Mayesero Kuphatikizapo Ngozi ya Malignancy Index Kuti Muziyesa Maso a Ovariya
Ngati dokotala akupeza misala ya ovari pambuyo poyang'ana ultrasound, kapena amamva chimodzi pa kafukufuku, ndizotheka kuti zomwe zapezeka ndi khansara ya ovari?
Kodi Mungadziwe Bwanji Ngati Misa Yanu Yopambana Ndi Ovarian Khansa?
Ngati muli ndi misa m'dera limene mazira anu amakhalapo, mukhoza kukhala oopa pokhapokha mutasokonezeka kwambiri. Zingakhale zotani?
Mwinamwake mukuwopa kwambiri pamene mukuzindikira dokotala wanu sakudziwa ngati misa yanu ingakhale ndi khansa kapena ayi. Kodi sakudziwa? Kodi pali chinachake chimene sakukuwuzani?
Pofuna kuthetsa mantha anu, zimakhala zovuta kuti madokotala azidodometsedwa ndi misala yamtundu wa m'mimba mwake (yotchedwa "adnexal mass" ngati mumva mawu amenewo.)
Panthawi imodzimodzi yomwe madotolo sangakhale ndi lingaliro ngati adnexal mass mu pelvis yanu ingakhale khansara, mwayi "kukhala wolakwika" -kuchita asanayambe kuganiza bwino-ndizofanana. Pangakhale mavuto: Njira za opaleshoni yoperewera ngati muli ndi khansa, ndi kuopsezedwa kwa opaleshoni yosafunikira ndi kuthekera kwa zovuta ndi opaleshoni ngati mulibe khansara.
Kodi Mwayesedwa ndi Khansa ya Ovarian?
Tili ndi lingaliro la omwe ali pachiopsezo cha khansara ya ovari, koma izi zimatchulidwa makamaka kuti musathenso kuthetsa vuto lanu la khansa ya ovari ngati mulibe zifukwa zina zoopsa.
Pali chifukwa chomwe khansara ya ovari yakhazikitsira munthu wakupha . Nthawi zambiri zimayambitsa zizindikiro zochepa mpaka khansayo ikapita patsogolo, ndipo aliyense, mosasamala kanthu za zoopsa, akhoza kukhala pachiopsezo chotenga matendawa.
Ngati ndinu postmenopausal, muli pachiopsezo chachikulu. Amayi ambiri odwala matendawa amapezeka mwa amayi achikulire (ngakhale angakhalepo kwa atsikana kapena ngakhale ana.) Pa nthawi yomweyo, misala ya adnexal m'mabambo amodzi ndi amodzi ndipo nthawi zambiri amabwera ndikupita.
Mphepete mwachisawawa ndizosavuta kusanayambe, pamene misa yomwe imawoneka m'mayi omwe amatha kupha amayi sakhala ochepa okha. Kumbukirani, ngakhale kuti mwatha kusamba, mukhoza kukhala ndi misa yomwe si khansara.
Zizindikiro za khansara ya ovari zimaphatikizapo kuphulika ndi kulemera, kupweteka panthawi yogonana, kapena kusintha kwa ziwalo. Zinthu zoopsa zimaphatikizapo kunenepa kwambiri, kukhala ndi mbiri ya banja la khansa, mazira, kapenanso khansa yamtundu, komanso kugwiritsa ntchito mankhwala osokoneza bongo kapena mankhwala ochizira. (Phunzirani zambiri za khansa ya m'mawere yomwe imayambitsa khansa .)
Kufunika Kodziwa Ngati Misa ndi Khansa ya Ovarian
Ndithudi ndikofunika kudziŵa ngati muli ndi khansa kapena ayi chifukwa cha mtendere wanu wa mumtima. Koma ndi khansa ya ovarira makamaka, kudziwa ngati khansayo ikhoza kukhalapo kapena yosafunika kwambiri kuposa ena ambiri khansa.
Ngati opaleshoni idzachitidwa kwa khansara ya ovari, dokotala wa opaleshoni ayenera kukhala wokonzeka kuti azitenga nthawi yaitali ngati akufunikira. Kuchitidwa opaleshoni mosamala kungakhale ndi zotsatira zenizeni pa moyo. Pa nthawi yomweyi, kafukufuku apeza kuti opaleshoni yovuta ( opaleshoni ya cytoreduction ya khansara ya ovari ) imakhala ndi ubwino wambiri wochitidwa ndi akatswiri a khansa ya ovarian (mwazidzidzimodzi pazomwe amachititsa opaleshoni) m'malo opanga opaleshoni yambiri, m'malo mwa opaleshoniyi azimayi omwe amachita opaleshoni pang'ono.
Zidakali zofala kwambiri kuti dokotala wa opaleshoni azindikire kuti khansara ya ovari yomwe imafuna kuchitidwa opaleshoni yovuta komanso yochuluka ilipo pokhapokha opaleshoni itayamba.
