Kutaya Bwino Kunagwiritsidwanso Ntchito Pogwiritsa Ntchito Malanoma, Mzere wa Clark Uli Wogwiritsidwa Ntchito
Dokotala wanu akunena kuti chiwerengero chanu cha melanoma ndi siteji IIA (T2bN0M0) ndi Pansi ya 2 mm.
Mukudabwa kuti ndi chilankhulo chotani chomwe akulankhula-ndithudi, zida zowonongeka zimatha kusokoneza ndi kukhumudwitsa. Pofuna kukuthandizani kumvetsetsa chifukwa chake chithandizo china chinasankhidwa kwa inu, apa pali kufotokozera mwachidule kuti mawu awa akutanthauza chiyani.
Matenda a Melanoma
Ngati dokotala wanu akuwona mole wodandaula pakhungu la khungu , sitepe yotsatira ndi chikopa cha khungu .
Ngati chiwonetserochi chimawulula khansa, katswiriyu adzayang'ana chiwerengerochi kuti adziwe momwe matendawa angakhalire kuti athe kukonzekera bwino mankhwalawa .
Kuwonjezera pa nambala ya TNM , mukhoza kumvanso dokotala akugwiritsa ntchito nambala ya Breslow kapena nambala ya Clark kuti afotokoze momwe mumaganizira. Njira ziwirizi zimagwiritsiridwa ntchito ngati khansa yatha, kutanthauza kuti siifala ku nthendayi iliyonse kapena thupi lina la thupi. nambala ya Clark kufotokozera maonekedwe anu (maganizo). Njira ziwirizi zimagwiritsiridwa ntchito ngati khansa yatha, kutanthauza kuti siifala ku nthendayi iliyonse kapena thupi lina la thupi.
Apa pali momwe mungatanthauzire iwo:
Kuwoneka Bwino
Choyamba cholembedwa ndi Alexander Breslow, MD, mu 1970, Kuwala kochepa kumatanthauzidwa ngati chiwerengero chonse cha matenda a melanoma, kuchokera pamwamba kwambiri (kutchedwa "granular layer") kumalo ozama kwambiri kulowa mu khungu.
Chombo chotchedwa "micrometer ocular" chimagwiritsidwa ntchito kuyeza makulidwe a chotupa chochotsa (kuchotsedwa).
Kawirikawiri, kukwera kwa Breslow makulidwe, kumakhala koyipa kwambiri-mwa kuyankhula kwina, kuchepa kwa khansa ya melanoma, mwayi waukulu womwe uli nawo kufalikira. Pano pali zaka 5 zomwe zikupulumuka chifukwa cha kukula kwa Breslow.
Kumbukirani kuti kupulumuka kumeneku ndipadera ndipo sikungasonyeze vuto lanuli:
- Pakati pa 1 mm: Kupitirira zaka zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zitatu (92%) kupitirira 97 peresenti-anthu 92 mpaka 97 mwa anthu 100 adzakhala ali ndi moyo zaka 5 atapezeka kuti ali ndi khansa ya malanoma yomwe ili yosachepera 1mm.
- 1.01 mpaka 2 mm: Kupulumuka kwa zaka 5 kuli pafupifupi 81 peresenti mpaka 92 peresenti
- 2.01 mpaka 4 mm: Kupulumuka kwa zaka 5 kumakhala pafupifupi 70 peresenti mpaka 81 peresenti
- oposa 4 mm: kupulumuka kwa zaka zisanu ndi 53 peresenti mpaka 70 peresenti
Chifukwa cha kulondola kwake pazochitika zowonongeka, Kuwala kwapang'ono kwakhala kuphatikizidwa mu dongosolo la TNM staging dongosolo la melanoma. Ndipotu, Kuwala kwapafupi ndi chinthu chofunika kwambiri pa matenda a melanoma, pamodzi ndi chotupa (T) siteji, komanso kukhala ndi zilonda zakhungu (kutayika khungu, kutuluka magazi, kutupa).
Mzere wa Clark
Mzere wa Clark umatanthawuza momwe chifuwacho chafikira mu zigawo za khungu . Ndondomekoyi inayambitsidwa ndi WH Clark, MD, mu 1966. MaseĊµero a Clark akufotokozedwa momveka bwino motere:
- Mzere Woyamba: Wosungidwa ku epidermis (pamwambapa phungu) wotchedwa "situ" ya khansa ya khansa
- Mutu Wachiwiri: Kukoka kwa papillary (pamwamba)
- Mtsinje Wachitatu: Kuzaza mapepala a papillary, koma palibe zowonjezereka m'madzi ochepa (m'munsi)
- Mtsinje Wachiwiri: Kuwukira kwachitsulo chodziwika bwino
- Mzere V: Kuthamangitsidwa kwa minofu yakuya, yapansi
Zonsezi zikunenedwa, Maselo a Clark sagwiritsidwa ntchito kawirikawiri powerengera zochitika tsopano. Izi ndi chifukwa chakuti kafukufuku wasonyeza kuti iwo saganizira za zotsatira zake, zochepetsetsa zochepa, komanso omvera kuposa momwe akuyendera. Zowononga zina za ma stage ndi kuti nthawi zambiri zimakhala zovuta kusiyanitsa pakati pa Clark Level 2 ndi Level III , ndipo sizingagwiritsidwe ntchito pa khansa ya palmu ndi mitengo.
Pali nthawi imodzi yomwe ma Clark angagwiritsidwe ntchito kuti adziwiratu-odwala omwe ali ndi malinoma ochepa (oposa 1.0mm).
Ngakhale zili choncho, zimagwiritsidwa ntchito ngati zosasintha ngati minotic mlingo wochepa kwambiri wa melanoma sungadziwe. Mitotic imaimira chiwerengero cha maselo a khansa omwe akugawanitsa. Mankhwala apamwamba kwambiri amasonyeza kuti khansara imafalikira.
Mawu Ochokera
Yesetsani kuti musagwiritsidwe ntchito mosamala kwambiri pa ndondomeko ya khansa ya melanoma. M'malo mwake, ganizirani zomwe siteji ya kansa yanu imatanthauza kuti mukhale ndi chithandizo ndi malingaliro anu.
> Zotsatira:
> American Cancer Society. (May 2016). Matenda a khansa ya khungu la Melanoma.
> American Cancer Society. (May 2016). Kupulumuka kwa khansa ya khungu la khansa ya khansa, pamsinkhu.
> Bani CM ndi al. Mapeto a 2009 AJCC Kupanga Melanoma Kupanga ndi Kulemba. J Clin Oncol . 2009 Dec 20; 27 (36): 6199-6206.
> Balch CM, ndi al. Kuyeza kwa zizindikiro za odwala matenda a khansa 17,600: kutsimikiziridwa kwa American Joint Komiti ya khansa ya khansa ya khansa. J Clin Oncol . 2001 Aug 15; 19 (16): 3622-34.