Nthaŵi zambiri sichifunika
Khansa ya chiwindi (yomwe imatchedwanso hepatocellular carcinoma ) imachitika pamene maselo osadziwika m'chiwindi amayamba kukula mosalekeza. Kawirikawiri, matenda a khansa ya chiwindi ndi zotsatirazi: kuyesa thupi, kuyesa magazi, kuganiza komanso nthawi zina.
Malinga ndi ngati mwapezeka kale ndi matenda aakulu a chiwindi ndi / kapena matenda a chiwindi , pamene chiwindi chopanda chiwindi chifukwa cha matenda aakulu a chiwindi, dokotala wanu angapite mosiyana kwambiri ndi matenda a chiwindi cha chiwindi.
Kusanthula thupi
Pambuyo pofufuza zomwe zimayambitsa matenda a khansa ya chiwindi (mwachitsanzo, ngati muli ndi mbiri ya chiwindi kapena mbiri ya kumwa mowa mopitirira muyeso), ngati dokotala akukayikira khansa, amamvetsera mwatcheru pamimba, makamaka kumanja komwe chiwindi chili. Mwapadera kwambiri, dokotala wanu adzakanikiza pansi pa nthiti yanu yolondola kuti muwone ngati chiwindi chanu chakulitsidwa.
Dokotala wanu adzafunanso zizindikiro zina za matenda a chiwindi aatali (zomwe zimawonjezera chiopsezo chanu chokhala ndi khansa ya chiwindi) monga:
- Nkhungu yotambasula, yomwe ili kumbali yakumanzere ya m'mimba
- Mitsempha yooneka pamimba mwako
- Mimba yodzaza madzi, yotupa
- Umboni wa jaundice (mwachitsanzo, chikasu choyera cha diso lako
Labs
Pali mayeso ochuluka a magazi omwe dokotala wanu angapereke kuti athandizidwe kudziwa matenda a kansa ya chiwindi ndi kudziwa chomwe chingayambitse khansa.
Alpha-Fetoprotein (AFP) Chilakolako Chamimba
AFP ndi mapuloteni omwe ali otetezeka kwambiri koma amatha kufika pochepa kwambiri atabereka.
Kutanthauzira zotsatira za zotsatira za magazi a AFP zingakhale zovuta. Kwa wina, munthu akhoza kukhala ndi khansa ya chiwindi ndi msinkhu wawo wa AFP ukhoza kukhala wachibadwa (sizingaukebe). Komanso, mkulu wa AFP akhoza kukwera chifukwa cha zifukwa zina osati khansa ya chiwindi (mwachitsanzo, matenda a chiwindi kapena matenda opatsirana a chiwindi).
Mfundo yaikulu ndi yakuti, ngakhale kuyesedwa kwothandiza, msinkhu wa AFP sizowona kuti ndibwino kuti magazi azindikire khansa ya chiwindi-ndi chinthu chimodzi chokha.
Mayesero a Cirrhosis
Ngati kuyezetsa thupi kapena kuyesera kukuwonetsa kuti muli ndi matenda aakulu a chiwindi ndi / kapena matenda ozungulira thupi, koma chifukwa chake m'mbuyo mwake sichinayambe, dokotala wanu adzalamula kuyesera magazi. Mwachitsanzo, adzalangiza mayeso a magazi kuti aone ngati akudwala matenda a hepatitis B ndi C. Adzakhalanso akupanga ferritin ndi zitsulo kuti azifufuza hemochromatosis , yomwe imayambitsa matenda a chiwindi.
Ntchito ya Chiwindi Mayesero (LFTs)
LFTs imaphatikizapo mayesero ambiri a magazi omwe amapatsa madokotala anu lingaliro la momwe chiwindi chanu chimagwirira ntchito. Mayeserowa angathandizenso dokotala wanu kupeza njira yabwino kwambiri yothandizira khansa ya chiwindi. Mwachitsanzo, ngati khansa yanu ya chiwindi ndi yaing'ono ndipo ilipo ndipo chiwindi chanu chimawoneka chikugwira ntchito bwino, ndiye kuchotsa khansara ndi opaleshoni kungakhale njira yabwino.
Mayesero Ena
Dokotala wanu akhoza kulamula mayeso ena a magazi kuti adziwe momwe ziwalo zina m'thupi lanu zikugwirira ntchito. Mwachitsanzo, akhoza kuitanitsa mayeso a magazi omwe amafufuza momwe impso zanu zikugwirira ntchito. Kuwonjezera pamenepo, popeza khansa ya chiwindi ingakhudze magazi m'magazi, shuga, ndi mapulateletsiti , mayeserowa akhoza kulamulidwa.
Kujambula
Mayesero ojambula ndi ofunikira kuti apeze khansa ya chiwindi.
Ultrasound
Chiyeso choyamba chimene munthu angakhale nacho ndi ultrasound. Panthawi ya ultrasound, kafukufuku amatsitsimutsa pamimba kuti awone ngati pali misala iliyonse yomwe ili m'chiwindi.