Njira Zidatsimikizira Kuopsa kwa Malignancy (Kusiyanitsa Benign ku Masignant Ovarian Masses)
Popeza n'kofunika kuyesa kusiyanitsa khansa ya ovari ndi mazira ena asanathe opaleshoni, kufufuza kwa 2016 kunayesa kufufuza zipangizo zomwe tili nazo panopo, ndikuyang'ana kuthekera kwawo kuti athetsere khansa ku misala yomwe si khansara.
Ndizothandiza kudziŵa mau ochepa pamene mukuyang'ana zotsatira izi.
Kukhalanso ndi chidziwitso ndiyeso yomwe ikugwiritsidwa ntchito kusonyeza momwe mayesero amathandizira kupeza khansara; Nthawi zambiri zimatha kudziwa bwino anthu omwe ali ndi matenda. Mwachitsanzo, mayesero okhudzidwa ndi 90 peresenti angathe kupeza 90 mwa 100 khansa 100.
Ndikofunika kuti musamadziwe zambiri, komanso kuti kuwonetsetsa kwambiri kungachititse opaleshoni yosafunikira komanso mankhwala. Chodziwika ndi mayeso omwe amathandiza kufotokoza momwe kaŵirikaŵiri matenda opatsirana amatha kupezeka ndi mayesero. Chodziwika bwino chikufunsa funsoli, "Ndi kangati, pamene munthu alibe matenda, kodi mayeserowo akhale oipa?"
Mayesero amasiku ano omwe angagwiritsidwe ntchito poyesa misala ya ovariya ndi monga:
- Kufufuza mosamala
- Malamulo osavuta - Ovarian Tumor Analysis International (OOTAAN Tumor Analysis)
- LR2 - IOTA yoyendera njira yogwiritsira ntchito 2
- Kuopsa kwa Malignancy Index (RMI)
Tawuni yotsatira ikuwonetsa zotsatira zomwe zikuyerekeza miyeso inayi kuphatikizapo chidwi chawo ndi zolemba zinazake.
Mayesero kuti aone ngati Misa ndi Khansa ya Ovariya
| Mayeso | Kutengeka | Zenizeni |
| Kufufuza mosamala | 93 peresenti | 89 peresenti |
| Malamulo Osavuta * | 93 peresenti | 80 peresenti |
| LR2 * | 93 peresenti | 84 peresenti |
| Ngozi ya Malignancy Index | 75 peresenti | 92 peresenti |
* International Ovarian Tumor Analysis (IOTA) malamulo ophatikizidwa ndi ultrasound (malamulo osavuta) ndi IOTA zowonongeka kwachitsanzo 2 (LR2)
Mapeto a kafukufuku waposachedwapa ndi kuti kuphatikiza kwa ma polojekiti ophatikizira komanso malamulo ophweka angapereke chiwerengero chabwino chokhala ndi khansa kapena ayi.
Kuopsa kwa Malignancy Index ya Khansa ya Ovarian
Madokotala ambiri amagwiritsa ntchito kuopsa kwa Malignancy Index (RMI) pokhapokha kapena kuphatikizapo "kuwunika kovomerezeka" ndi zotsatira za ultrasound kuti zithetse mtundu wa ovari. Pali matembenuzidwe angapo a RMI, ndipo onsewa akulosera chiopsezo choyipa y (chiopsezo chakuti misa ndi khansa). Bukuli layesedwa kangapo ndi ochita kafukufuku osiyana zaka.
Pali zinthu zitatu zazikulu zomwe zimagwiritsidwa ntchito pozindikira RMI. Izi zikuphatikizapo:
- Zaka
- Mlingo wa CA-125 , chotupa chodziwitsa (Phunzirani zambiri za zizindikiro za khansa ndi khansa ya ovari .)
- Mapulosi a ultrasound - Ultrasounds amayang'ana zofukufuku zambiri kuphatikizapo maonekedwe a misa, kaya ndi amatsenga kapena olimba, ndi kupezeka kwa malo asanu ndi awiri (mbali ya misa yomwe yagawidwa ndi ziwalo). Mfundo imodzi imaperekedwa pazinthu zotsatirazi: magulu ambirimbiri (monga mtundu wa mphesa zazikulu), malo olimba, umboni wa kufalikira (metastases), madzi osadziwika osadziwika bwino ( ascites ), kapena masses pa mazira ochuluka. (Phunzirani zambiri za kumvetsetsa wanu ovarian ultrasound .)
Ngozi ya Malignancy Formula ya Ovarian Khansa
Ngati mukufuna kuti mupeze luso labwino, chidziwitso choyamba cha chiopsezo cha malignancy index (RMI) ndi:
- RMI = U x M x serum mlingo CA-125
U amaimira chiwerengero cha ultrasound, kuchokera pa 0 mpaka 5. M ndi ndondomeko ya kusamba kwa nthawi pomwe 1 imaperekedwa kwa omwe ali ammopaopausal, ndipo 3 amapatsidwa kwa omwe ali pambuyo poti amatha. Chinthu chotsiriza ndi mtengo wa chiwerengero cha msinkhu wanu wa CA-125; mtengo wa 35 kapena wotsika umatengedwa ngati wabwino. Mumangowonjezera ma U, M ndi CA-125 kuti mupeze RMI.
Kumvetsetsa Vuto Lanu la Kuipa (RMI) Makhalidwe - Kodi Amatanthauzanji?
An RMI amaponya oposa 200, owerengedwa motere, akuwoneka ngati akukayikira. Ngati izo zoposa 250, mwayi woti zomwe muli nazo ndi khansa. Komabe, mawu ofunika ndi "mwayi." Kumbukirani kuti ndondomekoyi ikuthandizira kuthetsa zinthu, koma sizikutsimikizira njira imodzi kapena ayi ngati muli ndi kansa ndithu. Mwachitsanzo, ngati muli ndi zaka zopitirira 50 ndipo muli ndi endometriosis, kapena muli ndi zifukwa zina za CA-125 kukwezedwa, RMI ikhoza kukhala yonyenga. Choncho, simungakhale ndi khansa. Koma, khansa zina sizimapereka CA-125, kotero RMI ikhoza kukhala yonyozeka.
Zotsatira Zotsatira Pofufuza Zotheka Khansa ya Ovariya
Dokotala wanu angagwiritse ntchito mayesero amodzi kapena angapo pamwambapa kuti ayesetse kupeza mwayi woti mimba yanu yayamba ndi khansara. Kuzindikira izi kutsogolo kungakuthandizeni kudziŵa ngati opaleshoni yanu iyenera kupezeka kapena ayi. Mwinanso misa yanu ndi khansa, chofunika kwambiri ichi ndi ichi.
Zolepheretsa Mchitidwe Wopenda Misala ya Ovani
Ndikofunika kuzindikira kuti pali zoperewera ngakhale ngakhale mayesero abwino omwe amagwiritsidwa ntchito kuti adziwe ngati khansara ya ovari ingakhalepo kapena ayi. Inu ndi dokotala wanu mudzafunika kuphatikiza zotsatira za mayesero aliwonsewa ndi zina, monga zizindikiro zathu ndi zifukwa zilizonse zomwe zingakhalepo chifukwa cha khansa ya ovari. Mwa kuyankhula kwina, ndikofunikira kuti ndikuyang'ane ngati munthu, osati nambala iliyonse yeniyeni pamene mukuganiza pazotsatira zomwe mukuwona kuti mukuchiza chithandizo.
Kulimbana Ngati Muli ndi Misa Yambiri ya Ovariana
Ndikofunika kuti mukambirane bwinobwino ndi dokotala ngati muli ndi masewera olimbitsa thupi. Malingana ndi zotsatira zabwino pakati pa omwe ali ndi opaleshoni ya khansa ya ovari yomwe amachititsa opaleshoni ya amayi , komanso zotsatira zabwino m'madera omwe amachititsa njira zambirizi, lingaliro lachiŵiri ndi amayi odziwa za matenda a umuna akhoza kukhala anzeru mosasamala kanthu za zotsatira za mayesero alionse kapena zoopsa.
Tengani nthawi kuti mudziwe za vuto lanu. Funsani ndi kuvomereza chithandizo kuchokera kwa iwo akuzungulira. Kuopsa kofa chifukwa cha khansa ya m'mimba ndikutalika kwambiri, ndipo kukhala wokonda pawekha ndi chinthu chimodzi chomwe mungadzipange nokha chomwe chingathetsere zotsatira zanu.
Zotsatira:
Kaijser, J., Bourne, T., Valentine, L. et al. Kupititsa patsogolo Njira Zowunikira Khansa ya Ovarian: A Chidule cha International Ovarian Tumor Analysis (IOTA) Studies. Ultrasound mu Obstetrics ndi Gynecology . 2013. 41 (1): 9-20.
Minig, L., Padilla-Iserte, P., ndi C. Zoerrero. Kufunika kwa Odwala Magynecologic Oncologist Kuti Awonetsere Akazi Omwe Amakhala ndi Matenda a Khansa Yachikazi. Malire a Oncology . 2015. 5: 308.
Meys, E., Kaijser, J., Kruitwagen, R. et al. Kufufuza Moyenera ndi Njira Zomwe Zimapangidwira Kufufuza Khansara ya Ovenda: Kusanthula Mwachidule ndi Kusintha Meta. European Journal ya Cancer . 2016. 58: 17-29.
Stuart, G., Kithener, H., Bacon, M. et al. Gulu la khansa ya matenda a khansa ya 2010 (GCIG) Consensus Statement on Clinical Trials in Cancer Ovarian: lipoti la Msonkhano wa Fourth Ovarian Cancer Consensus. Magazini ya International Journal ya Cancer Gynecologic . 2011. 21 (4): 750-5.