Izinhlobo / i-pancreatic / isiguli / i-pnet-treatment-pdq

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Ukwelashwa kwe-Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) (®) –Patient Version

Imininingwane ejwayelekile Mayelana nePancreatic Neuroendocrine Tumors (Islet Cell Tumors)

AMAPHUZU ASEMQOKA

  • Izidumba zePancreatic neuroendocrine zakha amaseli enza ama-hormone (islet cell) wamanyikwe.
  • Ama-NET epancreatic angadala noma angabangeli izimpawu noma izimpawu.
  • Kunezinhlobo ezahlukahlukene zama-NET asebenzayo we-pancreatic.
  • Ukuba nama-syndromes athile kungakhuphula ubungozi bama-pancreatic NET.
  • Izinhlobo ezahlukahlukene zama-pancreatic NET anezimpawu nezimpawu ezihlukile.
  • Ukuhlolwa kweLab nokuhlolwa kwe-imaging kusetshenziselwa ukuthola (ukuthola) nokuhlola ama-NET e-pancreatic.
  • Ezinye izinhlobo zokuhlolwa kwelebhu zisetshenziselwa ukubheka uhlobo oluthile lwama-NET we-pancreatic.
  • Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Izidumba zePancreatic neuroendocrine zakha amaseli enza ama-hormone (islet cell) wamanyikwe.

Ama-pancreas yindlala engamasentimitha ayisithupha ubude emise njengepheya elincanyana elele ngohlangothi. Umkhawulo obanzi wamanyikwe ubizwa ngokuthi inhloko, isigaba esiphakathi sibizwa ngomzimba, kuthi ukuphela okuncane kubizwe umsila. Ama-pancreas alala ngemuva kwesisu naphambi komgogodla.

I-anatomy yamanyikwe. Ama-pancreas anezindawo ezintathu: ikhanda, umzimba, nomsila. Itholakala esiswini eduze kwesisu, amathumbu, nezinye izitho.

Kunezinhlobo ezimbili zamaseli emanyikwe:

  • Amaseli we-endocrine pancreas enza izinhlobo eziningana zamahomoni (amakhemikhali alawula izenzo zamaseli athile noma izitho emzimbeni), njenge-insulin yokulawula ushukela wegazi. Zihlangana ndawonye ngamaqembu amaningi amancane (iziqhingana) kuwo wonke amanyikwe. Amaseli we-endocrine pancreas abizwa nangokuthi ama-islet cells noma iziqhingana zaseLangerhans. Izimila ezakha kumaseli we-islet zibizwa ngokuthi ama-islet cell tumors, ama-pancreatic endocrine tumors, noma ama-pancreatic neuroendocrine tumors (ama-pancreatic NETs).
  • Amaseli we-pancreas e-Exocrine enza ama-enzyme akhishwa emathunjini amancane ukusiza umzimba ukugaya ukudla. Iningi lamanyikwe lenziwa ngamapayipi anamasaka amancane ekugcineni kwamapayipi, agcwele amaseli e-exocrine.

Lesi sifinyezo sidingida ama-islet cell tumors ama-endocrine pancreas. Bona isifinyezo se- se-Pancreatic Cancer Treatment (Adult) ukuthola imininingwane ngomdlavuza we-pancreatic we-exocrine.

Izidumba ze-Pancreatic neuroendocrine (NETs) zingaba nobungozi (hhayi umdlavuza) noma zibe yingozi (umdlavuza). Lapho ama-NET e-pancreatic ayingozi, abizwa ngokuthi umdlavuza we-pancreatic endocrine noma i-islet cell carcinoma.

Ama-NET epancreatic ajwayelekile kakhulu kunezimila ze-pancreatic exocrine futhi anokubikezela okungcono.

Ama-NET epancreatic angadala noma angabangeli izimpawu noma izimpawu.

Ama-NET epancreatic angahle asebenze noma angasebenzi:

  • Izicubu ezisebenzayo zenza inani elengeziwe lamahomoni, njenge-gastrin, i-insulin, ne-glucagon, edala izimpawu nezimpawu.
  • Izicubu ezingasebenzi azenzi inani elengeziwe lamahomoni. Izimpawu nezimpawu zidalwa yisimila njengoba sisakazeka futhi sikhula. Izicubu eziningi ezingasebenzi ziyingozi (umdlavuza).

Ama-NET amaningi we-pancreatic yizicubu ezisebenzayo.

Kunezinhlobo ezahlukahlukene zama-NET asebenzayo we-pancreatic.

Ama-NET epancreatic enza izinhlobo ezahlukahlukene zamahomoni afana ne-gastrin, i-insulin, ne-glucagon. Ama-NET asebenzayo e-pancreatic afaka okulandelayo:

  • I-Gastrinoma - Isigaxa esakha amaseli akha i-gastrin. IGastrin yihomoni edala ukuthi isisu sikhiphe i-asidi esiza ukugaya ukudla. Kokubili i-gastrin ne-acid esiswini kuyanda ngama-gastrinomas. Lapho ukwanda kwe-asidi esiswini, izilonda zesisu, nohudo kubangelwa isimila esenza i-gastrin, sibizwa ngokuthi yiZollinger-Ellison syndrome. I-gastrinoma ivame ukwakheka enhlokweni yamanyikwe futhi kwesinye isikhathi yakheke emathunjini amancane. Iningi lama-gastrinomas libi (umdlavuza).
  • Insulinoma: Isigaxa esakha amaseli akha i-insulin. I-insulin yihomoni elawula inani le-glucose (ushukela) osegazini. Ihambisa ushukela kumaseli, lapho ingasetshenziswa khona umzimba ukuthola amandla. Ama-insulinomas imvamisa yizicubu ezikhula kancane ezingandile ukusabalala. I-insulinoma yakha ekhanda, emzimbeni, noma emsileni wamanyikwe. Ama-insulinomas ngokuvamile abungozi (hhayi umdlavuza).
  • IGlucagonoma - Isigaxa esakha amaseli enza i-glucagon. IGlucagon yihomoni ekhulisa inani le-glucose egazini. Kubangela ukuthi isibindi sichithe i-glycogen. I-glucagon eningi kakhulu ibangela i-hyperglycemia (ushukela ophakeme wegazi). I-glucagonoma imvamisa yakha emsileni wamanyikwe. Iningi lama-glucagonomas ayingozi (umdlavuza).
  • Ezinye izinhlobo zamathumba: Kunezinye izinhlobo ezingandile zama-pancreatic NET asebenzayo enza ama-hormone, kufaka phakathi ama-hormone alawula ibhalansi yoshukela, usawoti namanzi emzimbeni. Lezi zicubu zifaka:
  • I-VIPomas, eyenza i-vasoactive peptide yamathumbu. I-VIPoma ingabizwa nangokuthi i-Verner-Morrison syndrome.
  • AmaSomatostatinomas, enza i-somatostatin.

