Pamene khansa imakhudza mafupa, izi zimakhala chifukwa cha khansara yopanda fupa yomwe yayamba kwinakwake m'thupi ndikufalitsa, kapena kuwonetsa mafupa. Mosiyana ndi izi, zomwe zikuchitika apa ndizo za khansa zomwe zimayamba m'mafupa, zomwe zimatchedwanso mafupa oyambirira a khansa.
Khansara yapafupa yapamtunda kwenikweni ndi gulu lalikulu, lokhala ndi mitundu yosiyanasiyana ya malungo, ena mwa iwo ndi osowa kwambiri; Komabe, ma osteosarcoma, chondrosarcoma, ndi Ewing sarcoma ndi zina mwazofala.
Zomwe Zimadziwika
Ngakhale kuti zidziŵitso za khansa ya fupa sizidziwika bwino, kusintha kwa DNA ya maselo a khansa kumadziwika kukhala kofunika. Nthawi zambiri, kusintha uku kumachitika mwadzidzidzi ndipo sikudutsa kuchokera kwa makolo kupita kwa ana.
Asayansi aphunzira njira za chitukuko pofuna kuyesa kumvetsetsa zomwe zimachitika. Osteosarcoma ndi mtundu wachitatu wonyansa umene umakhudza mafupa ali achinyamata, amayamba kokha ndi khansa ya m'magazi ndi lymphoma. Chondrosarcoma imakhalanso khansa yapakhungu yoyamba, koma imakhala yodziwika kwambiri kwa anthu akuluakulu kuposa ana ndi achinyamata, omwe ali ndi zaka zoposa makumi asanu ndi zisanu. Kusuta sarcoma kawirikawiri kumapezeka kuti ali achinyamata, ndipo zaka zambiri za matendawa zimakhala zaka 15.
Mauthenga Oseosarcoma Oopsya
Osteosarcoma ndi khansa yapamtima yambiri ya mafupa. Pali zinthu zingapo zomwe zimadziwika kuti zikhale zovuta kuti zikhazikitsidwe. Anthu omwe ali ndi chotupa chochepa cha diso chomwe chimadziwika kuti retinoblastoma cholowa chawo ali ndi chiopsezo chowonjezereka chokhala ndi osteosarcoma.
Kuwonjezera pamenepo, awo amene adachiritsidwa kale ndi khansa pogwiritsa ntchito radiotherapy ndi chemotherapy ali ndi chiopsezo chowonjezereka chokhala ndi osteosarcoma m'tsogolo.
Nthawi zambiri, madokotala ambiri amavomereza kuti mafupa osweka ndi ovulala ndi masewera a masewera samayambitsa osteosarcoma. Komabe, kuvulala koteroko kungabweretsere osteosarcoma kapena mafupa ena omwe amapezeka kuchipatala, motero pali kugwirizana pakati pa ziwirizi-kungokhala kuti kuwonongeka kwa makina sikuwoneka kuti kumayambitsa osteosarcoma.
Zaka, Zogonana, ndi Amitundu-Zochitika Zowopsa
Osteosarcoma makamaka imakhudza mibadwo iwiri yapamwamba-chigawo choyamba chiri mu zaka zachinyamata ndipo chachiwiri ndi pakati pa akuluakulu.
- Kwa okalamba, osteosarcoma nthawi zambiri imachokera ku fupa losalimba, monga omwe amakhudzidwa ndi matenda a mitsempha yakale (mwachitsanzo, matenda a Paget ).
- Pakati pa achinyamata, osteosarcoma ndi yosawerengeka kwambiri asanakwanitse zaka zisanu, ndipo chiwerengero chachikulu chikuchitika panthawi ya kukula kwa achinyamata. Kawirikawiri, "zaka zofanana" za osteosarcoma mwa achinyamata ndi zaka 16 kwa atsikana komanso zaka 18 za anyamata.
