Mitundu / m'mimba / wodwala / chithandizo cham'mimba-pdq

Chithandizo cha Khansa ya m'mimba

Zambiri Zokhudza Khansa ya m'mimba

MFUNDO ZOFUNIKA

• Khansa ya m'mimba ndi matenda omwe mumakhala maselo owopsa (khansa) mkatikati mwa m'mimba.

• Ukalamba, zakudya, ndi matenda am'mimba zimatha kusokoneza chiopsezo chokhala ndi khansa yam'mimba.

• Zizindikiro za khansa yam'mimba zimaphatikizapo kudzimbidwa komanso kusapeza m'mimba kapena kupweteka.

• Kuyesa komwe kumayang'ana m'mimba ndi kummero kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya m'mimba.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Khansa ya m'mimba ndi matenda omwe mumakhala maselo owopsa (khansa) 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).

Khoma la m'mimba limapangidwa ndi zigawo zisanu za minofu. Kuchokera mkati mpaka mkatikati, zigawo za khoma la m'mimba ndi izi: mucosa, submucosa, minofu, subserosa (zolumikizira), ndi serosa. Khansara ya m'mimba imayamba mu mucosa ndipo imafalikira kudzera kunja kwake pamene ikukula.

Zotupa zam'mimba zimayamba kuthandizira minofu yolumikizana ndipo amathandizidwa mosiyana ndi khansa ya m'mimba. Onani chidule cha pa Chithandizo cha m'mimba cha Stromal Tumors Chithandizo kuti mumve zambiri.

Kuti mumve zambiri za khansa yam'mimba, onani mwachidule zotsatirazi za :

• Khansa Yachilendo Ya Chithandizo Chaubwana

• Kupewa Khansa Yam'mimba (Gastric)

• Kuyesera Khansa Yam'mimba (Gastric)

Ukalamba, zakudya, ndi matenda am'mimba zimatha kusokoneza chiopsezo chokhala ndi khansa yam'mimba.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo. Zowopsa za khansa ya m'mimba ndi izi:

• Kukhala ndi izi:

• Helicobacter pylori (H. pylori) matenda am'mimba.

• Matenda gastritis (kutupa m'mimba).

• Kuchepa kwa magazi m'thupi.

• Matumbo a metaplasia (vuto lomwe matumbo abwinobwino amalowedwa m'malo ndi maselo omwe amayendetsa matumbo).

• Tizilombo ting'onoting'ono m'mimba.

• Vuto la Epstein-Barr.

• Ma syndromes odziwika (kuphatikiza achibale adenomatous polyposis).

• Kudya zakudya zokhala ndi mchere wambiri, zakudya zosuta komanso zipatso ndi ndiwo zamasamba zochepa.

• Kudya zakudya zomwe sizinakonzedwe kapena kusungidwa bwino.

• Kukhala wamkulu kapena wamwamuna.

• Kusuta ndudu.

• Kukhala ndi amayi, abambo, mlongo, kapena mchimwene yemwe adadwala khansa yam'mimba.

Zizindikiro za khansa yam'mimba zimaphatikizapo kudzimbidwa komanso kusapeza m'mimba kapena kupweteka.

Izi ndi zizindikilo zina zimatha kubwera chifukwa cha khansa ya m'mimba kapena zovuta zina.

Kumayambiriro kwa khansa ya m'mimba, izi zingachitike:

• Kudzimbidwa ndi kusapeza m'mimba.

• Kumva kotupa mutatha kudya.

• Mseru wofatsa.

• Kutaya njala.

• Kutentha pa chifuwa.

M'magawo otsogola kwambiri a khansa ya m'mimba, zizindikilo zotsatirazi zitha kuchitika:

• Magazi mu chopondapo.

• Kusanza.

• Kuchepetsa thupi popanda chifukwa chodziwika.

• Kupweteka m'mimba.

• Jaundice (chikasu cha maso ndi khungu).

• Ascites (kumanga kwamadzi m'mimba).

• Vuto kumeza.

Funsani dokotala wanu ngati muli ndi mavuto amenewa.

Kuyesa komwe kumayang'ana m'mimba ndi kummero kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya m'mimba.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza 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.

• 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 nyemba lopangidwa ndi maselo ofiira amwazi.

