Ngati mukuyesera kuti muwone siteji ya khansa yanu yamapapo mungakhale mukukhumudwa kwambiri. Kodi zikutanthauzanji pamene wanu oncologist akukamba za "TNM" ndi momwe izi zikugwirizana ndi magawo? Tiyeni tiwone tanthauzo la lirilonse la makalatawa, momwe madokotala amagwiritsira ntchito izi poyambitsa khansara, ndipo chomwe chimatanthawuza potengera mankhwala.
Dongosolo la TNM
Nthenda ya TNM yokhala ndi khansara yamapapu ikhoza kusokoneza kuti wina aliyense amvetse, samangomva wina yemwe watanganidwa kumene ndi nkhani za matenda a kansa yamapapo. Kodi mgwirizano wa TNM umagwirizana bwanji ndi magawo a khansa ya m'mapapo , monga gawo 2 ndi siteji 4?
Zimene Makalata Amatanthauza
Makalata onse a TNM amaimira kukula kapena kufalikira kwa khansara motere:
- T - Akuyesa kukula kwa chotupa. Kawirikawiri kukula kwake kumaperekedwa masentimita (masentimita). Kuti muzimvetse izi mu mainchesi, masentimita asanu ndi ofanana ndi masentimita awiri.
- N - N imayimira ma lymph node ndipo imanena ngati chotupacho chafalikira ku maselo a mitsempha, ndipo ngati ziri choncho, ndi kutali bwanji ndi chotupacho.
- M - M amaimira metastasis , ndiko kuti, kufalikira kwa chotupa ku mbali zina za thupi.
Chifukwa Choyimira Mapiri Ndi Chofunika
Mapulogalamu a TNM amathandiza madokotala kumvetsetsa kuti khansara ndi yotani ndipo, motero, chomwe chithandizo chabwino kwambiri cha mankhwala ndi khansa imeneyi. Zingathandizenso kutchula chomwe chiwerengero chazomwe zimakhalapo ndi munthu yemwe ali ndi khansara yamapapu.
Ndalama za TNM zimachokera ku deta yapadziko lonse ya khansa ya m'mapapo mwa anthu zikwizikwi ndikuyerekezera ndi khansa ya m'mapapo ndi mayankho a chithandizo ndi mankhwala.
Izi zikutanthauza kuti ndizofunika kumvetsetsa kuti pali zinthu zambiri zomwe zimakhudza momwe thupi la khansa ya m'mapapo limakhudzidwira .
Umoyo wanu wonse, khansara ya mtundu wa mapapu yomwe muli nayo, kaya muli ndi "zovuta" kusintha kwa chibadwa chanu, ndipo ngakhale amuna anu amatha kuchita nawo mankhwala omwe angapindulitseni inu ndi zomwe munthu wina angakuwonereni .
Kusokonezeka kwa TNM
Mudzawona kuti makalata anu a TNM adzakhala ndi manambala omwe akutsatira. Tiyeni tiwone zomwe nambala zosiyana zimatanthauza:
T - Tumor Size
- Tx - Kukula kwa chotupa sikunadziwika, kapena maselo a khansa amapezeka kupezeka.
- T0 - Palibe umboni wa chotupa chachikulu.
- Tis - Carcinoma in situ - Chotupacho chiripo mu maselo omwe akuyenda pamsewu ndipo sinafalikira kumatenda oyandikira.
- T1 - Kutupa pang'ono kapena kofanana ndi masentimita atatu (1½½).
- T1a - Osakwana kapena ofanana ndi 2 cm.
- T1b - Woposa 2 cm koma osachepera kapena wofanana ndi masentimita atatu.
- T2 - Chotupachi n'choposa 3 cm koma osachepera 7 cm. Matenda a T2 amalepheretsa mbali ina, koma sanabweretse chibayo kapena kupangitsa mapapu kugwa ( atelectasis ). Mwinamwake amafalikira kumalo ozungulira mapapo. Angakhalenso pafupi ndi bronchus yaikulu koma osachepera 2 cm (pafupi inchi) kutali ndi malo omwe bronchus amapatukira kupita m'mapapo onse.
- T2a - Zoposa 3 cm koma zosakwana kapena zofanana ndi masentimita 5.
- T2b - Zoposa 5 cm koma zosakwana kapena zofanana ndi masentimita 7.
- T3 - Tumimba zoposa masentimita 7, kapena osachepera 7 masentimita koma ndi chofufumitsa chosiyana mu lobe yomweyo. Matenda a T3 amakhalanso ndi matumbo omwe sali oposa masentimita 7 koma amalowa m'kati mwa mapapo ( pleura ), khoma la chifuwa , phokoso , bronchus, kapena pansi pa 2 cm malo omwe bronchus amapatukira kumapapo . Chotupachi chimatchulidwanso ngati T3 ngati sichikhala masentimita 7 koma chikugwirizana ndi chibayo kapena kugwa kwa mapapo onse.
- T4 - Chotupa cha kukula kwake kulikonse, koma ndi nthenda ina mumtundu wosiyana pambali imodzi ya thupi, kapena chotupa chimene chimalowa m'zifuwa monga mtima, mitsempha yambiri ya magazi pafupi ndi mtima, trachea , mitsempha ya mitsempha (mitsempha pafupi ndi trachea), mediastinum (danga pakati pa mapapo), malo ozungulira, kapena dera limene bronchus yaikulu imagawira kupita kumapapo awiri.
