Maphunziro akuluakulu ndi Small Cell Neuroendocrine Mimba za Colon
Ngati inu kapena wokondedwa wanu mwapezeka kuti muli ndi chotupa choopsa kapena chapamwamba cha neuroendocrine cha colon kapena rectum mwina mukuchita mantha komanso kusokonezeka. Matenda opweteka kwambiri a nthenda yotchedwa neuroendocrine ndi ochepa kwambiri kusiyana ndi ena a khansa zina. Kuonjezera apo, kawiri kaŵirikaŵiri amadziwika bwino ndipo ndikofunikira kukhala wothandizira ngati muli ndi zotupazo.
Kodi tikudziwa chiyani za khansayi, kodi amachiritsidwa bwanji, ndipo ndi chiyani chomwe chikugwiritsidwa ntchito?
Kodi Matenda a Neuroendocrine Ndi Chiyani?
Ziphuphu za Neuroendocrine ndi zotupa zomwe zimayamba mu maselo a neuroendocrine. Zitha kuchitika m'magazi, m'mapapo, kapena mu ubongo. M'magazi amatha kukhala ndi mimba, mphukira, matumbo aang'ono, colon, ndi rectum.
M'matumbo ndi m'matumbo, zotupa za nthenda za m'mimba zimatulutsa 2 peresenti yokha kapena yocheperako khansa . Mwamwayi, mosiyana ndi mitundu ina ya khansa yamtundu, matendawa samasintha kwambiri zaka zaposachedwapa ndi kuyang'aniridwa ndi khansa ya coloni.
Matenda a Neuroendocrine akhala akuwonjezeka, ndi kuwonjezeka kwa maulendo asanu kuyambira 1973 mpaka 2004 ndipo kuwonjezeka kwapitirira kuyambira nthawi imeneyo. Sitikukayikira chifukwa chake izi zikuchitika panthawi ino.
Otsutsa vs. Matenda Osauka
Ziphuphu za Neuroendocrine zimagawidwa m'zinthu ziŵiri zochokera m'mimbayi.
- Selo lalikulu la selo lalikulu ndi selo laling'ono la neuroendocrine zotupa ndizoopsa. Ziphuphuzi zimakula mofulumira ndikuukira zida zina
- Ziphuphu za carcinino za colon zikuonedwa ngati zopanda pake. Amakonda kukhala ochepa pang'onopang'ono komanso ocheperapo kusiyana ndi maselo akuluakulu ndi tizilombo tochepa.
Ndikofunika kusiyanitsa zithupsa zoopsa komanso zopanda ulemu monga mankhwala oyenera komanso majekeseni osiyana kwambiri.
Magulu akuluakulu a Cell ndi Small Cell
Maphunziro apamwamba, kapena amwano, amagazi amagawidwa m'maselo akuluakulu ndi maselo ang'onoang'ono a selo, omwe amasiyana malinga ndi maonekedwe a maselo omwe ali pansi pa microscope. Mitundu yonse ya khansara imaonedwa kuti ndi "undifferentiated" zomwe zimatanthauza kuti maselo amawoneka ngati osaphatikizana kwambiri ndi maselo omwe amachititsa kuti thupi liziyenda bwino komanso kuti azichita zinthu mopweteka kwambiri. M'mbuyomu ankaganiza kuti zotupa zazikuluzikulu zimakhala zofala, komabe kafukufuku wa 2016 anapeza kuti 89 peresenti ya zotupazo zinali zotupa zazing'ono za seuroendocrine.
Mu njira zina, zotupa zapamwamba za mitsempha ya m'mimba ndizofanana ndi khansa yaing'ono yamapapu ya m'mapapo, ndipo nthawi zambiri imalandira chithandizo chomwecho, koma sichikhoza kusokonezedwa ndi kusuta kusiyana ndi tizilombo tating'onoting'ono timene timakhala ndi khansa ndipo sitingathe kukhala ndi masitima mafupa ndi ubongo.
Kafukufuku wina apeza kuti zotupazo zimachitika kawirikawiri kumbali yoyenera ya colon (kukwera kolon) pamene kafukufuku waposachedwapa anapeza kuti malo omwe amapezeka pamatendawa anali chiwindi ndi chizindikiro cha sigimoid.
Khansara ya Colon siinayambe kuwonjezeka kwakukulu kwa zizindikiro za matendawa, ngakhale mu phunziro limodzi, 30 peresenti ya zotupa zinapezeka kuti zikugwirizana ndi adenomas .
Matenda ambiri (64 peresenti) ndi siteji 4 kapena metastatic panthawi ya kugonana.
Zizindikiro
Zizindikiro za zotupa za ubongo za m'thupi zimaphatikizapo kusintha kwa ziwalo, monga kutsekula m'mimba, kupweteka kwa m'mimba, komanso msinkhu wa magazi. Popeza kuti zotupazi zimapezeka nthawi zambiri, zizindikiro za khansa yapakhungu monga kutaya kwadzidzidzi sizimawoneka.
Kutsimikizira Kuzindikira Koyenera
Kafukufuku amasonyeza kuti ziphuphu zoopsa zokhudzana ndi ubongo nthawi zambiri zimayamba kusokonezedwa ngati zotupa zapakhungu. Icho ndi kulakwitsa kosautsa chifukwa ma carcinoids amakula pang'onopang'ono ndipo kawirikawiri safalitsidwa.
