Isigaxa se-neuroendocrine se-pancreas kanye ne-gastrointestinal i-adenoma noma i-neoplasm, ebonakala ngokusebenza ngokweqile kwama-cell amaseli enza izitho zangaphakathi, okuholela ekuphuleni umthetho wokuhlukumezeka kwe-interstitial.
Umthombo we-neoplasms uyinto ehlelekile yesistimu ye-disuse neuroendocrine, efaka amaseli ahlanganisa ama-peptide mahormone nama-biogenic amines, ahlanganiswe ngaphansi kwegama elithi "APUD-system."
Amaseli walolu hlelo abizwa ngokuthi ama-apudocytes, asebenza ngokomzimba, angabamba izimbangela zasemayini, i-decarboxylate futhi ahlanganise amines, adingekayo ekukhiqizeni nasekulawuleni ama-peptides e-hormonal.
Isayensi yanamuhla iyazi izinhlobo ezingaphezu kwama-20 zama-apudocytes atholakala enkabeni yomzimba (i-hypothalamus ne-pituitary gland), engxenyeni engaphetheki yohlelo lwezinzwa, esiswini, duodenum, pancreas kanye nakwelinye ipheshana lesisu.
Yini isimila se-neuroendocrine?
I-Pancreatic NEO ibizwa nge-islet cell tumor kwezokwelapha. Izinhlobo ezinjalo ze-tumor neoplasms zicacisiwe, ngakho-ke, ku-endocrinology zidinga ukucatshangelwa okuhlukile.
Kuma-pancreas, kunezinhlobo ezimbili zamaseli - i-endocrine ne-exocrine. Iqembu lokuqala lamaseli lifaka isandla ekwenziweni kwezinhlobo eziningana zezinto ze-hormonal - zinikeza ukulawula kwamaseli noma amasistimu athile emzimbeni womuntu. Isibonelo, i-hormone insulin ilawula ukugxila kwe-glucose.
Lawa maseli ahlelwe ndawonye eziqhingini ezincane kuwo wonke ama-pancreas. Babizwa ngokuthi ama-Langerhans cell noma ama-islet cell. I-neoplasm etholakala endaweni kulezi zindawo ibizwa ngokuthi i-tumor of islet cell. Amanye amagama - i-endocrine neoplasm noma i-NEO.
Amaseli engxenyeni ye-exocrine yomzimba akhiqiza ama-enzyme akhishwa emathunjini amancane. Zenzelwe ukusiza inqubo yokugaya ukudla. Iningi lamapheya liqukethe iziteshi ezincane ezinama-sacs amancane lapho akhona khona la maseli.
Ama-tumor e-Neuroendocrine ama-benign ngokwemvelo (hhayi umdlavuza) noma alimala ngokwemvelo (umdlavuza). Uma ukuxilongwa kukhombisa i-neoplasm ebabayo, khona-ke bakhuluma nge-onocrology ye-endocrine yamanyikwe noma i-insuloma.
I-pancreatic neuroendocrine tumor kwenzeka kaningi kakhulu kune-tumor ye-exocrine cell, ene-prognosis engcono yokusinda kweziguli.
Ukuhlukaniswa kwe-NEO pancreas
Kwezokwelapha, i-NEO iyahlukahluka ngokuya ngendawo. Uma isimila siqhamukile emgodini wokugaya ukudla, khona-ke cishe akunakwenzeka ukuxilonga i-pathology ezigabeni zokuqala kuze kube yilapho i-neoplasm inika i-metastases kwezinye izitho zomzimba.
Ama-pancreas omuntu aqukethe izingxenye - ikhanda, umsila nomzimba. Njengoba kunama-tumors kulezi zindawo, ukukhululeka kwe-hormone kukhubazeka, bese kuba nezimpawu ezingezinhle. Uma ngokweqiniso, ngaphandle kwentuthuko yesayensi, kunzima kakhulu ukuthola isifo esinjalo.
Ngokuya ngendawo, isiguli sinezimpawu. Bahluke kakhulu. Ngokufanelekile, inkambo yokwelashwa eyengeziwe inqunywa izici eziningi - indawo, usayizi wemfundo, njll.
Ama-tumor we-pancreatic e-Neuroendocrine asebenzayo, atholakala kakhulu kulokhu okulandelayo:
- IGastrinoma iyi-neoplasm eyenzelwe ekhaya kumaseli ahlanganisa i-gastrin yehomoni. Le nto ikhuthaza ukukhishwa kwejusi lesisu, isiza ukugaya ukudla. Njengoba kunesimila, okuqukethwe Ijusi esiswini kanye nokuqunjelwa kwe-hormone kukhuphuka. IGastrinoma ezithombeni eziningi yenziwe yasekhanda ekhanda lesitho sangaphakathi. Kwezinye izithombe, faka amathumbu amancane. Kaningi, isimo se-neoplasm esibuhlungu siyasungulwa.
- I-Insulinoma ukwakheka okutholakala emangqamuzaneni akhiqiza i-hormone insulin. Ingxenye le ibhekene nokuqukethwe kwe-glucose emzimbeni. Le neoplasm ikhula kancane, kuyaqabukela inikeze i-metastases. Kutholakala ekhanda, emsileni noma emzimbeni wesikhumba. Imvamisa kunesimo semvelo.
- I-Glucagonoma. Isimila senziwe endaweni emangqamuzaneni abhekele ukukhiqizwa kwe-glucagon emzimbeni. Le ngxenye ikhulisa okuqukethwe ushukela ngokuqhekeka kwe-glycogen esibindini. Emhlanganweni omkhulu we-glucagon, isimo se-hyperglycemic siyabhekwa. I-pancreatic imisila ye-neuroendocrine isimila imbi kakhulu.
Kwezokwelapha, ezinye izinhlobo ze-tumor neoplasms ziyahlukaniswa, okuvame ngandlela thile. Zihlangene futhi nokukhiqizwa kwama-hormone, kufaka phakathi izakhi ezilawula ushukela, okuqukethwe usawoti kanye noketshezi.
I-Vipoma (i-pancreatic cholera) - i-neoplasm, eyenziwe endaweni kumaseli akhiqiza i-peptide yamathumbu; somatostatinoma isimila samangqamuzana akhiqiza i-hormone somatostatin.
ISomatostatinoma ibonakala kahle ngokuskena kwe-radionuclide.
Ukubonakaliswa kwemitholampilo kuya ngohlobo lwesimila
Izimpawu ze-neoplasm ye-pathological ikhula ngenxa yokukhula kwe-tumor kanye / noma ngenxa yokukhiqizwa kwama-hormone angasebenzi kahle. Ezinye izinhlobo zamathumba azikhombisi ukuthuthuka kwazo nganoma yiziphi izimpawu, ngenxa yalokho, zitholakala ezigabeni zokugcina, okuholela ekuqhamukeni kwesifo okungafanele.
Ukwakheka kwamanyikwe kumvelo engasebenziyo kungakhula isikhathi eside, kungabikho zimpawu eziphawuliwe. Bayakwazi ukusakazeka kwezinye izitho zangaphakathi. Izimpawu eziphambili zibandakanya ukuphazamiseka komgudu wokugaya ukudla, isifo sohudo, izinhlungu esiswini noma emuva, ukukhala kwesikhumba kanye nesifo sokuqina kwezitho zombono.
I-Symbomatology ye-tumic esebenzayo ye-pancreatic ingenxa yohlobo lwe-hormonal ntho, ukuqoqwa kwayo okukhula ngokuqinile ngenxa yokukhula kwe-neoplasm. Ngezinga eliphakeme le-gastrin, izimpawu ezilandelayo ziyabonakala:
- Isilonda esiswini esiswini.
- Ubuhlungu esiswini, budlulela emuva. Ubuhlungu bubonwa njalo noma kwenzeka ngezikhathi ezithile.
- Uhudo olungapheli.
- I-Gastroesophageal Reflux.
Ngokuphikisana nesizinda sokuhlaselwa okuphezulu kwe-insulin, isimo se-hypoglycemic siyakhula (ushukela ophansi emzimbeni). Futhi, i-hypoglycemia iholela ebuhlungwini bekhanda, isiyezi, ubuthakathaka, ukuphazamiseka kwemizwa, ukukhuphuka kokujuluka. Futhi, iziguli zikhononda ngokushaya kwenhliziyo okusheshayo nokushaya ngamandla.
Ngokukhula okusheshayo kwe-glucagon, kuvezwa ukubonwa kwemitholampilo:
- Ukudlikiza ebusweni, isisu kanye nemikhawulo ephansi.
- Ukwanda kwe-glucose emzimbeni, okuholela ekhanda, ukwanda kwamandla athile okuchama ngosuku, ukoma emgodini womlomo nesikhumba, indlala, ukoma nobuthakathaka obungapheli.
- Ifomu lokugoqwa kwegazi. Uma ukushayeka kwegazi kutholakala endaweni emaphashini, khona-ke lokhu kuholela ekuphefumuleni, ukukhohlela, izinhlungu esifubeni. Lapho kukhona ukuhlangana kwegazi ezindaweni eziphezulu noma eziphansi, kukhona ubuhlungu, ukuvuvukala kwezandla noma izinyawo, i-hyperemia yesikhumba.
- Ukuphazamiseka kwendlela yokugaya ukudla.
- Yehlise iphango.
- Ubuhlungu emlonyeni, izilonda emakhoneni omlomo.
Ngokukhuphuka kwe-peptide yamathumbu, kuvela isisu esiqhubekayo, okuholela ekuphelisweni komzimba ngezibonakaliso ezihlanganayo - isifiso esiqhubekayo sokuphuza, ukwehla komchamo, isikhumba esomile kanye nolwelwesi lwama-mucous emlonyeni, ikhanda elibuhlungu kanye nesiyezi, kanye ne-malaise ejwayelekile.
Ukuhlolwa kwelebhu kukhombisa ukwehla kokuxineka kwe-potassium esegazini, okuvusa amandla obuthakathaka bemisipha, ukuqaqamba kwamalungu omzimba, ukubanjwa ngamandla, ukukhubazeka kanye nokuqunjelwa kwemikhawulo, ukuchama kaningi, ukushaya kwenhliziyo okusheshayo, ubuhlungu besisu kanye nokuncipha kwesisindo se-etiology engaziwa.
Ngokukhuphuka kwamazinga we-somatostatin, izimpawu eziphambili yi-hyperglycemia, isifo sohudo, ukuba khona kwamafutha ezinduneni, amatshe egalofu, ukuphazamiseka kwesikhumba namaprotheni eso, ukuncipha kwesisindo.
Ukwelashwa kwe-pancreatic tumor
Ekwelapheni i-neuroendocrine pancreatic tumor, ukungenelela kokuhlinzwa kuyadingeka. Ukuhlinzwa kubizwa ngokuthi i-gastrectomy. Kodwa-ke, indlela yokusebenza inezinkinga zayo, okubangelwa ama-neoplasms amaningi, anesihluku futhi ayimvelo emvelweni.
Kwezinye izithombe zomtholampilo, umthamo wokuhlinzwa kunzima ukubikezela, ngakho-ke inqubo yenqubo yezokwelapha inqunywa yiqiniso - ngemuva kokuthi udokotela ohlinzayo eqale ukuhlinzwa.
Yazi ngesikhathi esifanele ukubonakaliswa kwesimila se-pancreatic tumor, ngokulandelana, ukuqala ukwelashwa okwanele, udokotela onolwazi kuphela ongakwazi. Kepha ama-neoplasms akuvamile, ngakho-ke akunakwenzeka ngaso sonke isikhathi ukuthola lesi sifo ekuqaleni kwawo.
Uma isimila sikhula ngokushesha, kuyilapho kutholwa isilinganiso esithile sokwehlukanisa, khona-ke isiguli sinqunyelwe i-chemotherapy. Kusetshenziswa le mithi elandelayo ngesikhathi sokukhohlisa kwezokwelapha:
- I-Chlorozotocin.
- I-Doxorubicin.
- Epirubicin.
Kwesinye isikhathi ukwethulwa kwe-synthetic hormone somatostatin kuyadingeka, okungukuthi, ukwelashwa kwe-hormone kuyenziwa. Uhlelo lokwelashwa kweziguli, umthamo wezidakamizwa, imvamisa yokuphatha kwabo - konke ngokuqondile. Ukwelashwa okunamandla kubekelwa kuphela ngemuva kokuxilongwa okujulile, kubhekwe nemibandela eminingi.
Ukusebenza kwe-chemotherapy kuncane. Izibalo ziqaphele ukuthi umphumela omuhle utholakala kuma-15-20% wamacala. Uma i-chemotherapy inikeza umphumela omuhle ngemuva kwezifundo eziningana, khona-ke isiguli sizokwazi ukuphila kusuka eminyakeni emi-2 kuye kweli-9.
Ngaphezu kwe-chemotherapy, eminye imithi ibekiwe ehlose ukunciphisa izimpawu zokukhathazeka. Ukukhetha umuthi kuncike ekubonakalisweni komtholampilo. Udokotela angabeka izidakamizwa:
- I-Octreotide.
- Omez.
- I-Ranitidine.
- Omeprazole
Lapho ungekho umphumela omuhle ngenxa ye-chemotherapy, kuphakama umbuzo wokungenelela kokuhlinzwa. Ezokwelapha zesimanje, bazama ukusebenzisa izindlela eziphumelela kakhulu. Enye yazo ukwelashwa kwe-radionuclide.
Ithuba lokululama ngokuphelele (i-prognosis) lincike ezicini eziningi: izinhlobo zamaseli womdlavuza, indawo yesimila, ukuba khona / ukungabikho kwe-metastases, izifo ezihlangene, iqembu leminyaka lesiguli. I-prognosis ethandeka kakhulu yamathumbu ehlukanisiwe ayidluli amasentimitha amabili, engazange ihlangane nama-lymph node nesibindi.
Ama-pancreatic tumors achazwe kuvidiyo kule ndatshana.