N - Kuyanjana kwa Lymph Nodes
- N0 - Palibe nambala yomwe ikukhudzidwa.
- N1 - Chotupacho chafalikira kumadera oyandikana nawo mbali imodzi ya thupi.
- N2 - Kutupa kwafalikira ku nodes kutali koma pambali imodzi ya chifuwa.
- N3 - Chotupacho chafalikira ku minofu kumbali ina ya chifuwa kuchokera ku chotupa choyambirira, kapena kufalikira ku nodes pafupi ndi collarbone kapena minofu ya m'khosi.
M - Metastasis (Kufalikira) ku madera ena
- M0 - Chotupacho sichinafalikire kumadera akutali.
- M1
- M1a - Chotupacho chafalikira kumapapu osiyana, kupita ku mapapo ( kupweteka kwachinyengo ) kapena kupanga mapulaneti pa phokosolo.
- M1b - Kutupa kwafalikira kumadera akutali a thupi, monga ubongo kapena mafupa.
Kuyerekezera Machitidwe a Khansa Yam'mimba ndi TNM Stage
Anthu ambiri amadziwika bwino ndi magawo a khansara yamapapo kuposa momwe alili ndi TNM. Pano pali kuyerekezera kwa magawo a kansa yamapapo ndi mayendedwe a TNM:
- TisN0M0
- Gawo 1A Khansa Yam'mimba
- T1aN0M0
- T1bN0M0
- Gawo 1B Khansa Yam'mimba
- T2aN0M0
- Gawo 2A Khansa Yam'mimba
- T1aN1M0
- T1bN0M0
- T2aN1M0
- Gawo 2B Lungula Khansa
- T2bN0M0
- T2bN1M0
- T3N0M0
- Gawo 3A Khansa Yopsa
- T3N1M0
- T4N0M0
- T4N1M0
- T1N2M0
- T2N2M0
- T3N2M0
- Gawo 3B Lungula Khansa
- T1N3M0
- T2N3M0
- T3N3M0
- T4N2M0
- T4N3M0
- T aliyense, aliyense N, M1a
- T aliyense, aliyense N, M1b
Kufufuza Kwatsopano Ndi Khansa Yam'mimba
Ngati mwapezeka kuti muli ndi khansara yamapapo , mwinamwake mumawopa ndi mantha. Mwinamwake mwamvapo kuti kudziŵa mozama za khansara yanu kungapindulitse zotsatira, koma mungachite bwanji pamene chirichonse chikuwoneka kuti chinalembedwa m'chinenero china?
Tengani nthawi yoti mudziphunzitse nokha. Lankhulani ndi dokotala wanu ndipo mufunse mafunso ambiri. Phunzirani za momwe mungapezere uthenga wabwino wa khansa pa intaneti . Anthu ambiri omwe ali ndi khansara yamapapu amalingalira kupeza kachiwiri, ndipo izi ndizofunika kwambiri. Nthawi zambiri zimalimbikitsidwa kuti mupange lingaliro lachiwiri pa chimodzi mwa zikuluzikulu za National Cancer Institute-malo opatsirana khansa omwe amatha kukhala a oncologist omwe amapanga kansa ya mtundu wina wa mapapo. Komanso, ngati muli ndi khansa ya m'mapapo yopanda maselo, onetsetsani kuti dokotala wanu walamula kuti pulojekiti yanu ikhale yosavuta .
Onetsetsani kuti mukhale woyimilira wanu pa chisamaliro chanu cha khansa. Kuti muchite izi, zingakhale zothandiza kuti zitha kugwirizana ndi khansa ya m'mapapo pa intaneti (hashtag ndi #LCSM). Midzi izi zimangobwereka chithandizo koma zingakuthandizeni kuphunzira ndi kuyendetsa njira yanu kudzera mu zisankho zambiri zomwe mukukumana nazo.
Koposa zonse, khalani ndi chiyembekezo. Mankhwala a kansa ya m'mapapo akukwera, ndipo chiwerengero cha anthu omwe ali ndi khansa chikukula bwino. Pakhala pali mankhwala ena atsopano omwe amavomereza khansara yamapapo mu zaka zingapo zapitazi kuposa zaka makumi angapo zapitazo.
> Zotsatira:
> Edge, S. ndi al (Eds). Buku la AJCC la Kukhazikitsa Khansa. Gulu lachisanu ndi chiwiri. Springer. New York, NY. 2010.
> National Cancer Institute. Mankhwala Osakaniza Amtundu Wambiri Wopanda Khansa (PDQ) - Health Professional Version. Kusinthidwa 03/31/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all
> Nicholson, A., Chansky, K., Crowley, J. et al. International Association for the Study of Lung Cancer Staging Project: Kukonzekera kwa Kukonzanso Kachilombo ka Kachilombo Kakang'ono Kamene Kameneka Kameneka Kameneka Kachitidwe Kachisanu ndi Chinayi cha Kachilombo ka TNM kwa Khansa Yam'mimba. Journal of Thoracic Oncology . 2016. 11 (3): 300-11.
> Rami-Porta, R., Crowley, J., ndi PP. Goldstraw. Ndondomeko ya TNM Staging System ya Khansa ya M'magazi . Annals ya Opaleshoni Yachilu ndi Opaleshoni . 2009. Vol 12, No 1.