Kusanthula, Kutsegula, ndi Kutupa kwa Matenda a Lymph Node Metastases
Khansara ya m'magazi nthawi zambiri imafalikira ku maselo am'mimba asanafike kufalikira kumadera ena a thupi. Kodi ndi khansa ya m'mapapo yomwe imafalitsa kansa ya m'mapapo, dokotala wanu amadziwa bwanji ngati kansa yanu yamapapu yafalikira kumatenda anu, ndipo kodi izi zikutanthawuza bwanji momwe mukuchitira ndi mankhwala anu?
Mwachidule
Khansara yammimba ingathe kufalitsa ( kuchepetsa mphamvu ) mu njira zitatu zoyambirira. Ikhoza kufalikira kudzera:
- mchitidwe wamakono
- magazi
- malo pafupi ndi chotupacho
(Panopa ndikuganiza kuti khansara yamapapo, mosiyana ndi ena khansa, ingafalikire kudzera mumlengalenga).
Pamene maselo a khansa yamapapu amayendayenda kudzera mu mitsempha yamatenda amanyamula kupita kumalo am'mimba omwe amatha kukhala ndi kukula. Khansara ya m'magazi imayamba kufalikira ku maselo am'mimba pafupi ndi chotupacho, chomwe chimadziwika kuti malo am'derali, koma amatha kufalikira kumadera akutali. Mawu ena omwe mungamve omwe akufotokoza za khansa yamapapu yomwe yafalikira ku maselo am'mimba pafupi ndi chotupacho ndi "matenda a m'deralo," "kufalikira kwanuko," kapena "matenda apakati."
Momwe Lymph Nodes Angakhudzire
Mitsempha ya khansa yomwe khansa yamapapo imafalikira kumayambiriro imadalira malo a chotupacho. Ngati mukuwerenga kudzera mu mauthenga anu a radiology, mawu omwe akufotokoza kukhudza thupi la mliri akhoza kukhala wosokoneza kwambiri. Njira yosavuta kuganizira za khansara yamapapu yomwe imafalikira ku maselo am'mimba ndi kugawaniza zigawo zitatuzo:
- Zilonda zam'mimba: Dzina limeneli limatanthawuza zam'mimba zomwe zili m'mapapo. Izi zikhonza kukhala zitsulo zam'mimba zomwe zimapezeka m'madera akutali a m'mapapo, kapena m'magulu a minofu omwe ali m'dera la chifuwa pomwe mitsempha ndi mitsempha yambiri imalowa m'mapapo. (chipinda).
- Zilonda za m'magazi: Awa ndiwo maselo amphongo omwe ali pambali pamapapo ( mediastinum ).
- Zilonda zam'mimba zowonjezereka: Mawu awa amatanthauza zam'mimba zomwe zimapezeka kunja kwa thotho (chifuwa). Izi zimaphatikizapo mitsempha yambiri yomwe ili pamwamba pa collarbone; ndi zojambula zamtundu wa scalene, zomwe zili m'khosi, pafupi ndi nthiti zakumtunda.
Njira ina imene maselo amadzimadzi amatchulidwira pambali ya thupi kumene ili:
- Zilonda zam'mimba: Izi zimatanthawuza ma lymph nodes kumbali imodzi ya thupi ngati chotupa.
- Zilonda zam'mimba: Zilonda zam'mimba zimayambanso mbali ina ("contra") ya chifuwa kuchokera ku chotupa.
Zizindikiro
Mwina simungakhale ndi zizindikiro zilizonse zokhudzana ndi khansara yanu yomwe ikufalitsidwa ku maselo anu. Ngati muli ndi zizindikiro, izi zikuphatikizapo:
- Kutupa m'khosi kapena m'dera lanu pamwamba pa collarbone yanu.
- Kupuma pang'ono chifukwa cha kupanikizika kwa mitsempha yotupa.
- Kuwopsya chifukwa cha kupsyinjika kwa mitsempha yowonongeka ndi ma lymph nodes kapena pafupi ndi mapapu anu.
Kudziwa
Pambuyo pa khansa yamapapu imapezeka, dokotala wanu amalangiza mayesero kuti awone ngati chotupa chanu chafalikira ku maselo am'mimba kapena kumalo akutali. Kudziwa ngati, ndi chiyani, zomwe zimapangitsa khansa yanu kufalikira kufunika ndi kusankha njira yabwino kwambiri yothandizira.
Mayesero ena omwe angachitidwe ndi awa:
- CT scan kapena MRI m'chifuwa chanu ndi mimba
- Kusintha kwa PET - Makamaka ngati muli ndi khansa ya m'mapapo yopanda maselo
- Endobronchial Ultrasound
- Mediastinoscopy
- Lymph node biopsy - Ngati minofu ingathe kupezeka mwa njira monga endobronchial ultrasound kapena mediastinoscopy , dokotala wanu angatenge chitsanzo cha maselo a mliri kuti ayese maselo a khansa
Kusinthana
Kansalu ya khansa ya m'mapapo ya TNM ndi njira yothetsera kuganizira kukula kwa chifuwa chanu, kukhalapo kwa maselo am'mimba omwe amakhudzidwa ndi khansara, ndi umboni uliwonse wa kufalikira kwa chifuwa chanu kumadera akutali a thupi lanu.
M'madera a TNM, N imayimira kutenga nawo mbali mthupi:
- N0 - Palibe kufalikira kwa zilonda zam'mimba
- N1 - Chotupacho chafalikira kumadera oyandikana nawo mbali imodzi ya thupi
- N2 - Chotupacho chafalikira ku nodes patsogolo koma pambali imodzi ya thupi
- N3 - Maselo a khansa afalikira ku minofu kumbali ina ya chifuwa kuchokera ku chotupa, kapena ku maselo am'mimba pafupi ndi mitsempha
Chithandizo
Chithandizo cha khansara yamapapu yomwe yafalikira ku maselo am'mimba amadalira pa siteji ya khansa yanu komanso thanzi lanu lonse. Ngati khansara yamapapu yakulalikira ku maselo ochepa chabe omwe ali pafupi, chithandizo cha opaleshoni chingaganizidwe . Ngati chotupa chafalikira kumadera ena akutali kapena kutali, njira zamachiritso zimaphatikizapo mankhwala a radiotherapy , mankhwala ochizira matenda , mankhwala ochiritsira, ndi ma chithandizo chamankhwala.
Kuthamangitsani
Chizindikiro cha khansara yamapapu yomwe yafalikira ku maselo a mitsempha imadalira zinthu zingapo, kuphatikizapo zomwe zimayambitsa matenda a khansa , mtundu wa khansara wamapapu yomwe muli nayo, kukula kwa chifuwa chanu, kaya chifuwa chanu chafalikira kumalo ena a thupi lanu, ndi thanzi lanu lonse. Mayesero ambiri a kachipatala akuyang'ana njira zabwino zothandizira khansa ya m'mapapo ndikupereka chiyembekezo kuti zizindikiro zidzakwaniritsidwa m'tsogolomu.
Mawu Ochokera ku Lymph Code Kuyanjana ndi Khansa ya M'mimba
Kudziwa kuti, ngati minofu iliyonse m'thupi lanu ili yabwino kwa maselo a kansa yamapapo ndi ofunika kwambiri posankha njira zabwino zothandizira mankhwala anu. Kudziwa kuti ma lymph nodes ndi maubwenzi awo ndi chifuwa chanu chachikulu zimakhala ndi gawo lalikulu pa stage.
Zingakhale zovuta kuti mudziwe ngati mitsempha ya mitsempha imakhudzidwa ndi khansa, ndipo sizingatheke kupanga biopsies pa malo onse omwe angathe. Pachifukwa ichi, kufufuza opaleshoni ndi zojambula zithunzi zimadalira kwambiri. Kukhalapo kwa ma lymph nodes mu mediastinum (chigawo cha chifuwa pakati pa mapapo) ndikofunikira kwambiri posiyanitsa njira zothandizira (mwachitsanzo, opaleshoni ndi mankhwala ena) koma zakhala zovuta kuwerengera. M'mbuyomu, ndondomeko yotchedwa mediastinoscopy kawirikawiri inkachitidwa kotero kuti madokotala ochita opaleshoni angawone bwino kwambiri mfundo izi. Pakalipano, zolemba za PET pamodzi ndi CT nthawi zambiri zimapereka chidziwitso ichi m'njira yosavuta kwambiri.
> Zotsatira:
> Almeida, F. et al. Kuyesa koyambirira kwa wodwalayo wodwala khansa ya m'mapapo: kugwiritsidwa ntchito ndi kupatsirana. Malingaliro enieni mu Pulmonary Medicine . 2010. 16 (4): 307-14.
> Riquet, M. et al. Kugawidwa kwa mitsempha ya khansa yophatikizapo khansa ya m'mapapo ndi a International Association for Study of Lung Cancer descriptory classification m'madera. Kugwiritsa Ntchito Opaleshoni Yophatikizapo Opaleshoni Ndiponso Opaleshoni Yophulika . 2010. 11: 260-264.
> Xia, Y., Zhang, B., Zhang, J., Li, W., Wang, K., ndi H. Shen. Kuyeza kwa mitsempha ya mitsempha ya khansa yamapapo mu khansa yamapapo: ndi ndani yemwe ali wamkulu wa chilungamo ?. Journal of Thoracic Disease . 2015. 7 (Suppl 4): S231-7.