Mitundu / khansa yaubwana / wodwala / khansa yachilendo-ubwana-pdq

Khansa Yachilendo ya Chithandizo cha Ana (?)

Zambiri Zokhudza Khansa Yachilendo Yaubwana

MFUNDO ZOFUNIKA

• Khansa yachilendo yaubwana ndi khansa yomwe samawonedwa kawirikawiri mwa ana.

• Mayeso amagwiritsidwa ntchito kuti azindikire (kupeza), kuzindikira, komanso kukhazikitsa khansa yachilendo yaubwana.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa yachilendo yaubwana ndi khansa yomwe samawonedwa kawirikawiri mwa ana.

Khansa mwa ana ndi achinyamata ndiyosowa. Kuyambira 1975, chiwerengero cha anthu omwe ali ndi khansa yatsopano yaubwana chikuwonjezeka pang'onopang'ono. Chiyambire 1975, kuchuluka kwa omwe amwalira ndi khansa yaubwana kwatsika kupitirira theka.

Khansa yachilendo yomwe yafotokozedwa mwachidule ndi yosowa kwambiri kotero kuti zipatala zambiri za ana zimatha kuwona zochepa mwa mitundu ina m'zaka zingapo. Chifukwa khansa zachilendo ndizosowa, palibe zambiri pazomwe mankhwala amagwirira ntchito bwino. Chithandizo cha mwana nthawi zambiri chimazikidwa pazomwe aphunzira pochiza ana ena. Nthawi zina, zidziwitso zimapezeka kokha kuchokera ku malipoti akupezeka, chithandizo, ndikutsatiridwa kwa mwana m'modzi kapena kagulu kakang'ono ka ana omwe adapatsidwa mankhwala amtundu womwewo.

Khansa zosiyanasiyana zimafotokozedwa mwachidule. Amagawidwa m'magulu momwe amapezeka mthupi.

Mayeso amagwiritsidwa ntchito kuti azindikire (kupeza), kuzindikira, komanso kukhazikitsa khansa yachilendo yaubwana.

Kuyesedwa kumachitika kuti azindikire, azindikire, komanso khansa yapakati. Mayeso omwe amagwiritsidwa ntchito amatengera mtundu wa khansa. Khansa itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira kuchokera pomwe khansayo idayamba kupita mbali zina za thupi. Njira yomwe amagwiritsidwa ntchito pofufuza ngati maselo a khansa afalikira mbali zina za thupi amatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo chabwino kwambiri.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito kuzindikira, kuzindikira, ndi khansa yapagawo:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikizapo kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

• X-ray: X-ray ndi mtundu wa mphamvu yamagetsi yomwe imatha kupyola thupi ndikulowa mufilimu.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

Kusanthula kwam'mimba kwa kompyuta. Mwanayo wagona patebulo lomwe limadutsa pa scanner ya CT, yomwe imatenga zithunzi za x-ray zamkati mwamimba.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira.

Kusanthula kwa Positron emission tomography (PET). Mwanayo wagona patebulo lomwe limadutsa pa makina a PET. Kupuma kwamutu ndi kansalu koyera kumathandiza mwanayo kugona. Kagawidwe kakang'ono ka shuga (radio) kamene kamabayidwa mu mtsempha wa mwanayo, ndipo sikaniyo imapanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo a khansa amawonekera bwino pachithunzichi chifukwa amatenga shuga wambiri kuposa momwe maselo amachitira.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito ndi mawailesi kupanga zithunzi zingapo mwatsatanetsatane zamkati mwa thupi. Zithunzizo zimapangidwa ndi kompyuta. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

Kujambula kwamaginito (MRI) pamimba. Mwanayo wagona patebulo lomwe limalowa mu sikani ya MRI, yomwe imatenga zithunzi zamkati mwa thupi. Pedi pamimba pamwana limathandizira kuti zithunzizo zizimveka bwino.

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.

M'mimba ultrasound. Transducer ya ultrasound yolumikizidwa ndi kompyuta imakanikizidwa pakhungu la pamimba. Transducer imaponya mafunde am'mimba ndi ziwalo zamkati kuti apange ma echo omwe amapanga sonogram (chithunzi cha pakompyuta).

• Endoscopy: Ndondomeko yoyang'ana ziwalo ndi zotupa mkati mwa thupi kuti muwone ngati pali zovuta zina. Endoscope imalowetsedwa kudzera mu cheka (khungu) pakhungu kapena potsegula mthupi, monga pakamwa kapena pakhosi. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu kapena ma lymph node, omwe amayang'aniridwa ndi microscope ngati ali ndi matenda.

Pamwamba endoscopy. Thupi laling'ono, lowala limalowetsedwa mkamwa kuti liwone malo osakhazikika pammero, m'mimba, ndi gawo loyamba la m'mimba.

• Kujambula mafupa: Njira yowunika ngati pali magawo omwe amagawa mwachangu, monga maselo a khansa, m'mafupa. Katundu wocheperako kwambiri wa jakisoni amalowetsedwa mumtsempha ndikuyenda m'magazi. Zinthu zowononga nyukiliya zimasonkhanitsa m'mafupa omwe ali ndi khansa ndipo imadziwika ndi sikani.

Kujambula mafupa. Katundu wambiri wama radio amabayidwa mumitsempha ya mwana ndikuyenda m'magazi. Zinthu zakuthupi zimasonkhanitsa m'mafupa. Mwanayo akugona patebulo lomwe limayenda pansi pa sikani, zida zowulutsa ma radio zimapezeka ndipo zithunzi zimapangidwa pakompyuta.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Pali mitundu yambiri yamachitidwe a biopsy. Mitundu yofala kwambiri ndi iyi:

• Zabwino-singano aspiration (FNA) biopsy: Kuchotsa minofu kapena madzi pogwiritsa ntchito singano yopyapyala.

• Core biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu.

• Incopal biopsy: Kuchotsa gawo limodzi kapena mtundu wina wa minofu yomwe sikuwoneka bwino.

• Chidwi chodabwitsa: Kuchotsa chotupa chonse kapena gawo la mnofu lomwe silikuwoneka bwino.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

• Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

• Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati khansa ya chithokomiro imafalikira m'mapapu, maselo am'mapapo m'mapapo mwake ndimaselo a khansa ya chithokomiro. Matendawa ndi khansa ya chithokomiro, osati khansa ya m'mapapo.

Imfa yambiri ya khansa imayamba khansa ikamachoka pachotupa choyambirira ndikufalikira kumatenda ena ndi ziwalo. Izi zimatchedwa khansa ya m'matumbo. Makanema ojambulawa amawonetsa momwe ma cell a khansa amayendera kuchokera mthupi momwe adapangidwira kumadera ena amthupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi khansa yachilendo.

• Ana omwe ali ndi khansa yachilendo ayenera kukonzekera mankhwala awo ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandiza khansa kwa ana.

• Mitundu isanu ndi inayi yothandizidwa moyenera imagwiritsidwa ntchito:

• Opaleshoni

• Thandizo la radiation

• Chemotherapy

• Chemotherapy yamphamvu kwambiri yopulumutsa ma cell a autologous

• Thandizo la mahomoni

• Chitetezo chamatenda

• Kudikira kudikira

• Chithandizo chofuna

• Kuphatikiza

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Mankhwala a Gene

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

• Chithandizo cha khansa yachilendo yaubwana chingayambitse mavuto.

Pali mitundu yosiyanasiyana ya chithandizo cha ana omwe ali ndi khansa yachilendo.

Pali mitundu yosiyanasiyana ya mankhwala kwa ana omwe ali ndi khansa. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba.

Chifukwa khansa mwa ana ndiyosowa, kutenga nawo mbali pakuyesa kwachipatala kuyenera kuganiziridwa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Ana omwe ali ndi khansa yachilendo ayenera kukonzekera mankhwala awo ndi gulu la othandizira azaumoyo omwe ndi akatswiri othandiza khansa kwa ana.

Chithandizo chidzayang'aniridwa ndi oncologist wa ana, dokotala yemwe amadziwika bwino pochiza ana omwe ali ndi khansa. Katswiri wa oncologist amagwira ana ndi othandizira ena othandizira zaumoyo omwe ndi akatswiri pochiza ana omwe ali ndi khansa komanso omwe amadziwika bwino pamankhwala ena. Izi zingaphatikizepo akatswiri awa:

• Dokotala wa ana.

• Dokotala wa ana.

• Dokotala wa hematologist.

• Wofufuza oncologist.

• Katswiri wa namwino wa ana.

• Katswiri wokonzanso.

• Katswiri wazamaphunziro.

• Wogwira ntchito.

• Katswiri wa zamaganizo.

Mitundu isanu ndi inayi yothandizidwa moyenera imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni ndi njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa ilipo, kuchotsa khansa mthupi, kapena kukonza gawo la thupi. Kuchita opaleshoni yothandizira kumachitika kuti athetse zizindikiro zomwe zimayambitsidwa ndi khansa. Opaleshoni amatchedwanso opaleshoni.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena atha kupatsidwa chemotherapy kapena radiation pochita opaleshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, amatchedwa adjuvant therapy.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu yosiyanasiyana ya mankhwalawa:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

Thandizo la radiation la radiation ndi mtundu wa mphamvu yayikulu, mankhwala owonekera kunja. Makina othandizira ma radiation amayang'ana mitsinje yama proton (tinthu tating'onoting'ono, tosaoneka, tomwe timayikidwa bwino) m'maselo a khansa kuti tiwaphe. Chithandizo chamtunduwu sichimawononga pang'ono minofu yabwinobwino yapafupi.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive omwe amalowetsedwa mthupi kapena osindikizidwa mu singano, mbewu, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

• Thandizo la 131I-MIBG (radioactive iodine) ndi mtundu wamankhwala amkati omwe amagwiritsidwa ntchito pochiza pheochromocytoma ndi paraganglioma. Iodini ya radioactive imaperekedwa mwa kulowetsedwa. Amaloŵa m'magazi ndi kusonkhanitsa mitundu ina ya zotupa, ndikuzipha ndi cheza chomwe chimaperekedwa.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu wa khansa yomwe ikuthandizidwa.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kukhudza ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, matupi am'mimba monga pamimba, kapena chiwalo, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo. Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa. Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.

Chemotherapy yamphamvu kwambiri yopulumutsa ma cell a autologous

Mlingo waukulu wa chemotherapy umaperekedwa kuti uphe ma cell a khansa. Maselo athanzi, kuphatikiza maselo opanga magazi, nawonso amawonongedwa ndi chithandizo cha khansa. Kupulumutsa ma cell ndi chithandizo m'malo mwa maselo omwe amapanga magazi. Maselo opangira magazi (maselo osakhwima amwazi) amachotsedwa m'magazi kapena m'mafupa a wodwalayo ndipo amawundana ndikusungidwa. Wodwalayo akamaliza chemotherapy, maselo osungidwa amasungunuka ndikubwezeretsedwanso mwa kulowetsedwa. Maselo amtundu wobwezeretsansowa amakula (ndikubwezeretsanso) maselo amthupi.

Thandizo la mahomoni

Thandizo la mahomoni ndi mankhwala a khansa omwe amachotsa mahomoni kapena amalepheretsa zochita zawo ndikuletsa maselo a khansa kuti asakule. Mahomoni ndi zinthu zomwe zimapangidwa ndi tiziwalo timene timatuluka m'thupi ndipo timayenda m'magazi. Mahomoni ena amatha kupangitsa khansa kukula. Ngati kuyesa kukuwonetsa kuti ma cell a khansa ali ndi malo omwe mahomoni amatha kulumikiza (receptors), mankhwala osokoneza bongo, opareshoni, kapena mankhwala a radiation amagwiritsidwa ntchito pochepetsa mahomoni kapena kuwaletsa kuti asagwire ntchito. Mankhwala a Hormone okhala ndi mankhwala otchedwa corticosteroids atha kugwiritsidwa ntchito pochiza thymoma kapena thymic carcinoma.

Mankhwala a mahomoni okhala ndi somatostatin analogue (octreotide kapena lanreotide) atha kugwiritsidwa ntchito pochiza zotupa za neuroendocrine zomwe zafalikira kapena zomwe sizingachotsedwe ndi opaleshoni. Octreotide itha kugwiritsidwanso ntchito kuchiza thymoma yomwe siyankha mankhwala ena. Mankhwalawa amaletsa mahomoni owonjezera kuti asapangidwe ndi chotupa cha neuroendocrine. Octreotide kapena lanreotide ndizofanana ndi somatostatin zomwe zimayikidwa pansi pa khungu kapena muminyewa. Nthawi zina mankhwala ochepetsa mphamvu ya radioak amaphatikizidwa ndi mankhwalawa ndipo cheza chake chimapheranso maselo a khansa. Izi zimatchedwa peptide receptor radionuclide therapy.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

• Interferon: Interferon imakhudza kugawanika kwa maselo a khansa ndipo imatha kuchepetsa kukula kwa chotupa. Amagwiritsidwa ntchito pochiza khansa ya nasopharyngeal ndi papillomatosis.

• Matenda a Epstein-Barr (EBV) -ma cytotoxic T-lymphocyte: Maselo oyera amwazi (T-lymphocytes) amathandizidwa ku labotale ndi kachilombo ka Epstein-Barr kenako amapatsidwa wodwalayo kuti athandize chitetezo cha mthupi ndikulimbana ndi khansa. Matenda a cytotoxic T-lymphocyte akuwerengedwa kuti athe kuchiza khansa ya nasopharyngeal.

• Thandizo la katemera: Chithandizo cha khansa chomwe chimagwiritsa ntchito chinthu kapena gulu la zinthu kulimbikitsa chitetezo cha mthupi kuti chipeze chotupacho ndi kuchipha. Mankhwala a katemera amagwiritsidwa ntchito pochiza papillomatosis.

• Mankhwala oteteza ku chitetezo cha mthupi: Mitundu ina yamaselo amthupi, monga ma T cell, ndi ma cell ena a khansa ali ndi mapuloteni ena, omwe amatchedwa checkpoint protein, kumtunda kwawo omwe amayang'anira kuyankha kwa chitetezo cha mthupi. Maselo a khansa ali ndi mapuloteni ambiri, samenyedwa ndikuphedwa ndi ma T. Chitetezo cha chitetezo cha mthupi chimatseka mapuloteniwa ndipo kuthekera kwa maselo a T kupha ma cell a khansa kumakulitsidwa.

Pali mitundu iwiri ya chitetezo cha chitetezo cha mthupi:

• CTLA-4 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. CTLA-4 ikamangirira puloteni ina yotchedwa B7 pa khungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. CTLA-4 inhibitors amadziphatika ku CTLA-4 ndikulola ma T maselo kupha ma cell a khansa. Ipilimumab ndi mtundu wa CTLA-4 inhibitor. Ipilimumab itha kuganiziridwa ngati chithandizo cha khansa yapakhosi yomwe ili pachiwopsezo chachikulu yomwe idachotsedwa kwathunthu pakuchita opaleshoni. Ipilimumab imagwiritsidwanso ntchito ndi nivolumab pochiza ana ena omwe ali ndi khansa yoyipa.

Chitetezo cha chitetezo cha mthupi. Mapuloteni a checkpoint, monga B7-1 / B7-2 pama cell antigen-presenting cell (APC) ndi CTLA-4 pama cell a T, amathandizira kuteteza mayankho a chitetezo cha mthupi. T-cell receptor (TCR) ikamangirira ku antigen komanso mapuloteni akuluakulu a histocompatibility complex (MHC) pa APC ndi CD28 amamangiriza ku B7-1 / B7-2 pa APC, T cell imatha kuyatsidwa. Komabe, kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 kumapangitsa kuti ma T maselo akhale osagwira ntchito kotero kuti sangathe kupha ma cell am'mimba mthupi (kumanzere). Kuletsa kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 yokhala ndi chitetezo cha chitetezo cha mthupi (anti-CTLA-4 antibody) kumalola ma T kuti azitha kugwira ntchito ndikupha ma cell a chotupa (gulu lamanja).