Osteosarcoma ndi yochepa poyerekeza ndi khansa zina; Akuti anthu pafupifupi 400 okha osakwana zaka 20 amapezeka ndi osteosarcoma chaka chilichonse ku United States. Anyamata amakhudzidwa kawirikawiri m'maphunziro ambiri, ndipo chiwerengero cha achinyamata a ku Africa ndi apamwamba kwambiri kuposa achizungu.
Zinthu Zowopsa Kwa Anthu Achinyamata
- Kukhalapo kwa matenda enaake osaphatikiza khansa syndromes
- Zaka pakati pa zaka 10 ndi 30
- Kutalika kwautali
- Zogonana amuna
- Mtundu wa ku America ndi America
- Kukhalapo kwa matenda ena a mafupa
Zinthu Zowopsa Kwa Anthu Okalamba
Matenda ena a pfupa monga matenda a Paget , makamaka m'kupita kwanthawi, amawopsa kwambiri chifukwa cha osteosarcoma.
Komabe, chiopsezo chachikulu ndi chochepa, ndipo pafupifupi mmodzi peresenti ya anthu omwe ali ndi matenda a Paget anayamba kukhala ndi osteosarcoma.
Kuwotcha mazira ndi chinthu choopsa kwambiri, komanso chifukwa nthawi yomwe imakhala ndi khansa komanso maonekedwe a osteosarcoma nthawi zambiri (mwachitsanzo, zaka khumi kapena kuposerapo), izi zimakhala zogwirizana kwambiri ndi magulu akale.
Zojambula Zachibadwa
Kupanga ma genetic syndromes kwa osteosarcoma ndi awa:
- Matenda a pachimake
- Mankhwala a Diamond-Blackfan
- Matenda a Li-Fraumeni
- Matenda a Paget
- Retinoblastoma
- Rothmund-Thomson syndrome (yomwe imatchedwanso poikiloderma congenitale)
- Werner matenda
- Kutayika kwa ntchito ya jekeseni ya p53 ndi retinoblastoma chifuwa choyambitsa matenda amtunduwu kumakhulupirira kukhala ndi mbali yofunikira pa chitukuko cha osteosarcoma.
Ngakhale kusintha kwa majeremusi (mazira ndi umuna) ya majeremusi a p53 ndi retinoblastoma ndi osowa, majini amenewa amasinthidwa m'matumbo ambiri a osteosarcoma, kotero pali kugwirizana kwa chitukuko cha osteosarcoma. Kusintha kwa majeremusi m'thupi la p53 kungayambitse chiopsezo chachikulu chokhala ndi malungo kuphatikizapo osteosarcoma amene amatchedwa matenda a Li-Fraumeni .
Ngakhale kusintha kwa chifuwa choyambitsa matenda a majeremusi ndi oncogenes n'kofunikira kuti apange osteosarcomas, sizikuwonekeratu kuti zochitika izi zimachitika choyamba ndi chifukwa chiyani kapena zimachitika bwanji.
Osteosarcomas kwa Amene Ali Ndi Matenda a Paget
Pali kachilombo kakang'ono ka osteosarcomas kamene kamakhala kosauka kwambiri. Matendawa amapezeka mwa anthu omwe ali ndi zaka zoposa 60. Matendawa ndi aakulu panthawi yomwe amawonekera ndipo amayamba kukhala owononga kwambiri, zimapangitsa kuti zikhale zovuta kupeza opaleshoni yothandizira (kuchotsa), komanso mapuloteni a mapapo nthawi zambiri amakhalapo pachiyambi.
Maonekedwe owopsa ndi a okalamba. Amakhala pafupifupi pafupifupi 1 peresenti ya anthu omwe ali ndi matenda a Paget, kawirikawiri pamene mafupa ambiri amakhudzidwa. Ziphuphu zimapezeka mumphuno, ntchafu pafupi ndi m'chiuno, ndi mkono wa fupa pafupi ndi mapewa; amavutika kuchipatala, makamaka chifukwa cha msinkhu wake komanso kukula kwa chotupacho.
Nthawi zina zimakhala zofunikira, makamaka pamene fupa limatha chifukwa cha khansa, yomwe imachitika kawirikawiri.