Ngati mwauzidwa kuti muli ndi chotupa chamagazi, onetsetsani kuti munthu wodwala matenda odwala matendawa amavomereza kuti mukudwala matendawa. Kuchita zimenezi kudzakufunsani dokotala mafunso ena ofunika:
- Kodi katswiri wamagulu adagwira nawo gawo lomaliza la kuwerenga kwanga?
- Kodi katswiriyu amatha kusiyanitsa pakati pa zotupa zamagulu ndi zachiwawa?
- Kodi katswiriyu amavomereza kukayikira kwanga?
Ngati mayankho sakuli, inde, ndipo ayi (kapena kuti pafupi kwenikweni), gulu lanu lachipatala liri ndi ntchito yambiri yochita musanakupatseni chitsimikizo chotsimikizira.
Chithandizo
Pakalipano palibe mankhwala ochiritsira a ziphuphu zamtundu wankhanza za colon ndi rectum. Mankhwalawa, komabe, amadalira pa siteji ya chotupacho. Ngati imodzi mwa zotupazi zikupezeka kumayambiriro oyambirira, kuphatikizapo opaleshoni, ma radiation therapy, ndi chemotherapy angaganizidwe.
Kwa zotupa zapamwamba zam'mimba zotchedwa neuroendocrine zotupa, chemotherapy ndi chithandizo chosankha ndipo chingapangitse kukhala ndi moyo wautali. Matenda a Chemotherapy ali ofanana ndi omwe amagwiritsidwa ntchito pochita khansa yaing'ono ya m'mapapo , makamaka kaamba ka mankhwala a platinum monga Platinol (cisplatin) kapena Paraplatin (carboplatin.)
Kafufuzidwe kamene kamakhudzana ndi maonekedwe otupawa amachititsa kuti chiyembekezo chamakono chikhale chotheka kuchiza matendawa.
Kuthamangitsani
Matenda opweteka a neuroendocrine nthawi zambiri amapezeka kuti akupita patsogolo kwambiri, mkhalidwe umene umabweretsa mavuto ambiri. Chithandizo chokha chimene chawonetseratu kuti apitirize kupulumuka ndi chemotherapy.
Pakali pano, kupulumuka kwapakati (kutalika kwa nthawi yomwe theka la anthu amwalira ndi theka likudalira) ndi miyezi 13 mpaka 15, ndipo zaka ziwiri ndizopitirira 23 peresenti komanso zaka zisanu ndi zitatu zokha peresenti.
Kulimbana
Kuwoneka kuti ali ndi chotupa chachikulu cha matenda osokoneza bongo sikungowopsya chabe, koma kungakhale kusokoneza chifukwa chikhalidwe sichiri chofala. Malingaliro a chotupacho, mwatsoka sadasinthidwe kwambiri mzaka zaposachedwa, koma kupita patsogolo kwa mankhwala, monga kubwera kwa mankhwala ochiritsira ndi immunotherapy , kumapereka chiyembekezo kuti mankhwala atsopano adzakhalapo m'tsogolomu yatsopano.
Lankhulani ndi dokotala wanu za chisankho cha mayesero a zachipatala omwe akufufuza za mankhwala atsopanowa. Khalani wovomerezeka wanu mu chisamaliro chanu cha khansa ndikufunsani mafunso. Funsani thandizo kwa okondedwa anu ndikuwalola kuti akuthandizeni. Kuonjezera apo, anthu ambiri amawona kuti n'kopindulitsa kufikitsa kumidzi yothandizira pa intaneti. Ngakhale kuti zotupa za nthenda zokhala ndi nthenda zachiwawa ndizosazolowereka ndipo sizikuwoneka kuti muli ndi gulu lothandizira izi m'deralo, intaneti imakulolani kuti muyanjane ndi ena omwe akukumana ndi chinthu chomwecho chomwe muli padziko lonse lapansi.
Zotsatira:
Conte, B., George, B., Overman, M. et al. Maphunziro apamwamba a m'magulu otchedwa Neuroendocrine Colorectal Carcinomas: Kufufuza Kwambiri kwa Odwala 100. Kachipatala Chokongoletsa Khansa . 2016. 15 (2): e1-7.
Hammond, W., Crozier, J., Nakhleh, R., ndi K. Mody. Genomic Profiling of High-Grade Large-Cell Neuroendocrine Carcinoma ya Colon. Journal of Zovomerezeka pa Oncology . 2016. 7 (2): E22-4.
Shafgat, J., Ali, S., Salhab, M., ndi A. Oszewski. Kupulumuka kwa Odwala ndi Neuroendocrine Carcinoma ya Colon ndi Rectum: A Based Based Based Analysis. Matenda a Colon ndi Rectum . 2015. 58 (3): 294-303.
Smith, J., Reidy, D., Goodman, K., Shia, J., ndi G. Nash. Kubwereza Kwambiri Kwambiri kwa 126 Mapamwamba a Matenda a Neuroendocrine a Colon ndi Rectum. Zolemba za Oncology Opaleshoni . 2014. 21 (9): 2956-62.