Lezi ezinye izinhlobo zamathumba zihlelwe ndawonye ngoba ziphathwa ngendlela efanayo.

Ukuba nama-syndromes athile kungakhuphula ubungozi bama-pancreatic NET.

Noma yini enyusa ubungozi bokuthola isifo ibizwa ngokuthi ingozi. Ukuba nengcuphe akusho ukuthi uzothola umdlavuza; ukungabi nezici zobungozi akusho ukuthi ngeke uthole umdlavuza. Khuluma nodokotela wakho uma ucabanga ukuthi ungaba sengozini.

Izinhlobo eziningi ze-endocrine neoplasia type 1 (MEN1) syndrome ziyingozi engozini yama-pancreatic NET.

Izinhlobo ezahlukahlukene zama-pancreatic NET anezimpawu nezimpawu ezihlukile.

Izimpawu noma izimpawu zingadalwa ukukhula kwesimila kanye / noma ngamahomoni akhiwa isimila noma ngezinye izimo. Ezinye izicubu zingase zingabangeli izimpawu noma izimpawu. Buza nodokotela wakho uma unanoma iyiphi yalezi zinkinga.

Izimpawu nezimpawu ze-pancreatic NET engasebenzi

I-pancreatic NET engasebenzi ingakhula isikhathi eside ngaphandle kokubangela izimpawu noma izimpawu. Ingakhula ibe nkulu noma isabalale kwezinye izingxenye zomzimba ngaphambi kokuba ibangele izimpawu noma izimpawu, njenge:

  • Uhudo.
  • Ukugaya ukudla.
  • Isigaxa esiswini.
  • Ubuhlungu esiswini noma emuva.
  • Ukuphuzi kwesikhumba nabamhlophe bamehlo.

Izimpawu nezimpawu ze-pancreatic NET esebenzayo

Izimpawu nezimpawu ze-pancreatic NET esebenzayo kuncike ohlotsheni lwehomoni eyenziwe.

I-gastrin eningi kakhulu ingadala:

  • Izilonda zesisu ezilokhu zibuya.
  • Ubuhlungu esiswini, obungasakazeka emuva. Ubuhlungu bungafika budlule futhi bungaphela ngemuva kokuthatha i-antacid.
  • Ukugeleza kokuqukethwe kwesisu kubuyela emuva ku-esophagus (gastroesophageal reflux).
  • Uhudo.

I-insulin eningi ingadala:

  • Ushukela wegazi ophansi. Lokhu kungadala ukungaboni kahle, ukuphathwa ikhanda, nokuzizwa unekhanda, ukhathele, ubuthakathaka, uthuthumela, unovalo, uthukuthele, uyajuluka, udidekile noma ulambile.
  • Ukushaya kwenhliziyo okusheshayo.

I-glucagon eningi ingadala:

  • Ukuqhuma kwesikhumba ebusweni, esiswini, noma emilenzeni.
  • Ushukela ophakeme wegazi. Lokhu kungadala ikhanda elibuhlungu, ukuchama kaningi, isikhumba esomile nomlomo, noma uzizwe ulambile, womile, ukhathele noma ubuthakathaka.
  • Amahlule egazi. Amahlule egazi emaphashini angadala ukuphefumula okuncane, ukukhwehlela, noma ubuhlungu esifubeni. Amahlule egazi engalweni noma emlenzeni angadala ubuhlungu, ukuvuvukala, ukufudumala, noma ukubomvu kwengalo noma komlenze.
  • Uhudo.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.
  • Ulimi oluhlabayo noma izilonda emakhoneni omlomo.

I-peptide yamathumbu emathunjini amaningi kakhulu (i-VIP) ingadala:

  • Inani elikhulu kakhulu lohudo lwamanzi.
  • Ukuphela kwamanzi emzimbeni. Lokhu kungadala ukoma, ukwenza umchamo omncane, isikhumba nomlomo owomile, ikhanda, isizungu, noma ukuzizwa ukhathele.
  • Izinga eliphansi le-potassium egazini. Lokhu kungadala ubuthakathaka bemisipha, ukuqaqamba, noma amajaqamba, ukuba ndikindiki nokushosholoza, ukuchama njalo, ukushaya kwenhliziyo okusheshayo, nokuzizwa udidekile noma womile.
  • Amajaqamba noma ubuhlungu esiswini.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

I-somatostatin eningi kakhulu ingadala:

  • Ushukela ophakeme wegazi. Lokhu kungadala ikhanda elibuhlungu, ukuchama kaningi, isikhumba esomile nomlomo, noma uzizwe ulambile, womile, ukhathele noma ubuthakathaka.
  • Uhudo.
  • I-Steatorrhea (indle enephunga elibi kakhulu entantayo).
  • Amatshe amatshe amade.
  • Ukuphuzi kwesikhumba nabamhlophe bamehlo.
  • Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

I-pancreatic NET nayo ingenza i-hormone ye-adrenocorticotropic eningi kakhulu (i-ACTH) futhi ibangele iCushing syndrome. Izimpawu nezimpawu ze-Cushing syndrome zifaka okulandelayo:

  • Ubuhlungu bekhanda.
  • Okunye ukulahleka kombono.
  • Ukuzuza kwesisindo ebusweni, entanyeni, nasemgqonyeni womzimba, nezingalo nemilenze emincane.
  • Isigaxa samafutha ngemuva kwentamo.
  • Isikhumba esincanyana esingaba namamaki wokunweba onsomi noma apinki esifubeni noma esiswini.
  • Ukulinyazwa okulula.
  • Ukukhula kwezinwele ezinhle ebusweni, emuva emuva, noma ezandleni.
  • Amathambo aphuka kalula.
  • Izilonda noma ukusikeka okuphola kancane.
  • Ukukhathazeka, ukucasuka, nokudangala.

Ukwelashwa kwama-pancreatic NET enza i-ACTH ne-Cushing syndrome ngokweqile akuxoxwa ngakho kulesi sifinyeto.

Ukuhlolwa kweLab nokuhlolwa kwe-imaging kusetshenziselwa ukuthola (ukuthola) nokuhlola ama-NET e-pancreatic.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

  • Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.
  • Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-glucose (ushukela), ekhishelwa egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.
  • I-Chromogranin A test: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-chromogranin A egazini. Inani eliphakeme kunelejwayelekile le-chromogranin A kanye nenani elijwayelekile lamahomoni afana ne-gastrin, i-insulin, ne-glucagon kungaba uphawu lwe-pancreatic NET engasebenzi.
  • Isiswini se-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yesisu, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.
  • I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).
  • I-Somatostatin receptor scintigraphy: Uhlobo lwe-radionuclide scan olungasetshenziswa ukuthola ama-NET amancane we-pancreatic. Inani elincane le-octreotide enemisebe (i-hormone enamathisela izicubu) lijovwa emthanjeni futhi lihambe ngegazi. I-octreotide enemisebe inamathela kulesimila nekhamera ekhethekile ethola ukusebenza kwemisebe ye-radioactivity isetshenziselwa ukukhombisa ukuthi izicubu zikuphi emzimbeni. Le nqubo ibizwa nangokuthi i-octreotide scan ne-SRS.
  • I-endoscopic ultrasound (EUS): Inqubo lapho kufakwa khona i-endoscope emzimbeni, imvamisa ngomlomo noma nge-rectum. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Iphenyo ekugcineni kwe-endoscope isetshenziselwa ukuqhuma amaza omsindo wamandla aphezulu (i-ultrasound) ezicutshini zangaphakathi noma ezithweni futhi enze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Le nqubo ibizwa nangokuthi i-endosonography.
  • I-Endoscopic retrograde cholangiopancreatography (ERCP):Inqubo esetshenziselwa ukufaka i-x-ray amapayipi (amashubhu) athwala inyongo kusuka esibindini kuya enyongweni nasenyameni kuya emathunjini amancane. Kwesinye isikhathi umdlavuza we-pancreatic ubangela ukuthi la mapayipi anciphise futhi avimbe noma anciphise ukuhamba kwe-bile, kubangele i-jaundice. Kudluliswa i-endoscope ngomlomo, ngomphimbo, nasesiswini engxenyeni yokuqala yamathumbu amancane. I-endoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Ipayipi (ithubhu elincane) bese lifakwa nge-endoscope lingene emiphakathini yepancreatic. Idayi ijojowe nge-catheter emapayipini bese kuthathwa i-x-ray. Uma amapayipi evinjelwe isimila, ithubhu enhle ingafakwa emgodini ukuze ivulwe. Le tube (noma i-stent) ingashiywa endaweni ukuze kugcinwe umsele uvulekile. Amasampula amathishu angathathwa futhi ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza.
  • I-Angiogram: Inqubo yokubheka imithambo yegazi nokuhamba kwegazi. Idayi ehlukile ifakwa emthanjeni wegazi. Njengoba udayi wokuqhathanisa uhamba phakathi kwesitsha segazi, ama-x-ray ayathathwa ukuze abone ukuthi kukhona yini ukuvinjelwa.
  • I-Laparotomy: Inqubo yokuhlinza lapho kwenziwa ukusikeka (ukusika) odongeni lwesisu ukubheka ngaphakathi kwesisu ukuthi asinazo yini izimpawu zesifo. Ubukhulu bokusikwa buxhomeke ekutheni kungani i-laparotomy yenziwa. Kwesinye isikhathi izitho ziyasuswa noma amasampula wezicubu athathwe ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zesifo.
  • I-intraoperative ultrasound: Inqubo esebenzisa amaza omsindo anamandla amakhulu (i-ultrasound) ukudala izithombe zezitho zangaphakathi noma izicubu ngesikhathi sokuhlinzwa. I-transducer ebekwe ngqo esithweni noma ezicutshini isetshenziselwa ukwenza amaza omsindo, akha ama-echoes. I-transducer ithola ama-echoes bese iwathumela kukhompyutha, esebenzisa ama-echoes ukwenza izithombe ezibizwa ngama-sonograms.
  • I-Biopsy: Ukususwa kwamaseli noma izicubu ukuze kubhekwe ngaphansi kwesibonakhulu ngudokotela wezifo ukuhlola izimpawu zomdlavuza. Kunezindlela eziningana zokwenza i-biopsy yama-pancreatic NET. Amaseli angasuswa kusetshenziswa inaliti enhle noma ebanzi efakwe kuma-pancreas ngesikhathi se-x-ray noma i-ultrasound. Izicubu zingasuswa futhi ngesikhathi se-laparoscopy (imbobo yokuhlinzwa eyenziwe odongeni lwesisu).
  • Ukuskena kwamathambo: Inqubo yokubheka ukuthi kunamaseli ahlukanisa ngokushesha yini, njengamaseli womdlavuza, ethanjeni. Inani elincane kakhulu lezinto ezinomsakazo lifakwa emthanjeni futhi lihambe phakathi kwegazi. Izinto ezinemisebe eqoqa emathanjeni ezinomdlavuza futhi zitholwa isithwebuli.

Ezinye izinhlobo zokuhlolwa kwelebhu zisetshenziselwa ukubheka uhlobo oluthile lwama-NET we-pancreatic.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

I-Gastrinoma

  • Ukuzila ukudla kwe-serum gastrin: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-gastrin egazini. Lokhu kuhlolwa kwenziwa ngemuva kokuthi isiguli singenakho ukudla noma ukuphuza okungenani amahora ayi-8. Izimo ngaphandle kwe-gastrinoma zingadala ukwanda kwenani le-gastrin egazini.
  • Isivivinyo sokukhishwa kwe-basal acid: Isivivinyo sokulinganisa inani le-asidi eyenziwe isisu. Ukuhlolwa kwenziwa ngemuva kokuthi isiguli singenakho ukudla noma ukuphuza okungenani amahora ayi-8. Ishubhu lifakwa ngamakhala noma emphinjeni, esiswini. Okuqukethwe yisisu kuyasuswa bese amasampula amane we-gastric acid asuswa ngepayipi. Lawa masampula asetshenziselwa ukuthola inani le-gastric acid eyenziwe ngesikhathi sokuhlolwa kanye nezinga le-pH lezimfihlo zesisu.
  • Ukuhlolwa kokukhuthaza kwe-Secretin: Uma umphumela wokuhlolwa kwe-basal acid ungajwayelekile, kungenziwa isivivinyo sokukhuthaza i-secretin. Ishubhu lifakwa emathunjini amancane futhi amasampuli athathwa emathunjini amancane ngemuva kokujova umuthi obizwa ngokuthi i-secretin. USecretin ubangela ukuthi amathumbu amancane enze i-asidi. Uma kune-gastrinoma, i-secretin ibangela ukwanda kokuthi ingakanani i-gastric acid eyenziwe nezinga le-gastrin egazini.
  • I-Somatostatin receptor scintigraphy: Uhlobo lwe-radionuclide scan olungasetshenziswa ukuthola ama-NET amancane we-pancreatic. Inani elincane le-octreotide enemisebe (i-hormone enamathisela izicubu) lijovwa emthanjeni futhi lihambe ngegazi. I-octreotide enemisebe inamathela kulesimila nekhamera ekhethekile ethola ukusebenza kwemisebe ye-radioactivity isetshenziselwa ukukhombisa ukuthi izicubu zikuphi emzimbeni. Le nqubo ibizwa nangokuthi i-octreotide scan ne-SRS.

Insulinoma

  • Ukuzila ukudla kwe-serum glucose nokuhlolwa kwe-insulin: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-glucose (ushukela) ne-insulin egazini. Ukuhlolwa kwenziwa ngemuva kokuthi isiguli singenakho ukudla noma ukuphuza okungenani amahora angama-24.

IGlucagonoma [[[[[[

  • Ukuzila ukudla kwe-serum glucagon: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-glucagon egazini. Ukuhlolwa kwenziwa ngemuva kokuthi isiguli singenakho ukudla noma ukuphuza okungenani amahora ayi-8.

Ezinye izinhlobo zesimila

  • VIPoma
  • Ukuhlolwa kwe-Serum VIP (vasoactive intestinal peptide): Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-VIP.
  • Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo. Ku-VIPoma, kune-potassium ephansi kunejwayelekile.
  • Ukuhlaziywa kwesitokisi: Isampula yendle ihlolwe i-sodium ephakeme (usawoti) kanye namazinga we-potassium.
  • Somatostatinoma
  • Ukuzila ukudla kwe-serum somatostatin: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-somatostatin egazini. Ukuhlolwa kwenziwa ngemuva kokuthi isiguli singenakho ukudla noma ukuphuza okungenani amahora ayi-8.
  • I-Somatostatin receptor scintigraphy: Uhlobo lwe-radionuclide scan olungasetshenziswa ukuthola ama-NET amancane we-pancreatic. Inani elincane le-octreotide enemisebe (i-hormone enamathisela izicubu) lijovwa emthanjeni futhi lihambe ngegazi. I-octreotide enemisebe inamathela kulesimila nekhamera ekhethekile ethola ukusebenza kwemisebe ye-radioactivity isetshenziselwa ukukhombisa ukuthi izicubu zikuphi emzimbeni. Le nqubo ibizwa nangokuthi i-octreotide scan ne-SRS.

Izici ezithile zithinta ukubikezela (ithuba lokululama) kanye nezinketho zokwelashwa.

Ama-NET epancreatic angahle elapheke. Isibikezelo (ithuba lokululama) nezinketho zokwelashwa zincike kokulandelayo:

  • Uhlobo lweseli lomdlavuza.
  • Lapho kutholakala khona isimila kumanyikwe.
  • Ukuthi isimila sesisabalalele ezindaweni ezingaphezu kweyodwa yini kumanyikwe noma kwezinye izingxenye zomzimba.
  • Ukuthi isiguli sine-MEN1 syndrome.
  • Iminyaka yesiguli nempilo ejwayelekile.
  • Ukuthi umdlavuza usanda kutholakala noma usuphindile (buyela emuva).