Matenda a Parosteal ndi Periosteal Osteosarcomas
Awa ndi gawo lomwe limatchulidwa chifukwa cha malo awo mu fupa; kawirikawiri amakhala osteosarcomas oopsa kwambiri omwe amapezeka pamthambo kuphatikizapo minofu yomwe imakhala pafupi ndi fupa, kapena kuti periosteum. Nthawi zambiri zimalowa m'kati mwa mafupa ndipo nthawi zambiri zimakhala zoopsa kwambiri za osteosarcomas.
Maonekedwe oopsya a osteosarcoma amasiyana ndi a osteosarcoma amodzi: amadziwika kwambiri ndi akazi kusiyana ndi amuna, amodziwika kwambiri pa zaka 20 mpaka 40, ndipo amayamba kumbuyo kwa chifuwa, pafupi ndi mawondo , ngakhale fupa liri lonse m'matumbo lingakhudzidwe.
Matenda Osteosarcoma Oopsa Kwambiri
Zinthu zoopsa zakhala zikugwirizanitsidwa ndi zizindikiro zabwino ndi zoipa, koma mwatsoka, zinthu zomwezi sizinakhale zothandiza pakuzindikiritsa odwala omwe angapindule ndi machitidwe ochiritsira ovuta kwambiri kapena ocheperapo kwambiri pamene akukhala ndi zotsatira zabwino kwambiri. Zinthu zomwe zimadziwika kuti zimakhudza zotsatira zimaphatikizapo zotsatirazi.
Webusaiti Yoyamwitsa
Za zotupa zomwe zimapanga m'manja ndi miyendo, zomwe ziri kutali kwambiri ndi thupi, kapena torso, zimakhala bwino.
Ziphuphu zazikuluzikulu zomwe zimapangika m'magazi ndi msana zimakhudzidwa ndi chiopsezo chachikulu cha kupita patsogolo ndi imfa, makamaka chifukwa ndi zovuta kukwaniritsa kuchotsedwa kwathunthu kwa khansara m'malo awa. Mphuno yamutu ndi khosi m'kamwa ndi m'kamwa amakhala ndi chithunzithunzi chabwino kuposa malo ena oyambirira pamutu ndi pamutu, mwinamwake chifukwa amayamba kumvetsera.
Mafupa a Hipbone amapanga 7 mpaka 9 peresenti ya osteosarcomas onse; chiwerengero cha odwala ndi 20 mpaka 47 peresenti.
Odwala osteosarcoma (omwe amatchulidwa ngati mafupa ambirimbiri osapatsa chifuwa chachikulu) ali ndi vuto losauka kwambiri.
Zomwe zimayang'anizana ndi Matenda a Metastatic
Odwala omwe ali ndi matenda amtunduwu (omwe sali kufalikira kumadera akutali) amakhala ndi chithunzithunzi chabwino kuposa omwe ali ndi matenda a metastatic. Odwala makumi asanu ndi awiri (20%) aliwonse adzakhala ndi mitsempha yowonongeka pamatenda, ndipo mapapo ndi malo omwe amapezeka kwambiri. Chizindikiro cha odwala omwe ali ndi matendawa amatsimikiziridwa makamaka ndi malo a metastases, chiwerengero cha metastases, ndi opaleshoni ya matenda oopsa.
Kwa anthu omwe ali ndi matenda a metastatic, zizindikiro zikuoneka kuti zili bwino ndi kuchepa kwa mapapo a m'mapapo komanso pamene matendawa afalikira kumapapu amodzi okha, osati m'mapapo onse awiri.
Tumor Necrosis Pambuyo pa Chemotherapy
Tumor necrosis apa akutanthauza minofu ya khansa yomwe "yafa" chifukwa cha chithandizo.
Pambuyo pa chemotherapy ndi opaleshoni, katswiriyu amayesa zotupa necrosis mu chotupa chochotsedwacho. Odwala omwe ali ndi 90 peresenti ya necrosis mu chotupa chachikulu pambuyo chemotherapy amakhala ndi chithunzithunzi chabwino kuposa odwala omwe ali ndi necrosis yochepa.
Komabe, ofufuza amavomereza kuti necrosis yochepa sayenera kutanthauzira kutanthawuza kuti mankhwala a chemotherapy akhala opanda ntchito; mankhwala ochiritsira odwala omwe ali ndi nthenda yaing'ono kapena yosavomerezeka pambuyo poti mankhwalawa amathandiza kwambiri kuposa mankhwala ochiza odwala omwe samalandira mankhwala a chemotherapy.
Mbiri ya ngozi ya Chondrosarcoma
Ichi ndi chotupa choopsa cha maselo otulutsa khungu, ndipo amaimira pafupifupi 20 peresenti ya ziphuphu zonse zapathupa . Chondrosarcoma ikhoza kuimirira yokha kapena yachiwiri, mu zomwe zimatchedwa "kuwonongeka koopsa" kwa zotupa zowononga (monga osteochondroma kapena enchondroma benign). Zinthu zoopsa zimaphatikizapo:
- Zaka: Kawirikawiri zimachitika mwa anthu oposa zaka 40; Komabe, imakhalanso ndi zaka zazing'ono, ndipo zikachitika, zimakhala zovuta kwambiri zomwe zimatha kukhala ndi matenda.
- Gender: Amakhala ndi mafupipafupi ofanana pakati pa amuna ndi akazi onse.
- Malo: Ikhoza kuchitika mu fupa lililonse, koma pali chizolowezi cha chitukuko mu hipbone ndi thighbone. Chondrosarcoma ingatuluke m'mafupa ena apansi, monga scapula, nthiti, ndi fuga.
- Genetics: Matenda ambiri omwe amachititsa kuti thupi likhale ndi matenda ambiri (nthawi zina limatchedwa matenda ochuluka a osteochondromas) ndi vuto lobadwa nalo limene limayambitsa mavupa ambiri pamapfupa a munthu, omwe amapangidwa ndi mafupa. Exostoses ikhoza kukhala yopweteka ndipo imapangitsa mafupa osokonekera komanso / kapena kupasuka. Matendawa ndi majini (chifukwa cha kusintha kwa mitundu ina ya majeremusi 3 EXT1, EXT2, kapena EXT3), ndipo odwala omwe ali ndi vutoli ali ndi chiopsezo chowonjezeka cha chondrosarcoma.
- Matenda Ena a Benign: An enchondroma ndi chotupa cha kadoti chomwe chikukula mumphongo. Anthu omwe amapeza matumbo ambiri amakhala ndi vuto lotchedwa multiple enchondromatosis. Amakhalanso ndi chiopsezo chachikulu chokhala ndi chondrosarcoma.
Ewing Sarcoma Risk Profile
Izi ndi zofala kwambiri pakati pa azungu (mwina osakhala Achipanishi kapena a ku Puerto Rico) ndi osowa kwambiri pakati pa anthu a ku Asia ndi osawerengeka kwambiri pakati pa a ku America. Kutaya zotupa kungathe kuchitika pa msinkhu uliwonse, koma kumakhala kofala m'zaka zachinyamata ndipo sizodziwika pakati pa achinyamata komanso ana. Iwo ndi osowa mwa akulu akuluakulu.
Pafupifupi onse Kutaya maselo a zotupa ali ndi kusintha komwe kumayambitsa matenda a EWS, omwe amapezeka pa chromosome 22. Kugwiritsa ntchito jini la EWS kumabweretsa kuwonjezeka kwa maselo ndi kukula kwa khansa iyi, koma njira yeniyeni yomwe izi zimachitika sizinayambe momveka bwino.
> Zotsatira:
> American Cancer Society. Mayesero a Osteosarcoma. Chiwongola dzanja
> Institute Cancer Institute. Osteosarcoma ndi Malignant Fibous Histiocytoma ya Matenda a Matenda (PDQ®) -Health Professional Version. https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq.