻoiai kekahi manawa hiki ke ulu koke a pāhola ʻia i nā ʻāpana ʻē aʻe o ke kino. Kū pinepine ʻo Chondrosarcoma i nā mākua makua (ma luna o 40 mau makahiki). Hoʻonui ka makaʻi me ka neʻe ʻana o ka makahiki. ʻO kahi ʻano chondrosarcoma kakaikahi i kapa ʻia ʻo extraskeletal chondrosarcoma ʻaʻole ia e hana i ka iwi iwi. Akā, hana ia i nā mea palupalu o ka ʻaoʻao luna o nā lima a me nā wāwae.

Ewing sarcoma

Kū pinepine ʻo Ewing sarcoma i ka iwi akā hiki iki paha ke ala aʻe i nā mea palupalu (nāʻiʻo, nā momona, nā mea fibrous, nā kīʻaha koko, a me nā mea ʻē aʻe e kākoʻo ana). Hoʻokumu maʻamau ʻo Ewing sarcomas i ka pelvis, nā wāwae, a i ʻole nā ​​iwi ʻaoʻao, akā hiki ke hana i kekahi iwi (3). Piʻi koke kēia tumo a pāhola aku i nā ʻāpana ʻē aʻe o ke kino, me nā akemāmā. ʻOi aku ka makaʻu o ka Ewing sarcoma i nā keiki a me nā ʻōpio ma mua o 19 mau makahiki. E hoʻomohala paha nā keikikāne iā Ewing sarcoma ma mua o nā kaikamahine. ʻOi aku ka maʻamau o ka Ewing sarcoma i nā keʻokeʻo ma mua o nā ʻeleʻele a i ʻole nā ​​ʻAsia.

ʻO Chordoma

ʻO Chordoma kahi tumo laha ʻole e hana i nā iwi o ka iwi kuamoʻo. Kū pinepine kēia mau tumors i nā mākua makua a hana ma ke kumu o ka iwi kuamoʻo (saktum) a ma ke kumu o ka iwi poʻo. Ma kahi o ʻelua mau kāne a ʻo ka wahine e ʻike ʻia me ka chordoma. Ke hiki lākou i ka poʻe ʻōpio a me nā keiki, ʻike pinepine ʻia lākou ma ke kumu o ka iwi poʻo a me ka iwi ʻāʻī (ʻāʻī).

Hiki i kekahi ʻano o nā ʻāʻī iwi benign, i nā manawa kakaikahi, lilo i mea ʻino a pāhola ʻia i nā ʻāpana ʻē aʻe o ke kino (4). Hoʻopili kēia i nā tumo o ka iwi nui (i kapa ʻia hoʻi ʻo osteoclastoma) a me ka osteoblastoma. ʻO ka tumo pūnaewele nui o ka iwi ka hopena ma nā wēlau o nā iwi lōʻihi o nā lima a me nā wāwae, kokoke pinepine i ka hui kuli (5). ʻO kēia mau tumors, i hana mau ʻia i ka poʻe ʻōpio a me nā makahiki waena, hiki ke lilo i ka huhū kūloko, e luku ana i ka iwi. I nā hihia maʻamau hiki iā lākou ke hoʻolaha (metastasize), pinepine i nā akemāmā. Hoʻololi ʻo Osteoblastoma i nāʻiʻo iwi paʻakikī paʻakikī me kahi ʻano nāwaliwali i kapa ʻia ʻo osteoid. Kūpono kēia tumo i ka iwi kuamoʻo (6). Ke ulu lohi a ulu nei i ka poʻe ʻōpio a me waena. Ua hōʻike ʻia nā hihia kakaikahi o kēia tumo e lilo i mea hōʻino.

He aha nā kumu kūpono o ka maʻi ʻaʻai iwi?

ʻOiai ʻaʻohe kumu kikoʻī i wehewehe ʻia i ka maʻi ʻaʻa iwi nui, ua ʻike nā mea noiʻi i nā kumu he nui e hoʻonui i ka likelike o ka ulu ʻana o kēia mau tumors.

• ʻO ka mālama mua ʻana i ka maʻi ʻaʻai me ka radiation, chemotherapy, a i ʻole ke transplantation o ke koʻokoʻo koʻokoʻo. Kū pinepine ʻo Osteosarcoma i ka poʻe i loaʻa i ka lāʻau nui i waho o ka radiation radiation (ʻo ia hoʻi ma kahi o ke kino kahi i hāʻawi ʻia ai ka radiation) a i ʻole ka lapaʻau ʻana me kekahi mau lāʻau anticancer, ʻo ia hoʻi nā ʻākena alkylating; ʻo ka poʻe i mālama ʻia i ka wā kamaliʻi. Hoʻohui ʻia, hoʻomohala ka osteosarcoma i kahi pākēneka liʻiliʻi (ma kahi o 5%) o nā keiki e hele nei i ka myeloablative hematopoietic stem cell transplantation.

• Nā kūlana hoʻoili.ʻO kahi helu liʻiliʻi o nā maʻi ʻaʻai iwi ma muli o nā kūlana hoʻoilina (3). ʻO kahi laʻana, ʻo nā keiki i loaʻa ka retinoblastoma hereditary (kahi maʻi ʻaʻa maʻamau o ka maka) i ka nui o ka makaʻu o ka hoʻomōhala ʻana i ka osteosarcoma, ke nānā pono ʻia me ka radiation. ʻO nā lālā o nā ʻohana me ka maʻi Li-Fraumeni ma ka nui o ka makaʻu o ka osteosarcoma a me ka chondrosarcoma a me nā ʻano maʻi ʻē aʻe. Hoʻohui ʻia, ʻo ka poʻe i loaʻa nā kīnā hoʻoilina o nā iwi i ka nui o ka pilikia o ke kūkulu ʻana i ka chondrosarcoma. Hoʻopili ʻia ka chordoma kamaliʻi i ka complex tuberous sclerosis complex, kahi maʻi genetical kahi e kū ai nā tumo benign i nā puʻupaʻa, ka lolo, nā maka, ka puʻuwai, nā akemāmā, a me ka ʻili. ʻOiai ʻaʻole pili ikaika ʻo Ewing sarcoma me nā maʻi maʻi ʻaʻai heredity a i ʻole nā ​​maʻi ʻōpio ʻōpio (7, 8),

• Nā kūlana iwi maikaʻi. ʻO ka poʻe ma luna o 40 mau makahiki i loaʻa ka maʻi Paget o ka iwi (kahi ʻano maikaʻi i ʻike ʻia e ka hoʻomohala pono ʻole ʻana o nā iwi iwi hou) e hoʻonui ana i ka osteosarcoma.

He aha nā hōʻailona o ka maʻi ʻaʻai iwi?

ʻO ka ʻeha ka hōʻailona maʻamau o ka maʻi ʻaʻai iwi, akā ʻaʻole naʻe nā maʻi maʻi iwi āpau e ʻeha ai. ʻO ka ʻeha mau a ʻokoʻa paha a i ʻole kūhū i loko a kokoke paha i kahi iwi hiki ke kumu ʻia e ka maʻi ʻaʻai a i ʻole nā ​​ʻano ʻē aʻe. ʻO nā ʻōuli ʻē aʻe o ka maʻi ʻaʻai iwi me ka puʻupuʻu (e ʻoluʻolu a mehana paha) i nā lima, nā wāwae, ka umauma, a i ʻole pelvis; wela kuni ʻole; a he iwi haki no ke kumu ʻole i ʻike ʻia. He mea nui ia e ʻike i ke kauka e hoʻoholo i ke kumu o nā ʻōuli o nā iwi.

Pehea e ʻike ʻia ai ka maʻi ʻaʻai iwi?

E kōkua i ke kuhi ʻana i ka maʻi ʻaʻai iwi, nīnau ke kauka e pili ana i ka mōʻaukala pilikino pilikino a me ka ʻohana. Hana pū ke kauka i kahi hoʻokolohua kino a kauoha paha i ka hale hana a me nā hoʻokolohua diagnostics ʻē aʻe. Pili pū paha kēia mau hoʻāʻo i kēia mau mea:

• X-kukuna, hiki ke hōʻike i kahi, ka nui, a me ke ʻano o kahi tumo iwi. Inā hōʻike nā x-ray i kahi maʻi maʻi ʻaʻai paha, e ʻōlelo paha ke kauka i nā hoʻokolohua kiʻi kūikawā. ʻOiai inā e hōʻike nā x-ray i kahi ʻano maikaʻi ʻole o kahi wahi, makemake paha ke kauka e hana hou i nā hoʻokolohua, keu hoʻi inā ʻike ka mea maʻi i ka ʻeha mau a hoʻomau paha.

• ʻO kahi scan iwi, kahi hoʻāʻo kahi e hoʻokomo ʻia ai kahi mea liʻiliʻi o ka mea radioactive i loko o kahi kīʻaha koko a hele ma waena o ke kahe koko; ʻohiʻohi ia i nā iwi a ʻike ʻia e kahi scanner.

• ʻO kahi scan tomography i helu ʻia (CT a i ʻole CAT), kahi ʻano o nā kiʻi kikoʻī o nā wahi i loko o ke kino, i lawe ʻia mai nā ʻaoʻao ʻokoʻa, i haku ʻia e kahi kamepiula e pili ana i kahi mīkini x-ray.

• ʻO ke kaʻina hana kiʻi magnetic (MRI), kahi e hoʻohana ai i ka magnet ikaika i hoʻopili ʻia i kahi kamepiula e hana i nā kiʻi kikoʻī o nā wahi i loko o ke kino me ka hoʻohana ʻole i nā kukuna x.

• ʻO kahi scan tomography emission positron (PET), kahi e hoʻokomo ʻia ai kahi glucose liʻiliʻi o ka radioactive (kō) i loko o kahi aa, a hoʻohana ʻia kahi scanner e hana i nā kiʻi kikoʻī, kamepiula o nā wahi i loko o ke kino kahi e hoʻohana ʻia ai ka glucose. Ma muli o ka hoʻohana pinepine ʻana o nā hunaola maʻi ʻaʻai i ka glucose ma mua o nā hunaola maʻamau, hiki ke hoʻohana ʻia i nā kiʻi e ʻike i nā hunaola maʻi ʻaʻai i loko o ke kino.

• ʻO kahi angiogram, kahi x-ray o nā kīʻaha koko.

• ʻO Biopsy (ka hemo ʻana o kahi kiko kiko mai ka iwi iwi) e hoʻoholo inā aia ka maʻi ʻaʻai. Hiki i ke kaukipoki ke hana i kahi biopsy nila, kahi biopsy kūikawā, a he biopsy incisional paha. I ka wā o kahi biopsy o ka nila, hana ka lāʻau lapaʻau i kahi puka liʻiliʻi i ka iwi a hemo i kahi laʻana o nā kiko mai ka puʻupuʻu me kahi mea e like me ka nila. No ka biopsy kūwaho, wehe ke kauka lāʻau i kahi puʻupuʻu āpau a i ʻole kahi wahi kānalua no ka ʻike. I loko o kahi biopsy incisional, ʻokiʻoki ke kauka i loko o ka tumelo a hemo i kahi hāpana o kaʻaʻaʻa. Hana maikaʻi ʻia nā biopsies e kahi oncologist orthopedic (kahi kauka i ʻike ʻia i ka mālama ʻana i ka maʻi ʻaʻai iwi) no ka mea ʻo ke kau ʻana i ka ʻokiʻoki biopsy hiki ke hoʻohuli i nā koho ʻoki aʻe. Nānā kahi pathologist (kahi kauka nāna e kuhikuhi i ka maʻi ma ke aʻo ʻana i nā hunaola a me nā mea maʻa ma lalo o kahi microscope) e nānā inā he maʻi ʻaʻai paha ia.

• ʻO nā hoʻokolohua koko e hoʻoholo i nā pae o ʻelua mau enzyme i kapa ʻia ʻo alkaline phosphatase a me lactate dehydrogenase. Loaʻa paha nā nui o kēia mau enzyme i ke koko o ka poʻe me ka osteosarcoma a i ʻole ka Ewing sarcoma. ʻO ke kiʻekiʻe o ke koko o ka alkaline phosphatase ke hana nui nā hunaola e hana ana i ka iwi iwi — ke ulu nei nā keiki, ke hoʻonui ʻia kahi iwi haʻihaʻi, a i ʻole ke hana ʻia nei kahi maʻi a me kahi tumo i ka hana ʻana o nā iwi iwi maʻamau. No ka mea maʻamau nā pae kiʻekiʻe o nā alkaline phosphatase i ka ulu ʻana o nā keiki a me nā ʻōpio, ʻaʻole kēia hōʻike i kahi hōʻailona pono o ka maʻi ʻaʻai iwi.

Pehea e mālama ʻia ai ka maʻi ʻaʻai iwi mua?

Pili nā koho lapaʻau i ke ʻano, ka nui, kahi, a me ke kahua o ka maʻi ʻaʻai, a me ka makahiki o ke kanaka a me ke olakino laulā. ʻO nā koho lapaʻau no ka maʻi ʻaʻai iwi me ke kīʻaha, chemotherapy, radiation radiation, cryosurgery, a me ka hoʻomōhala hoʻomōhala.

• ʻO ke ʻoki lāʻau ka lāʻau maʻamau no ka maʻi ʻaʻai iwi. Lawe ke kaukōkō i ka tumo holoʻokoʻa me nā palena maikaʻi ʻole (ʻo ia hoʻi, ʻaʻohe mau pūnaʻi maʻi ʻaʻai i loaʻa ma ka lihi o ka mea i lawe ʻia i ka wā o ke ʻoki kino). Hiki i ke kaukipoki ke hoʻohana i nā hana ʻoki kūikawā e hōʻemi i ka nui o nā mea olakino i hoʻoneʻe ʻia me ka tumo. ʻO ka hoʻomaikaʻi hou ʻana i nā hana ʻokiʻoki a me ka hoʻomaʻemaʻe tumora mua i hiki ai i ka hapanui o nā mea maʻi me ka maʻi ʻaʻai iwi i ka lima a me ka wāwae e hōʻole i nā kaʻina hana radical (ʻo ia hoʻi, ka hemo ʻana o ka lālā holoʻokoʻa). Eia nō naʻe, ʻo ka hapa nui o nā mea maʻi e hana i ka ʻoki ʻana i ka lālā e pono ai i ke ʻoki hou e hoʻi hou i ka hana o nā lālā (3).

• ʻO Chemotherapy ka hoʻohana ʻana i nā lāʻau anticancer e pepehi i nā hunaola maʻi ʻaʻai. ʻO nā mea maʻi i loaʻa iā Ewing sarcoma (ʻike hou ʻia a hoʻi hou ʻia) a i ʻole o ka osteosarcoma hou i ʻike pinepine ʻia e loaʻa i kahi hui o nā lāʻau anticancer ma mua o ka hana ʻoki ʻana. ʻAʻole hoʻohana pinepine ʻia ʻo Chemotherapy e mālama i ka chondrosarcoma a i ʻole chordoma (3).

• ʻO ka radiation radiation, i kapa ʻia ʻo radiotherapy, pili i ka hoʻohana ʻana o nā x-ray ikaika loa e pepehi i nā hunaola maʻi ʻaʻai. Hiki ke hoʻohana ʻia kēia lāʻau lapaʻau me ka ʻoki kino. Hoʻohana pinepine ʻia e mālama iā Ewing sarcoma (3). Hiki nō ke hoʻohana ʻia me nā ʻano lāʻau ʻē aʻe no ka osteosarcoma, chondrosarcoma, a me ka chordoma, ʻoiai ke waiho iki kahi maʻi ʻaʻai ma hope o ke kaha ʻana. Hiki ke hoʻohana ʻia no nā mea maʻi ʻaʻole ʻokiʻoki. ʻO kahi mea radioactive e hōʻiliʻili i ka iwi, i kapa ʻia ʻo samarium, kahi ʻano o ka radiation radiation i hiki ke hoʻohana ʻia a i ʻole me ka transplant cell stem e mālama ai i ka osteosarcoma i hoʻi mai ma hope o ka lapaʻau ʻana. i ka iwi ʻokoʻa.

• ʻO Cryosurgery ka hoʻohana ʻana o ka nitrogen wai e paʻa a pepehi i nā hunaola maʻi ʻaʻai . Hiki ke hoʻohana i kēia ʻenehana i kekahi manawa ma kahi o ke kaha maʻamau e luku i nā tumors i ka iwi (10).

• Hoʻomāka Inc o ka hoʻohana 'ana i ka lāʻau i ua papahana e pāʻani aku me kekahi mau' lātoma komo i loko o ka ulu a me ka laha ana o Ka maʻi 'aʻai keena. ʻO ka monoclonal antibody denosumab (Xgeva®) kahi lāʻau i hoʻomākaukau ʻia e ʻae ʻia e mālama i nā mākua a me nā ʻōpio makua skeletally me ka iwi tumone nui o ka iwi i hiki ʻole ke hemo me ke ʻoki. Pale ia i ka luku ʻia ʻana o ka iwi i hoʻokumu ʻia e kekahi ʻano iwi iwi i kapa ʻia he osteoclast.

Hiki ke ʻike hou aku i ka ʻike e pili ana i ka mālama ʻana i nā ʻano maʻi ʻino o nā iwi i loko o nā hōʻuluʻulu maʻi maʻi maʻi ®:

• Hoʻomaʻo Ewing Sarcoma

• ʻO Osteosarcoma a me Malignant Fibrous Histiocytoma o ka mālama ʻana i ka iwi

• Nā maʻi ʻōlohelohe maʻamau ʻole o ka hoʻomaʻamaʻa kamaliʻi (ʻāpana ma Chordoma)

He aha nā hopena o ka mālama ʻana no ka maʻi ʻaʻai iwi?

ʻO ka poʻe i mālama ʻia no ka maʻi ʻaʻai iwi e hoʻonui i ka likelike o ka hoʻomōhala ʻana i nā hopena o ke ola ʻana i ko lākou mau makahiki. Pili kēia hopena hopena i ke ʻano o ka mālama ʻana a me nā makahiki o ka mea maʻi ma ka mālama ʻana a me nā pilikia o ke kino e pili ana i ka puʻuwai, ka māmā, ka lohe ʻana, ka momona, a me ka iwi; nā pilikia neurological; a me nā maʻi ʻelua (ka maʻi myeloid leukemia, myelodysplastic syndrome, a me radiation-induced sarcoma). ʻO ka mālama ʻana i nā pūpū iwi me ka cryosurgery hiki i ka luku ʻia ʻana o nā iwi iwi kokoke a hopena i nā haki, akā ʻaʻole ʻike ʻia kēia mau hopena no kekahi manawa ma hope o ka hana mua.

Hoʻomaʻamaʻa ka maʻi ʻaʻai iwi i kekahi manawa, keu hoʻi i nā akemāmā, a i ʻole hiki ke hoʻi hou (hoʻi), ma ka wahi like a i ʻole nā ​​iwi ʻē aʻe i ke kino. ʻO ka poʻe i loaʻa i ka maʻi ʻaʻa iwi e ʻike pinepine i kā lākou kauka a pono e hōʻike koke i nā ʻōuli maʻamau ʻole. Hoʻololi nā ukali no nā ʻano like ʻole a me nā pae o ka maʻi ʻaʻai iwi. ʻO ka mea maʻamau, nānā pinepine ʻia nā mea maʻi e kā lākou kauka a loaʻa i nā hoʻokolohua koko maʻamau a me nā kukuna x. Mālama ka mālama ʻana maʻamau i ke kūkākūkā ʻana i nā loli i ke olakino a mālama ʻia nā pilikia i ka wā hiki loa.

Nā kūmole i koho ʻia '

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