Khansara yamatenda yotchedwa Metaplastic (metaplastic carcinoma ya m'mawere) ndi mtundu wosazolowereka wa khansa ya m'mawere. Zingakhale zovuta kuchita ndi zochepa zomwe zimadziwika pazifukwa zomwe zimayambitsa matendawa.
Khansara yamatenda yotchedwa Metaplastic ndi mtundu wa khansara yowonongeka , yomwe imatanthauza kuti imapanga mkaka wa mkaka ndiyeno imalowa m'magulu ena a m'mawere.
Mankhwalawa amasiyana ndi mitundu ina ya khansa ya m'mawere chifukwa minofuyi imakhala ndi mitundu ina ya minofu yomwe sichipezeka m'mimba. Mwachitsanzo, zotupazi zingaphatikizepo maselo a squamous (khungu) kapena maselo osasa (maselo a mafupa.)
Metaplastic vs. Metastatic
Mawu akuti metaplastic amveka kwambiri ngati metastatic, koma awiriwo ali ndi matanthauzo osiyana kwambiri. Mataplasitiki amachokera ku mawu achi Greek akuti "asinthidwa mawonekedwe," ndipo chifukwa chake amagwiritsiridwa ntchito kufotokoza maselo omwe amawoneka asinthidwa kukhala a mbali ina ya thupi. Metastatic imachokera ku mawu achi Greek akuti "asinthidwa m'malo," 'kufotokoza khansara yomwe yafalitsidwa kuchokera ku malo ake oyambirira kupita kumadera ena.
Khansara ya m'mawere yapamtima imatha kusokonezeka chifukwa cha mawu akuti metaplasia, monga momwe nthawi zina amagwiritsidwira ntchito kufotokoza zotsatira zopanda pake pazomwe zimachitika. Pamene mawu akuti metaplasia amagwiritsidwa ntchito mu lipoti la matenda lomwe limafotokoza maselo osadziwika mu mitundu ina ya minofu, nthawi zambiri amagwiritsidwa ntchito pofotokoza maselo omwe ali osowa koma osakhala ndi khansa.
Zizindikiro
Azimayi ena omwe ali ndi khansara ya m'mawere samakhala ndi zizindikilo konse ndipo amadziwika kudzera mu kuyang'ana nthawi zonse. Kwa ena, zizindikirozo n'zofanana ndi zina za khansa ya m'mawere. Izi ziphatikizapo:
- Mapumphu kapena kuuma kwa m'mawere omwe sanalipo kale
- Chikondi, kutulutsa kapena kusintha maonekedwe a chinsalu
- Kusintha kwa maonekedwe a khungu la m'mawere: redness, kukula, puckering kapena dimpling
- Kutupa kwa bere, kuphatikizapo kufiira, kutupa, ndi kuthamanga
- Kupweteka kosadziwika bwino m'mimba , makamaka ndi zizindikiro zili pamwambazi
Kudziwa
Mayesero kuti azindikire khansa ya m'mawere ndi ofanana ngakhale kuti ali ndi khansa yotani. Mayesero ojambula omwe angagwiritsidwe ntchito ndi awa:
- Kusanthula mammography . Izi ndizofanana ndi momwe mungayang'anire masewerawa, kupatula kuti khansara (osati kungoyang'ana khansara) imafuna zithunzi zambiri kuti zizitengedwe ndikuyang'aniridwa.
- Ultrasound . Izi zimagwiritsa ntchito mafunde amphamvu kwambiri kuti azipanga zithunzi za minofu ya m'mawere. Zithunzi izi zimathandiza madokotala kudziwa ngati mimba yomwe ili m'mimba ndi chida chodzaza madzi kapena chotupa cholimba.
- Maganizo opanga maginito (MRI) . Izi zimagwiritsa ntchito maginito kuti azipanga zithunzi za mkati mwa thupi.
- Kujambula tomato (CT kapena CAT) . Izi zimapanga zithunzi zogawanika zamkati mwa thupi, kenako zimaphatikizapo kujambula chithunzi chomwe chimaonetsa kuti pali zotupa.
