Mawu akuti "maselo osakanikirana" ndi oopsa. Ndikofunika kuyamba kulankhula za maselowa ponena kuti sikuti maselo onse osakanikirana amayamba kukhala khansara. Ndipotu, ambiri samatero.
Anthu ambiri amva maselo osakanikirana a chiberekero cha uterine omwe amapezeka pa mapepala a Pap , koma maselo amodzi amatha kupezeka m'mbali iliyonse ya thupi: bronchi, khungu, mabere, colon, ndi zina.
Tiyeni tiyambe mwa kufotokoza zomwe maselo awa ali ndi momwe amasiyanirana ndi maselo "abwino" m'matupi athu.
Tanthauzo
Maselo oyambirira (omwe amatchedwanso maselo oyambirira) amatchulidwa ngati maselo osadziwika omwe angasanduke maselo a khansa koma omwe okhawo sakhala ovuta.
Lingaliro la maselo olondola kwambiri limasokoneza chifukwa si nkhani yakuda ndi yoyera. Kawirikawiri, maselo samachoka pa tsiku limodzi, amawongolera tsiku lachiwiri, kenako amapita ku khansa tsiku lachitatu. Nthawi zina maselo osakanikirana amapita ku khansa, koma nthawi zambiri samatero. Zingakhale zofanana-ndiko kuti, zikhale zachilendo koma osati zovuta-kapena zikhoza kukhala zachilendo kachiwiri.
Ndemanga yotsirizayi ndi yatsopano kwa akatswiri a kansa. M'mbuyomu, amakhulupirira kuti "kuwonongeka kunkachitika" pamene selo linasinthidwa kuti liziwoneka bwino ndi zizindikiro za chilengedwe. Panopa tikuphunzira (m'munda wotchedwa epigenetics) kuti maselo athu ndi ovuta kwambiri kuposa amenewa komanso zinthu zomwe zili m'malo mwathu (ngati khansa, mahomoni kapena ngakhale kupanikizika) zimagwirira ntchito limodzi kuti zidziwe zomwe zingasinthe kuti maselo asinthe.
Ndikofunika kutsimikiziranso kuti maselo omwe ali otetezeka si maselo a khansa . Izi zikutanthauza kuti zatsala zokha, sizili zowonongeka-ndiko kuti, sizidzafalitsidwa kumadera ena a thupi. Amangokhala maselo osadziwika omwe angapangitse kusintha komwe kumawasandutsa maselo a khansa.
Mfundo ina ya chisokonezo ndi yakuti maselo a kansa ndi maselo osakanikirana akhoza kukhalapo. Mwachitsanzo, anthu ena amapezeka kuti ali ndi khansa ya m'mawere, pali zigawo zina m'mabere komanso ngakhale chotupa chomwe maselo amodzi amapezekanso. Mu zotupa zambiri, maselo owopsa ndi otsogolera amapezeka.
Maphunziro a Kusintha kwa Dysplasia
Mawu akuti dysplasia nthawi zambiri amagwiritsidwa ntchito mofanana ndi maselo osakanikirana, komabe pali kusiyana kochepa. Madokotala akamanena za dysplasia, akulankhula za maselo osadziwika omwe angakhale odwala khansa. Koma nthawi zina, mawu oopsa a dysplasia amagwiritsidwa ntchito polongosola maselo omwe ali kale ndi khansa koma amakhala m'matumbo omwe anayamba-chinthu chomwe chimadziwika kuti carcinoma-in-situ .
Kusintha kwakukulu kumayambiriro kawiri kaŵirikaŵiri kumafotokozedwa muzigawo kapena zovuta. Pali njira zikuluzikulu ziwiri zomwe izi zikufotokozedwa: kuuma ndi kalasi.
Kukhwima
- Dild dysplasia: Wofatsa dysplasia amatanthauza maselo omwe ali ochepa chabe. Maselo amenewa sapita patsogolo ku khansa.
- Dysplasia yapamwamba: Maselo amenewa ndi osapitirira malire ndipo ali ndi chiopsezo chachikulu chokhala khansara.
- Dysplasia yoopsa: Ichi ndi chosaopsa kwambiri chomwe chikuwonedwa pamaso pa selo chikanenedwa ngati khansa. Dysplasia yoopsa imakhala yochuluka kwambiri kuti ifike patsogolo pa khansa.
Chitsanzo chomwe chingamve bwino kwambiri ndi chiberekero cha dysplasia chopezeka pamap smears ena . Maselo amene ali ochepa thupi osapangika amakhala odwala khansa. Koma, ngati sichikutsatiridwa, dysplasia yaikulu yomwe imapezeka pa mapepala apamapu idzapita ku khansa 30 peresenti mpaka 50 peresenti ya nthawiyo.
Pali chisokonezo chokhudza m'mene mungapezere mzere pakati pa dysplasia ndi carcinoma mu situ. Carcinoma in situ ndi mawu omwe amatanthauziridwa kuti "khansara m'malo." Awa ndi maselo ophera khansa omwe sanayambe kupyola mu chidziwitso chapansi.
Maphunziro
Njira inanso yofotokozera kuopsa kwa kusintha kwa maselo mwachangu ndi masukulu.
Ndi maselo achiberekero, zigawozi zimagwiritsidwa ntchito pamene chiwopsezo chitachitika atapeza dysplasia pamap pap.
- Dysplasia yapamwamba: Kusintha kwapafupi sikungatheke kuti ayambe khansa.
- Maphunziro apamwamba a dysplasia: Maselo okhala ndi apamwamba kwambiri a dysplasia amakhala ovuta kwambiri kupita patsogolo ku khansa.
Chitsanzo cha izi chikanakhala chiwerengero chochepa cha dysplasia chomwe chimawonekera pa chiberekero cha chiberekero. Mwinamwake kusintha kumeneku kukufika ku khansa ndikochepa. Mosiyana ndi zimenezi, apamwamba kwambiri a colon dysplasia omwe amagwirizana ndi mapulotoni amatha kukhala ndi chiopsezo chachikulu chopitirizabe kukhala khansa ya coloni .
Kudziwa
Maselo oyambirira amapezeka ndi mawonekedwe awo osadziwika pogwiritsa ntchito microscope, kawirikawiri pambuyo pake.
Zimayambitsa
Pali zifukwa zambiri zomwe zingayambitse maselo kukhala osakanikirana, ndipo izi zimasiyana malinga ndi mtundu wa maselo omwe akukhudzidwa.
Njira yosavuta kumvetsetsa imayambitsa kuyang'ana zokhudzana ndi chilengedwe zomwe zingawononge maselo a thanzi, zomwe zimapangitsa kusintha kwa DNA ya selo, yomwe imatha kutsogolera kukula ndi kukula. Njira zingapo zomwe zingayambitse zovuta m'maselo (ndi zitsanzo zingapo kuti ziwonetse) zimaphatikizapo:
- Kutenga: Pamene 4 peresenti peresenti ya khansa ku US imayenderana ndi matenda, matenda opatsirana ndi mavairasi, mabakiteriya, ndi tizilombo toyambitsa matenda ali ndi udindo wa pafupifupi magawo anayi a khansa padziko lonse lapansi.
Kugonjetsedwa ndi papillomavirus yaumunthu (HPV) kungayambitse kutupa, kumatsogolera ku maselo osatetezeka m'chibelekero . HPV ndi chifukwa chachikulu cha dysplasia chomwe chimatsogolera khansa yambiri ya mutu ndi khosi, monga khansa ya lilime ndi khansa ya mmero . Matenda ambiri ndi HPV amatsuka musanachitike kusintha kwina kwa maselo. Ngati dysplasia ikukula, ikhoza kuthetsa payekha kapena kuchiza, kapena kupita ku khansara ya chiberekero popanda mankhwala.
Matenda ndi kutupa kotere ndi mabakiteriya a Helicobacter pylori (H. pylori) angapangitse matenda aakulu a atrophic gastritis, kusintha kwakukulu kwa kutupa m'mimba komwe kungayambitse khansa ya m'mimba . - Kutupa Kwambiri: Kutupa Kwambiri mu minofu kungapangitse kusintha kwakukulu komwe kungapangitse khansa. Chitsanzo chili mwa anthu omwe amadwala matenda a reflux a gastroesophageal (GERD) kwa nthawi yaitali. Kutupa kosatha kwa mimba ndi mimba yamkati kungabweretse chidziwitso chodziwika ngati bongo la Barrett . Pakati pa anthu omwe ali ndi vuto la Barrett, pafupifupi 1 peresenti pachaka adzakhala ndi khansa yosayembekezereka . Malo ofunika kwambiri a kafufuzidwe ndikutanthawuza ngati kuchotsa kapena kusachotsa madera a high-grade dysplasia kudzachepetsera chiopsezo chokhala ndi khansa yaumphawi.
Chitsanzo china ndi kutupa kwa coloni mwa anthu omwe ali ndi matenda opatsirana (IBD) . IBD ikhoza kutsogoloza ndi colon dysplasia, yomwe imatha kutsogolera khansa yamtunda. - Kuwopsyeza Kwambiri: Kukhumudwa kosatha kwa mpweya wochokera ku utsi wa fodya , kuwonongeka kwa mpweya , ndi mankhwala ena amtundu wa mankhwala kungayambitse ubweya wa dysplasia (dysplasia wa bronchi ). Ngati izi zimawoneka msanga nthawi ya bronchoscopy ndi biopsy, mwachitsanzo-maselo osakanikirana nthawi zina amatha kuchiritsidwa ndi mankhwala osokoneza bongo asanakhale ndi mwayi wopita ku khansara yamapapo .
Mitundu Yabwino Yoyamba Kwambiri
Khansa yomwe imayambira m'maselo a epithelial (pafupifupi 85 peresenti ya khansa) ikhoza kukhala ndi chonchi. Izi ndi zosiyana ndi khansa zomwe zimayambira maselo a mesothelial monga mitsempha. Zina zodziwika bwino zatchulidwa pamwamba, koma zikuphatikizapo:
- Cervical intraepithelial neoplasia (CIN) - Matenda a khansa ya pachibelekero
- Mitsempha ya Barrett (maselo osadziwika omwe amatha kukhala odwala matenda a kansa)
- Atypical lobular hyperplasia (yomwe ikhoza kukhala khansa ya m'mawere)
- Adenomatous polyps mu khola (lomwe lingakhale khansara ya coloni)
- Actinic keratoses (kusintha kosasintha khungu lomwe lingakhale khansara ya khungu la khungu)
- Dysplastic moles (yomwe ikhoza kukhala melanoma)
- Mphuno yamphongo yotchedwa dysplasia (yomwe ikhoza kukhala khansara yamapapo)
- Atrophic gastritis (precancerous changes in the stomach) yomwe ingakhale khansara ya m'mimba (m'mimba)
Apanso ndizofunika kuzindikira kuti maselo osakanizidwa akhoza kapena sangapitirire kukhala maselo a khansa.
Kodi Nthawi Yakale Ndi Chiyani?
Kulongosola za kusintha kwakukulu ndi mwayi wabwino kuti mulankhule za lingaliro lovuta kumvetsa pakukula kwa khansa: latency.
Nthawi ya latency imatchulidwa kuti ndi nthawi ya pakati pa kugwidwa ndi mankhwala opatsirana khansa (khansa) komanso kukula kwa khansa. Nthawi zambiri anthu amadabwa akakhala ndi khansa patatha zaka zambiri atakhala ndi khansa; Mwachitsanzo, anthu ena amakhumudwa akamakula kansa ya m'mapapo ngakhale atasiya kusuta fodya zaka makumi atatu kale.
Pamene maselo amayamba kupezeka ku kansajeni, kuwonongeka kwachitidwa kwa DNA mu selo. Kaŵirikaŵiri kuwonjezeka kwa kuwonongeka uku (kusungunuka kwa kusintha kwa thupi) m'kupita kwa nthawi kumapangitsa selo kukhala yoyenera. Pambuyo pake, selo likhoza kupita kupyolera mu magawo ofatsa mpaka ochepa-mpaka ku dysplasia musanakhale kansalu ya khansa. Selo ikhoza kuwonetsedwanso ku malo omwe amalepheretsa kukula kwa khansara, kapena kuibweretsanso ku selo yeniyeni (chifukwa chiyani zakudya zabwino ndi zochita zolimbitsa thupi n'zofunika ngakhale mutakhala ndi khansa).
Iyi ndi njira yophweka yofotokozera ndondomekoyi, ndipo tikuphunzira kuti ndi zovuta kwambiri kuposa momwe tinaganizira kale. Koma kumvetsetsa ndondomeko yodziwika bwino kumathandizira kufotokozera nthawi ya latency yomwe timawona ndi khansa zambiri.
Kodi Maselo Amakhala Oopsa Angatani?
Yankho lake ndiloti nthawi zambiri, sitidziwa kuti zimatenga nthawi yaitali bwanji kuti maselo osakanikirana azikhala ndi khansa. Kuonjezerapo, yankho lake limasiyanasiyana malinga ndi mtundu wa selo wophunzira.
Monga taonera kale, maselo a chiberekero omwe ali ndi dysplasia aakulu adakula mpaka khansa 30 mpaka 50 peresenti ya nthawiyo, koma nthawi yomwe izi zinkachitika kuti zisinthe zinali zosiyana. Mu kafukufuku wina akuyang'ana anthu 115 omwe ali ndi dysplasia ya zingwe, 15 anayamba kukhala ndi khansa yowopsya (inali ndi dysplasia yofatsa, imodzi inali ndi dysplasia yocheperapo, isanu ndi iwiri inali ndi dysplasia yambiri, ndipo 6 inali ndi carcinoma in situ). Pa 73 peresenti ya odwala awa, zilonda zawo zodziwika bwino zinayamba kukhala khansara yowopsa kwambiri m'kati mwa chaka chimodzi, ndi zina zotsala zomwe zimakhala ndi khansa.
Kodi Pali Zizindikiro Zina?
Maselo oyambirira amapezeka nthawi zambiri popanda zizindikiro. Ngati zizindikiro zilipo, zimadalira malo omwe asintha; Mwachitsanzo, kusintha kwachilombo koyambitsa chibelekero kumayambitsa maselo mosavuta, zomwe zimapangitsa kuti magazi asatulukidwe . Kusintha kwapadera kwa mkamwa kungapangidwe ngati malo oyera (leukoplakia). Ndipo m'madera omwe sakuwonekera, monga minofu yomwe imayendetsa ndege, dysplasia kawirikawiri imawonekera pamene kuyang'ana kwazithunzi kumachitika chifukwa china.
Chithandizo
Mankhwala a maselo oopsa kwambiri amadalira malo omwe maselo amakhala.
Nthawi zina kuyang'anitsitsa pafupi ndi zonse zomwe zikulimbikitsidwa kuona ngati mlingo wa dysplasia ukuyenda kapena kuthetsa popanda mankhwala.
Kawirikawiri maselo a precancerous adzachotsedwa mwa njira monga cryotherapy (kuzizira maselo) kapena opaleshoni kuchotsa dera lomwe maselo osadziwika alipo. Ngakhale maselo osadziwika atachotsedwa, ndi bwino kukumbukira kuti chilichonse chomwe chinayambitsa maselo kukhala cholakwika pachiyambi chingakhudze maselo ena m'tsogolomu.
Mwachitsanzo, ngati maselo achiberekero osachiritsika amachiritsidwa ndi cryotherapy, zidzakhalabe zofunika kuyang'anira zowonongeka ndi mapepala a Pap mtsogolo. Ndipo ngati mankhwala a Barrett akuchitidwa ndi cryotherapy, mudzafunikanso kuti muyambe kuyang'anitsitsa pang'onopang'ono.
Chifukwa cha zovuta zina, dokotala wanu angayamikire mankhwalawa. Izi ndizo mankhwala omwe amachepetsa chiopsezo cha maselo kukhala osowa m'tsogolo. Chitsanzo cha izi ndi kuchiza matenda ndi H. pylori mabakiteriya mmimba. Kuchotsa thupi la mabakiteriya kumawoneka kuchepetsa maselo osatetezeka komanso kukula kwa khansa ya m'mimba. Ochita kafukufuku akuyang'ana kugwiritsa ntchito mankhwala ndi mavitamini angapo kuti aone ngati ntchito yawo kwa osuta fodya akale ndi omwe amatha masiku ano amachepetsa chiopsezo cha khansa ya m'mapapo m'tsogolomu.
Mfundo yomalizira ndi yofunika kwambiri ndi kukumbutsa kuti, nthawi zina, kusintha kwasintha kungasinthidwe ndi chilengedwe: zakudya zomwe timadya, zomwe timapeza, komanso zomwe timasankha kuchita. Zakudya zokhudzana ndi zakudya zomwe zili ndi mavitamini ena, mwachitsanzo, zingathandize thupi kutulutsa kachilombo ka HIV mofulumira.
Zotsatira Zowonongeka Kwambiri
Pali mau ambiri okhudza maselo omwe amamvetsetsetsa phunziroli, choncho chitsanzo chingathandize kumvetsetsa bwino.
Ndi khansa yapakhungu yamapapu , zikuwoneka kuti maselo amatha kupitilirapo pang'ono chisanafike khansa. Amayamba ndi maselo abwino a mapapo. Kusintha koyamba ndi hyperplasia, omwe amatanthauza maselo omwe amakula kwambiri kapena mofulumira kuposa momwe akuyembekezeredwa. Mwachitsanzo, hyperplasia wa mtima adzakhala mawu ogwiritsira ntchito kufotokoza mtima wofutukuka.
Khwerero yachiwiri ndi metaplasia pamene maselo amasintha kukhala mtundu wa selo omwe sapezeka. Metaplasia pachimake (chomwe chingakhale chithunzithunzi cha khansa yosakanikirana), mwachitsanzo, ndi pamene maselo omwe amawoneka ngati omwe amapezeka m'matumbo ang'onoang'ono amapezeka m'mimba. Khwerero lachitatu ndi dysplasia, yomwe imatsatiridwa ndi carcinoma in situ ndipo potsiriza, invasive squamous cell carcinoma.
Kuchepetsa Vuto Lanu
Sichichedwa kuchepetsa kutenga njira zothandizira-ngakhale mutapezeka kuti muli ndi khansa. Malingana ndi American Institute for Cancer Research, anthu omwe ali ndi khansa angapindule ndi kuphunzira za kuchepetsa chiopsezo cha khansa kapena kuchepetsa kubwereza kudzera mwa zakudya ndi masewero olimbitsa thupi.
Gwiritsani ntchito ndondomeko kuti muchepetse chiopsezo chanu cha khansa , zomwe zingathandize kuchepetsa khansa ya m'mapapo ndi khansa zina, komanso zakudya zopatsa thanzi zomwe zingakuthandizeni kuchepetsa chiopsezo cha khansa kapena kubwereza khansa.
> Zotsatira:
> Chen, L., Shen, R., Ye, Y. et al. Maselo a Stem Precercerous Ali ndi Mphamvu ya Benign ndi Malignant Kusiyanitsa. PLosOne . 2007. doi.org/10.1371/journal.pone.0000293
> Keith, mankhwala a khansa ya R. Lung. Proceedings ya American Thoracic Society . 2012. 9 (2): 52-6.
> Rohde, M. et al. Kuchotsa mwachangu zipsera zozizira zamatenda kuti muteteze chiopsezo cha khansa. Danish Medical Journal . 2012. 59 (5): A4399.
> Seo, J. et al. Kuchetsedwa kwa Helicobacter pylori Kumachepetsa Metachronous Gastric Cancer pambuyo pa Kutha kwa Endoscopic kwa Khansa Yoyamba Yamimba. Hepatogastroenterology . 2012. 60 (125).
> Toll, A. et al. Zofunika zowonetsera zapamwamba zedi dysplasia mu zolakwika adenomas. Matenda Olakwika . 2011. 14 (4): 370-3.