Chizindikiro cha Melanoma: Njira Yomwe Katundu Wodziwira Amavumbulutsira

Tsatanetsatane ndi Kugonjetsa Kuyambira Gawo 0 mpaka Gawo IV

Chilondachi ndi mtundu waukali kwambiri wa khansa yapakhungu . Mapulogalamu a melanoma ndiyo njira yomwe amagwiritsidwa ntchito kuti azindikire kukula kwa chifuwa cha khansa ya khansa ya khansa komanso komwe yayendayenda. Melanoma imagawidwa mu magawo ochokera ku 0, yomwe ndi malo otsika kwambiri, mpaka ku IV, yomwe ndipamwamba kwambiri. Kulemba masewera n'kofunikira chifukwa kumathandiza gulu lanu lachipatala kukonza chithandizo choyenera.

Mafilimuwa akuwonetseratu masitepe a zithunzi. Pezani zambiri za zomwe zimatanthauza kukhala ndi siteji yambiri ya khansa ya khansa.

TNM Kupanga Mankhwala a Melanoma

Ophunzira zaumoyo abwera ndi njira zosiyanasiyana za ma cancer khansa. Nkhaniyi ikugwiritsa ntchito njira ya TNM ya 2009 yomwe ikugwirizana ndi American Joint Commission pa Cancer. Ndi njira yogwiritsiridwa ntchito kwambiri popita kudziko.

Mu njira ya TNM, makalata T, N, ndi M amatanthawuza kuti:

• T = chotupa: T imatsatiridwa ndi nambala yomwe ikugwirizana ndi kukula kwake kwa matumbo.
• N = node: N imatsatiridwa ndi nambala yomwe ikugwirizana ndi kukula kwa maselo a mliri .
• M = metastasis (kufalikira kwa kutalika): M imatsatiridwa ndi nambala yomwe ikugwirizana ndi kukula kwa metastasis.

Dokotala wanu angapatsenso Clark ndi Breslow nambala- zofunikira za kupweteka kwa chifuwa ndi makulidwe, motero-kuti mupitirize kukhazikitsa khansa yanu ndipo muzindikire kuti mukudwala.

Kuwonjezera apo, "T" ikhoza kutsatiridwa ndi "a" zomwe sizikutanthauza zilonda zam'thupi, kapena "b" zomwe zimatanthauza zilonda.

Kuwombera, komwe kumasonyeza matenda oopsa kwambiri ndipo kumapezeka pansi pa microscope, kumachitika pamene khansa ya khansa imalowa m'khungu.

Kawirikawiri, chowopsa kwambiri ndi khansa yafalikira, ndipamwamba pamtunda umene wapatsidwa. Pamwamba pa siteji, kuwonongeka kwakukulu kwa nthawi yaitali ndi.

Phunzirani zambiri za magawo osiyanasiyana a khansa ya khansa komanso zomwe akuwonetsa, pansipa.

Gawo 0

Pamene khansa ya khansa imagwidwa msanga kwambiri ndipo siinalowe pansi pa khungu, imadziwika kuti melanoma in situ. Icho chimachiritsidwa kwambiri ndipo chimatchedwa siteji 0 kapena sichiperekedwa siteji.

Gawo I

Mankhwala ochiritsidwa amakhala abwino kwambiri pochotsa opaleshoni chifukwa ma melanomawa sangafalikire.

• Gawo 1A (T1aN0M0): Chotupacho sichinafalikire ku nodes. Ndi zosakwana 1 mm ndipo sizilonda. Kusunga kwa zaka zisanu ndi 95 peresenti.
• Gawo IB (T1bN0M0 kapena T2aN0M0): Chotupacho sichinafalikire ku nodes. Ziri zosakwana 1 mm, koma zimakhala zilonda zam'mimba kapena zili pakati pa 1.01 ndi 2 mm koma sizilonda. Kusunga kwa zaka zisanu ndi 89 peresenti kufika 91 peresenti.

Ndikoyenera kudziwa kuti chotupa chingakhale chochepera 1 mm ndipo sichingakhale zilonda zam'mimba koma sichikuonedwa ngati Gawo IA-ngati lili ndi mlingo wa Clark woposa. Mofananamo, chotupa chingakhale T1b ndi osachepera 1 mm popanda zilonda ngati chiri ndi mlingo wapamwamba wa Clark.

Gawo II

Melanomas ikhoza kuchiritsidwa, koma chiwongoladzanja chimayambira kumbuyo kwa Gawo I chifukwa chiwerengero chochepa cha maselo a khansa chikhoza kufalikira kumalo akutali. Kuphatikiza pa opaleshoni, mitundu ina ya mankhwala ingakonzedwe.

• Gawo IIA (T2bN0M0 kapena T3aN0M0): Chotupacho sichinafalikire ku nodes. Zili pakati pa 1.01 ndi 2 mm ndipo ndi zilonda zam'mimba, kapena 2.01 mpaka 4 mm popanda zilonda. Kusunga kwa zaka zisanu ndilo 77 peresenti kufika pa 79 peresenti.
• Gawo IIB (T3bN0M0 kapena T4aN0M0): Chotupacho sichinafalikire ku nodes. Ndi pakati pa 2.01 ndi 4 mm ndipo ndi ulcerated kapena kuposa 4 mm popanda zilonda. Kusunga kwa zaka zisanu ndi 63 peresenti kufika 67 peresenti.
• Gawo IIC (T4bN0M0): Chotupacho sichinafalikire ku nodes. Ndiposa 4 mm ndipo ndi ulcerated. Kupulumuka kwa zaka zisanu ndi 45 peresenti.

Gawo III

Popeza kuti chotupachi chayamba kuchepa, kupitirira kwa masitepewa ndi kochepa kusiyana ndi poyamba.

• Gawo IIIA (T1a-4a, N1a-N2a, M0): Chotupa sichiri chilonda. Yafalikira mpaka ma node atatu, koma salikulitsidwa. Kufalikira kwa nthendayi kumaonekera kokha pa kuyesedwa kochepa, osati pa kafukufuku wa kuchipatala. Kupulumuka kwa zaka zisanu ndi 63 peresenti kwa 69 peresenti.
• Gawo la IIIB: Iyi ndi malo ovuta komanso zochitika zambiri:
  1. T1b-T4b, N1a-N2a: Kutupa ndi zilonda zam'mimba. Yafalikira mpaka ma node atatu, koma salikulitsidwa. Kufalikira kwa nthendayi kumaonekera kokha pa kuyesedwa kochepa, osati pa kafukufuku wa kuchipatala.
  2. T1a-T4a, N1b-N2b: Chotupa sichiri chilonda. Yafalikira mpaka ma node atatu, ndipo nodezi zikulitsidwa chifukwa cha melanoma.
  3. T1a / b-T4a / b, N2c: Chotupacho chingakhale chilonda kapena ayi. Chotupacho chafalikira pakhungu chomwe chiri pafupi ndi khansa ya khansa (satana metastasis) kapena kumayendedwe amphamvu a pafupi ndi mitsempha yam'mimba, koma maselo am'mimba samakhala ndi melanoma.

  Kupitirira zaka zisanu kupitilira gawo lino ndi 30 peresenti mpaka 59 peresenti.

• Gawo IIIC:
  1. T1b-T4b, N1b kapena N2b: Chotupacho ndi zilonda zam'mimba. Mankhwalawa akufalikira mpaka maselo atatu, omwe amakula chifukwa cha khansa.
  2. Matenda onse T, N3: Chotupacho chingakhale makulidwe alionse ndipo chingakhale zilonda zam'mimba kapena ayi. Khansa ya khansa imafalikira ku nthiti zinayi kapena pafupi, kapena pali nthendayi yomwe imakhala ndi ma melanoma mwa iwo, kapena pali satana kapena masentimita amtunduwu ndipo khansara yafalikira ku maselo oyandikana nawo.

  Kupulumuka kwa zaka zisanu ndi 24 peresenti mpaka 29 peresenti.

Gawo IV

Mbali iyi ya khansa ya khansa imakhala ndi ma metastasis kupitirira malo am'derali kumalo akutali m'thupi monga mapapo, chiwindi, kapena ubongo, kapena kumadera akutali khungu. Palibe malo amtundu wa lymph kapena makulidwe omwe amaganiziridwa. Kusunga kwa zaka zisanu kumakhala pakati pa 7 peresenti ndi 19 peresenti.

Chidule cha Masitepe

Gawo	Zizindikiro
IA	Kutupa ≤ 1.0 mm popanda zilonda; osayanjanitsika; palibe metastases kutali
IB	Kutupa ≤ 1.0 mm ndi zilonda zam'mimba kapena Clark mlingo IV kapena V; chotupa 1.01-2.0 mm popanda zilonda; osayanjanitsika; palibe metastases kutali
IIA	Kutupa 1.01-2.0 mm ndi zilonda; chotupa 2.01-4.0 mm popanda zilonda; osayanjanitsika; palibe metastases kutali
IIB	Kutupa 2.01-4.0 mm ndi zilonda
IIB	Kutupa> 4.0 mm popanda zilonda; osayanjanitsika; palibe metastases kutali
IIC	Kutupa> 4.0 mm ndi zilonda; kulimbikitsana; palibe metastases kutali
IIIA	Kutupa kwa makulidwe aliwonse popanda zilonda zam'mimba ndi mliri umodzi wabwino
IIIB	Kutupa kwa makulidwe alionse popanda zilonda zam'mimba ndi ziwiri kapena zitatu zabwino zam'mimba
IIIC	Kutupa kwa nthendayi iliyonse kapena zowonjezera zinayi kapena zina zowonjezereka zamtenda kapena masitepe / satana (osataya maselo kapena satana), OR ulcerated melanoma ndi ma lymph node ( metastatic node)
IV	Kutupa kwa makulidwe aliwonse ndi nodes aliwonse ndi metastases zilizonse zakutali

Mawu Onena za Kupulumuka Misonkho ndi Gawo

Mwinanso mungachite mantha ndi ndalama zomwe mwasunga pamwambapa, koma kumbukirani izi. Ziwerengero ndi manambala, osati anthu. Amaneneratu kuti zotsatira zake zingakhale zotani, koma samanena pang'ono za momwe inu, monga munthu, mungayankhire mankhwala . Kuwonjezera apo, mankhwala akukula. Mankhwala atsopano avomerezedwa, ndipo ambiri akuyesedwa panopa. Kafukufuku nthawi zambiri amakhala ndi zaka zingapo, ndipo sangathe kufotokoza momwe wina angayankhire mankhwala masiku ano.

Kuchiza Mankhwala

Monga tanenera poyamba, chithandizo cha khansa ya khansa imadalira kwambiri pa sitepe yeniyeni. Nkhani zotsatirazi zifotokoze njira zomwe mungachite posankha chithandizo:

• Zochitika Zoyambirira Zodwala Mankhwala a Kansalu (Gawo I ndi Gawo II)
• Njira Zothandizira Mankhwala a Melanoma (Gawo III ndi Gawo IV)

> Zotsatira:

> Balch, C., Gershenwald, J., Soong, S. et al. Mapeto a 2009 AJCC Kupanga Melanoma Staging ndi Kulemba. Journal of Clinical Oncology . 2009. 27 (36): 6199-6206.

> Mahar, A., Compton, C., Halabi, S. ndi al. Zowonongeka Zopangira Zamakono Zamagetsi mu Melanoma. Zolemba za Oncology Opaleshoni . 2016. 23 (9): 2753-61.