• PD-1 ndi puloteni pamwamba pamaselo a T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. PD-1 ikamangirira puloteni ina yotchedwa PDL-1 pakhungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. PD-1 inhibitors amadziphatika ku PDL-1 ndikulola ma T maselo kupha ma cell a khansa. Nivolumab ndi mtundu wa PD-1 inhibitor. Nivolumab imagwiritsidwa ntchito ndi ipilimumab pochiza ana ena omwe ali ndi khansa yoyipa. Pembrolizumab ndi nivolumab amagwiritsidwa ntchito pochiza khansa yapakhungu yomwe yafalikira mbali zina za thupi. Nivolumab ndi pembrolizumab akuwerengedwa pochiza khansa ya khanda kwa ana ndi achinyamata. Chithandizo cha mankhwala awiriwa chaphunziridwa makamaka mwa akulu.

Chitetezo cha chitetezo cha mthupi. Mapuloteni owunika, monga PD-L1 pama cell a chotupa ndi PD-1 pama cell a T, amathandizira kuyang'anira mayankho amthupi. Kumanga kwa PD-L1 mpaka PD-1 kumapangitsa kuti ma T asaphe ma cell am'mimba (gulu lakumanzere). Kuletsa kumangiriza kwa PD-L1 mpaka PD-1 yokhala ndi chitetezo chodzitetezera (anti-PD-L1 kapena anti-PD-1) kumalola ma T maselo kupha ma cell a chotupa (gulu lamanja).

• BRAF kinase inhibitor therapy: BRAF kinase inhibitors amaletsa mapuloteni a BRAF. Mapuloteni a BRAF amathandizira kuchepetsa kukula kwa ma cell ndipo amatha kusintha (kusintha) mumitundu ina ya khansa. Kuletsa mapuloteni a BRAF osinthika kungathandize kuti maselo a khansa asakule. Dabrafenib, vemurafenib, ndi encorafenib amagwiritsidwa ntchito pochiza khansa ya pakhungu. Orab dabrafenib ikuphunziridwa mwa ana ndi achinyamata omwe ali ndi khansa ya pakhungu. Chithandizo cha mankhwala atatuwa makamaka amaphunzira kwa achikulire.

Kudikira kudikira

Kuyembekezera mwachidwi kumayang'anitsitsa matenda a wodwalayo osamupatsa chithandizo chilichonse mpaka zizindikilo kapena zizindikiritso zikuwoneka kapena kusintha. Kuyembekezera mwachidwi kumatha kugwiritsidwa ntchito ngati chotupacho chikukula pang'onopang'ono kapena ngati zingatheke chotupacho chitha kutha popanda chithandizo.

Chithandizo chofuna

Chithandizo choyenera ndi chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti zizindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Mitundu yamankhwala omwe amalimbana ndi khansa yachilendo yaubwana ndi awa:

• Tyrosine kinase inhibitors: Mankhwalawa amalimbana ndi zotupa kuti zikule. Vandetanib ndi cabozantinib amagwiritsidwa ntchito pochiza khansa ya chithokomiro ya medullary. Sunitinib imagwiritsidwa ntchito pochizira pheochromocytoma, paraganglioma, zotupa za neuroendocrine, thymoma, ndi thymic carcinoma. Crizotinib imagwiritsidwa ntchito pochizira zotupa za tracheobronchial.

• mTOR inhibitors: Mtundu wa mankhwala omwe amalimbana ndi mapuloteni omwe amathandiza maselo kugawanika ndikukhala ndi moyo. Everolimus imagwiritsidwa ntchito pochizira mtima, neuroendocrine, ndi zotupa zam'mimba.

• Ma antibodies a monoclonal: Mankhwalawa amagwiritsa ntchito ma antibodies opangidwa mu labotore, kuchokera ku mtundu umodzi wamatenda amthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Bevacizumab ndi antioclonal antibody yomwe imagwiritsidwa ntchito pochizira papillomatosis.

• Histone methyltransferase inhibitors: Mtundu wothandizirayi umachedwetsa khungu la khansa kuti likule ndikugawana. Tazemetostat imagwiritsidwa ntchito pochiza khansa ya m'mimba. Tazemetostat ikuwerengedwa pochiza ma chordomas omwe abwereranso atalandira chithandizo.

• MEK inhibitors: Mankhwalawa amalimbana ndi zotupa kuti zikule. Trametinib ndi binimetinib amagwiritsidwa ntchito pochiza khansa yapakhungu yomwe yafalikira mbali zina za thupi. Chithandizo cha trametinib kapena binimetinib chaphunziridwa makamaka mwa akulu.

Njira zochiritsira zikuwerengedwa pochiza khansa zina zachilendo zaubwana.

Kuphatikiza

Kuphatikizira ndi mankhwala omwe utoto wosiyanitsa ndi tinthu tina timalowetsedwa mumtsempha wa hepatic kudzera mu catheter (chubu chochepa). Tinthu timene timatseka mtsempha wamagazi, kudula magazi mpaka chotupacho. Nthawi zina mankhwala ocheperako ndi ma radio amamangiriridwa ku ma particles. Ma radiation ambiri agwidwa pafupi ndi chotupacho kuti aphe ma cell a khansa. Izi zimatchedwa radioembolization.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Mankhwala a Gene

Mankhwala a Gene ndi mankhwala omwe majini akunja (DNA kapena RNA) amalowetsedwa m'maselo amunthu kuti ateteze kapena kulimbana ndi matenda. Chithandizo cha Gene chikuwerengedwa pochiza papillomatosis.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati matenda a mwana wanu asintha kapena ngati khansa yabwereranso (kubwerera). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Chithandizo cha khansa yachilendo yaubwana chingayambitse mavuto.

Kuti mumve zambiri zamankhwala oyambilira omwe amayamba mukalandira chithandizo cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Zotsatira zoyipa za mankhwala a khansa omwe amayamba atalandira chithandizo ndikupitilira kwa miyezi kapena zaka amatchedwa zotsatira zakuchedwa. Zotsatira zakumapeto kwa chithandizo cha khansa zitha kuphatikizira izi:

• Mavuto athupi.

• Kusintha kwa malingaliro, malingaliro, kuganiza, kuphunzira, kapena kukumbukira.

• Khansa yachiwiri (mitundu yatsopano ya khansa).

Zotsatira zina mochedwa zimatha kuthandizidwa kapena kuwongoleredwa. Ndikofunika kuti mulankhule ndi madotolo a mwana wanu pazomwe zingachitike chifukwa chakumapeto kwa khansa komanso chithandizo cha khansa. (Onani chidule cha pa Zotsatira Zotsiriza za Chithandizo cha Khansa ya Ana kuti mumve zambiri).

Khansa Yachilendo ya Mutu ndi Khosi

M'chigawo chino

• Khansa ya Nasopharyngeal

• Esthesioneuroblastoma

• Zotupa za chithokomiro

• Khansa Yamlomo Yamlomo

• Zotupa za Salivary Gland

• Khansa ya Laryngeal ndi Papillomatosis

• Khansa ya Midline Tract yokhala ndi NUT Gene Changes (NUT Midline Carcinoma)

Khansa ya Nasopharyngeal

Onani chidule cha pa Chithandizo cha Khansa ya Ana Nasopharyngeal kuti mumve zambiri.

Esthesioneuroblastoma

Onani chidule cha pa Chithandizo cha Ubwana Esthesioneuroblastoma Kuti mumve zambiri.

Zotupa za chithokomiro

Onani chidule cha pa Chithandizo cha Khansa ya Chithokomiro cha Ana kuti mumve zambiri.

Khansa Yamlomo Yamlomo

Onani chidule cha pa Chithandizo cha Cancer Oral Cavity Cancer kuti mumve zambiri.

Zotupa za Salivary Gland

Onani chidule cha pa Chithandizo cha Ubwana Salivary Gland Tumors Treatment kuti mumve zambiri.

Khansa ya Laryngeal ndi Papillomatosis

Onani chidule cha pa Chithandizo cha Childhood Laryngeal Tumors Treatment kuti mumve zambiri.

Khansa ya Midline Tract yokhala ndi NUT Gene Changes (NUT Midline Carcinoma)

Onani chidule cha pa Childhood Midline Tract Carcinoma ndi NUT Gene Changes Treatment kuti mumve zambiri.

Khansa Yachilendo ya Chifuwa

M'chigawo chino

• Khansa ya m'mawere

• Khansa Yam'mapapo

• Zotupa za Esophageal

• Thymoma ndi Thymic Carcinoma

• Zotupa Zamtima (Mtima)

• Mesothelioma

Khansa ya m'mawere

Onani chidule cha pa Chithandizo cha Khansa ya M'mawere kuti mudziwe zambiri.

Khansa Yam'mapapo

Onani zidule za zotsatirazi kuti mumve zambiri:

• Chithandizo cha Ana Tracheobronchial Tumors Chithandizo

• Kuchiza Kwachinyamata kwa Bluroma Blastoma

Zotupa za Esophageal

Onani chidule cha pa Chithandizo cha Khansa ya Esophageal Cancer kuti mumve zambiri.

Thymoma ndi Thymic Carcinoma

Onani chidule cha pa Chithandizo cha Ubwana Thymoma ndi Thymic Carcinoma kuti mumve zambiri.

Zotupa Zamtima (Mtima)

Onani chidule cha pa Chithandizo cha Zotupa za Childhood Cardiac (Mtima) kuti mumve zambiri.

Mesothelioma

Onani chidule cha pa Chithandizo cha Childhood Mesothelioma Chithandizo kuti mumve zambiri.

Khansa Yachilendo Yam'mimba

M'chigawo chino

• Khansa ya m'mimba (Gastric)

• Khansa ya Pancreatic

• Khansa Yoyenera

• Zotupa za Neuroendocrine (Zotupa za Carcinoid)

• Mimba ya m'mimba Stromal Tumors

Adrenocortical Carcinoma

Adrenocortical carcinoma ndi matenda momwe maselo owopsa (khansa) amapangika kunja kwa adrenal gland. Pali zopangitsa ziwiri za adrenal. Zilonda za adrenal ndizochepa ndipo zimapangidwa ngati kansalu kakang'ono. Chidutswa chimodzi cha adrenal chimakhala pamwamba pa impso iliyonse. Chidutswa chilichonse cha adrenal chili ndi magawo awiri. Pakatikati mwa adrenal gland ndi adrenal medulla. Mbali yakunja ya adrenal gland ndi adrenal cortex. Adrenocortical carcinoma amatchedwanso khansa ya adrenal cortex.

Childhood adrenocortical carcinoma imachitika makamaka mwa odwala ochepera zaka 6 kapena zaka zaunyamata, komanso nthawi zambiri mwa akazi.

Adrenal cortex imapanga mahomoni ofunikira omwe amachita izi:

• Sungani madzi ndi mchere m'thupi.

• Thandizani kuti magazi aziyenda bwino.

• Thandizani kuwongolera momwe thupi limagwiritsira ntchito mapuloteni, mafuta, ndi chakudya.

• Pangani thupi kukhala ndimakhalidwe achimuna kapena achikazi.

Zowopsa, Zizindikiro ndi Zizindikiro, ndi Kuzindikira ndi Kuyesa Kwakanthawi

Chiwopsezo cha adrenocortical carcinoma chimawonjezeka pakukhala ndi kusintha kwina mu jini kapena ena mwa ma syndromes awa:

• Matenda a Li-Fraumeni.

• Matenda a Beckwith-Wiedemann.

• Matenda a Hemihypertrophy.

Adrenocortical carcinoma imatha kuyambitsa izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Chotupa m'mimba.

• Kupweteka m'mimba kapena kumbuyo.

• Kumva chidzalo m'mimba.

Komanso, chotupa cha adrenal cortex chimatha kugwira ntchito (chimapanga mahomoni ochulukirapo kuposa masiku onse) kapena sichimagwira (sichipanga mahomoni owonjezera). Zotupa zambiri za adrenal cortex mwa ana zimagwira ntchito zotupa. Mahomoni owonjezera omwe amapangidwa ndi zotupa amatha kuyambitsa zizindikilo kapena zizindikilo za matenda ndipo zimadalira mtundu wa mahomoni opangidwa ndi chotupacho. Mwachitsanzo, mahomoni owonjezera a androgen atha kupangitsa ana onse amuna ndi akazi kukhala ndi zizolowezi zachimuna, monga tsitsi la thupi kapena mawu akuya, amakula msanga, komanso amakhala ndi ziphuphu. Mahomoni a estrogen owonjezera amatha kuyambitsa kukula kwa minofu ya m'mawere mwa ana amuna. Mahomoni owonjezera a cortisol amatha kuyambitsa matenda a Cushing (hypercortisolism).

(Onani chidule cha pa Chithandizo Chachikulu cha Adrenocortical Carcinoma kuti mumve zambiri pazizindikiro za adrenocortical carcinoma.)

Mayeso ndi njira zomwe amagwiritsidwa ntchito pozindikira komanso kuyambitsa adrenocortical carcinoma zimadalira zizindikiro za wodwalayo. Mayeserowa ndi njirazi zitha kukhala izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kafukufuku wamagazi.

• X-ray ya chifuwa, mimba, kapena mafupa.

• Kujambula kwa CT.

• MRI.

• Sakanizani PET.

• Ultrasound.

• Biopsy (misa imachotsedwa pakuchita opareshoni kenako chitsanzocho chimayang'aniridwa ngati chili ndi khansa).

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira adrenocortical carcinoma ndi awa:

• Kuyesa mkodzo kwa maola 24 : Kuyesedwa komwe mkodzo umasonkhanitsidwa kwa maola 24 kuti muyese kuchuluka kwa cortisol kapena 17-ketosteroids. Kuchuluka kwazinthu izi mkodzo kungakhale chizindikiro cha matenda mu adrenal cortex.

• Chiyeso chotsitsa cha dexamethasone chotsika kwambiri: Chiyeso chomwe chimaperekedwa kamodzi kapena kangapo kakang'ono ka dexamethasone. Mulingo wa cortisol amayang'aniridwa kuchokera pagulu la magazi kapena mkodzo womwe umasonkhanitsidwa masiku atatu. Kuyesaku kumachitika kuti muwone ngati adrenal gland ikupanga cortisol yochulukirapo.

• Chiyeso chotsitsimutsa cha dexamethasone: Kuyesedwa komwe amapatsidwa dexamethasone imodzi kapena zingapo. Mulingo wa cortisol amayang'aniridwa kuchokera pagulu la magazi kapena mkodzo womwe umasonkhanitsidwa masiku atatu. Kuyesaku kumachitika kuti muwone ngati adrenal gland ikupanga cortisol yochulukirapo kapena ngati vuto la pituitary likuwuza ma adrenal gland kuti apange cortisol wambiri.

• Maphunziro a mahomoni amwazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa mahomoni ena omwe amatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Magazi amatha kufufuzidwa ngati testosterone kapena estrogen. Mahomoni opitilira muyeso amatha kukhala chizindikiro cha adrenocortical carcinoma.

• Adrenal angiography: Njira yoyang'ana mitsempha ndi kutuluka kwa magazi pafupi ndi adrenal gland. Utoto wosiyanasiyana umalowetsedwa m'mitsempha ya adrenal. Dye akamadutsa mumtsuko wamagazi, ma x-ray amatengedwa kuti awone ngati mitsempha iliyonse yatsekedwa.

• Adrenal venography: Njira yoyang'ana mitsempha ya adrenal komanso kutuluka kwa magazi pafupi ndi gland adrenal. Utoto wosiyana umayikidwa mu mitsempha ya adrenal. Daya wosiyanayo akamadutsa mumtsempha, ma x-ray amatengedwa kuti awone ngati mitsempha ili yotsekedwa. Catheter (chubu chochepa kwambiri) chitha kulowetsedwa mumtsinje kuti mutenge magazi, omwe amafufuzidwa kuti ali ndi mahomoni osadziwika bwino.

Kutulutsa

Kulosera (mwayi wochira) ndibwino kwa odwala omwe ali ndi zotupa zazing'ono zomwe zachotsedwa kwathunthu ndi opareshoni. Kwa odwala ena, kufotokozera kumatengera izi:

• Kukula kwa chotupacho.

• Khansara ikukula mwachangu.

• Kaya pali kusintha kwa majini ena.

• Kaya chotupacho chafalikira mbali zina za thupi, kuphatikiza ma lymph node.

• Zaka za mwana.