CT Scans ndi MRIs
Ngati misa ikuwoneka pa ultrasound, mayesero ovuta kwambiri monga computed tomography (CT scan) ndi / kapena maginito imaging (MRI) pachiwindi chachitidwa kuti mudziwe zambiri za misa, monga:
- Kukula
- Malo pachiwindi
- Pitani kumitsinje yapafupi pafupi kapena mbali zina za mimba
Mayeso ojambulawa angathenso kudziwa zambiri za mtundu umene ulipo, kutanthauza ngati misa ndi yowononga (osati khansa) kapena yoopsa (khansa).
Angiography
Pomalizira pake, CT angiography kapena MRI angiography akhoza kuchitidwa kuti apereke chithunzi cha mitsempha yopereka magazi ku chiwindi. Pachiyeso ichi, mufunika kuyika IV kuti ikhale mkono wanu kuti dye wosiyana akhoza kuperekedwa panthawi ya CT scan kapena MRI.
Chimake
Pa chiwindi cha chiwindi, singano imayikidwa kupyolera pakhungu la mimba mpaka chiwindi. Pochepetsa kuchepa kulikonse, malo a khungu kumene singano ikupita amayamba kuchepa. Maselo ochokera ku misa amachotsedwa ndikuyesedwa ndi dokotala (wotchedwa pathologist) kuti awone ngati khansa ilipo.
Nthawi zina chiwerengero cha chiwindi chimachitidwa pa opaleshoni (yotchedwa biopsy opaleshoni). Ndi mtundu uwu wa biopsy, chidutswa cha misa kapena misa yonse imachotsedwa ndi kuyesedwa kwa khansa.
Ndikofunika kuzindikira kuti kawirikawiri nthawi yambiri sinayambe kulamulira mu (kapena kunja) matenda a khansa ya chiwindi. Izi ndichifukwa chakuti CT scan ndi / kapena MRI zingapereke umboni wokwanira wakuti misa ndi khansa kapena ayi.
Pachifukwa ichi, kupeŵa chiwopsezo ndibwino, popeza pali nkhawa kuti kuchotsa maselo a khansa ku misala akhoza "mbewu" pafupi ndi malo omwe ali ndi khansa. Zikatero, kufalikira kwa khansa kungapangitse munthu kuti asayambe kuika chiwindi (chiwopsezo cha mankhwala).
Mosasamala kanthu, nthawi zina biopsy ndi yofunikira kuti apange matenda ngati chithunzi sichiri chomveka.
Kusiyanitsa kusiyana
Ndikofunika kunena kuti matenda a khansa pachiwindi mwina sangakhale khansara yoyamba ya chiwindi koma osati kansalu yamatenda ya khansa ina. Mwachitsanzo, khansara yamtunda yomwe ikufalikira pachiwindi imatchedwa khansa yamatenda kapena khansa yachiwiri ya chiwindi. Pachifukwa ichi, dokotala wanu adzafunika kufufuza zomwe khansa yoyamba ili, ngati sichidziwika.
Kuwonjezera pamenepo, dziwani kuti pali zidziŵitso zambiri zomwe zingatheke ku chiwindi, kutanthauza kuti sikuti ndi khansa.
Zitsanzo ziwiri zowononga (osati khansa) zomwe zimayambitsa matenda a chiwindi ndi awa:
Hepatic Hemangioma
Hepatic hemangioma ndi mitsempha ya mitsempha yomwe ndi yofala kwambiri ya chiwindi chachikulu cha chiwindi. Sizimayambitsa zizindikiro, koma zimayambitsa kupweteka m'mimba, kupweteka, kapenanso kusamalitsa msanga ngati kumakhala kwakukulu. Ngakhale kuti hemangioma yosavuta nthawi zambiri imasowa chithandizo, ikhoza kuchotsedwa ndi dokotala wochita opaleshoni ngati iyo imatsegula ndipo imatuluka, ngakhale izi sizikusowa.
Hepatic Adenoma
Adenoma yapamwamba ndi chifuwa chachikulu cha chiwindi chomwe nthawi zambiri sichimawoneka ngati sichikutsuka kapena chikukula mokwanira. Pang'ono peresenti, adenoma yapamwamba imatha kukhala khansa ya chiwindi, chifukwa chake imachotsedwa.
> Zotsatira:
> American Cancer Society (2018). Mayeso a Chiwindi Chowopsa.
> Bruix J, Sherman M, American Association for Phunziro la Matenda a Chiwindi. Hepatology . 2011 Mar; 53 (3): 1020-2. dx.doi.org/10.1002/hep.24199
> Schwartz JM, Carithers RL. (2017). Zomwe amachititsa kuchipatala komanso matenda a matenda a hepatocellular carcinoma. Chopra S, ed. Zaposachedwa. Waltham, MA: UpToDate Inc.