Ngati muli ndi nthendayi imapangitsa kuti dokotala wanu opaleshoni kapena wa oncologist atchule ma micrometastases. Zoonadi, micrometastases ndi ofunika kwambiri ndi pafupifupi mtundu uliwonse wa khansara ndipo ndi chifukwa cha zomwe zimatchedwa "adjuvant therapy."
Kodi kwenikweni micrometastases ndi chiyani chomwe chimatanthauza ngati muli ndi micrometastases m'matumbo anu?
Mwachidule
Micrometastases ndi kagulu kakang'ono ka maselo a khansa omwe adakhetsedwa kuchokera ku chotupa chapachiyambi ndikufalikira kumbali ina ya thupi. Sangaoneke ndi mayesero aliwonse monga kugonana, MRI, ultrasound, PET, kapena CT. Maselo a khansa ochokera m'mayiko ena amatha kuphatikiza pamodzi ndikupanga chotupa chachiwiri, chomwe ndi chochepa kwambiri moti chimatha kuwona pansi pa microscope.
Kufunika
Kupezeka kwa micrometastases ndikofunikira kwambiri. Kawirikawiri si khansa yaikulu (kaya ili m'mawere, m'mapapo, kapena m'madera ena a thupi) omwe amawononga kwambiri. Ndipotu, ndi pamene khansa imafalitsa ( metastasizes ) kumadera ena a thupi pamene iwonongeke kwambiri. Pafupifupi 90 peresenti ya anthu amene amafa ndi khansa amafa ndi matenda a metastatic.
Kansara ikayamba kufalikira, imakhala ngati kagulu kakang'ono ka maselo a kansa. Masango ang'onoang'ono a khansa amadziwika kuti micrometastasis (microscopic metastasis).
Gululi la maselo a khansa ndi laling'ono kwambiri kuti lisamveke ndipo limatha kuwonetseredwa bwino mu microscope. Masango awa sakuwoneka pa mayesero alionse omwe tili nawo lero. Mwa kuyankhula kwina, njira yokhayo yodziwira ngati micrometastases alipo ndi kuchotsa minofu yomwe ilipo ndikuyang'ana magawo a minofu pansi pa microscope.
Ndi nthendayi yamakono, n'zotheka kuchita izi, koma n'zosatheka kuchotsa minofu iliyonse. N'zosatheka kuchotsa ziwalo zina za thupi kuti ziwone kufalikira. Sitingathe kutenga mapapo a chiwindi, chiwindi, ndi mafupa kuti apeze umboni uliwonse wa chotupa. Awa ndi lingaliro la mankhwala a adjuvant chemotherapy kapena adjuvant radiation. Pamene chotupa chiri ndi kukula kwake kapena ngati chikufalikira ku maselo a mitsempha, amaganiza kuti pangakhale zochepetsetsa pang'ono kwinakwake m'thupi lomwe silingadziwikebe. Zimamva kuti zotupa zomwe zimafafaniza ndikukula kutali ndi chotupa choyambirira zimayamba monga magulu ang'onoang'ono a maselo a khansa.
Micrometastases ndi chifukwa cha mankhwala monga adjuvant chemotherapy kapena adjuvant. Mankhwalawa amagwiritsidwa ntchito pambuyo poti chotupa chachikulu chachotsedwa kuti "kuyeretsa" micrometastases iliyonse pafupi ndi chiyambi cha chotupacho (kudzera mumayendedwe) kapena paliponse mu thupi kumene iwo angayende (kudzera mu rayation).
Micrometastases vs Kutalikirana Matenda a Maselo
Ngati amagwiritsidwa ntchito pamayendedwe ambiri a khansa, micrometastases imatanthawuza maselo amene akuyesa kuti adayenda (akugonjetsa) kuchokera ku chotupa koma sakuwoneka ndi maphunziro ojambula zithunzi omwe tili nawo panopa.
Gawo lina la magawo ang'onoang'ono a kufalikira ndi lothandizira pa kukambirana za biopsies ya fetinel ndi khansa ya m'mawere. Pachikhalidwe chimenecho, micrometastases amatchulidwa monga magulu a maselo a kansa omwe ali pakati pa 0,2 mm (millimeters) ndi mamita awiri mmitala. Mosiyana ndi zimenezo, "maselo otsekemera omwe ali kutali" ndiwo magulu a khansa omwe ali ang'onoang'ono; zosakwana 0,2 mm m'mimba mwake.
Micrometastases mu chida cha Sentinel Lymph Node Biopsy
Kwa amayi omwe ali ndi khansara ya m'mawere omwe alibe umboni wa maselo a mliri wophatikizidwa pa kafukufuku kapena ultrasound, chiwalo chodziwika bwino chotchedwa lymph node biopsy chakhala chikhalidwe cha chisamaliro.
Mwa njira iyi, dye ya buluu (yomwe imatchulidwanso kotero kuti ikhoza kudziwika mwaiwoloji) imayikidwa mu chotupa ndipo imaloledwa kuyenda. Pamene khansara imafalikira kumatenda nthawi zambiri imafalikira ku maselo am'mimba mwachitsanzo.
Pochita chidziwitso cha nthendayi kapena node-nambala zochepa zomwe khansara ikhoza kupita kwa azimayi ambiri sagwiritsidwa ntchito ndi mankhwala osokoneza bongo omwe amachotsedwa. Popeza kuti kusokonezeka kwa axillary kungayambitse mavuto monga lymphedema , njirayi ikhoza kupulumutsa akazi ena vutoli.
Kafukufuku akupitirira kuti azindikire kufunika kwa micrometastase mu nthenda yamtunduwu. Pakadali pano amadziwika kuti macrometastases (metastases ikuluikulu kuposa 2.0 mm) imaipitsa matendawa. Zikuwonekanso kuti zizindikiro za amayi omwe ali ndi micrometastases ku nthenda ya nthendayi ali ndi vuto losauka kwambiri kuposa amayi omwe alibe umboni wa chotupa m'matendawa. Mosiyana ndi zimenezi, amayi omwe ali ndi maselo amtundu wambiri m'matope (mwakutanthauzira malo omwe ali ndi maselo osapitirira 0,2 mm m'mimba mwake) alibe choyipa china kuposa mkazi yemwe alibe umboni wa metastase kwa nthendayi.
Kudziwa zimenezi kungathandize ochita kafukufuku kuti adziwe zambiri zomwe akazi angafunikire kusagwiritsidwa ntchito kosalekeza, komanso amayi omwe ayenera kuganizira za khansa ya m'mawere.
Pansi
Pakati pa khansa ya m'mawere, kufufuza kwa micrometastases n'kofunika posankha chithandizo chabwino. Matenda a khansa omwe ayamba kuyenda kotero kuti masango a khansa amapezeka m'magulu amtunduwu amatha kufalikira kumadera ena a thupi. Choncho nthawi zambiri zimakhala zopweteka kwambiri komanso kugwiritsa ntchito mankhwala a adjuvant komanso mankhwala omwe amachititsa kuti asapitirire kudwala mafupa a khansa osati m'magulu am'mbali omwe ali pafupi, koma omwe amapita ku mafupa, chiwindi kapena madera ena.
Komabe micrometastases ndi ofunika kwambiri ndi khansa iliyonse. Ndizigawo zoyambirira za maselo a khansa omwe amayenda kuchokera ku chotupa choyambirira, nthawi zambiri kupita ku ziwalo zam'mimba, ndiyeno kumadera ena a thupi monga mapapo, mafupa, chiwindi, ubongo, kapena madera ena. Ngati tingapeze ndikuchotseratu micrometastases timatha kuthetsa vuto la 90 peresenti ya imfa za khansa.
> Zotsatira:
> Mayer, E., ndi L. Dominici. Khansa ya m'mawere Axillary Staging: Ambiri Ado About Matenda a Micrometastatic. Journal of Clinical Oncology . 2015. 33 (10): 1095-7.
> National Cancer Institute. Matenda a khansa ya m'mawere (PDQ) -Health Professional Version. Kusinthidwa 10/13/17.
> Tvedskov, T., Meretoia, T., Jensen, B., Leidenius, M., ndi N. Kroman. Kutsimikiziridwa pamtunda kwa Zida zitatu Zotsatsa Zamatenda Opanda Matenda a Zachilendo M'matenda a M'thupi. European Journal of Oncology Opaleshoni . 2014. 40 (4): 435-41.