• 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 (chubu chowonda, chowunikira) imadutsa pakamwa ndikutsika pakhosi kupita kummero.

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

• 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.

Barium kumeza khansa ya m'mimba. Wodwalayo ameza madzi a barium ndipo amayenda kupyola pamimba ndikulowa m'mimba. Ma X-ray amatengedwa kuti akayang'ane malo achilendo.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• Biopsy: Kuchotsa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope kuti aone ngati ali ndi khansa. Chidziwitso cha m'mimba nthawi zambiri chimachitika nthawi ya endoscopy.

Zoyeserera za minofu zitha kuwunikidwa kuti muone kuchuluka kwa majini a HER2 omwe alipo komanso kuchuluka kwa mapuloteni a HER2. Ngati pali majini ambiri a HER2 kapena mapuloteni apamwamba a HER2 kuposa masiku onse, khansara amatchedwa HER2 positive. Khansa yapamimba ya HER2 itha kuchiritsidwa ndi antioclonal antibody yomwe imayang'ana protein ya HER2.

Zoyeserera za minofu zitha kuwunikiranso matenda a Helicobacter pylori (H. pylori).

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa (kaya ndi m'mimba mokha kapena lafalikira kumalo am'mimba kapena malo ena m'thupi).

• Thanzi labwino la wodwalayo.

Khansa ya m'mimba ikapezeka msanga kwambiri, pamakhala mwayi wabwino wochira. Khansa ya m'mimba nthawi zambiri imapita patsogolo ikapezeka. Pamapeto pake, khansa ya m'mimba imatha kuchiritsidwa koma imatha kuchiritsidwa. Kutenga nawo gawo limodzi mwazoyeserera zamankhwala zomwe zikuchitika kuti chithandizo chithandizidwe bwino. Zambiri zamayesero azachipatala omwe akupitilira amapezeka patsamba la NCI.

Magawo a Khansa ya m'mimba

MFUNDO ZOFUNIKA

• Khansa ya m'mimba itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira m'mimba kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

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

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya m'mimba:

• Gawo 0 (Carcinoma mu Situ)

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

Khansa ya m'mimba itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira m'mimba kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yafalikira m'mimba kapena mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

• 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.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamkati mwa thupi, monga chifuwa, pamimba, kapena m'chiuno, zotengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• 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. PET scan ndi CT scan zitha kuchitika nthawi yomweyo. Izi zimatchedwa PET-CT.

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo zazomwe zili mkati mwa thupi. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• 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 mwazinthuzo. 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 khansa. Njira yothetsera vutoli imatha kutsukidwa pamwamba pamimba m'mimba ndiyeno nkuchotsedwa kuti ipeze maselo. Maselowa amayang'ananso pansi pa microscope kuti aone ngati ali ndi khansa.

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 m'mimba imafalikira mpaka pachiwindi, maselo a khansa omwe ali pachiwindi ndi maselo a khansa yam'mimba. Matendawa ndi khansa ya m'mimba, osati khansa ya chiwindi.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya m'mimba:

Gawo 0 (Carcinoma mu Situ)

Pa gawo 0, maselo osadziwika amapezeka mumkati mwa mkati mwa khoma la m'mimba. Maselo achilendowa amatha kukhala khansa ndikufalikira m'minyewa yabwinobwino. Gawo 0 limatchedwanso carcinoma in situ.

Zigawo za khoma la m'mimba. Khoma la m'mimba limapangidwa ndi mucosa (mkatikati kwambiri), submucosa, minofu wosanjikiza, subserosa, ndi serosa (kunja kwenikweni). Mimba ndi chiwalo chakumtunda.

Gawo I

Gawo I lagawika magawo IA ndi IB.

• Gawo IA: Khansa yapanga mucosa (mkatikati kwambiri) mwa khoma la m'mimba ndipo mwina ifalikira ku submucosa (wosanjikiza wa minofu pafupi ndi mucosa).

• Gawo IB: Khansa:

• wapanga mucosa (mkatikati kwambiri) mwa khoma la m'mimba ndipo atha kufalikira ku submucosa (wosanjikiza wa minofu pafupi ndi mucosa). Khansa yafalikira ku 1 kapena 2 ma lymph node apafupi; kapena

• wapanga mucosa wam'mimba khoma ndipo wafalikira mpaka pamimba.

Gawo II

Khansa yachiwiri ya m'mimba imagawika magawo IIA ndi IIB.

• Gawo IIA: Khansa:

• atha kufalikira ku submucosa (wosanjikiza wa minofu pafupi ndi mucosa) wamkati mwamimba. Khansa yafalikira mpaka ma 3 mpaka 6 ma lymph node apafupi; kapena

• yafalikira ku gawo laminyewa la khoma la m'mimba. Khansa yafalikira ku 1 kapena 2 ma lymph node apafupi; kapena

• yafalikira ku subserosa (wosanjikiza wa minofu yolumikizana pafupi ndi minofu) ya khoma la m'mimba.

• Gawo IIB: Khansa:

• atha kufalikira ku submucosa (wosanjikiza wa minofu pafupi ndi mucosa) wamkati mwamimba. Khansa yafalikira mpaka ma 7 mpaka 15 ma lymph node apafupi; kapena

• yafalikira ku gawo laminyewa la khoma la m'mimba. Khansa yafalikira mpaka ma 3 mpaka 6 ma lymph node apafupi; kapena

• yafalikira ku subserosa (wosanjikiza wa minofu yolumikizana pafupi ndi minofu) ya khoma la m'mimba. Khansa yafalikira ku 1 kapena 2 ma lymph node apafupi; kapena

• yafalikira ku serosa (kunja kwenikweni) kwa khoma la m'mimba.

Gawo III

Khansa ya m'mimba mwa Gawo III imagawika magawo IIIA, IIIB, ndi IIIC.

• Gawo IIIA: Khansa yafalikira:

• mpaka pamimba pamimba. Khansa yafalikira mpaka ma 7 mpaka 15 ma lymph node apafupi; kapena

• kwa subserosa (wosanjikiza wa minofu yolumikizana pafupi ndi minofu) ya khoma la m'mimba. Khansa yafalikira mpaka ma 3 mpaka 6 ma lymph node apafupi; kapena

• kupita ku serosa (kunja kwenikweni) kwa khoma la m'mimba. Khansa yafalikira ku 1 mpaka 6 ma lymph node apafupi; kapena

• ku ziwalo zapafupi, monga ndulu, kholingo, chiwindi, chifundamtima, kapamba, khoma la pamimba, adrenal gland, impso, kapena matumbo ang'onoang'ono, kapena kumbuyo kwamimba.

• Gawo IIIB: Khansa:

• atha kufalikira ku submucosa (wosanjikiza wa minofu pafupi ndi mucosa) kapena kulumikizana kwa minofu yam'mimba. Khansa yafalikira ku ma lymph node 16 kapena kupitilira apo; kapena

• yafalikira ku subserosa (wosanjikiza wa minofu yolumikizana pafupi ndi minofu yosanjikiza) kapena ku serosa (kunja kwenikweni) kwa khoma la m'mimba. Khansa yafalikira mpaka ma 7 mpaka 15 ma lymph node apafupi; kapena

• yafalikira kuchokera m'mimba kupita ku ziwalo zapafupi, monga ndulu, kholoni, chiwindi, diaphragm, kapamba, khoma la pamimba, adrenal gland, impso, kapena m'matumbo ang'onoang'ono, kapena kumbuyo kwa pamimba.

Khansa yafalikira mpaka 1 mpaka 6 ma lymph node apafupi.

• Gawo IIIC: Khansa yafalikira:

• kwa subserosa (wosanjikiza wa minofu yolumikizana pafupi ndi minofu yosanjikiza) kapena ku serosa (kunja kwenikweni) kwa khoma la m'mimba. Khansa yafalikira ku ma lymph node 16 kapena kupitilira apo; kapena

• kuchokera mmimba kulowa m'ziwalo zapafupi, monga ndulu, koloni, chiwindi, diaphragm, kapamba, khoma la pamimba, adrenal gland, impso, kapena m'matumbo ang'onoang'ono, kapena kumbuyo kwa pamimba. Khansa yafalikira ku ma lymph node 7 kapena kupitilira apo.

Gawo IV

Pa gawo IV, khansa yafalikira mbali zina za thupi, monga mapapu, chiwindi, ma lymph node akutali, ndi minofu yomwe imayala khoma la pamimba.

Khansa Yam'mimba Yobwereza

Khansa yapamimba yaposachedwa ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwerera m'mimba kapena mbali zina za thupi monga chiwindi kapena ma lymph node.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya m'mimba.

• Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Opaleshoni

• Kutulutsa kwa endoscopic mucosal

• Chemotherapy

• Thandizo la radiation

• Kukonzekera

• Chithandizo chofuna

• Chitetezo chamatenda

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Chithandizo cha khansa yam'mimba chimatha kuyambitsa zovuta zina.

• Odwala angaganize zopita nawo kukayezetsa.

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

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya m'mimba.

Pali mitundu ingapo yamankhwala othandizira odwala khansa ya m'mimba. 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. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mitundu isanu ndi iwiri yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni ndi njira yodziwika bwino yothandizira magawo onse a khansa yam'mimba. Mitundu yotsatirayi ingagwiritsidwe ntchito:

• Subtotal gastrectomy: Kuchotsa gawo la m'mimba lomwe mumakhala khansa, ma lymph node oyandikira, komanso ziwalo zina ndi ziwalo zina pafupi ndi chotupacho. Nthata imatha kuchotsedwa. Nthata ndi chiwalo chomwe chimapanga ma lymphocyte, chimasunga maselo ofiira ndi ma lymphocyte, chimasefa magazi, ndikuwononga maselo akale amwazi. Nduluyo ili kumanzere kwa mimba pafupi ndi m'mimba.

• Gastrectomy yathunthu: Kuchotsa m'mimba monse, ma lymph node oyandikira, ndi ziwalo zam'mero, matumbo ang'ono, ndi ziwalo zina pafupi ndi chotupacho. Nthata imatha kuchotsedwa. Mimbayo imalumikizidwa ndi m'matumbo ang'onoang'ono kuti wodwalayo azitha kudya ndikumeza.

Ngati chotupacho chikuletsa m'mimba koma khansara sichitha kuchotsedwa kwathunthu ndi opaleshoni yokhazikika, njira zotsatirazi zitha kugwiritsidwa ntchito:

• Endoluminal stent placement: Njira yoyika stent (chubu chowonda, chotambasuka) kuti njira yotseguka (monga mitsempha kapena kholingo) itseguke. Kwa zotupa zomwe zimatseka kulowa kapena kutuluka m'mimba, opareshoni itha kuchitidwa kuti ipangitse kununkhira kuchokera kummero kupita m'mimba kapena kuchokera m'mimba kupita m'matumbo ang'onoang'ono kuti wodwalayo azidya bwino.

• Endoluminal laser therapy: Njira yomwe endoscope (chubu chowonda, chowala) yokhala ndi laser yolumikizidwa imalowetsedwa mthupi. Laser ndi nyali yayikulu yakuwala yomwe ingagwiritsidwe ntchito ngati mpeni.

• Gastrojejunostomy: Opaleshoni yochotsa gawo la m'mimba ndi khansa yomwe imatseka kutsegula m'matumbo ang'onoang'ono. Mimba imalumikizidwa ndi jejunum (gawo la m'matumbo ang'ono) kuti chakudya ndi mankhwala zizidutsa kuchokera m'mimba kupita m'matumbo ang'onoang'ono.

Kutulutsa kwa endoscopic mucosal

Endoscopic mucosal resection ndi njira yomwe imagwiritsa ntchito endoscope kuti ichotse khansa yoyambira msanga komanso zotupa zoyambilira kuchokera m'mbali mwa mundawo popanda kuchitidwa opareshoni. Endoscope ndi chida chopyapyala, chokhala ngati chubu chokhala ndi kuwala ndi mandala owonera. Zitha kuphatikizanso zida zochotsera zophuka kuchokera m'mbali yam'mimba.

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 kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.

Mtundu wa chemotherapy wam'madera omwe akuphunziridwa kuti athetse khansa ya m'mimba ndi intraperitoneal (IP) chemotherapy. Mu IP chemotherapy, mankhwala a anticancer amatengeredwa molunjika mu peritoneal cavity (danga lomwe lili ndi ziwalo zam'mimba) kudzera mu chubu chochepa.

Hyperthermic intraperitoneal chemotherapy (HIPEC) ndi mankhwala omwe amagwiritsidwa ntchito pa opaleshoni yomwe ikuphunziridwa ndi khansa ya m'mimba. Dokotalayo atachotsa zotupa zambiri momwe angathere, chemotherapy yotenthedwa imatumizidwa molunjika m'mimbamo ya peritoneal.

Onani Mankhwala Ovomerezeka a Khansa Yam'mimba (Gastric) Khansa kuti mumve zambiri.

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 iwiri ya mankhwala a radiation:

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

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza khansa yam'mimba.

Kukonzekera

Mankhwala a Chemoradiation amaphatikiza chemotherapy ndi radiation radiation kuti iwonjezere zotsatira zake zonse ziwiri. Chemoradiation yoperekedwa atachitidwa opareshoni, kuti achepetse chiopsezo kuti khansayo ibwereranso, amatchedwa adjuvant therapy. Chemoradiation yoperekedwa asanachite opareshoni, kuti ichepetse chotupacho (neoadjuvant therapy), ikuwerengedwa.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osavulaza maselo abwinobwino. Ma antibodies a monoclonal ndi multikinase inhibitors ndi mitundu ya mankhwala omwe amagwiritsidwa ntchito pochiza khansa ya m'mimba.

• Thandizo la monoclonal antibody: Mankhwala amtunduwu 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.

Pali mitundu yosiyanasiyana ya mankhwala a monoclonal antibody:

• Trastuzumab imatseka zotsatira za kukula kwa protein HER2, yomwe imatumiza zizindikilo zakukula kumaselo am'magazi am'mimba.

• Ramucirumab amaletsa zotsatira za mapuloteni ena, kuphatikiza kukula kwam'mimba. Izi zitha kuthandiza kuti ma cell a khansa asakule komanso akhoza kuwapha. Zingatetezenso kukula kwa mitsempha yatsopano yamagazi yomwe zotupa zimayenera kukula.

Trastuzumab ndi ramucirumab amagwiritsidwa ntchito pochiza khansa ya m'mimba ya siteji IV komanso khansa ya m'mimba yomwe singachotsedwe ndi opaleshoni kapena yabwereranso.

• Multikinase inhibitors: Awa ndi mankhwala ang'onoang'ono omwe amapyola mu selo ndipo amagwira ntchito mkati mwa maselo a khansa kuti atseke ma protein angapo omwe ma cell a khansa amafunika kukula ndikugawana. Ma multikinase inhibitors amakhalanso ndi angiogenesis inhibitor zotsatira. Angiogenesis inhibitors amaletsa kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula.

Pali mitundu yosiyanasiyana ya mankhwala a multikinase inhibitor:

• Regorafenib ndi multikinase inhibitor ndi angiogenesis inhibitor yomwe imatseka zovuta zamapuloteni angapo mkati mwa zotupa. Regorafenib ikuwerengedwa pochiza khansa ya m'mimba ya gawo IV komanso khansa ya m'mimba yomwe singachotsedwe ndi opaleshoni kapena yabwerezedwanso.

Onani Mankhwala Ovomerezeka a Khansa Yam'mimba (Gastric) Khansa kuti mumve zambiri.

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.

Mankhwala oteteza chitetezo cha mthupi ndi mtundu wa immunotherapy.

• Mankhwala oteteza ku chitetezo cha mthupi: PD-1 ndi mapuloteni pamwamba pa ma 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. Pembrolizumab ndi mtundu wa immune checkpoint inhibitor.

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).

Onani Mankhwala Ovomerezeka a Khansa Yam'mimba (Gastric) Khansa kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Chithandizo cha khansa yam'mimba chimatha kuyambitsa zovuta zina.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

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 vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Mayesero ena amathanso kuchitidwa:

• Kuyesa kwa Carcinoembryonic antigen (CEA) ndi CA 19-9 kuyeserera: Njira yomwe minyewa yoyeserera imawunikiridwa kuti izindikire kuchuluka kwa zinthu zina zopangidwa ndi ziwalo, zotupa, kapena zotupa m'mthupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magulu owonjezeka mthupi. Izi zimatchedwa zolembera zotupa. Kuposa kuchuluka kwa carcinoembryonic antigen (CEA) ndi CA 19-9 kungatanthauze kuti khansa ya m'mimba yabweranso atalandira chithandizo.

Njira Zothandizira ndi Gawo

M'chigawo chino

• Gawo 0 (Carcinoma mu Situ)

• Gawo I Khansa Yam'mimba

• Magawo II ndi III Khansa ya m'mimba

• Khansa ya Gastric ya Gawo Lachitatu, Khansa ya m'mimba yomwe Sitha Kuchotsedwa ndi Opaleshoni, ndi Khansa Yam'mimba Yam'mapapo

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

Gawo 0 (Carcinoma mu Situ)

Chithandizo cha gawo 0 chingaphatikizepo izi:

• Opaleshoni (yathunthu kapena yotsika kwambiri ya gastrectomy).

• Kutulutsa kwa endoscopic mucosal.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Gawo I Khansa Yam'mimba

Chithandizo cha siteji yoyamba ya khansa yam'mimba ingaphatikizepo izi:

• Opaleshoni (yathunthu kapena yotsika kwambiri ya gastrectomy).

• Endoscopic mucosal resection kwa odwala ena omwe ali ndi khansa ya m'mimba ya IA.

• Opaleshoni (yathunthu kapena yotsika kwambiri ya gastrectomy) yotsatiridwa ndi mankhwala a chemoradiation.

• Kuyesedwa kwachipatala kwa mankhwala opangira mankhwala opatsirana asanaperekedwe opaleshoni.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Magawo II ndi III Khansa ya m'mimba

Chithandizo cha khansa yachiwiri ya m'mimba ndi khansa yachitatu ya khansa yam'mimba ingaphatikizepo izi:

• Opaleshoni (yathunthu kapena yotsika kwambiri ya gastrectomy).

• Chemotherapy yoperekedwa asanachite opareshoni.

• Opaleshoni (yathunthu kapena yotsika kwambiri ya gastrectomy) yotsatiridwa ndi chemoradiation therapy kapena chemotherapy.

• Kuyesedwa kwachipatala kwa mankhwala opangira mankhwala opatsirana asanaperekedwe opaleshoni.

• Kuyesedwa kwachipatala kwa chemotherapy yoperekedwa asanachite opareshoni.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Khansa ya Gastric ya Gawo Lachitatu, Khansa ya m'mimba yomwe Sitha Kuchotsedwa ndi Opaleshoni, ndi Khansa Yam'mimba Yam'mapapo

Chithandizo cha khansa ya m'mimba yapa IV, khansa ya m'mimba yomwe singachotsedwe ndi opareshoni, kapena khansa yam'mimba yabwereza imatha kukhala izi:

• Chemotherapy ngati mankhwala ochepetsa nkhawa kuti athetse vuto ndikukhala ndi moyo wabwino.

• Chithandizo chojambulidwa ndi antioclonal antibody omwe alibe kapena chemotherapy.

• Chitetezo chamatenda.

• Endoluminal laser therapy kapena endoluminal stent mayikidwe kuti athetse kutsekeka m'mimba, kapena gastrojejunostomy kuti idutse kutsekeka.

• Thandizo la radiation ngati mankhwala ochepetsa magazi kuti asiye kutaya magazi, kuchepetsa ululu, kapena kuchepetsa chotupa chomwe chikuletsa m'mimba.

• Kuchita opaleshoni ngati mankhwala ochepetsa magazi kuti asiye kutuluka kapena kuchepetsa chotupa chomwe chimatseka m'mimba.

• Kuyesedwa kwachipatala kwa chemotherapy yatsopano monga mankhwala ochepetsa nkhawa kuti athetse zofooka ndikukhala ndi moyo wabwino.

• Kuyesedwa kwachipatala kwa mankhwala omwe ali ndi vuto la multikinase inhibitor.

• Kuyesedwa kwachipatala kwa opareshoni ndi hyperthermic intraperitoneal chemotherapy (HIPEC).

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri za khansa ya m'mimba

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa ya m'mimba, onani izi:

• Mimba (Gastric) Khansa Yoyamba Tsamba

• Kupewa Khansa Yam'mimba (Gastric)

• Kuyesera Khansa Yam'mimba (Gastric)

• Khansa Yachilendo Ya Chithandizo Chaubwana

• Lasers mu Chithandizo cha Khansa

• Mankhwala Ovomerezeka a Khansa Yam'mimba (Gastric) Cancer

• Fodya (kuphatikizapo chithandizo chosiya)

• Helicobacter pylori ndi Cancer

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira