Syndromes ya Paraneoplastic mu Anthu Amene Ali ndi Khansa Yam'mimba
Paraneoplastic syndrome ndi chizindikiro cha zizindikiro zomwe zimachitika chifukwa cha chotupa chiripo m'thupi, koma osati chachiwiri kwa khansa yokha. Zizindikiro zapirinoplasti zimapezeka chifukwa cha chitetezo cha thupi kumatenda, kapena zinthu zobisika ndi maselo otupa.
Paraneoplastic Syndrome mu Khansa Yam'mimba
Matenda a paraneoplastic amapezeka pafupifupi 10 peresenti ya anthu omwe ali ndi kansa ya m'mapapo.
Zitha kuphatikizapo pafupifupi thupi lililonse (zotchulidwa pansipa) ndipo ndi zizindikiro zomwe sizimagwirizanitsidwa ndi khansa ya m'mapapo. Zizindikiro za syndromes izi zikhoza kukhala zoyamba za khansa ya m'mapapo, yomwe imabwera bwino zisanachitike zizindikiro za khansa yokha.
Mitundu Yambiri
Pali mitundu yambiri ya zizindikiro zowonongeka zomwe zimawonedwa ndi khansara yamapapu, koma kawiri kaŵirikaŵiri ndi:
- Hypercalcemia ndi squamous cell carcinoma m'mapapu
- Kachilombo kosavomerezeka kwa ADH (SIADH) ndi khansara yaing'ono ya m'mapapo
Hypercalcemia monga Chizindikiro cha Paraneoplastic
Matenda a hypercalcemia monga epanoplastic syndrome amapezeka kawirikawiri ndi squamous cell carcinoma m'mapapo , mawonekedwe a kansa yaing'ono yopanda maselo. Mankhwala a hypercalcemia amatanthauza kashiamu wamtundu wokwezeka m'magazi. Mankhwala a khansa ya khansa ya khansa imatha chifukwa cha khansa yomwe imatulutsa mahomoni otchedwa hormone a parathyroid, kuphatikizapo calcium yomwe imatuluka chifukwa cha kuphwera kwa mafupa chifukwa cha khansayo .
Zizindikiro zingakhale ndi ludzu, kufooketsa mthupi, kusowa kwa njala, chisokonezo, kupweteka kwa m'mimba, ndi kupsinjika maganizo. Njira yabwino yothetsera matenda a hypercalcemia ndikuteteza kansalu yokha, koma kuonetsetsa kuti anthu ali ndi madzi okwanira ndi ofunikira kwambiri, komanso chifukwa chakuti matendawa amawopsa kwambiri.
Syndrome of Inappropriate ADH Kuchokera (SIADH)
SIADH imapezeka makamaka ndi khansa yaing'ono yamapapu ya m'mapapo , ndipo imadziwika ndi kuchepa kwa sodium m'magazi (hyponatremia.) Zizindikiro zingakhale monga kupweteka kwa mutu, kufooka kwa minofu, kutaya mtima, ndi kutopa, koma ngati zikuchitika mofulumira kapena zovuta kwambiri zingayambitse kupweteka ndi kutaya chidziwitso. Njira yabwino kwambiri yothandizira SIADH ndiyo kuchiza khansara, ndipo kafukufuku wina anapeza kuti kuchiza khansa yaing'ono ya m'mapapo ndi mankhwala a chemotherapy kungachepetse chiwerengero cha anthu 80 peresenti. Mankhwala oyenera a hyponatremia (sodium yochepa) chifukwa cha SIADH angaphatikizepo kuchepetsa kumwa madzi kapena kugwiritsa ntchito madzi ena kapena mankhwala ena.
Other Paraneoplastic Syndromes ndi khansa ya m'mimba
Matenda a paraneoplastic syndromes angakhudze pafupifupi dera lililonse la thupi ndipo amachititsa zizindikiro zambiri. Zina mwa ma syndromes omwe amafala kwambiri amaphatikizanso ubongo, dongosolo la endocrine, khungu, impso, maso, mafupa, ndi maselo a magazi. Popeza zizindikirozi zikhoza kuchitika kansana yamapapu isanafike, zimakhala zokhumudwitsa kwambiri monga madokotala akuyang'ana zifukwa. Zitsanzo zingapo za syndromes zomwe zingachitike m'kansanga yamapapo ndi awa:
- Cushing's syndrome - Chiwerengero chokwanira cha kortisol m'magazi chingayambitse kutupa, kuthamanga kwa magazi, "mawonekedwe a mwezi," komanso momwe angathere (monga amayi angayambe kukhala ndi mimba).
- Acromegaly - Mu matenda awa, khansara yamapapu ikhoza kupanga hormone yofanana ndi kukula kwa hormone, yomwe akuluakulu amatha kukulitsa manja ndi mapazi.
- Polymyositis / dermatomyositis - Kutupa khungu ndi zofewa zimatuluka, makamaka ndi kansa ya squamous yamapapu.
- Syndromes ya Neurological - Pali mitundu yambiri ya ma syndromes yomwe imatha kuyimira matenda a khansa ya m'mapapo ndi khansa ya m'mapapo, ndi chitsanzo chimodzi kukhala cerebellar ataxia - kutupa kwa ubongo chifukwa cha kusowa kapena kugwirizana.
- Paraneolplastic glomerulopathy ndi matenda a impso omwe angakhalepo ndi khansara yamapapo monga matenda a paraneoplastic.
Kuchiza
Matenda a paraneoplastic syndromes amasiyana kwambiri ndi zizindikiro zawo, ndipo pangakhale ngakhale zifukwa zingapo zomwe zimayambitsa imodzi mwa syndromesyi, kotero kuti chithandizocho chikhale payekha payekha. Zonsezi, chithandizo chabwino kwambiri cha zonsezi - makamaka popeza zinthu zomwe zimayambitsa zizindikirozi zimatulutsidwa ndi maselo a khansa kapena thupi lomwe limayang'aniridwa ndi maselo a kansa - ikuyambitsa khansa yapakhungu. Mwamwayi, mankhwala opatsirana khansa ya m'mapapo - ngakhale khansara yamapapu yapamwamba - yakula bwino m'zaka zingapo zapitazi, ndipo zikupita patsogolo ngakhale pakuvuta kwambiri kuchiza khansa monga squamous cell carcinoma m'mapapo ndi khansa yaing'ono yamapapu ya m'mapapo.
> Zotsatira:
> Pelosof, L, ndi D. Gerber. Matenda a Paraneoplastic syndromes: njira yopezera matenda ndi chithandizo. Mayo Clinic Proceedings . 2010. 85 (9): 838-54.
> Kanaji, N., Watanabe, N., Kita, N. ndi al Paraneoplastic syndromes omwe ali ndi khansa ya m'mapapo. World Journal of Clinical Oncology . 2014. 5 (3): 197-223.