- Kusintha kwa positron-emission tomography (PET) . Pambuyo pa jekeseni wa mamolekyu a shuga otentha, pET imafufuzidwa kuti ione mbali zina za thupi zomwe zimadya shuga mwamsanga. Chifukwa maselo a kansa amakula pa shuga, amawunika "PET".
- PET-CT. Izi zimaphatikizapo luso lamakono la PET ndi CT, lololeza madokotala kusunga maselo omwe ali ndi khansa ndikudziŵa bwino momwe aliri m'thupi.
Pamatenda a khansa, khansa ya m'mawere imatha kufanana kwambiri ndi ductal carcinoma ndi masewera omwe amachititsa kuti matendawa akhale ovuta kwambiri.
Chifuwa cha m'mimba
Zonse za mayesero omwe ali pamwambawa zingakhale zothandiza pakuphunzira zambiri za chotupa, koma chifuwa cha m'mawere n'chofunika kuti mudziwe mtundu weniweni wa kansa ya m'mawere ndi kuphunzira za makhalidwe a chifuwacho, monga chifuwa chachikulu (kupweteka kwa chotupa) ndi udindo wolandira.
Kuti mudziwe bwinobwino khansa ya m'mawere, mawere a pachifuwa ayenera kutchulidwa, kutanthauza kuti minofu imachotsedwa pamimba (opaleshoni kapena singano yapadera) ndikuyang'anitsitsa ndi microscope. Chiwombankhanga chimatha kutsanzira chithunzithunzi cha mtundu wina kuti chitsimikizire kuti pali chotupa cha khansa panopa (mosiyana ndi chotupa chothetsa matenda, kapena chida chodzaza madzi ).
Zizindikiro
Ndikofunika kuzindikira kuti palibe khansa ya m'mawere yomwe ili yofanana, ngakhale zotupa zomwe zimapezeka ngati khansa ya m'mawere. Zina mwa zizindikirozi sizingakhale zoona kwa khansara yanu. Matenda otchedwa Metaplastic amatuluka mwamphamvu ndipo amakula mofulumira. Amakhalanso osagwirizana ndi mankhwala a chemotherapy komanso mankhwala ochizira.
Chithandizo
Chifukwa chokhala osadziwika bwino, njira zabwino zothandizira mankhwala sizidziwikiratu, koma zikuwoneka kuti opaleshoni kuchotsa chotupa ndi mankhwala odzola mazira ndi opindulitsa kwambiri. Kutsika kwafupipafupi kwa mtundu uwu wamatumbo kumatanthauzanso kuti njira yoyesayesa-ndi-yoona muzolemba ikuwoneka mosavuta. Komabe, monga khansa yonse, mankhwala amatsogoleredwa ndi:
- Kukula ndi malo a chotupacho
- Kaya khansa yayamba kufalikira (izi zimaphatikizapo kufalikira kwa dera kumapiri komanso kumadera akutali monga mafupa, chiwindi, mapapo, ndi ubongo)
- Kukhala ndi thanzi lathunthu
- Zaka zakubadwa
Ndi mafunso awa m'maganizo, sitepe yoyamba ndi opaleshoni kuchotsa chotupa chooneka. Kuchokera kumeneko, zotsatira zotsatirazi kuchokera ku chithunzithunzi zingathandize kuthandizira:
- Kuyesedwa kwa kulandiridwa kwa mahomoni. Mayesero kuti ayang'ane estrogen ndi progesterone receptor positivity kudziwa ngati maselo a khansa amavomereza bwino mankhwala otchedwa hormone, monga tamoxifen , kapena aromatase inhibitors monga adjuvant therapy. Tamoxifen amagwira ntchito poletsa ma recerose a estrogen pa maselo osakanikirana ndi odwala khansa, monga estrogen imamangiriza ndi mapulogalamuwa kuti azikula mu zotupa zotchedwa estrogen. Aromatase inhibitors amagwira ntchito poletsa kutembenuka kwa mahomoni amphongo (androgens) kwa estrogen, motero kuchepetsa kukula kwa khansa zina za m'mawere.
- Kuyesera kwa mapuloteni a HER-2. Puloteni ya HER2 imadwaliranso m'thupi limodzi mwa magawo anayi onse a khansa ya m'mawere. Ngati mapuloteniwa amapezeka mu chotupa, ndiye kuti mankhwala ndi Herceptin (trastuzumab) akhoza kukhala njira. Adavomerezedwa ndi FDA mu 1998, Herceptin amamatira mapuloteni a HER-2 pa maselo a khansa, kotero kuti kukula kwa thupi sikungamange ndi kuyambitsa chotupacho. Kuyambira pamene Herceptin adavomerezedwa, palinso mankhwala ena owonjezera omwe amapezeka ndi matenda okwana HER2.
Njira zabwino zothetsera chithandizo (kupatula mankhwala ochizira kapena ochiritsira ngati chotupa ndi receroor estrogen kapena HER2 zabwino ndi:
- Kuchita opaleshoni: Mankhwalawa amachititsa kuti munthu asamalidwe kwambiri. Popeza kuti khansa ya m'mawere imakhala yayikulu kuposa mitundu ina ya khansa ya m'mawere mukamayesedwa, mastectomy ingafunikire m'malo mwa lumpectomy.
- Chemotherapy: Ambiri mwa khansawa ndi apamwamba kwambiri kuposa omwe ali ndi khansa ya m'mawere pa matendawa ndipo motero chemotherapy nthawi zambiri imalimbikitsidwa. Izi zimati, mankhwala a chemotherapy samaoneka ngati othandiza pa khansa ya m'mawere.
- Thandizo la mankhwala: Mmodzi mwa maphunziro akuluakulu mpaka lero, kufufuza kwa 2017 pakuyang'ana njira zothandizira chithandizo anapeza kuti mankhwalawa ndi ofunika kwambiri pofuna kuteteza matenda a khansa ya m'mawere.
Kulimbana
Kukhala ndi khansa ya m'mawere yosazolowereka yotereyi kungakuchititseni kukhala osungulumwa komanso osokonezeka. Nazi njira zina zothandizira kuchepetsa nkhawa zanu:
- Pezani gulu lothandizira . Chipatala chanu kapena chipatala cha chithandizo cha khansa chingakhale ndi magulu othandizira odwala khansa ya m'mawere, kapena, mwina, kukuthandizani. Ngakhale kuti ndiwe nokha mu gululi ndi matendawa, mumatha kukakumana ndi amayi omwe akudwala mankhwala omwewo ndipo mumakhala ndi mafunso omwewo.
- Pezani pa intaneti. Kuti muyanjane ndi ena omwe ali ndi kansa ya m'mawere, mungathe kugwirizana nawo m'madera akumidzi kumene odwala amagawana zomwe akumana nazo. American Cancer Society ili ndi mndandanda waukulu wa magulu othandizira pa intaneti kuti akuyambe.
- Taganizirani mayesero a zachipatala. Dokotala wanu angadziwe za mayesero a zachipatala omwe cholinga chake ndi kuphunzira zambiri za matenda anu. Kulembera mayesero awa kungakhale njira yabwino yothandizira kuti mukumverera kuti mukugwirizana kwambiri ndi ndondomekoyi komanso muthandizidwe pozindikira njira zatsopano zothandizira. Kuti mudziwe zambiri za ubwino ndi zoyipa za mayesero a zachipatala ndi momwe mungapezere, funsani ma tsamba a National Institutes of Health.
> Zotsatira:
> Levrer, C., Berriochoa, C., Agrawal, S. ndi al. Zochitika Zowonongeka pa Zotsatira za Metaplastic Khansa ya m'mawere. Kafukufuku ndi Chithandizo cha khansa ya m'mawere . 2017 July 8. (Epub patsogolo pa kusindikiza).
> McKinnon, E., ndi P. Xiao. Metaplastic Carcinoma ya Chifuwa. Archives of Pathology ndi Lab Medicine . 2015. 139 (6): 819-22.
> Tzanninis, I., Kotteas, E., Ntanasis-Stathopoulos, I., Kontogianni, P., ndi G. Fotopoulos. Kusamalira ndi Zotsatira mu Matenda a Mataplastic Cancer. Khansa ya m'mimba ya khansa . 2016. 16 (6): 437-443.