Izigaba zamaPancreatic Neuroendocrine Tumors

AMAPHUZU ASEMQOKA

  • Uhlelo lokwelashwa komdlavuza luxhomeke ekutheni i-NET itholakala kuphi kumanyikwe nokuthi isabalale yini.
  • Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.
  • Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Uhlelo lokwelashwa komdlavuza luxhomeke ekutheni i-NET itholakala kuphi kumanyikwe nokuthi isabalale yini.

Inqubo esetshenziswayo ukuthola ukuthi umdlavuza ususabalele ngaphakathi kwamanyikwe noma kwezinye izingxenye zomzimba ibizwa ngokuthi yi-staging. Imiphumela yokuhlolwa nezinqubo ezisetshenziselwa ukuxilonga izicubu ze-pancreatic neuroendocrine (NETs) nazo ziyasetshenziswa ukuthola ukuthi umdlavuza ususabalalisile yini. Bheka isigaba solwazi jikelele ukuthola incazelo yalezi zivivinyo nezinqubo.

Yize kukhona uhlelo olujwayelekile lokubeka ama-pancreatic NET, alusetshenziselwa ukuhlela ukwelashwa. Ukwelashwa kwama-pancreatic NETs kusekelwe kokulandelayo:

  • Ukuthi umdlavuza utholakala endaweni eyodwa emanyikwe yini.
  • Noma ngabe umdlavuza utholakala ezindaweni eziningana emanyikwe.
  • Ukuthi umdlavuza ususabalele kuma-lymph node eduze kwamanyikwe noma kwezinye izingxenye zomzimba njengesibindi, amaphaphu, i-peritoneum, noma ithambo.

Zintathu izindlela umdlavuza osakazeka ngayo emzimbeni.

Umdlavuza ungasakazeka ngezicubu, uhlelo lwe-lymph, kanye negazi:

  • Izicubu. Umdlavuza usakazeka lapho uqale khona ngokukhulela ezindaweni eziseduze.
  • Uhlelo lweLymph. Umdlavuza usakazeka lapho uqale khona ngokungena ohlelweni lwe-lymph. Umdlavuza udabula imithambo ye-lymph uye kwezinye izingxenye zomzimba.
  • Igazi. Umdlavuza usakazeka lapho uqale khona ngokungena egazini. Umdlavuza uhamba ngemithambo yegazi uye kwezinye izingxenye zomzimba.

Umdlavuza ungasakazeka usuka lapho uqale khona kwezinye izingxenye zomzimba.

Lapho umdlavuza usakazekela kolunye uhlangothi lomzimba, ubizwa ngokuthi yi-metastasis. Amaseli womdlavuza aqhamuka lapho aqale khona (isimila sokuqala) futhi ahamba ngohlelo lwe-lymph noma igazi.

  • Uhlelo lweLymph. Umdlavuza ungena ohlelweni lwe-lymph, udabule emithanjeni ye-lymph, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.
  • Igazi. Umdlavuza ungena egazini, udabule emithanjeni yegazi, bese wenza isimila (isimila se-metastatic) kwenye ingxenye yomzimba.

Isigaxa se-metastatic luhlobo olufanayo lwesimila njengesimila sokuqala. Isibonelo, uma isimila se-pancreatic neuroendocrine sisakazeka esibindi, amangqamuzana wesimila esibindini empeleni angamaseli we-neuroendocrine tumor. Lesi sifo yi-metastatic pancreatic neuroendocrine tumor, hhayi umdlavuza wesibindi.

AmaTumour aphindaphindiwe we-Pancreatic Neuroendocrine

Izicubu ze-pancreatic neuroendocrine eziphindaphindwayo (ama-NETs) yizicubu eziphinde zabuya (zabuya) ngemuva kokwelashwa. Izimila zingabuya kumanyikwe noma kwezinye izingxenye zomzimba.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

  • Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinama-pancreatic NET.
  • Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:
  • Ukuhlinzwa
  • Ukwelashwa ngamakhemikhali
  • Ukwelashwa kweHormone
  • Ukuvalwa kwe-hepatic arterial noma i-chemoembolization
  • Ukwelashwa okuhlosiwe
  • Ukunakekelwa okusekelayo
  • Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.
  • Ukwelashwa kwezimila zepancreatic neuroendocrine kungadala imiphumela emibi.
  • Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.
  • Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.
  • Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kweziguli ezinama-pancreatic NET.

Izinhlobo ezahlukahlukene zokwelashwa ziyatholakala ezigulini ezinamathumba we-pancreatic neuroendocrine (NETs). Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile. Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izinhlobo eziyisithupha zokwelashwa okujwayelekile zisetshenzisiwe:

Ukuhlinzwa

Kungenzeka kwenziwe ukuhlinzwa ukuze kususwe isimila. Olunye lwezinhlobo ezilandelayo zokuhlinzwa lungasetshenziswa:

  • I-Enucleation: Ukuhlinzwa ukukhipha isimila kuphela. Lokhu kungenziwa lapho umdlavuza uvela endaweni eyodwa kuma-pancreas.
  • I-Pancreatoduodenectomy: Inqubo yokuhlinza lapho kukhishwa khona ikhanda lamanyikwe, i-gallbladder, ama-lymph node aseduze nengxenye yesisu, amathumbu amancane kanye nomgudu wenyongo. Ama-pancreas anele asele ukwenza ujusi wokugaya ukudla ne-insulin. Izitho ezisuswe phakathi nale nqubo zincike esimweni sesiguli. Lokhu kubizwa nangokuthi inqubo ye-Whipple.
  • I-Distre pancreatectomy: Ukuhlinzwa ukususa umzimba nomsila wamanyikwe. Ubende bungasuswa futhi uma umdlavuza usakaze ubende.
  • Ingqikithi ye-gastrectomy: Ukuhlinzwa ukukhipha isisu sonke.
  • I-Parietal cell vagotomy: Ukuhlinzwa ukusika inzwa ebangela ukuthi amangqamuzana esisu enze i-asidi.
  • Ukuthengiswa kwesibindi: Ukuhlinzwa ukususa ingxenye noma sonke isibindi.
  • I-Radiofrequency ablation: Ukusetshenziswa kwephenyo ekhethekile enama-electrode amancane abulala amangqamuzana omdlavuza. Kwesinye isikhathi iphenyo lifakwa ngqo ngesikhumba futhi kudingeka kuphela i-anesthesia yendawo. Kwezinye izimo, iphenyo lifakwa ngokusikeka esiswini. Lokhu kwenziwa esibhedlela nge-anesthesia ejwayelekile.
  • Ukukhishwa kwe-Cryosurgical: Inqubo lapho izicubu zifriziwe ukubhubhisa amaseli angajwayelekile. Lokhu kuvame ukwenziwa ngensimbi ekhethekile equkethe i-nitrogen engamanzi noma i-liquid carbon dioxide. Ithuluzi lingasetshenziswa ngesikhathi sokuhlinzwa noma i-laparoscopy noma lifakwe esikhunjeni. Le nqubo ibizwa nangokuthi i-cryoablation.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy). Lapho i-chemotherapy ifakwa ngqo ku-cerebrospinal fluid, isitho, noma umgodi womzimba njengesisu, izidakamizwa zithinta kakhulu amangqamuzana omdlavuza kulezo zindawo (i-chemotherapy yesifunda). Inhlanganisela yokwelashwa ngamakhemikhali ukusetshenziswa kwezidakamizwa ezingaphezu kweyodwa ze-antiticancer Indlela i-chemotherapy enikezwa ngayo incike ohlotsheni lomdlavuza owelashwa.

Ukwelashwa kweHormone

Ukwelashwa kweHormone ukwelashwa komdlavuza okususa ama-hormone noma kuvimbe isenzo sabo futhi kumise amangqamuzana omdlavuza ukuthi angakhuli. AmaHormone yizinto ezenziwe yizindlala emzimbeni futhi zisatshalaliswa egazini. Amanye ama-hormone angadala ukuthi umdlavuza othile ukhule. Uma ukuhlolwa kukhombisa ukuthi amangqamuzana omdlavuza anezindawo lapho ama-hormone anganamathisela khona (ama-receptors), izidakamizwa, ukuhlinzwa, noma ukwelashwa ngemisebe kusetshenziselwa ukunciphisa ukukhiqizwa kwamahomoni noma ukuwavimba ekusebenzeni.

Ukuvalwa kwe-hepatic arterial noma i-chemoembolization

I-hepatic arteryial occlusion isebenzisa izidakamizwa, izinhlayiya ezincane, noma amanye ama-ejenti ukuvimba noma ukunciphisa ukugeleza kwegazi kuye esibindini ngomthambo we-hepatic (umthambo omkhulu wegazi ohambisa igazi esibindini). Lokhu kwenzelwa ukubulala amangqamuzana omdlavuza akhula esibindini. Isimila sivinjelwe ekutholeni umoya-mpilo nezakhamzimba esidinga ukuthi sikhule. Isibindi siyaqhubeka sithola igazi elivela emthanjeni we-portatic hepatic, ophethe igazi esiswini nasemathunjini.

Ukwelashwa ngamakhemikhali okwenziwa ngesikhathi sokuvaleka komzimba okune-hepatic kubizwa ngokuthi yi-chemoembolization. Isidakamizwa se-anticancer sijojelwa emthanjeni we-hepatic nge-catheter (ithubhu elincanyana). Isidakamizwa sixutshwe nento evimba umthambo futhi isike ukugeleza kwegazi kuye kulesimila. Iningi lomuthi olwa nomdlavuza ubhajwe eduze kwesimila futhi inani elincane kuphela lomuthi lifinyelela kwezinye izingxenye zomzimba.

Ukuvinjelwa kungaba okwesikhashana noma unomphela, kuya ngento esetshenzisiwe ukuvimba umthambo.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukukhomba nokuhlasela amangqamuzana omdlavuza athile ngaphandle kokulimaza amaseli ajwayelekile. Izinhlobo ezithile zokwelashwa okubhekiswe kuzo ziyafundwa ekwelapheni ama-pancreatic NET.

Ukunakekelwa okusekelayo

Ukunakekelwa kokusekelwa kunikezwa ukunciphisa izinkinga ezibangelwa yisifo noma ukwelashwa kwaso. Ukunakekelwa okusekela ama-pancreatic NET kungafaka ukwelashwa kwalokhu okulandelayo:

  • Izilonda zesisu zingalashwa ngokwelashwa kwezidakamizwa njenge:
  • Imithi ye-Proton pump inhibitor efana ne-omeprazole, i-lansoprazole, noma i-pantoprazole.
  • Izidakamizwa ezivimbela umlando njenge-cimetidine, i-ranitidine, noma i-famotidine.
  • Izidakamizwa zohlobo lweSomatostatin ezifana ne-octreotide.
  • Uhudo lungaphathwa nge:
  • Uketshezi olufakwa ngaphakathi (IV) olunama-electrolyte afana ne-potassium noma i-chloride.
  • Izidakamizwa zohlobo lweSomatostatin ezifana ne-octreotide.
  • Ushukela wegazi ophansi ungalashwa ngokudla okuncane, okuvamile noma ukwelashwa ngezidakamizwa ukugcina izinga elijwayelekile likashukela egazini.
  • Ushukela wegazi ophakeme ungalashwa ngemithi ethathwe ngomlomo noma nge-insulin ngomjovo.

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa kwezimila zepancreatic neuroendocrine kungadala imiphumela emibi.

Ngemininingwane ngemiphumela engemihle ebangelwe ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Izinketho Zokwelapha AmaPancreatic Neuroendocrine Tumors

Kulesi Sigaba

  • I-Gastrinoma
  • Insulinoma
  • IGlucagonoma
  • Amanye amaPancreatic Neuroendocrine Tumors (Islet Cell Tumors)
  • Ama-Tumors Aphindaphindayo noma Aqhubekayo ePancreatic Neuroendocrine (Islet Cell Tumors)

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

I-Gastrinoma

Ukwelashwa kwe-gastrinoma kungafaka ukunakekelwa okusekelayo nokulandelayo:

  • Ngezimpawu ezibangelwa i-acid eningi kakhulu esiswini, ukwelashwa kungaba ngumuthi owehlisa inani le-asidi eyenziwe isisu.
  • Ngesimila esisodwa ekhanda lamanyikwe:
  • Ukuhlinzwa ukukhipha isimila.
  • Ukuhlinzwa ukusika inzwa ebangela ukuthi amaseli esiswini enze i-asidi nokwelashwa ngomuthi owehlisa i-acid esiswini.
  • Ukuhlinzwa ukususa isisu sonke (okungajwayelekile).
  • Ngesimila esisodwa emzimbeni noma emsileni wamanyikwe, ukwelashwa kuvamise ukuhlinzwa ukususa umzimba noma umsila wamanyikwe.
  • Kuma-tumors amaningana kumanyikwe, ukwelashwa kuvame ukuhlinzwa ukususa umzimba noma umsila wamanyikwe. Uma isimila sihlala ngemuva kokuhlinzwa, ukwelashwa kungafaka:
  • Ukuhlinzwa ukusika imizwa ebangela ukuthi amangqamuzana esisu enze i-asidi nokwelashwa ngomuthi owehlisa i-acid esiswini; noma
  • Ukuhlinzwa ukususa isisu sonke (okungajwayelekile).
  • Ngesimila esisodwa noma ngaphezulu ku-duodenum (ingxenye yamathumbu amancane exhuma esiswini), ukwelashwa imvamisa yi-pancreatoduodenectomy (ukuhlinzwa ukususa ikhanda lamanyikwe, i-gallbladder, ama-lymph node aseduze nengxenye yesisu, amathumbu amancane , ne-bile duct).
  • Uma kungatholakali isimila, ukwelashwa kungafaka okulandelayo:
  • Ukuhlinzwa ukusika inzwa ebangela ukuthi amaseli esiswini enze i-asidi nokwelashwa ngomuthi owehlisa i-acid esiswini.
  • Ukuhlinzwa ukususa isisu sonke (okungajwayelekile).
  • Uma umdlavuza ususakaze esibindini, ukwelashwa kungafaka:
  • Ukuhlinzwa ukususa ingxenye noma sonke isibindi.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation.
  • I-Chemoembolization.
  • Uma umdlavuza usabalalele kwezinye izingxenye zomzimba noma ungabi ngcono ngokuhlinzwa noma ngemithi yokwehlisa i-acid esiswini, ukwelashwa kungafaka:
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa kweHormone.
  • Uma umdlavuza uthinta kakhulu isibindi futhi isiguli sinezimpawu ezinzima ezivela kuma-hormone noma ngosayizi wesimila, ukwelashwa kungafaka:
  • Ukuvaleka komzimba kwe-Hepatic, noma ngaphandle kwe-systemic chemotherapy.
  • I-Chemoembolization, noma ngaphandle kwe-systemic chemotherapy.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Insulinoma

Ukwelashwa kwe-insulinoma kungafaka okulandelayo:

  • Ngesimila esisodwa esincane ekhanda noma emsileni wamanyikwe, ukwelashwa kuvame ukuhlinzwa ukuze kususwe isimila.
  • Ngesimila esisodwa esikhulu ekhanda lamanyikwe elingasuswa ngokuhlinzwa, ukwelashwa kuvame ukuba yi-pancreatoduodenectomy (ukuhlinzwa ukususa ikhanda lamanyikwe, i-gallbladder, ama-lymph node aseduze nengxenye yesisu, ithumbu elincane, nomgudu wenyongo) .
  • Ngesimila esisodwa esikhulu emzimbeni noma emsileni wamanyikwe, ukwelashwa kuvame ukuba yi-distal pancreatectomy (ukuhlinzwa ukususa umzimba nomsila wamanyikwe).
  • Kwesisu esingaphezu kwesisodwa emanyikwe, ukwelashwa kuvame ukuhlinzwa ukuze kususwe noma yiziphi izimila ekhanda lamanyikwe nomzimba nomsila wamanyikwe.
  • Ngezicubu ezingenakususwa ngokuhlinzwa, ukwelashwa kungafaka okulandelayo:
  • Inhlanganisela chemotherapy.
  • Ukwelashwa kwezidakamizwa okunciphisayo ukwehlisa inani le-insulin elenziwe amanyikwe.
  • Ukwelashwa kweHormone.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation.
  • Ngomdlavuza osakazekele kuma-lymph node noma ezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukuhlinzwa ukususa umdlavuza.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation, uma umdlavuza ungeke ususwe ngokuhlinzwa.
  • Uma umdlavuza uthinta kakhulu isibindi futhi isiguli sinezimpawu ezinzima ezivela kuma-hormone noma ngosayizi wesimila, ukwelashwa kungafaka:
  • Ukuvaleka komzimba kwe-Hepatic, noma ngaphandle kwe-systemic chemotherapy.
  • I-Chemoembolization, noma ngaphandle kwe-systemic chemotherapy.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

IGlucagonoma

Ukwelashwa kungafaka okulandelayo:

  • Ngesimila esisodwa esincane ekhanda noma emsileni wamanyikwe, ukwelashwa kuvame ukuhlinzwa ukuze kususwe isimila.
  • Ngesimila esisodwa esikhulu ekhanda lamanyikwe elingasuswa ngokuhlinzwa, ukwelashwa kuvame ukuba yi-pancreatoduodenectomy (ukuhlinzwa ukususa ikhanda lamanyikwe, i-gallbladder, ama-lymph node aseduze nengxenye yesisu, ithumbu elincane, nomgudu wenyongo) .
  • Kwesisu esingaphezu kwesisodwa emanyikwe, ukwelashwa kuvame ukuhlinzwa ukususa isimila noma ukuhlinzwa ukususa umzimba nomsila wamanyikwe.
  • Ngezicubu ezingenakususwa ngokuhlinzwa, ukwelashwa kungafaka okulandelayo:
  • Inhlanganisela chemotherapy.
  • Ukwelashwa kweHormone.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation.
  • Ngomdlavuza osakazekele kuma-lymph node noma ezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukuhlinzwa ukususa umdlavuza.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation, uma umdlavuza ungeke ususwe ngokuhlinzwa.
  • Uma umdlavuza uthinta kakhulu isibindi futhi isiguli sinezimpawu ezinzima ezivela kuma-hormone noma ngosayizi wesimila, ukwelashwa kungafaka:
  • Ukuvaleka komzimba kwe-Hepatic, noma ngaphandle kwe-systemic chemotherapy.
  • I-Chemoembolization, noma ngaphandle kwe-systemic chemotherapy.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Amanye amaPancreatic Neuroendocrine Tumors (Islet Cell Tumors)

Kwi-VIPoma, ukwelashwa kungafaka okulandelayo:

  • Uketshezi kanye nokwelashwa kwamahomoni kuzobuyisela uketshezi nama-electrolyte okulahlekile emzimbeni.
  • Ukuhlinzwa ukukhipha isimila kanye nama-lymph node aseduze.
  • Ukuhlinzwa ukukhipha isimila esiningi ngangokunokwenzeka lapho isimila singeke sisuswe ngokuphelele noma sesisabalale saya ezingxenyeni ezikude zomzimba. Lokhu kuyindlela yokwelapha ekwehliseni izimpawu nokuthuthukisa ikhwalithi yempilo.
  • Ngezicubu ezisabalalele kuma-lymph node noma ezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukuhlinzwa ukukhipha isimila.
  • Ukukhishwa kwe-Radiofrequency ablation noma i-cryosurgical ablation, uma isimila singeke sisuswe ngokuhlinzwa.
  • Kwezimila eziqhubeka zikhula ngesikhathi sokwelashwa noma zisabalalele kwezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa okuhlosiwe.

Nge-somatostatinoma, ukwelashwa kungafaka okulandelayo:

  • Ukuhlinzwa ukukhipha isimila.
  • Ngomdlavuza osusabalale waya ezingxenyeni ezikude zomzimba, ukuhlinzwa ukuze kususwe umdlavuza omningi ngangokunokwenzeka ukukhulula izimpawu nokwenza ngcono impilo.
  • Kwezimila eziqhubeka zikhula ngesikhathi sokwelashwa noma zisabalalele kwezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa okuhlosiwe.

Ukwelashwa kwezinye izinhlobo zamathumba we-pancreatic neuroendocrine (NETs) kungafaka okulandelayo:

  • Ukuhlinzwa ukukhipha isimila.
  • Ngomdlavuza osudlulele ezingxenyeni ezikude zomzimba, ukuhlinzwa ukuze kususwe umdlavuza omningi ngangokunokwenzeka noma ukwelashwa kwamahomoni ukukhulula izimpawu nokwenza ngcono impilo.
  • Kwezimila eziqhubeka zikhula ngesikhathi sokwelashwa noma zisabalalele kwezinye izingxenye zomzimba, ukwelashwa kungafaka okulandelayo:
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa okuhlosiwe.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ama-Tumors Aphindaphindayo noma Aqhubekayo ePancreatic Neuroendocrine (Islet Cell Tumors)

Ukwelashwa kwama-pancreatic neuroendocrine tumors (NETs) aqhubeka nokukhula ngesikhathi sokwelashwa noma ukuphinda (abuye) angafaka okulandelayo:

  • Ukuhlinzwa ukukhipha isimila.
  • Ukwelashwa ngamakhemikhali.
  • Ukwelashwa kweHormone.
  • Ukwelashwa okuhlosiwe.
  • Okwe-metastases yesibindi:
  • Ukwelashwa ngamakhemikhali kwesifunda.
  • Ukuvalwa kwe-hepatic arterial noma i-chemoembolization, noma ngaphandle kwe-systemic chemotherapy.
  • Isivivinyo somtholampilo sokwelapha okusha.

Sebenzisa ukusesha kwethu kokuhlolwa komtholampilo ukuthola izivivinyo zomtholampilo ezisekelwa yi-NCI ezamukela iziguli. Ungasesha izivivinyo ngokususelwa ohlotsheni lomdlavuza, iminyaka yesiguli, nalapho kwenziwa khona izivivinyo. Imininingwane ejwayelekile mayelana nokuhlolwa kwemitholampilo iyatholakala.

Ukufunda Okwengeziwe Ngamathumba We-Pancreatic Neuroendocrine (Islet Cell Tumors)

Ngemininingwane engaphezulu evela kuNational Cancer Institute mayelana nezicubu ze-pancreatic neuroendocrine (NETs), bheka okulandelayo:

  • Ikhasi Lasekhaya Lomdlavuza wePancreatic
  • Izindlela Zokwelapha Zomdlavuza

Ngemininingwane ejwayelekile yomdlavuza nezinye izinsiza ezivela ku-National Cancer Institute, bheka okulandelayo:

  • Mayelana Nomdlavuza
  • Isiteji
  • I-Chemotherapy kanye Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukwelashwa Kwemisebe Nawe: Ukusekelwa Kwabantu Abanomdlavuza
  • Ukubhekana Nomdlavuza
  • Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza
  • Kwabasindile Nabanakekeli


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