• Kaya chophimbacho chinali chotseguka panthawi yochita opaleshoni kuti muchotse chotupacho.

• Kaya chotupacho chidachotsedwa kwathunthu pa nthawi yochitidwa opaleshoni.

• Kaya mwanayo ali ndi makhalidwe achimuna.

Adrenocortical carcinoma imafalikira ku chiwindi, mapapo, impso, kapena fupa.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha adrenocortical carcinoma mwa ana chingaphatikizepo izi:

• Kuchita maopareshoni kuti muchotse adrenal gland ndipo, ngati kuli kofunika, khansa yomwe yafalikira mbali zina za thupi. Nthawi zina chemotherapy imaperekedwanso.

Chithandizo cha mobwerezabwereza adrenocortical carcinoma mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo chachikulu cha Adrenocortical Carcinoma kuti mumve zambiri.

Khansa ya m'mimba (Gastric)

Khansa yam'mimba ndimatenda momwe maselo owopsa (khansa) amapangira mkatikati mwa m'mimba. Mimba ndi chiwalo chofanana ndi J chakumtunda. Ndi gawo lam'magazi, lomwe limapanga michere (mavitamini, michere, zopatsa mphamvu, mafuta, mapuloteni, ndi madzi) mu zakudya zomwe zimadyedwa ndikuthandizira kutaya zinyalala mthupi. Chakudya chimachoka pakhosi kupita m'mimba kudzera mumachubu, yaminyewa yotchedwa esophagus. Pambuyo potuluka m'mimba, chakudya chopukutidwa pang'ono chimadutsa m'matumbo ang'ono ndikulowa m'matumbo akulu.

M'mero ​​ndi m'mimba ndi gawo limodzi lam'mimba (m'mimba).

Zowopsa ndi Zizindikiro ndi Zizindikiro

Chiwopsezo cha khansa yam'mimba chikuwonjezeka ndi izi:

• Kukhala ndi matenda a bakiteriya a Helicobacter pylori (H. pylori), omwe amapezeka m'mimba.

• Kukhala ndi cholowa chotchedwa khansa yotulutsa khansa yapamimba.

Odwala ambiri alibe zizindikilo mpaka khansa itafalikira. Khansara yam'mimba imatha kuyambitsa izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Kuchepa kwa magazi (kutopa, chizungulire, kugunda kwamtima mwachangu kapena mosasinthasintha, kupuma pang'ono, khungu lotumbululuka).

• Kupweteka m'mimba.

• Kutaya njala.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Nseru.

• Kusanza.

• Kudzimbidwa kapena kutsegula m'mimba.

• Kufooka.

Mavuto ena omwe si khansa ya m'mimba amatha kuyambitsa zizindikilo zomwezi.

Kuyesa Kudziwa ndi Kuyesa

Kuyesa kopeza khansa ya m'mimba kungaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• X-ray pamimba.

• Kafukufuku wamagazi.

• Kujambula kwa CT.

• Chisokonezo.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira komanso khansa ya m'mimba ndi awa:

• Pamwamba endoscopy: Njira yoyang'ana m'mimba, m'mimba, ndi duodenum (gawo loyamba la m'matumbo ang'ono) kuti muwone ngati pali zovuta zina. Endoscope imadutsa pakamwa ndikutsika pakhosi kupita kummero. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu kapena ma lymph node, omwe amayang'aniridwa ndi microscope ngati ali ndi matenda.

• Kumeza kwa Barium: Ma x-ray angapo am'mero ​​ndi m'mimba. Wodwalayo amamwa madzi omwe amakhala ndi barium (siliva yoyera yachitsulo). Madziwo amaphimba kumimba ndi m'mimba, ndipo ma x-ray amatengedwa. Njirayi imatchedwanso mndandanda wapamwamba wa GI.

• Kuwerengera kwathunthu kwa magazi (CBC): Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

Kutulutsa

Kulosera (mwayi wochira) zimadalira ngati khansayo yafalikira panthawi yodziwitsidwa komanso momwe khansa imayankhira kuchipatala.

Khansa yam'mimba imafalikira ku chiwindi, mapapo, peritoneum, kapena mbali zina za thupi.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa ya m'mimba mwa ana chingaphatikizepo izi:

• Opaleshoni yochotsa khansara ndi minofu yathanzi mozungulira.

• Opaleshoni yochotsa khansa yambiri momwe angathere, ndikutsatiridwa ndi radiation radiation ndi chemotherapy.

Chithandizo cha khansa yam'mimba yabwinobwino mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani gawo la Gastrointestinal Stromal Tumors (GIST) mwachidulechi ndi gawo la Neuroendocrine Tumors (Carcinoids) mwachidulechi kuti mumve zambiri za zotupa za m'mimba ndi zotupa za neuroendocrine.

Khansa ya Pancreatic

Khansa ya Pancreatic ndi matenda omwe mumakhala maselo owopsa (khansa) m'matumba a kapamba. Mphunoyi ndi kansalu kooneka ngati peyala pafupifupi mainchesi 6 m'litali. Kumapeto kwa kapamba kumatchedwa mutu, gawo lapakati limatchedwa thupi, ndipo kumapeto kwake kumatchedwa mchira. Mitundu yambiri yamatenda imatha kupanga kapamba. Zotupa zina zimakhala zabwino (osati khansa).

Anatomy ya kapamba. Mphunoyi ili ndi mbali zitatu: mutu, thupi, ndi mchira. Amapezeka pamimba pafupi ndi mimba, matumbo, ndi ziwalo zina.

Mankhanira ali ndi ntchito zazikulu ziwiri mthupi:

• Kupanga timadziti tomwe timathandiza kugaya (kuphwanya) chakudya. Timadziti timatuluka m'matumbo ang'onoang'ono.

• Kupanga mahomoni omwe amathandiza kuchepetsa shuga ndi mchere m'magazi. Mahomoni amenewa amabisika m'magazi.

Pali mitundu inayi ya khansa ya kapamba mwa ana:

• Cholimba chotupa cha pseudopapillary cha kapamba. Uwu ndiye mtundu wofala kwambiri wa chotupa cha kapamba. Nthawi zambiri zimakhudza akazi omwe ndi achikulire komanso achikulire. Zotupa zomwe zimakula pang'onopang'ono zimakhala ngati zotupa komanso zolimba. Olimba pseudopapillary chotupa cha kapamba ndi chodziwikiratu kufalikira mbali zina za thupi ndi madokotala ananena zawo zabwino kwambiri. Nthawi zina chotupacho chimatha kufalikira ku chiwindi, mapapo, kapena ma lymph node.

• Pancreatoblastoma. Nthawi zambiri zimachitika kwa ana azaka 10 kapena kupitirira apo. Ana omwe ali ndi matenda a Beckwith-Wiedemann komanso amtundu wa adenomatous polyposis (FAP) ali ndi chiopsezo chowonjezereka chokhala ndi pancreatoblastoma. Zotupa zokula pang'onopang'ono izi zimapangitsa chotupacho kukhala chizindikiro cha alpha-fetoprotein. Zotupazi zimatha kupanganso mahomoni a adrenocorticotropic (ACTH) ndi antidiuretic hormone (ADH). Pancreatoblastoma imafalikira ku chiwindi, mapapo, ndi ma lymph node. Kufotokozera kwa ana omwe ali ndi pancreatoblastoma ndibwino.

• Zilonda za Islet. Zotupa izi sizofala kwa ana ndipo zimatha kukhala zowopsa kapena zoyipa. Zilonda zam'mimba mwa Islet zimatha kupezeka mwa ana omwe ali ndi matenda a endocrine neoplasia type 1 (MEN1). Mitundu yofala kwambiri ya zotupa zam'madzi ndi ma insulinomas ndi ma gastrinomas. Mitundu ina ya zotupa zam'madzi pachilumba ndi ACTHoma ndi VIPoma. Zotupa izi zimatha kupanga mahomoni, monga insulin, gastrin, ACTH, kapena ADH. Pakapangidwa mahomoni ambiri, zizindikilo ndi zizindikilo za matenda zimachitika.

• Pancreatic carcinoma. Pancreatic carcinoma ndiyosowa kwambiri mwa ana. Mitundu iwiri ya pancreatic carcinoma ndi acinar cell carcinoma ndi ductal adenocarcinoma.

Zizindikiro ndi Zizindikiro

Zizindikiro zina za khansa ya kapamba imatha kukhala ndi izi:

• Kutopa.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kutaya njala.

• Kusokonezeka m'mimba.

• Chotupa m'mimba.

Kwa ana, zotupa zina zam'mimba sizimatulutsa mahomoni ndipo palibe zisonyezo za matenda. Izi zimapangitsa kuti zikhale zovuta kuzindikira khansa ya kapamba koyambirira.

Zotupa zapancreatic zomwe zimatulutsa mahomoni zimatha kuyambitsa zizindikilo. Zizindikiro zake zimadalira mtundu wa mahomoni opangidwa.

Ngati chotupacho chimatulutsa insulin, zizindikilo zomwe zingachitike ndi izi:

• Shuga wamagazi ochepa. Izi zimatha kuyambitsa masomphenya, kupweteka mutu, komanso kumva mopepuka, kutopa, kufooka, kugwedezeka, mantha, kukwiya, thukuta,

• osokonezeka, kapena anjala.

• Kusintha kwamakhalidwe.

• Kugwidwa.

• Coma.

Ngati chotupacho chimatulutsa gastrin, zizindikilo zomwe zingachitike ndi izi:

• Zilonda zam'mimba zomwe zimabwerabe.

• Kupweteka m'mimba, komwe kumatha kufalikira kumbuyo. Kupweteka kumatha kubwera ndikutha ndipo kumatha pambuyo poti atenga mankhwala ophera tizilombo.

• Kutuluka kwam'mimba kubwerera kummero (gastroesophageal reflux).

• Kutsekula m'mimba.

Zizindikiro zomwe zimayambitsa zotupa zomwe zimapanga mitundu ina ya mahomoni, monga ACTH kapena ADH, zitha kuphatikizira izi:

• Kutsekula m'madzi.

• Kutaya madzi m'thupi (kumva ludzu, kuchepa mkodzo, khungu louma ndi pakamwa, mutu, chizungulire, kapena kumva kutopa).

• Mulingo wocheperako wa sodium (mchere) m'magazi (chisokonezo, kugona, kufooka kwa minofu, ndi khunyu).

• Kuchepetsa thupi kapena phindu popanda chifukwa chodziwika.

• Nkhope yozungulira ndi mikono yopyapyala ndi miyendo.

• Kumva kutopa kwambiri komanso kufooka.

• Kuthamanga kwa magazi.

• Zotulutsa zofiirira kapena zapinki pakhungu.

Funsani kwa dokotala wa mwana wanu ngati mukuwona mavuto awa mwa mwana wanu. Mavuto ena omwe si khansa ya kapamba amatha kuyambitsa zizindikilo zomwezi.

Kuyesa Kudziwa ndi Kuyesa

Kuyesera kuzindikira khansa ya kapamba kaphatikizidwe ndi izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• X-ray ya chifuwa.

• Kujambula kwa CT.

• MRI.

• Sakanizani PET.

• Chisokonezo.

• Core-singano biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu.

• Laparoscopy: Njira yochitira opaleshoni yoyang'ana ziwalo zamkati mwa mimba kuti muwone ngati pali matenda. Tizinthu tating'onoting'ono (todulira) timapangidwa pakhoma pamimba ndipo laparoscope (chubu chowonda, chowunikira) imayikidwa mchimodzi mwazomwe zimapangidwazo. Zida zina zitha kulowetsedwa mwanjira yomweyo kapena zina kuti achite njira monga kuchotsa ziwalo kapena kutenga zitsanzo zamatenda kuti zikawunikidwe ndi microscope ngati ali ndi matenda.

• Laparotomy: Njira yochitira opareshoni yomwe imadulidwa pakhoma pamimba kuti ayang'ane mkati mwa mimba ngati muli ndi matenda. Kukula kwa katemera kumadalira chifukwa chomwe laparotomy ikuchitidwira. Nthawi zina ziwalo zimachotsedwa kapena zitsanzo za minofu zimatengedwa ndikufufuzidwa pa microscope ngati pali matenda.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira khansa ya kapamba ndi awa:

• Endoscopic ultrasound (EUS): Njira yomwe endoscope imayikidwa mthupi, nthawi zambiri kudzera pakamwa kapena m'matumbo. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Kafukufuku kumapeto kwa endoscope amagwiritsidwa ntchito kuphulitsa mafunde amphamvu kwambiri (ultrasound) pamatumba amkati kapena ziwalo ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Njirayi imatchedwanso endosonography.

• Somatostatin receptor scintigraphy: Mtundu wa radionuclide scan womwe umagwiritsidwa ntchito kupeza zotupa za kapamba. Octreotide wocheperako kwambiri (mahomoni omwe amangirira zotupa za carcinoid) amalowetsedwa mumtsempha ndikuyenda m'magazi. Octreotide wama radioact amata chotupacho ndipo kamera yapadera yomwe imazindikira kuti radioactivity imagwiritsidwa ntchito kuwonetsa komwe kuli zotupa mthupi. Njirayi imagwiritsidwa ntchito pofufuza zotupa zam'madzi.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha chotupa cha pseudopapillary cholimba cha kapamba mwa ana chingaphatikizepo izi:

• Opaleshoni kuchotsa chotupacho.

• Chemotherapy ya zotupa zomwe sizingachotsedwe ndi opaleshoni kapena zafalikira mbali zina za thupi.

Chithandizo cha pancreatoblastoma mwa ana chingaphatikizepo izi:

• Opaleshoni kuchotsa chotupacho. Ndondomeko ya Whipple itha kuchitidwa zotupa m'mutu mwa kapamba.

• Chemotherapy itha kuperekedwa kuti muchepetse chotupacho asanachite opareshoni. Chemotherapy yambiri imatha kuperekedwa pambuyo pochitidwa opareshoni ya zotupa zazikulu, zotupa zomwe sizingachotsedwe koyambirira ndi opareshoni, ndi zotupa zomwe zafalikira mbali zina za thupi.

• Chemotherapy itha kuperekedwa ngati chotupacho sichiyankha kuchipatala kapena kubwerera.

Chithandizo cha zotupa zam'mimba mwa ana chimatha kuphatikizira mankhwala ochizira matenda am'mimba ndi izi:

• Opaleshoni kuchotsa chotupacho.

• Chemotherapy and targeted therapy (mTOR inhibitor therapy) ya zotupa zomwe sizingachotsedwe ndi opaleshoni kapena zomwe zafalikira mbali zina za thupi.

Onani chidule cha pa Chithandizo chachikulu cha Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Chithandizo kuti mumve zambiri zamatumbo a kapamba.

Pali zochitika zochepa za pancreatic carcinoma mwa ana. (Onani chidule cha pa Chithandizo cha Khansa Yaikulu ya Pancreatic pazomwe mungachite posankha mankhwala.)

Chithandizo cha matenda a pancreatic carcinoma mwa ana atha kukhala ndi izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani mafupipafupi a pazachiritso za anthu odwala Pancreatic Cancer ndi akulu Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Chithandizo kuti mumve zambiri zamatumbo a kapamba.

Khansa Yoyenera

Khansa yoyipa ndi matenda omwe mumakhala maselo owopsa (khansa) m'matumba am'matumbo kapena m'matumbo. Colonicho ndi gawo lam'magazi amthupi. Njira yogaya chakudya imachotsa ndikupanga michere (mavitamini, michere, chakudya, mafuta, mapuloteni, ndi madzi) pazakudya ndikuthandizira kutaya zonyansa mthupi. Njira yogaya chakudya imapangidwa ndi khosi, m'mimba, ndi matumbo ang'ono ndi akulu. Colon (matumbo akulu) ndiye gawo loyamba la m'matumbo akulu ndipo ndi pafupifupi 5 mapazi kutalika. Pamodzi, kholingo lamatope ndi kumatako limapanga gawo lomaliza la m'matumbo akulu ndipo ndi mainchesi 6-8 kutalika. Ngalande ya kumatako imathera ku anus (kutsegula kwa m'matumbo akulu mpaka kunja kwa thupi).

Anatomy ya m'munsi dongosolo lakumagazi, kuwonetsa colon ndi ziwalo zina.

Zowopsa, Zizindikiro ndi Zizindikiro, ndi Kuzindikira ndi Kuyesa Kwakanthawi

Khansa yoyipa yaubwana ikhoza kukhala gawo la matenda obadwa nawo. Mitundu ina ya khansa yoyipa mwa achinyamata imalumikizidwa ndi kusinthika kwa majini komwe kumayambitsa ma polyps (kukula m'matumbo omwe amayenda m'matumbo) kuti apange khansa pambuyo pake.

Chiwopsezo cha khansa yoyipa chikuwonjezeka pokhala ndi zinthu zina zobadwa nazo, monga:

• Wodziwika bwino wa adenomatous polyposis (FAP).

• Kutsegula FAP.

• Polyposis yokhudzana ndi MUTYH.

• Matenda a Lynch.

• Oligopolyposis.

• Sinthani mumtundu wa NTHL1.

• Matenda a achinyamata a polyposis.

• Matenda a Cowden.

• Matenda a Peutz-Jeghers.

• Mtundu wa Neurofibromatosis 1 (NF1).

Ma poloni omwe amapangidwa mwa ana omwe alibe matenda obadwa nawo samalumikizidwa ndi chiopsezo chowonjezeka cha khansa.

Zizindikiro za khansa yoyipa yamwana nthawi zambiri zimadalira komwe chotupacho chimapangira. Khansa yoyipa imatha kuyambitsa zizindikilo ndi zizindikilo izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Zotupa za rectum kapena m'munsi m'matumbo zimatha kupweteka m'mimba, kudzimbidwa, kapena kutsekula m'mimba.

• Zotupa m'mbali yamatumbo kumanzere kwa thupi zimatha kuyambitsa:

• Chotupa m'mimba.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Nseru ndi kusanza.

• Kutaya njala.

• Magazi mu chopondapo.

• Kuchepa kwa magazi (kutopa, chizungulire, kugunda kwamtima mwachangu kapena mosasinthasintha, kupuma pang'ono, khungu lotumbululuka).

• Zotupa m'mbali yamatumbo kumanja kwa thupi zimatha kuyambitsa:

• Ululu m'mimba.

• Magazi mu chopondapo.

• Kudzimbidwa kapena kutsegula m'mimba.

• Nseru kapena kusanza.

• Kuchepetsa thupi popanda chifukwa chodziwika.

Mavuto ena omwe si khansa yoyipa amatha kuyambitsa zizindikilo zomwezi.

Kuyesera kuti mupeze khansa yoyipa ingaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• X-ray ya chifuwa.

• Kujambula kwa CT pachifuwa, pamimba, ndi m'chiuno.

• Sakanizani PET.

• MRI.

• Kujambula mafupa.

• Chisokonezo.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira khansa yoyipa ndi awa:

• Colonoscopy: Njira yoyang'ana mkati mwa rectum ndi colon ya polyps, madera achilendo, kapena khansa. Colonoscope imalowetsedwa kudzera m'matumbo mpaka kumtunda. Colonoscope ndi chida choonda ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chotsitsira ma polyps kapena minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

• Enema wa Barium: Ma x-ray angapo am'munsi m'mimba. Madzi okhala ndi barium (siliva wonyezimira wachitsulo) amaikidwa mu rectum. Bariamu imavala m'munsi mwa m'mimba ndi ma x-ray amatengedwa. Njirayi imatchedwanso kuti GI yotsika.

• Kuyezetsa magazi kwamatsenga: Kuyesedwa kuti muwone chopondapo (zinyalala zolimba) zamagazi omwe amatha kuwoneka ndi microscope. Zitsanzo zazing'ono zonyamulidwa zimayikidwa pamakadi apadera ndikubwezeredwa kwa dokotala kapena labotale kukayezetsa.

• Kuwerengera kwathunthu kwa magazi (CBC): Njira yomwe magazi amatengedwa ndikuwunika zotsatirazi:

• Chiwerengero cha maselo ofiira, maselo oyera amwazi, ndi ma platelet.

• Kuchuluka kwa hemoglobin (puloteni yomwe imanyamula mpweya) m'maselo ofiira amwazi.

• Gawo la magazi lomwe limapangidwa ndi maselo ofiira.

• Ntchito ya impso: Kuyesedwa komwe magawo amwazi kapena mkodzo amawunika kuchuluka kwa zinthu zina zotulutsidwa ndi impso. Kuchuluka kapena kutsika kuposa zinthu zachilendo kungakhale chizindikiro kuti impso sizikugwira ntchito momwe ziyenera kukhalira. Izi zimatchedwanso kuyesa kwa ntchito yaimpso.

• Kuyesa kwa chiwindi: Kuyesa magazi kuti mupimitse kuchuluka kwamagazi azinthu zina zotulutsidwa ndi chiwindi. Kuchuluka kapena kutsika kwa zinthu zina kumatha kukhala chizindikiro cha matenda a chiwindi.

• Kuyesa kwa Carcinoembryonic antigen (CEA): Chiyeso chomwe chimayeza kuchuluka kwa CEA m'magazi. CEA imatulutsidwa m'magazi kuchokera m'maselo onse a khansa komanso maselo abwinobwino. Mukapezeka mopitilira muyeso, amatha kukhala chizindikiro cha khansa yoyipa kapena zinthu zina.

Kutulutsa

Kulosera (mwayi wochira) zimatengera izi:

• Kaya chotupacho chinachotsedwa ndi opaleshoni.

• Kaya khansara yafalikira mbali zina za thupi, monga ma lymph node, chiwindi, m'chiuno, kapena thumba losunga mazira.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa yoyipa mwa ana ingaphatikizepo izi:

• Opaleshoni yochotsa chotupacho ngati sichinafalikire.

• Thandizo la radiation ndi chemotherapy ya zotupa mu rectum kapena m'munsi m'matumbo.

• Kuphatikiza chemotherapy, kwa khansa yoyipa yamatenda.

• Immunotherapy yokhala ndi chitetezo cha m'thupi (ipilimumab ndi nivolumab).

Chithandizo cha khansa yapawiri yabwinobwino mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Ana omwe ali ndi matenda am'magazi amtundu wam'magazi amathandizidwa ndi:

• Opaleshoni yochotsa kholoni asanafike khansa.

• Mankhwala ochepetsa kuchuluka kwa tizilombo tating'onoting'ono m'matumbo.

Zotupa za Neuroendocrine (Zotupa za Carcinoid)

Maselo a Neuroendocrine amatha kukhala ngati maselo amitsempha kapena ma cell opanga mahomoni. Maselowa amabalalika m'ziwalo zonse monga mapapo (tracheobronchial) kapena malo am'mimba.

Zotupa za Neuroendocrine (kuphatikiza zotupa za carcinoid) zimakonda kupangika m'mimba kapena m'matumbo (kuphatikiza zowonjezera), koma zimatha kupanga ziwalo zina, monga kapamba, mapapo, kapena chiwindi. Zotupa izi nthawi zambiri zimakhala zazing'ono, zikukula pang'onopang'ono, komanso zabwino (osati khansa). Zotupa zina za neuroendocrine ndizoyipa (khansa) ndipo zimafalikira m'malo ena m'thupi.

Zotupa zambiri za neuroendocrine mwa ana zimapanga zowonjezera (thumba lomwe limatuluka kuchokera mbali yoyamba yamatumbo akulu kumapeto kwa matumbo aang'ono). Chotupacho chimapezeka nthawi zambiri pochita opaleshoni kuti muchotse zakumapazi.

Zizindikiro ndi Zizindikiro

Zizindikiro za zotupa za neuroendocrine zimadalira komwe chotupacho chimapangidwira. Zotupa za Neuroendocrine zomwe zakumapeto zimatha kuyambitsa zizindikilo ndi izi:

• Kupweteka m'mimba, makamaka kumunsi kumanja pamimba.

• Malungo.

• Nseru ndi kusanza.

• Kutsekula m'mimba.

Zotupa za Neuroendocrine zomwe sizili mu zakumapeto zimatha kutulutsa mahomoni ndi zinthu zina. Matenda a Carcinoid omwe amayamba chifukwa cha timadzi ta serotonin ndi mahomoni ena, atha kuyambitsa zizindikiritso izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Kufiira ndikumverera kotentha pamaso, m'khosi, ndi pachifuwa chapamwamba.

• Kugunda kwamtima.

• Kuvuta kupuma.

• Kutuluka mwadzidzidzi kwa kuthamanga kwa magazi (kusakhazikika, kusokonezeka, kufooka, chizungulire, khungu loyera, lozizira komanso losalala).

• Kutsekula m'mimba.

Zina zomwe sizotupa za neuroendocrine zimatha kuyambitsa zizindikilo zomwezi.

Kuyesa Kudziwa ndi Kuyesa

Kuyesa komwe kumawunika ngati ali ndi khansa kumagwiritsidwa ntchito pozindikira zotupa za neuroendocrine. Zitha kuphatikiza:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kafukufuku wamagazi.

• MRI.

• Sakanizani PET.

• Kujambula kwa CT.

• Ultrasound.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira zotupa za neuroendocrine ndi awa:

• Kuyesa mkodzo kwa maola 24 : Kuyesedwa komwe mkodzo umasonkhanitsidwa kwa maola 24 kuti muyese kuchuluka kwa zinthu zina, monga mahomoni. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Chitsanzo cha mkodzo chikuwunika ngati chili ndi 5-HIAA (chinthu chowonongeka cha hormone serotonin chomwe chingapangidwe ndi zotupa za khansa). Kuyesaku kumagwiritsidwa ntchito kuthandizira kuzindikira matenda a khansa.

• Somatostatin receptor scintigraphy: Mtundu wa radionuclide scan womwe ungagwiritsidwe ntchito kupeza zotupa. Octreotide wocheperako kwambiri (mahomoni omwe amangirira zotupa) amalowetsedwa mumtsempha ndikuyenda m'magazi. Octreotide wama radioact amata chotupacho ndipo kamera yapadera yomwe imazindikira kuti radioactivity imagwiritsidwa ntchito kuwonetsa komwe kuli zotupa mthupi. Njirayi imatchedwanso octreotide scan ndi SRS.

Kutulutsa

Kulosera kwa zotupa za neuroendocrine zowonjezeredwa mwa ana nthawi zambiri kumakhala bwino atachitidwa opaleshoni kuti achotse chotupacho. Zotupa za Neuroendocrine zomwe sizili zowonjezeredwa nthawi zambiri zimakhala zazikulu kapena zimafalikira mbali zina za thupi panthawi yomwe zimapezeka ndipo sizimayankha bwino chemotherapy. Zotupa zazikulu zimatha kubwereranso (kubwerera).

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha zotupa za neuroendocrine zowonjezera mu ana zitha kuphatikizira izi:

• Opaleshoni kuchotsa zakumapeto.

Chithandizo cha zotupa za neuroendocrine zomwe zafalikira m'matumbo akulu, kapamba, kapena m'mimba nthawi zambiri zimachitidwa opaleshoni. Chithandizo cha zotupa zomwe sizingachotsedwe ndi opareshoni, zotupa zingapo, kapena zotupa zomwe zafalikira zitha kuphatikizira izi:

• Kuphatikiza.

• Somatostatin analogue therapy (octreotide kapena lanreotide).

• Peptide receptor radionuclide mankhwala.

• Chithandizo choyenera ndi tyrosine kinase inhibitor (sunitinib) kapena mTOR inhibitor (everolimus).

Chithandizo cha zotupa zobwerezabwereza za neuroendocrine mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo chachikulu cha m'mimba cha khansa ya m'mimba kuti mumve zambiri.

Mimba ya m'mimba Stromal Tumors

Zotupa zam'mimba zam'mimba (GIST) nthawi zambiri zimayamba m'maselo khoma la m'mimba kapena m'matumbo. GISTs ikhoza kukhala yosaopsa (osati khansa) kapena yoyipa (khansa). Ma GIST aubwana amapezeka kwambiri mwa atsikana, ndipo nthawi zambiri amawoneka azaka zaunyamata.

Zowopsa ndi Zizindikiro ndi Zizindikiro

GISTs mwa ana siofanana ndi GIST mwa akulu. Odwala amayenera kuwonedwa m'malo omwe amagwiritsa ntchito mankhwala a GIST ndipo zotupa ziyenera kuyesedwa kuti zisinthe. Chiwerengero chochepa cha ana chimakhala ndi zotupa zosintha chibadwa monga zomwe zimapezeka mwa achikulire odwala. Chiwopsezo cha GIST chikuwonjezeka ndi zovuta zotsatirazi:

• Carney triad.

• Matenda a Carney-Stratakis.

Ana ambiri omwe ali ndi GIST ali ndi zotupa m'mimba ndipo amakhala ndi kuchepa kwa magazi komwe kumayambitsidwa ndi kutuluka magazi. Zizindikiro za kuchepa kwa magazi m'thupi ndi izi:

• Kutopa.

• Chizungulire.

• Kugunda kwamtima mwachangu kapena mosasinthasintha.

• Kupuma pang'ono.

• Khungu lotumbululuka.

Chotupa m'mimba kapena kutsekeka kwa m'matumbo (kupweteka m'mimba, nseru, kusanza, kutsekula m'mimba, kudzimbidwa, ndi kutupa m'mimba) ndizizindikiro za GIST.

Mavuto ena omwe si kuchepa kwa magazi chifukwa cha GIST atha kuyambitsa zizindikilo zomwezo.

Kuyesa Kudziwa ndi Kuyesa

Kuyesa komwe kumafufuza ngati ali ndi khansa kumagwiritsidwa ntchito pozindikira komanso kuyambitsa ma GIST. Zitha kuphatikiza:

• Kuyezetsa thupi komanso mbiri yathanzi.

• MRI.

• Kujambula kwa CT.

• Sakanizani PET.

• X-ray pamimba.

• Chisokonezo.

• Kukhumba singano kwabwino: Kuchotsa minofu pogwiritsa ntchito singano yopyapyala.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira kuti GIST ndi awa:

• Endoscopy: Ndondomeko yoyang'ana ziwalo ndi zotupa mkati mwa thupi kuti muwone ngati pali zovuta zina. Endoscope imalowetsedwa kudzera mu cheka (khungu) pakhungu kapena potsegula mthupi, monga pakamwa kapena pakhosi. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu kapena ma lymph node, omwe amayang'aniridwa ndi microscope ngati ali ndi matenda.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha ana omwe ali ndi zotupa zosintha chibadwa monga zomwe zimapezeka mwa odwala akulu amathandizidwa ndi mankhwala a tyrosine kinase inhibitor (imatinib kapena sunitinib).

Chithandizo cha ana omwe zotupa zawo sizikuwonetsa kusintha kwa majini zingaphatikizepo izi:

• Opaleshoni kuchotsa chotupacho. Kuchita maopareshoni ambiri kungafunike ngati kutsekeka m'mimba kapena kutuluka magazi kumachitika.

Chithandizo cha GIST chobwereza mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa mankhwala atsopano a chemotherapy.

Khansa Yachilendo ya Njira zoberekera ndi Urinary

M'chigawo chino

• Khansa ya Chikhodzodzo

• Khansa Yam'mimba

• Khansa Yamchiberekero

• Khansa Yachiberekero ndi Nyini

Khansa ya Chikhodzodzo

Khansara ya chikhodzodzo ndimatenda momwe maselo owopsa (khansa) amapangika m'matumba a chikhodzodzo. Chikhodzodzo ndi chiwalo chobowoka m'munsi mwa mimba. Chopangidwa ngati chibaluni chaching'ono ndipo chimakhala ndi khoma la minofu chomwe chimalola kuti chikule kapena kuchepa. Timachubu ting'onoting'ono ta impso timasefa ndikuyeretsa magazi. Amatulutsa zonyansa ndikupanga mkodzo. Mkodzo umadutsa kuchokera ku impso iliyonse kudzera mu chubu lalitali lotchedwa ureter kupita m'chikhodzodzo. Chikhodzodzo chimagwira mkodzo mpaka umadutsa mu mtsempha ndi kutuluka mthupi.

Kutulutsa kwamkodzo wachikazi komwe kumawonetsa impso, ma adrenal gland, ureters, chikhodzodzo, ndi urethra. Mkodzo umapangidwa mu ma tubules amphongo ndipo umasonkhanitsa muimpso ya impso iliyonse. Mkodzo umayenda kuchokera ku impso kudzera mu ureters kupita ku chikhodzodzo. Mkodzo umasungidwa mu chikhodzodzo mpaka umachoka mthupi kudzera mu mtsempha wa mkodzo.

Mtundu wofala kwambiri wa khansa ya chikhodzodzo ndi khansa yakanthawi yama cell. Maselo a squamous ndi mitundu ina yaukali ya khansa ya chikhodzodzo siodziwika kwenikweni.

Zowopsa, Zizindikiro ndi Zizindikiro, ndi Kuzindikira ndi Kuyesa Kwakanthawi

Chiwopsezo cha khansa ya chikhodzodzo chikuwonjezeka mwa ana omwe amachiritsidwa khansa ndi mankhwala ena a anticancer, otchedwa alkylating agents, omwe amaphatikizapo cyclophosphamide, ifosfamide, busulfan, ndi temozolomide.

Khansara ya chikhodzodzo imatha kuyambitsa izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Magazi mkodzo (dzimbiri pang'ono pang'ono mpaka utoto wofiyira).

• Kukodza pafupipafupi kapena kumva kufunikira kokodza popanda kutero.

• Ululu pokodza.

• M'mimba kapena m'munsi ululu.

Mavuto ena omwe si khansa ya chikhodzodzo amatha kuyambitsa zizindikilo zomwezo.

Kuyesa kuzindikira khansa ya chikhodzodzo kungaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kujambula kwa CT.

• Ultrasound cha chikhodzodzo.

• Chisokonezo.

• Cystoscopy: Njira yoyang'ana mkati mwa chikhodzodzo ndi urethra kuti muwone ngati pali zovuta zina. Cystoscope imayikidwa kudzera mu urethra kupita mu chikhodzodzo. Cystoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa. Ngati cystoscopy sichichitidwa, matenda amachotsedwa ndikuwunika khansa panthawi yochita opaleshoni kuti achotse zonse kapena gawo la chikhodzodzo.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Kutulutsa

Kwa ana, khansara ya chikhodzodzo nthawi zambiri imakhala yotsika (osafalikira) ndipo matendawa amakhala abwino pambuyo pa opaleshoni kuchotsa chotupacho.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa ya chikhodzodzo mwa ana nthawi zambiri ndi izi:

• Opaleshoni kuchotsa gawo la chikhodzodzo. Transurethral resection (TUR) ndi njira yochitira opaleshoni yochotsa minofu pachikhodzodzo pogwiritsa ntchito resectoscope yomwe imayikidwa mchikhodzodzo kudzera mu mtsempha. Resectoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala, mandala owonera, ndi chida chothandizira kuchotsa minofu ndikuwotcha zotupa zilizonse zomwe zatsala. Zitsanzo zamatenda kuchokera kudera lomwe chotupacho chidachotsedwa zimayang'aniridwa ndi maikulosikopu ngati ali ndi khansa.

• Opaleshoni kuchotsa chikhodzodzo (chosowa).

Lankhulani ndi dokotala wa mwana wanu momwe opaleshoni yamtunduwu ingakhudzire kukodza, kugonana, ndi kubereka.

Chithandizo cha khansa ya khodzodzo yabwinobwino mwa ana ingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo chachikulu cha Khansa ya Chikhodzodzo kuti mumve zambiri.

Khansa Yam'mimba

Khansa ya testicular ndi matenda omwe ma cell oyipa (khansa) amapangika m'matumba amodzi kapena awiri. Machendewo ndi tiziwalo tating'onoting'ono tating'onoting'ono tomwe timakhala mkati mwa minyewa (thumba la khungu lotayirira lomwe lili pansi penipeni pa mbolo). Machendewo amakhala mkati mwa mikwingwirima ndi chingwe cha umuna, chomwe chimakhalanso ndi vas deferens ndi zotengera ndi mitsempha ya machende.

Anatomy ya ziwalo zoberekera ndi kwamikodzo, zowonetsa prostate, machende, chikhodzodzo, ndi ziwalo zina.

Pali mitundu iwiri ya zotupa za testicular:

• Zilonda zam'mimba zotupa: Zotupa zomwe zimayamba m'maselo a umuna mwa amuna. Zilonda zamatenda a testicular zitha kukhala zoyipa (osati khansa) kapena zoyipa (khansa). Matenda omwe amapezeka kwambiri mwa anyamata aamuna ndi ma benchi terstoma ndi ma nonseminomas owopsa. Seminomas nthawi zambiri imachitika mwa anyamata ndipo achinyamata samapezeka kawirikawiri. Onani chidule cha pa Chithandizo cha Childhood Extracranial Germ Cell Tumors Chithandizo kuti mumve zambiri zamatenda a testicular germ cell.

• Zotupa zosakhala ndi majeremusi: Zotupa zomwe zimayambira minofu yomwe imazungulira ndikuthandizira machende. Zotupa izi zitha kukhala zoyipa kapena zoyipa. Zotupa za cellular za achinyamata a granulosa ndi zotupa za Sertoli-Leydig ndi mitundu iwiri ya zotupa zomwe sizili majeremusi.

Zizindikiro ndi Zizindikiro ndi Kuzindikira ndi Kuyesa Kwawo

Khansara ya testicular ndi kufalikira kwake kumadera ena amthupi zimatha kuyambitsa zizindikilo ndi izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Bumbu lopanda machende.

• Zizindikiro zoyambirira za kutha msinkhu.

• Kukula kwa mawere.

Chotupa chopweteka m'machende chingakhale chizindikiro cha chotupa cha testicular. Zina zimayambitsanso chotupa m'matumbo.

Kuyesera kuti mupeze khansa yopanda majeremusi ya khansa ingaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kujambula kwa CT pachifuwa, pamimba, kapena m'chiuno.

• MRI ya pachifuwa, pamimba, kapena m'chiuno.

• Ultrasound.

• Chisokonezo. Minofu yomwe imachotsedwa pakuchita opaleshoni imawonedwa ndi microscope ndi wodwala kuti aone ngati ali ndi khansa.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira zotupa za testicular ndi awa:

• Kuyezetsa magazi kwa seramu: Njira yomwe magazi amayesedwa kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo, ziwalo, kapena zotupa m'thupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magazi ochulukirapo. Izi zimatchedwa zolembera zotupa. Chikhomo chotchedwa alpha-fetoprotein chimagwiritsidwa ntchito pozindikira zotupa zam'magazi.

Kutulutsa

Kwa ana, chiwonetsero chake chimakhala chabwino pambuyo pa opaleshoni kuti achotse chotupacho.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa ya testicular yomwe sinali yaying'ono mwa ana ingaphatikizepo izi:

• Opaleshoni yochotsa chotupacho m'thupi.

• Opaleshoni yochotsa machende amodzi kapena onse awiri.

Chithandizo cha khansa yapachiyambi yopanda tizilombo toyambitsa matenda mwa ana ingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo cha Childhood Extracranial Germ Cell Tumors Chithandizo kuti mumve zambiri zamatenda a testicular germ cell.

Khansa Yamchiberekero

Khansara yamchiberekero ndi matenda omwe maselo owopsa (khansa) amapangidwa mchiberekero. Thumba losunga mazira ndi ziwalo ziwiri mu njira yoberekera yaikazi. Amapezeka m'chiuno, chimodzi mbali zonse za chiberekero (dzenje, lopangidwa ndi peyala pomwe mwana amakula). Ovary iliyonse imafanana ndi kukula ndi mawonekedwe a amondi mwa mayi wachikulire. Thumba losunga mazira limatulutsa mazira ndi mahomoni achikazi (mankhwala omwe amayang'anira momwe maselo kapena ziwalo zina zimagwirira ntchito).

Kutengera kwa ziwalo zoberekera zazimayi. Ziwalo zam'mimba zoberekera zazimayi zimaphatikizapo chiberekero, thumba losunga mazira, timachubu, ziwalo zoberekera, ndi nyini. Chiberekero chimakhala ndi chingwe chakunja chotchedwa myometrium komanso mkati mwake chotchedwa endometrium.

Zotupa zambiri zamchiberekero mwa ana ndizabwino (osati khansa). Amapezeka nthawi zambiri mwa akazi azaka 15 mpaka 19.

Pali mitundu ingapo yamatenda oopsa (khansa) yamchiberekero:

• Zilonda zam'mimba zotupa: Zotupa zomwe zimayambira m'maselo azimayi mwa akazi. Awa ndi zotupa zofala kwambiri pakati pa atsikana. (Onani chidule cha pa Chithandizo cha Childhood Extracranial Germ Cell Tumors Chithandizo kuti mumve zambiri zamatenda am'mimba mwa ovari.)

• Zotupa za Epithelial: Zotupa zomwe zimayambira munyama zomwe zimaphimba ovary. Awa ndi otupa achiwiri omwe amapezeka kwambiri mwa atsikana.

• Zotupa zam'mimba: Zotupa zomwe zimayambira m'maselo am'mimba, omwe amapanga minyewa yomwe imazungulira ndikuthandizira thumba losunga mazira. Zotupa zamagulu a achinyamata a granulosa ndi zotupa za Sertoli-Leydig ndi mitundu iwiri ya zotupa za stromal.

• Small cell carcinoma of the ovary: Khansa yomwe imayamba mu ovary ndipo imatha kufalikira pamimba, m'chiuno, kapena mbali zina za thupi. Khansa yamchiberekero yamtunduwu ikukula mwachangu ndipo samazindikira.

Zowopsa, Zizindikiro ndi Zizindikiro, ndi Kuzindikira ndi Kuyesa Kwakanthawi

Chiwopsezo cha khansa yamchiberekero chikuwonjezeka pokhala ndi izi:

• Matenda a Ollier (matenda omwe amachititsa kukula kwa khungwa kumapeto kwamafupa ataliatali).

• Matenda a Maffucci (vuto lomwe limayambitsa kukula kachulukidwe kumapeto kwa mafupa ataliatali komanso mitsempha yamagazi pakhungu).

• Matenda a Peutz-Jeghers (matenda omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.

• Pleuropulmonary blastoma syndrome (matenda omwe angayambitse cystic nephroma, zotupa m'mapapo, mavuto a chithokomiro, ndi khansa zina za impso, ovary, ndi zofewa).

• Matenda a DICER1 (matenda omwe angayambitse goiter, ma polyps m'matumbo, ndi zotupa za ovary, khomo pachibelekeropo, testicle, impso, ubongo, diso, komanso mapapo).

Khansara yamchiberekero imatha kuyambitsa izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Kupweteka kapena kutupa m'mimba.

• Chotupa m'mimba.

• Kudzimbidwa.

• Kupweteka kapena kusowa msambo.

• Kutuluka mwazi kwachilendo.

• Makhalidwe ogonana amuna, monga tsitsi la thupi kapena mawu akuya.

• Zizindikiro zoyambirira za kutha msinkhu.

Mavuto ena omwe si khansa ya ovari angayambitse zizindikilo zomwezo.

Kuyesera kuti mupeze khansa yamchiberekero ikhoza kukhala ndi izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kujambula kwa CT.

• MRI.

• Ultrasound.

• Chisokonezo. Minofu yomwe imachotsedwa pakuchita opaleshoni imawonedwa ndi microscope ndi wodwala kuti aone ngati ali ndi khansa.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira zotupa zamchiberekero ndi awa:

• Kuyezetsa magazi kwa seramu: Njira yomwe magazi amayesedwa kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo, ziwalo, kapena zotupa m'thupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magazi ochulukirapo. Izi zimatchedwa zolembera zotupa. Zizindikiro zotupa za alpha-fetoprotein, beta-human chorionic gonadotropin (β-hCG), CEA, CA-125, ndi zina zimagwiritsidwa ntchito pozindikira khansa ya m'mimba.

Mukamachita opaleshoni kuti muchotse chotupacho, amayang'ana m'madzi m'mimba mwake ngati ali ndi khansa.

Kutulutsa

Khansara yam'mimba yam'mimba yam'mimba nthawi zambiri imapezeka koyambirira kwa ana ndipo imakhala yosavuta kuchiza kuposa odwala akulu.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha zotupa zotupa m'mimba mwa ana chingaphatikizepo izi:

• Opaleshoni.

Chithandizo cha khansa yamchiberekero cha khansa ya ana ikhoza kuphatikizira izi:

• Opaleshoni.

• Thandizo la radiation.

• Chemotherapy.

Chithandizo cha zotupa zotulutsa mazira, kuphatikiza zotupa za ana granulosa cell ndi zotupa za Sertoli-Leydig, mwa ana atha kukhala ndi izi:

• Opaleshoni yochotsa ovary imodzi ndi chubu chimodzi cha mazira a khansa yoyambirira.

• Opaleshoni yotsatiridwa ndi chemotherapy ya khansa yomwe yapita patsogolo.

• Chemotherapy ya khansa yomwe yabwereranso (kubwerera).

Chithandizo cha cell carcinoma ya ovary chingaphatikizepo izi:

• Opaleshoni yotsatiridwa ndi chemotherapy ndi chemotherapy yayikulu yopulumutsa ndi cell cell.

• Chithandizo choyenera (tazemetostat).

Chithandizo cha khansa yapamimba yamchiberekero mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani zidule za zotsatirazi kuti mumve zambiri:

• Chithandizo cha Ana Extracranial Germ Cell Tumors Chithandizo
• Ovarian Epithelial, Fallopian Tube, ndi Primary Peritoneal Cancer Treatment
• Chithandizo cha Ovarian Germ Cell Tumors Chithandizo

Khansa Yachiberekero ndi Nyini

Khansa ya pachibelekero ndi matenda omwe mumakhala maselo oyipa (khansa) m'mimba mwa chiberekero. Khomo lachiberekero ndilo kumapeto kwenikweni kwa chiberekero, chopapatiza, chowoneka ngati peyala pomwe mwana amakula). Khomo lachiberekero limatsogolera kuchokera pachiberekero kupita kumaliseche (njira yobadwira). Khansa ya kumaliseche imapangidwa kumaliseche. Nyini ndi ngalande yotsogolera kuchokera ku khomo pachibelekeropo kupita kunja kwa thupi. Pobadwa, mwana amatuluka mthupi kudzera kumaliseche (komwe kumatchedwanso njira yobadwira).

Kutengera kwa ziwalo zoberekera zazimayi. Ziwalo zam'mimba zoberekera zazimayi zimaphatikizapo chiberekero, thumba losunga mazira, timachubu, ziwalo zoberekera, ndi nyini. Chiberekero chimakhala ndi chingwe chakunja chotchedwa myometrium komanso mkati mwake chotchedwa endometrium.

Chizindikiro chofala kwambiri cha khansa ya pachibelekero ndi kumaliseche ndikutuluka magazi kumaliseche. Mavuto ena amathanso kuyambitsa magazi m'mimba. Ana nthawi zambiri amapezeka kuti ali ndi matenda opita patsogolo.

Kuyesa Kudziwa ndi Kuyesa

Kuyesa kuzindikira ndikupeza khansa ya khomo lachiberekero ndi nyini kungaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Ultrasound.

• MRI.

• Kujambula kwa CT.

• Chisokonezo. Chidutswa cha singano chakumapeto kwa khungu ndikutulutsa minofu pogwiritsa ntchito singano yomwe imayang'aniridwa ndi ultrasound.

• Kujambula mafupa.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena omwe amagwiritsidwa ntchito pozindikira zotupa za khomo lachiberekero ndi nyini ndi awa:

• Kuyezetsa magazi kwa seramu: Njira yomwe magazi amayesedwa kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo, ziwalo, kapena zotupa m'thupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magazi ochulukirapo. Izi zimatchedwa zolembera zotupa.

• Kuyesa kwa PAP: Njira yosonkhanitsira maselo kuchokera kummero mwa chiberekero ndi kumaliseche. Chidutswa cha thonje, burashi, kapena ndodo yaying'ono yamatabwa imagwiritsidwa ntchito kupeputsa bwino ma cell kuchokera pachibelekero ndi kumaliseche. Maselo amayang'aniridwa ndi microscope kuti adziwe ngati ali achilendo. Njirayi imatchedwanso Pap smear.

• Cystoscopy: Njira yoyang'ana mkati mwa chikhodzodzo ndi urethra kuti muwone ngati pali zovuta zina. Cystoscope imayikidwa kudzera mu urethra kupita mu chikhodzodzo. Cystoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

• Proctoscopy: Njira yoyang'ana mkati mwa rectum ndi anus kuti muwone malo osakhazikika, pogwiritsa ntchito proctoscope. Proctoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera mkati mwa rectum ndi anus. Ikhozanso kukhala ndi chida chothandizira kuchotsa minofu, yomwe imayang'aniridwa ndi microscope ngati ili ndi khansa.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa ya m'mimba ya khomo lachiberekero ndi nyini itha kuphatikizira izi:

• Opaleshoni yochotsa khansa yambiri momwe angathere, ndikutsatiridwa ndi mankhwala a radiation, ngati maselo a khansa atsalira pambuyo pa opareshoni kapena khansa yafalikira kumatenda am'mimba.

• Chemotherapy itha kugwiritsidwanso ntchito koma sizikudziwika momwe mankhwalawa amagwirira ntchito.

Chithandizo cha khansa yapakhosi yaberekero komanso nyini mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Ma Cancer Ena Achilendo Achilendo a Ana

M'chigawo chino

• Angapo Endocrine Neoplasia Syndromes

• Pheochromocytoma ndi Paraganglioma

• Khansa Yapakhungu (Melanoma, Cancamous Cell Cancer, Basal Cell Cancer)

• Matenda a m'mimba (Uveal) Melanoma

• Chordoma

• Khansa ya Malo Osadziwika Osadziwika

Angapo Endocrine Neoplasia Syndromes

Ma syndromes angapo a endocrine neoplasia (MEN) ndimavuto obadwa nawo omwe amakhudza dongosolo la endocrine. Dongosolo la endocrine limapangidwa ndimatenda ndi maselo omwe amapanga mahomoni ndikuwamasulira m'magazi. MEN syndromes angayambitse hyperplasia (kukula kwamaselo ambiri abwinobwino) kapena zotupa zomwe zitha kukhala zoyipa (osati khansa) kapena zoyipa (khansa).

Pali mitundu ingapo yama syndromes a MEN ndipo mtundu uliwonse umatha kuyambitsa mavuto osiyanasiyana kapena khansa. Kusintha kwa majini a RET nthawi zambiri kumalumikizidwa ndi khansa yamatenda a medullary mu matenda a MEN2. Ngati mukukayikira kuti matenda a MEN2 akukayikira mwanayo kapena wachibale wina atapezeka kuti ali ndi matenda a MEN2, makolo ayenera kulandira upangiri wa majini asanayesedwe mwanayo. Upangiri wa chibadwa umaphatikizaponso zokambirana za chiwopsezo cha matenda a MEN2 kwa mwanayo komanso abale ena.

Mitundu ikuluikulu yama syndromes a MEN ndi MEN1 ndi MEN2:

Matenda a MEN1 amatchedwanso matenda a Wermer. Matendawa nthawi zambiri amayambitsa zotupa m'matumbo a parathyroid, gland pituitary, kapena cell islet m'mapapo. Kuzindikira kwa matenda a MEN1 kumachitika pamene zotupa zimapezeka m'matenda awiriwa kapena ziwalo. Chidziwitso (mwayi wochira) nthawi zambiri chimakhala chabwino.

Zotupa izi zimatha kupanga mahomoni owonjezera ndikupangitsa zizindikilo kapena zizindikilo zina za matenda. Zizindikiro zake zimadalira mtundu wa mahomoni opangidwa ndi chotupacho. Nthawi zina palibe zizindikiro za khansa.

Chikhalidwe chofala kwambiri chokhudzana ndi matenda a MEN1 ndi hyperparathyroidism. Zizindikiro za hyperparathyroidism (mahomoni ochulukirapo a parathyroid) ndi awa:

• Kukhala ndi mwala wa impso.

• Kumva kufooka kapena kutopa kwambiri.

• Kupweteka kwa mafupa.

Zina zomwe zimakhudzana ndi matenda a MEN1 ndi zizindikilo zake ndi izi:

• Pituitary adenoma (kupweteka mutu, kusowa msambo nthawi kapena pambuyo pa kutha msinkhu, kupanga mkaka wa m'mawere popanda chifukwa chodziwika).

• Zotupa za Pancreatic neuroendocrine (shuga wotsika magazi [kufooka, kutaya chidziwitso, kapena kukomoka], kupweteka m'mimba, kusanza, ndi kutsekula m'mimba).

Zotupa zoyipa za ma adrenal glands, bronchi, thymus, minofu yolimba, kapena ma cell amafuta amathanso kuchitika.

Ana omwe ali ndi vuto la hyperparathyroidism, zotupa zomwe zimakhudzana ndi matenda a MEN1, kapena mbiri yabanja ya hypercalcemia kapena matenda a MEN1 atha kukhala ndi kuyesa kwa majini kuti aone ngati angasinthe kusintha kwa mtundu wa MEN1. Makolo ayenera kulandira upangiri wa majini (zokambirana ndi akatswiri ophunzitsidwa za kuopsa kwa matenda amtundu) kuyezetsa magazi kusanachitike. Upangiri wa chibadwa umaphatikizaponso zokambirana za chiwopsezo cha matenda a MEN1 kwa mwanayo komanso abale ena.

Ana omwe amapezeka kuti ali ndi matenda a MEN1 amafufuzidwa ngati ali ndi khansa kuyambira ali ndi zaka 5 ndikupitiliza moyo wawo wonse. Lankhulani ndi dokotala wa mwana wanu za mayeso ndi njira zofunika kuti muwone ngati ali ndi khansa komanso kuti azichita kangati.

Matenda a MEN2 amaphatikizapo timagulu tiwiri tating'ono: MEN2A ndi MEN2B.

• Matenda a MEN2A

Matenda a MEN2A amatchedwanso matenda a Sipple. Kuzindikira matenda a MEN2A kumatha kuchitika ngati wodwala kapena makolo a wodwalayo, abale, alongo, kapena ana ali ndi zotsatirazi:

• Khansa ya chithokomiro ya medullary (khansa yomwe imapangidwa m'maselo a parafollicular C m'thupi). Zizindikiro za khansa ya chithokomiro ya medullary ingaphatikizepo:

• Bulu pakhosi kapena m'khosi.

• Kuvuta kupuma.

• Vuto kumeza.

• Kuopsa.

• Pheochromocytoma (chotupa cha adrenal gland). Zizindikiro za pheochromocytoma zitha kuphatikiza:

• Ululu m'mimba kapena pachifuwa.

• Kugunda kwamphamvu, kwachangu, kapena kosasinthasintha.

• Mutu.

• Thukuta lolemera popanda chifukwa chodziwika.

• Chizungulire.

• Kumva kugwedezeka.

• Kukhala wokwiya kapena wamanjenje.

• Matenda a parathyroid gland (chotupa chosaopsa cha gland ya parathyroid kapena kuwonjezera kukula kwa England). Zizindikiro za matenda a parathyroid atha kukhala:

• Matenda a Hypercalcemia.

• Ululu m'mimba, mbali, kapena kumbuyo komwe sikutha.

• Kupweteka m'mafupa.

• Fupa losweka.

• Chotupa pakhosi.

• Kulephera kuyankhula.

• Vuto kumeza.

Matenda ena a khansa ya chithokomiro amapezeka ndi matenda a Hirschsprung (kudzimbidwa kosalekeza komwe kumayamba mwana akadali khanda), komwe kumapezeka m'mabanja ena omwe ali ndi matenda a MEN2A. Matenda a Hirschsprung amatha kuwonekera zizindikiro zina za matenda a MEN2A zisanachitike. Odwala omwe amapezeka kuti ali ndi matenda a Hirschsprung ayenera kuwunikidwa kuti asinthe mawonekedwe amtundu wa RET omwe amalumikizidwa ndi khansa yamatenda a medullary ndi matenda a MEN2A.

Wodziwika medullary carcinoma wa chithokomiro (FMTC) ndi mtundu wa matenda a MEN2A omwe amayambitsa khansa yamatenda a medullary. Matenda a FMTC atha kupezeka ngati mamembala awiri kapena kupitilira apo ali ndi khansa ya chithokomiro ndipo palibe abale omwe ali ndi vuto la parathyroid kapena adrenal.

• Matenda a MEN2B

Odwala omwe ali ndi matenda a MEN2B atha kukhala ndi thupi locheperako lomwe limakhala ndi manja ndi miyendo yayitali, yopyapyala. Milomo imatha kuwoneka yayikulu komanso yotupa chifukwa cha zotupa zoyipa m'mimbamo. Matenda a MEN2B angayambitse izi:

• Khansa ya chithokomiro ya Medullary (ikukula msanga).

• Parathyroid hyperplasia.

• Adenomas.

• Pheochromocytoma.

• Mitsempha yamitsempha yamitsempha m'matumbo kapena m'malo ena.

Mayeso omwe amagwiritsidwa ntchito pofufuza ndikuwonetsa ma syndromes a MEN amadalira zizindikilo ndi mbiri ya banja la wodwalayo. Zitha kuphatikiza:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Kafukufuku wamagazi.

• Ultrasound.

• MRI.

• Kujambula kwa CT.

• Sakanizani PET.

• Zabwino-singano aspiration (FNA) kapena biopsy ya opaleshoni.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena ndi njira zomwe zimagwiritsidwa ntchito pozindikira matenda a MEN ndi izi:

• Kuyesedwa kwachibadwa: Kuyesa kwa labotale komwe maselo kapena minofu imawunikiridwa kuti ifufuze zosintha za majini kapena ma chromosomes. Zosinthazi zitha kukhala chizindikiro choti munthu ali kapena ali pachiwopsezo chokhala ndi matenda kapena vuto linalake. Chitsanzo chamagazi chimayang'aniridwa ndi mtundu wa MEN1 kuti mupeze matenda a MEN1 komanso jini la RET kuti mupeze matenda a MEN2.

• Maphunziro a mahomoni amwazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa mahomoni ena omwe amatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Mwazi amathanso kufufuzidwa ngati mulingo wambiri wa mahomoni calcitonin kapena parathyroid hormone (PTH).

• Chithokomiro jambulani: A pang'ono chinthu nyukiliya ndi kuwameza kapena jekeseni. Zinthu zowononga nyukiliya zimasonkhanitsa m'maselo a chithokomiro. Kamera yapadera yolumikizidwa ndi kompyuta imazindikira ma radiation omwe apatsidwa ndikupanga zithunzi zosonyeza momwe chithokomiro chikuwonekera komanso momwe chimagwirira ntchito komanso ngati khansayo yafalikira kupitirira chithokomiro. Ngati kuchuluka kwa timadzi tomwe timayambitsa matenda a chithokomiro m'magazi a mwana ndikotsika, kuyesa kupanga zithunzi za chithokomiro kumachitika asanamuchite opaleshoni.

• Sestamibi scan: Mtundu wa radionuclide scan womwe umagwiritsidwa ntchito kuti upeze chithokomiro chopitilira muyeso. Kamtengo kakang'ono kwambiri ka radioactive kotchedwa technetium 99 kamalowetsedwa mumtsempha ndikuyenda m'magazi kupita ku matenda a parathyroid. Mankhwala owonongerawa amasonkhanitsidwa pamatenda opitilira muyeso ndikuwonekera bwino pakamera yapadera yomwe imazindikira kuwonongeka kwa radioact.

• Zitsanzo zamatenda a chithokomiro chopitilira muyeso: Njira yomwe magazi amachotsedwera pamitsempha pafupi ndi gland. Chitsanzocho chimayesedwa kuti chiyeza kuchuluka kwa timadzi timene timatulutsa magazi m'matenda onse. Zitsanzo za venous zitha kuchitidwa ngati kuyezetsa magazi kukuwonetsa kuti pali matenda opatsirana a parathyroid koma kuyerekezera kojambula sikukuwonetsa kuti ndi uti.

• Somatostatin receptor scintigraphy: Mtundu wa radionuclide scan womwe ungagwiritsidwe ntchito kupeza zotupa. Octreotide wocheperako kwambiri (mahomoni omwe amangirira zotupa) amalowetsedwa mumtsempha ndikuyenda m'magazi. Octreotide wama radioact amamangirira pachotupacho ndipo kamera yapadera yomwe imazindikira kuti radioactivity imagwiritsidwa ntchito kuwonetsa ngati pali zotupa zazilonda zam'mimba. Njirayi imatchedwanso octreotide scan ndi SRS.

• Kusanthula kwa MIBG: Njira yogwiritsira ntchito zotupa za neuroendocrine, monga pheochromocytoma. Kanthu kakang'ono kwambiri kamene kamatchedwa radioactive MIBG kamalowetsedwa mumtsempha ndikuyenda m'magazi. Maselo otupa a Neuroendocrine amatenga MIBG yamagetsi ndipo amadziwika ndi sikani. Zithunzi zitha kutengedwa masiku 1-3. Yankho la ayodini lingaperekedwe musanayesedwe kapena panthawi yoyesera kuti chithokomiro chisatenge MIBG yambiri.

• Kuyezetsa mkodzo kwa maola makumi awiri mphambu anayi: Njira yogwiritsira ntchito zotupa za neuroendocrine, monga pheochromocytoma. Mkodzo umasonkhanitsidwa kwa maola 24 kuti muyese kuchuluka kwa catecholamines mu mkodzo. Zinthu zomwe zimayambitsidwa chifukwa cha kuwonongeka kwa katekolamines izi zimayesedwa. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Zapamwamba kuposa zachilendo zitha kukhala chizindikiro cha pheochromocytoma.

• Kuyeserera kokopa kwa Pentagastrin: Kuyesedwa komwe kumayesedwa magawo amwazi kuti athe kuyeza kuchuluka kwa calcitonin m'magazi. Calcium gluconate ndi pentagastrin zimalowetsedwa m'magazi kenako magawo angapo amwazi amatengedwa mphindi zisanu zotsatira. Ngati mulingo wa calcitonin m'magazi ukuwonjezeka, atha kukhala chizindikiro cha medullary khansa ya chithokomiro.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Pali mitundu ingapo ya matenda a MEN, ndipo mtundu uliwonse umafunikira chithandizo chosiyanasiyana:

• Odwala omwe ali ndi matenda a MEN1 amathandizidwa ndi zotupa za parathyroid, pancreatic, ndi pituitary.

• Odwala omwe ali ndi matenda a MEN1 komanso primary hyperparathyroidism atha kuchitidwa opaleshoni kuti achotse zopangitsa zitatu za parathyroid ndi thymus.

• Odwala omwe ali ndi matenda a MEN2A nthawi zambiri amachitidwa opareshoni kuti achotse chithokomiro pofika zaka 5 kapena kupitilira apo ngati kuyesa kwa majini kumawonetsa kusintha kwa mtundu wa RET. Kuchita opaleshoniyo kumachitika kuti mupeze khansa kapena kuchepetsa mwayi womwe khansara ipange kapena kufalikira.

• Makanda omwe ali ndi matenda a MEN2B atha kuchitidwa opaleshoni kuti achotse chithokomiro kuti achepetse mwayi womwe khansa ipange kapena kufalikira.

• Ana omwe ali ndi matenda a MEN2B omwe ali ndi khansa ya chithokomiro ya medullary atha kuthandizidwa ndi mankhwala (kinase inhibitor otchedwa vandetanib).

Chithandizo cha odwala omwe ali ndi matenda a Hirschsprung ndi kusintha kwina kwa majini a RET ndi awa:

• Matenda onse a thyroidectomy amachepetsa mwayi woti khansa ipangidwe.

Chithandizo cha matenda obwerezabwereza a MEN mwa ana atha kukhala ndi izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Pheochromocytoma ndi Paraganglioma

Pheochromocytoma ndi paraganglioma ndi zotupa zosawerengeka zomwe zimachokera ku mitsempha yomweyo. Ambiri mwa zotupazi si khansa.

• Maonekedwe a Pheochromocytoma m'matenda a adrenal. Pali zopangitsa ziwiri za adrenal, imodzi pamwamba pa impso iliyonse kumbuyo kwa pamimba. Chidutswa chilichonse cha adrenal chili ndi magawo awiri. Mbali yakunja ya adrenal gland ndi adrenal cortex. Pakatikati mwa adrenal gland ndi adrenal medulla. Pheochromocytoma ndi chotupa cha adrenal medulla.

Matenda a adrenal amapanga mahomoni ofunikira otchedwa catecholamines. Adrenaline (epinephrine) ndi noradrenaline (norepinephrine) ndi mitundu iwiri ya katekolini zomwe zimathandiza kuchepetsa kugunda kwa mtima, kuthamanga kwa magazi, shuga m'magazi, komanso momwe thupi limachitira ndi nkhawa. Ma pheochromocytomas ena amatulutsa zowonjezera adrenaline ndi noradrenaline m'magazi ndipo zimayambitsa zizindikilo.

• Paraganglioma imapanga kunja kwa ma adrenal gland pafupi ndi mtsempha wama carotid, m'njira zamitsempha m'mutu ndi m'khosi, komanso mbali zina za thupi. Ma paragangliomas ena amapanga makatekolamu owonjezera otchedwa adrenaline ndi noradrenaline. Kutulutsa adrenaline ndi noradrenaline m'magazi kumatha kubweretsa zizindikilo.

Zowopsa, Zizindikiro ndi Zizindikiro, ndi Kuzindikira ndi Kuyesa Kwakanthawi

Chilichonse chomwe chimakulitsa mwayi wanu wodwala chimatchedwa chiopsezo. Kukhala ndi chiopsezo sizitanthauza kuti mutenga khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala wa mwana wanu ngati mukuganiza kuti mwana wanu akhoza kukhala pachiwopsezo.

Chiwopsezo cha pheochromocytoma kapena paraganglioma chikuwonjezeka pakukhala ndi syndromes kapena cholowa chamtunduwu:

• Matenda angapo a endocrine neoplasia type 1 (MEN1). Matendawa amatha kuphatikiza zotupa m'matumbo a parathyroid, gland pituitary, kapena maselo am'mimba mumankhwala, ndipo kawirikawiri, pheochromocytoma.

• Matenda angapo a endocrine neoplasia mtundu wa 2A. Matendawa atha kuphatikizira pheochromocytoma, khansa ya chithokomiro ya medullary, ndi matenda am'matumbo a parathyroid.

• Matenda angapo a endocrine neoplasia mtundu wa 2B. Matendawa atha kuphatikizira pheochromocytoma, medullary khansa ya chithokomiro, parathyroid hyperplasia, ndi zina.

• Matenda a von Hippel-Lindau (VHL). Matendawa atha kuphatikizira pheochromocytoma, paraganglioma, hemangioblastoma, clear cell renal carcinoma, zotupa za pancreatic neuroendocrine, ndi zina.

• Mtundu wa Neurofibromatosis 1 (NF1). Matendawa atha kuphatikizira ma neurofibromas, zotupa zamaubongo, pheochromocytoma, ndi zina.

• Carney-Stratakis nthawi. Matendawa amatha kuphatikizira paraganglioma ndi chotupa cham'mimba cham'mimba (GIST).

• Carney triad. Matendawa atha kuphatikizira paraganglioma, GIST, ndi pulmonary chondroma.

• Wodziwika pheochromocytoma kapena paraganglioma.

Oposa theka la ana ndi achinyamata omwe amapezeka ndi pheochromocytoma kapena paraganglioma ali ndi matenda obadwa nawo kapena kusintha kwa majini komwe kumaonjezera ngozi ya khansa. Upangiri wa chibadwa (kukambirana ndi katswiri wophunzitsidwa za matenda obadwa nawo) ndi kuyesa ndi gawo lofunikira pamakonzedwe amachiritso.

Zotupa zina sizimapanga adrenaline kapena noradrenaline ndipo sizimayambitsa matenda. Zotupazi zimatha kupezeka ngati chotupa m'khosi kapena pakachitika mayeso kapena chifukwa china. Zizindikiro za pheochromocytoma ndi paraganglioma zimachitika adrenaline kapena noradrenaline atatulutsidwa m'magazi. Izi ndi zina zimatha kuyambitsa pheochromocytoma, paraganglioma, kapena zina. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Kuthamanga kwa magazi.

• Mutu.

• Thukuta lolemera popanda chifukwa chodziwika.

• Kugunda kwamphamvu, kwachangu, kapena kosasinthasintha.

• Kumva kugwedezeka.

• Kukhala wotumbululuka kwambiri.

• Chizungulire.

• Kukhala wokwiya kapena wamanjenje.

Zizindikirozi zimatha kupezeka koma kuthamanga kwa magazi kumatha kuchitika kwa nthawi yayitali kwa odwala achichepere. Zizindikirozi zimathanso kupezeka ndi zolimbitsa thupi, kuvulala, kupweteka, opaleshoni yochotsa chotupacho, kudya zakudya monga chokoleti ndi tchizi, kapena mukamadutsa mkodzo (ngati chotupacho chili mchikhodzodzo).

Mayeso omwe amagwiritsidwa ntchito pofufuza ndi kupanga pheochromocytoma ndi paraganglioma zimadalira zizindikilo ndi mbiri ya banja la wodwalayo. Zitha kuphatikiza:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Sakanizani PET.

• Kujambula kwa CT (CAT scan).

• MRI (kulingalira kwa maginito).

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena ndi njira zomwe amagwiritsira ntchito pheochromocytoma ndi paraganglioma ndi izi:

• Mayeso a metanephrines opanda plasma: Kuyezetsa magazi komwe kumayeza kuchuluka kwa metanephrines m'magazi. Metanephrines ndi zinthu zomwe zimapangidwa thupi likawononga adrenaline kapena noradrenaline. Pheochromocytomas ndi paragangliomas amatha kupanga adrenaline ndi noradrenaline wambiri ndipo amayambitsa metanephrines m'magazi ndi mkodzo.

• Kafukufuku wamagazi a catecholamine: Njira yoyeserera magazi kuti ayese kuchuluka kwa catecholamines (adrenaline kapena noradrenaline) yotulutsidwa m'magazi. Zinthu zomwe zimayambitsidwa chifukwa cha kuwonongeka kwa katekolamines izi zimayesedwa. Kuchuluka kwachilendo (kosazolowereka kapena kochepera kuposa kwachilendo) kuchuluka kwa chinthu kumatha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Zapamwamba kuposa zachilendo zitha kukhala chizindikiro cha pheochromocytoma kapena paraganglioma.

• Kuyesa mkodzo kwa maola makumi awiri mphambu anayi: Kuyesedwa komwe mkodzo umasonkhanitsidwa kwa maola 24 kuti muyese kuchuluka kwa catecholamines (adrenaline kapena noradrenaline) kapena metanephrines mkodzo. Zinthu zomwe zimayambitsidwa chifukwa cha kuwonongeka kwa katekolamines izi zimayesedwa. Kuchuluka kwachilendo (kopitilira muyeso) kwa chinthu kumatha kukhala chizindikiro cha matenda m'chiwalo kapena minofu yomwe imapangitsa. Zapamwamba kuposa zachilendo zitha kukhala chizindikiro cha pheochromocytoma kapena paraganglioma.

• Kusanthula kwa MIBG: Njira yogwiritsira ntchito zotupa za neuroendocrine, monga pheochromocytoma ndi paraganglioma. Kanthu kakang'ono kwambiri kamene kamatchedwa radioactive MIBG kamalowetsedwa mumtsempha ndikuyenda m'magazi. Maselo otupa a Neuroendocrine amatenga MIBG yamagetsi ndipo amadziwika ndi sikani. Zithunzi zitha kutengedwa masiku 1-3. Yankho la ayodini lingaperekedwe musanayesedwe kapena panthawi yoyesera kuti chithokomiro chisatenge MIBG yambiri.

• Somatostatin receptor scintigraphy: Mtundu wa radionuclide scan womwe ungagwiritsidwe ntchito kupeza zotupa. Octreotide wocheperako kwambiri (mahomoni omwe amangirira zotupa) amalowetsedwa mumtsempha ndikuyenda m'magazi. Octreotide wama radioact amata chotupacho ndipo kamera yapadera yomwe imazindikira kuti radioactivity imagwiritsidwa ntchito kuwonetsa komwe kuli zotupa mthupi. Njirayi imatchedwanso octreotide scan ndi SRS.

• Kuyesedwa kwachibadwa: Kuyesa kwa labotale komwe maselo kapena minofu imawunikiridwa kuti ifufuze zosintha za majini kapena ma chromosomes. Zosinthazi zitha kukhala chizindikiro choti munthu ali kapena ali pachiwopsezo chokhala ndi matenda kapena vuto linalake. Otsatirawa ndi majini omwe angayesedwe kwa ana omwe ali ndi pheochromocytoma kapena paraganglioma: VHL, NF1, RET, SDHD, SDHB, SDHA, MAX, ndi TMEM127 majini.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha pheochromocytoma ndi paraganglioma mwa ana chingaphatikizepo izi:

• Opaleshoni kuchotsa kwathunthu chotupacho.

• Kuphatikiza kwa chemotherapy, mankhwala apamwamba a 131I-MIBG, kapena chithandizo chothandizira ma zotupa omwe afalikira mbali zina za thupi.

Asanachite opaleshoni, mankhwala osokoneza bongo omwe ali ndi alpha-blockers omwe amayang'anira kuthamanga kwa magazi ndi beta-blockers kuti athe kuwongolera kugunda kwa mtima amaperekedwa. Ngati matenda a adrenal onse atachotsedwa, mankhwala a mahomoni amoyo amoyo m'malo mwa mahomoni opangidwa ndi adrenal gland amafunikira pambuyo poti achite opaleshoni.

Chithandizo cha pheochromocytoma chokhazikika ndi paraganglioma mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa chithandizo cha 131I-MIBG.

• Kuyesedwa kwachipatala kwa mankhwala omwe ali ndi DNA methyltransferase inhibitor.

Khansa Yapakhungu (Melanoma, Cancamous Cell Cancer, Basal Cell Cancer)

Khansa yapakhungu ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba akhungu. Khungu ndilo chiwalo chachikulu kwambiri mthupi. Zimateteza kutentha, kuwala kwa dzuwa, kuvulala, komanso matenda. Khungu limathandizanso kuchepetsa kutentha kwa thupi ndikusungira madzi, mafuta, ndi vitamini D. Khungu lili ndi zigawo zingapo, koma zigawo zikuluzikulu ziwiri ndi epidermis (wosanjikiza kumtunda kapena kunja) ndi dermis (wosanjikiza kapena wamkati wosanjikiza). Khansa yapakhungu imayamba mu khungu, lomwe limapangidwa ndi mitundu itatu yamaselo:

• Ma Melanocyte: Amapezeka m'munsi mwa epidermis, maselowa amapanga melanin, pigment yomwe imapatsa khungu mtundu wachilengedwe. Khungu likawonekera padzuwa, ma melanocyte amapanga pigment yambiri ndikupangitsa khungu kuderali.

• Maselo osakanikirana: Maselo opyapyala, apansi omwe amapanga gawo lalikulu la khungu.

• Maselo oyambira: Maselo ozungulira pansi pama cell squamous.

Khungu la khungu, kuwonetsa khungu, khungu, ndi minofu yocheperako. Ma Melanocyte ali m'maselo osanjikiza am'munsi mwa epidermis.

Pali mitundu itatu ya khansa yapakhungu:

• Khansa ya pakhungu.

• Khansa yapakhungu lama cell squamous.

• Khansa yapakhungu yapakhungu.

Khansa ya pakhungu

Ngakhale khansa ya pakhungu ndi yosowa, ndi khansa yapakhungu yofala kwambiri mwa ana. Zimachitika kawirikawiri mwa achinyamata azaka 15 mpaka 19.

Chiwopsezo chokhala ndi khansa ya khansa chikuwonjezeka pokhala ndi izi:

• Giant melanocytic nevi (mawanga akulu akuda, omwe amatha kuphimba thunthu ndi ntchafu).

• Neurocutaneous melanosis (kobadwa nako melanocytic nevi pakhungu ndi ubongo).

• Xeroderma pigmentosum.

• Cholowa retinoblastoma.

• Chitetezo chofooka chamthupi.

Zina mwaziwopsezo za khansa ya khansa m'mibadwo yonse ndizo:

• Kukhala ndi mawonekedwe owoneka bwino, omwe akuphatikizapo izi:

• Khungu loyera lomwe limagundagunda ndikuwotcha mosavuta, siliongola, kapena kusanjika bwino.

• Buluu kapena wobiriwira kapena maso ena owala.

• Tsitsi lofiira kapena lofiira.

• Kuwonetsedwa ndi dzuwa lachilengedwe kapena dzuwa lochita kupanga (monga kuchokera kumabedi owotcha) kwa nthawi yayitali.

• Kukhala ndi timadontho tambiri tating'ono kapena tambiri.

• Kukhala ndi mbiri yabanja kapena mbiri yakale ya timadontho tachilendo (atypical nevus syndrome).

• Kukhala ndi mbiri yabanja ya khansa ya khansa.

Zizindikiro za khansa ya khansa ndi izi:

• Mole kuti:

• kusintha kukula, mawonekedwe, kapena utoto.

• ili ndi m'mbali kapena malire osakhazikika.

• ndi mitundu yoposa imodzi.

• ndiyosakanikirana (ngati mole imagawika pakati, magawo awiriwo ndiosiyana kukula kapena mawonekedwe).

• kuyabwa.

• Kutuluka, kutuluka magazi, kapena kutuluka zilonda zam'mimba (vuto lomwe khungu lam'mwamba limawonongeka ndipo minofu ili pansipa imawonekera).

• Sinthani khungu lakuda.

• Ma satellite (ma moles atsopano omwe amakula pafupi ndi mole yomwe ilipo).

Kuyesera kuti mupeze khansa ya khansa ikhoza kukhala ndi izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• X-ray ya chifuwa.

• Kujambula kwa CT.

• MRI.

• Sakanizani PET.

• Ultrasound.

Onani gawo la General Information kuti mumve zambiri za mayeserowa ndi njirazi.

Mayesero ena ndi njira zomwe amagwiritsira ntchito khansa ya khansa ndi izi:

• Kuyezetsa khungu: Dokotala kapena namwino amayang'ana khungu kuti apeze zotumphukira kapena mawanga omwe amawoneka achilendo pamtundu, kukula, mawonekedwe, kapangidwe kake.

• Biopsy: Zonse kapena gawo la kukula kosazolowereka limadulidwa pakhungu ndipo limayang'aniridwa ndi microscope ndi wodwala kuti aone ngati ali ndi khansa. Pali mitundu inayi yayikulu yamatenda achikopa:

• Shave biopsy: Lumo losabala limagwiritsidwa ntchito "kumeta" kukula kosawoneka bwino.

• Punch biopsy: Chida chapadera chotchedwa nkhonya kapena trephine chimagwiritsidwa ntchito pochotsa bwalo lazinyama pakukula kosawoneka bwino.

• Incopal biopsy: Scalpel imagwiritsidwa ntchito kuchotsa gawo la kukula kosawoneka bwino.

• Chisankho chodabwitsa: Scalpel imagwiritsidwa ntchito kuchotsa kukula konse.

• Sentinel lymph node biopsy: Kuchotsa kwa sentinel lymph node panthawi yochita opareshoni. Sentinel lymph node ndiye njira yoyamba yam'magulu am'magazi kuti alandire madzi m'mimba kuchokera pachotupa choyambirira. Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa sapezeka, mwina sikofunikira kuchotsa ma lymph node ambiri. Nthawi zina, sentinel lymph node imapezeka m'magulu angapo am'magulu.

• Lymph node dissection: Njira yochitira opaleshoni yomwe ma lymph node amachotsedwa ndipo mtundu wa minofu umayang'aniridwa ndi microscope ngati pali zizindikiro za khansa. Pochotsa minyewa yam'magawo am'magawo ena am'mimba, amachotsa ena mwa ma lymph node. Pochotsa minyewa yayikulu kwambiri yam'mimba, ma lymph node ambiri kapena aliwonse pachotupa amachotsedwa. Njirayi imatchedwanso lymphadenectomy.

Chithandizo cha khansa ya pakhungu

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa ya khansa yomwe siinafalikire ku ma lymph node kapena ziwalo zina za thupi imaphatikizapo izi:

• Opaleshoni yochotsa chotupacho ndi minofu yabwinobwino pozungulira.

Chithandizo cha khansa ya khansa yomwe yafalikira ku ma lymph node omwe ali pafupi ndi awa:

• Opaleshoni yochotsa chotupa ndi ma lymph node omwe ali ndi khansa.

• Immunotherapy yokhala ndi chitetezo cha chitetezo cha mthupi (pembrolizumab, ipilimumab, ndi nivolumab).

• Chithandizo choyenera ndi BRAF inhibitors (vemurafenib, dabrafenib, encorafenib) chokha kapena ndi MEK inhibitors (trametinib, binimetinib).

Chithandizo cha khansa ya khansa yomwe yafalikira kupitilira ma lymph node ingaphatikizepo izi:

• Immunotherapy (ipilimumab).

• Kuyesedwa kwachipatala kwa mankhwala opatsirana pakamwa (dabrafenib) mwa ana ndi achinyamata.

Chithandizo cha khansa yapakhungu yowopsa mwa ana chitha kuphatikizira izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

• Kuyesedwa kwachipatala kwa immunotherapy ndi immune checkpoint inhibitors (pembrolizumab, nivolumab, ipilimumab) mwa ana ndi achinyamata.

Onani chidule cha pa Chithandizo chachikulu cha Melanoma kuti mumve zambiri.

Khansa Ya squamous Cell ndi Khansa Ya khungu Loyambira

Khansa yapakhungu la Nonmelanoma (squamous cell ndi basal cell khansa) imapezeka kwambiri mwa ana ndi achinyamata. Chiwopsezo cha squamous cell kapena basal cell khansa chikuwonjezeka ndi izi:

• Kuwonetsedwa ndi dzuwa lachilengedwe kapena dzuwa lochita kupanga (monga kuchokera kumabedi owotcha) kwa nthawi yayitali.
• Kukhala ndi mawonekedwe owoneka bwino, omwe akuphatikizapo izi:

• Khungu loyera lomwe limagundagunda ndikuwotcha mosavuta, siliongola, kapena kusanjika bwino.

• Buluu kapena wobiriwira kapena maso ena owala.

• Tsitsi lofiira kapena lofiira.

• Kukhala ndi actinic keratosis.

• Kukhala ndi matenda a Gorlin.

• Mankhwala akale ndi radiation.

• Kukhala ndi chitetezo chamthupi chofooka.

Zizindikiro za khungu la squamous cell ndi basal cell khungu ndi izi:

• Chilonda chosachira.

• Madera akhungu omwe ali:

• Wamng'ono, wokweza, wosalala, wowala, komanso waxy.

• Wamng'ono, wokwera, ndi wofiyira kapena wofiirira.

• Lathyathyathya, lakuthwa, lofiira kapena lofiirira, komanso lansalu.

• Zowonongeka, zotuluka magazi, kapena zotupa.

• Zofanana ndi zipsera komanso zolimba.

Kuyesera kuti mupeze khungu lam'magazi komanso khungu la khungu loyambira kumaphatikizapo izi:

• Kuyezetsa khungu: Dokotala kapena namwino amayang'ana khungu kuti apeze zotumphukira kapena mawanga omwe amawoneka achilendo pamtundu, kukula, mawonekedwe, kapangidwe kake.

• Biopsy: Kukula konse kapena gawo lomwe silikuwoneka bwino limadulidwa pakhungu ndipo limayang'aniridwa ndi microscope ndi wodwala kuti aone ngati ali ndi khansa. Pali mitundu itatu yayikulu yamatenda achikopa:

• Shave biopsy: Mpeni wosabala umagwiritsidwa ntchito "kumeta" kukula komwe sikuwoneka bwino.

• Punch biopsy: Chida chapadera chotchedwa nkhonya kapena trephine chimagwiritsidwa ntchito pochotsa bwalo lanyama kuchokera pakukula komwe sikuwoneka bwino.

• Incopeal biopsy: Scalpel imagwiritsidwa ntchito kuchotsa gawo la kukula kosawoneka bwino.

• Chisankho chodabwitsa: Scalpel imagwiritsidwa ntchito kuchotsa kukula konse.

Kuchiza kwa khungu la squamous cell ndi khansa yapansi ya khungu

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha squamous cell ndi basal cell khansa mwa ana chingaphatikizepo izi:

• Opaleshoni kuchotsa chotupacho. Izi zitha kuphatikizira Mohs ma micrographic opareshoni.

Mohs micrographic opaleshoni ndi mtundu wa opaleshoni yomwe imagwiritsidwa ntchito khansa yapakhungu. Chotupacho chimadulidwa pakhungu pang'onopang'ono. Pochita opareshoni, m'mbali mwa chotupacho ndi chotupa chilichonse chotulutsidwa chimayang'aniridwa kudzera pa microscope kuti mufufuze ma cell a khansa. Zigawo zikupitilirabe kuchotsedwa mpaka pomwe sipadzakhalanso maselo a khansa. Opaleshoni yotereyi imachotsa minofu yabwinobwino momwe ingathere ndipo imagwiritsidwa ntchito pochotsa khansa yapakhungu kumaso.

Chithandizo cha khansa yowopsa yama cell ndi basal mwa ana imatha kuphatikizira izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo cha Khansa Yaikulu Ya khungu kuti mumve zambiri.

Matenda a m'mimba (Uveal) Melanoma

Intraocular khansa ya pakhungu imayamba pakati pa zigawo zitatu za khoma la diso. Mbali yakunja imaphatikizapo sclera yoyera ("yoyera ya diso") ndi khungu loyera kutsogolo kwa diso. M'kati mwake mumakhala minyewa ya minyewa, yotchedwa retina, yomwe imamva kuwala ndipo imatumiza zithunzi pamodzi ndi minyewa ya kuwala kupita ku ubongo. Mzere wapakati, womwe umapangidwa ndi khansa ya khansa ya m'mimba, umatchedwa uvea kapena uveal tract, ndipo uli ndi magawo atatu akuluakulu: iris, thupi la ciliary, ndi choroid.

Kutuluka kwa diso, kuwonetsa kunja ndi mkati kwa diso kuphatikiza sclera, cornea, iris, thupi la ciliary, choroid, retina, vitreous humor, ndi optic nerve. Vitreous kuseka ndi madzi omwe amadzaza pakatikati pa diso.

Zowopsa

Kuopsa kwa khansa yapakhosi ya intraocular kumawonjezeka ndi izi:

• Mtundu wowala wamaso.

• Mtundu wokongola wa khungu.

• Kulephera kusamba.

• Oculodermal melanocytosis.

• Nevi yodula.

Kuyesera kuti mupeze matenda a khansa yapakhungu ya m'mimba kungaphatikizepo izi:

• Kuyezetsa thupi komanso mbiri yathanzi.

• Ultrasound.

Mayesero ena ndi njira zomwe amagwiritsira ntchito matenda a khansa yapakhungu ndi intraocular ndi izi:

• Fluorescein angiography: Chiyeso chomwe chimagwiritsidwa ntchito kujambula chithunzi cha diso m'maso. Utoto wachikaso umalowetsedwa mumtsempha ndipo umayenda mthupi lonse kuphatikiza mitsempha yam'maso. Utoto wachikaso umapangitsa kuti zotengera m'maso zifulumire pamene chithunzi chatengedwa.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha khansa yapakhungu ya m'mimba mwa ana chimakhala ngati chithandizo kwa akulu ndipo chitha kuphatikizira izi:

• Opaleshoni kuchotsa chotupacho.

• Thandizo la radiation.

• Opaleshoni ya Laser

. Chithandizo cha khansa yapakhanda ya khansa ya ana imatha kuphatikizira izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Chithandizo chachikulu cha Intraocular (Uveal) Melanoma Treatment kuti mumve zambiri.

Chordoma

Chordoma ndi mtundu wosowa kwambiri wa chotupa chomwe chimakula pang'onopang'ono chomwe chimapangidwa kulikonse pamsana kuchokera kumutu kwa chigaza (fupa lotchedwa clivus) mpaka mchira. Kwa ana ndi achinyamata, ma chordomas amapangika m'mafupa m'munsi mwa chigaza kapena pafupi ndi fupa la mchira, kuwapangitsa kukhala kovuta kuchotsa kwathunthu ndi opareshoni.

Chordoma yaubwana imalumikizidwa ndi matenda a tuberous sclerosis, matenda am'magazi momwe zotupa zomwe zili zoyipa (osati khansa) zimapanga impso, ubongo, maso, mtima, mapapo, ndi khungu.

Zizindikiro ndi Zizindikiro

Zizindikiro za chordoma zimadalira komwe chotupacho chimapangidwira. Chordoma imatha kuyambitsa izi. Funsani dokotala wa mwana wanu ngati mwana wanu ali ndi zotsatirazi:

• Mutu.

• Masomphenya awiri.

• Mphuno yotsekedwa kapena yothina.

• Kulephera kuyankhula.

• Vuto kumeza.

• Khosi kapena ululu wammbuyo.

• Kupweteka kumbuyo kwa miyendo.

• Dzanzi, kumva kulasalasa, kapena kufooka kwa manja ndi miyendo.

• Kusintha kwa matumbo kapena zizolowezi za chikhodzodzo.

Zina zomwe sizili chordoma zimatha kuyambitsa zizindikilo zomwezi.

Kuyesa kudziwa chordoma kapena kuwona ngati kwafalikira ndi awa:

• MRI ya msana wonse.
• Kujambula kwa CT pachifuwa, pamimba, ndi m'chiuno.
• Chisokonezo. Zitsanzo za minofu zimachotsedwa ndikuwunika kuchuluka kwa mapuloteni otchedwa brachyury.

Chordomas imatha kubwereranso (kubwerera), nthawi zambiri pamalo omwewo, koma nthawi zina imabwereranso m'malo ena a mafupa kapena m'mapapu.

Kutulutsa

Kulosera (mwayi wochira) zimatengera izi:

• Msinkhu wa mwanayo.

• Kumene chotupacho chimakhalira m'mphepete mwa msana.

• Momwe chotupacho chimayankhira chithandizo.

• Kaya panali kusintha kwa matumbo kapena chikhodzodzo pakuzindikira.

• Kaya chotupacho chapezeka kumene kapena chachitika (kubwerera).

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo cha chordoma mwa ana chingaphatikizepo izi:

• Kuchita opaleshoni kuti ndichotse chotupa chonsecho, kenako ndikutsata ma radiation. Thandizo la radiation la radiation lingagwiritsidwe ntchito pa zotupa pafupi ndi tsinde la chigaza.

Chithandizo cha chordoma chobwerezabwereza mwa ana chingaphatikizepo izi:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini. Odwala omwe asintha mu jini la SMARCB1 atha kuchiritsidwa ndi tazemetostat pakuyesa kwachipatala.

Khansa ya Malo Osadziwika Osadziwika

Khansa ya pulayimale yosadziwika ndi matenda omwe amapezeka m'maselo owopsa (khansa) mthupi koma komwe khansa idayambira sikudziwika. Khansa imatha kupangika munyama zilizonse zamthupi. Khansa yoyamba (khansara yomwe idapanga koyamba) imafalikira mbali zina za thupi. Izi zimatchedwa metastasis. Maselo a khansa nthawi zambiri amawoneka ngati maselo amtundu wa khansa yomwe kansa idayambira. Mwachitsanzo, maselo a khansa ya m'mawere amatha kufalikira mpaka m'mapapu. Chifukwa khansayo idayamba m'mawere, maselo am'mapapo m'mapapo amawoneka ngati maselo a khansa ya m'mawere.

Nthawi zina madotolo amapeza komwe kansa yafalikira koma samapeza komwe m'thupi khansa idayamba kukula. Khansara yamtunduwu amatchedwa khansa ya chotupa choyambirira chosadziwika kapena chamatsenga.

Mu carcinoma ya pulayimale yosadziwika, maselo a khansa afalikira mthupi koma malo omwe khansa yoyamba idayambira sikudziwika.

Kuyesedwa kumachitika kuti mupeze komwe khansa yoyamba idayambira ndikudziwitsidwa komwe khansara yafalikira. Pamene mayesero amatha kupeza khansa yoyamba, khansayo sakhalanso khansa ya pulayimale yosadziwika ndipo mankhwala amachokera ku mtundu wa khansa yoyamba.

Chifukwa malo omwe khansayo idayambira sakudziwika, mayesero ndi njira zambiri, kuphatikiza kufotokozera za majini ndi kuyesa kwa majini, kungafunike kuti mupeze khansa yamtundu wanji. Ngati mayeso akuwonetsa kuti pangakhale khansa, kafukufuku amachitika. Biopsy ndikuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwala. Wodwala amayang'ana minofu kuti ayang'ane ma cell a khansa ndikupeza mtundu wa khansa. Mtundu wa biopsy womwe umachitika zimatengera gawo lomwe thupi limayesedwa khansa. Chimodzi mwazinthu zotsatirazi zingagwiritsidwe ntchito:

• Zabwino-singano aspiration (FNA) biopsy: Minyewa yochotsa kapena madzi pogwiritsa ntchito singano yopyapyala.

• Core biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu.

• Incopal biopsy: Kuchotsa gawo limodzi kapena chotupa cha mnofu.

• Chisankho chodabwitsa: Kuchotsa mtanda wonse wa minofu.

Mitundu ya khansa kapena minofu itachotsedwa ndiyosiyana ndi mtundu wa maselo a khansa omwe akuyembekezeka kupezeka, matenda a khansa ya pulayimale osadziwika amatha kupangidwa. Maselo m'thupi amakhala ndi mawonekedwe ena omwe amadalira mtundu wa minofu yomwe amachokera. Mwachitsanzo, mtundu wa minofu ya khansa yotengedwa pachifuwa ikuyembekezeka kukhala ndi maselo am'mawere. Komabe, ngati mtundu wa minofu ndi mtundu wina wamaselo (osapangidwa ndimaselo am'mabere), ndiye kuti ma cellwo afalikira ku bere kuchokera mbali ina ya thupi.

Ngati sizikudziwika komwe khansara idakhazikitsidwa poyambitsa matenda, adenocarcinomas, melanomas, ndi zotupa za m'mimba (monga rhabdomyosarcoma kapena neuroblastoma) ndi mitundu yotupa yomwe nthawi zambiri imapezeka mwa ana ndi achinyamata.

Chithandizo

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Chithandizo chimadalira momwe ma cell a khansa amawonekera pansi pa microscope, zaka za wodwalayo, zizindikilo ndi zizindikilo zake, komanso komwe khansara yafalikira mthupi. Chithandizo nthawi zambiri chimakhala chotsatira:

• Chemotherapy.

• Chithandizo chofuna.

• Thandizo la radiation.

Chithandizo cha khansa yabwinobwino ya ana osadziwika makamaka atha kukhala awa:

• Kuyesedwa kwachipatala komwe kumayang'ana chotupa cha wodwalayo ngati majini ena asintha. Mtundu wa mankhwala omwe akulimbikitsidwa omwe adzapatsidwe kwa wodwala umadalira mtundu wa kusintha kwa majini.

Onani chidule cha pa Carcinoma wamkulu wa Unknown Primary kuti mumve zambiri.

Kuti mudziwe Zambiri Zokhudza Khansa Yaubwana

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa yachilendo yaubwana, onani izi:

• Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi Khansa

• Computed Tomography (CT) Zithunzi ndi Khansa

• MyPART - Chotupa Changa Chotengera Ana ndi Achikulire

Kuti mumve zambiri za khansa yaubwana ndi zina zothandiza za khansa, onani izi:

• Za Khansa

• Khansa Za Ana

• Cure Search for Cancer ya Ana Tulukani Chodzikanira

• Zotsatira Zochedwetsa Khansa Yaana

• Achinyamata ndi Achinyamata Achikulire ndi Khansa

• Ana omwe ali ndi khansa: Upangiri wa Makolo

• Khansa mwa Ana ndi Achinyamata

• Kusinthana

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira

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