I-pancreatic tumor (neoplasia) yisifo esikhohlisayo futhi esibulalayo. Ngokusho kwe-WHO, cishe izinkulungwane ezingama-220 zalesi sifo zibhaliswa minyaka yonke emhlabeni. Kulaba, abayizinkulungwane ezingama-213 abaphela ekufeni. Lokhu kungenxa yemvamisa ephezulu yama-neoplasms anonya kabi.
Ingakapheli iminyaka emi-5 ngemuva kokuxilongwa kwe-tumor kuma-pancreas, 90% yeziguli ziyafa.
Zingaki iziguli ezihlala ngemuva kokwelashwa kwe-benign tumor kunqunywa uhlobo nendawo lesi sifo.
I-pancreatic neoplasia (i-pancreas) iyi-neuroendocrine pathology, i.e., iphazamisa uhlelo lwe-endocrine. Noma kungenxa yokususa okulula kwamafomu, imiphumela emibi yamanyikwe iyenzeka.
Ukukhula kwe-tumor kwizitho eziseduzane (i-spleen, duodenum, isibindi, isisu) kubangela ukufa.
Izimpawu ezejwayelekile ze-pathology
Ukuba khona kwe-pancreatic oncology kutholakala ezinyangeni zokuqala kuphela yi-fluke, ngesikhathi sokuhlolwa komzimba.
Ukuthuthuka okuqhubekayo kwalesi sifo kunikeza ukubuyekezwa okuxubile mayelana nenhlala-kahle, edidaniswa nokuphazamiseka kokugaya ukudla.
Isigaxa esivuthiwe kuphela esinikeza izimpawu noma ezicacisiwe ezithile zesimpawu se-oncology.
Esikhathini sokukhula, i-neoplasm isakazekela ezithweni nasemikhunjini eseduze.
Ukuvaleka kwama-ducts, i-necrosis yamaseli ngamanye noma izicubu kubangela lezi zimpawu ezilandelayo.
- Ubuhlungu obujwayelekile phakathi kwesisu (isifunda se-ltear vertebrae yokuqala noma yesithathu). Yindawo yakhe engakhombisa ngokusobala izinkinga ngomdlavuza wendlala yesinye. Esikhathini esizayo iba shingles. Akuncike ekudleni kokudla, kuyanda ebusuku. Ukubonakaliswa kungahlukahluka kusuka ekuhlatshweni kobuhlungu obungapheliyo.
- Ukuphazamiseka kwengqondo kwe-dyspeptic. Ukusinda esiswini, isicanucanu, ukuhlanza. Kuvame kakhulu nge-emathunjini ekuvinjelweni ngenxa yobukhulu bawo.
- I-jaundice eyingozi. Uphuzi wesikhumba, amehlo, izipikili. I-Stool discoloration nomchamo omnyama. Isibonakaliso esiqinisekile sokunciphisa izindunduma ze-bile, esibangela isimila ekhanda lamanyikwe.
- Shintsha esimweni sokudla. Ukwenqaba kwezitsha ezinamafutha nenyama, ikofi notshwala.
- Ukunciphisa umzimba ngokweqile.
- Izimpawu zesifo sikashukela Kwenzeka lapho i-neoplasm isemsileni wamanyikwe;
- I-Anemia
Isigaxa esilinganiselekile se-pancreas singabikezelwa ngokungabikhona kokudakwa okungokwemvelo kwe-neoplasia enobungozi.
Leli cala liqhubeka ngaphandle kobuthakathaka obujwayelekile, ukukhathala, umkhuhlane ophakeme, i-pallor. Okuhle kakhulu ukuthi ukungabi khona kwenhliziyo nokuhlanza.
Izimbangela ze-pathology
Ama-neoplasms e-oncological azenza azizwe kuphela esigabeni sekwephuzile sokuthuthuka kwe-pathology.
Uma umdlavuza we-pancreatic uzenza waziwe kuphela ezigabeni zakamuva, khona-ke ungazivikela kanjani?
Futhi wazi kanjani ukuthi kunokuphambuka kwalesi sifo?
Iqembu lengcuphe linqunywa yilezi zinto ezilandelayo:
- iminyaka esuka eminyakeni engama-50;
- ubulili besilisa (buthambekele kakhulu ezifweni);
- ukuba khona kwezifo zesisu, amathumbu;
- i-pancreatitis engapheli;
- ukubhema: kwandisa ubungozi besisu se-pancreatic amahlandla amathathu;
- ifa: ikhodi yofuzo engajwayelekile ibanga ukuthi isifo kungenzeka yini;
- ukusetshenziswa kabi kotshwala
- ukudla okugcwele inyama namafutha amaningi, kufaka nokudla okusheshayo;
- thayipha i-1 isifo sikashukela;
- imvelo elimazayo.
Enye yezinto ezibalulekile nezimpikisanayo yisifo sikashukela. Abantu okungafanele babe noshukela wegazi ophakeme (amadoda aphakathi kweminyaka, ngaphandle kwesisindo ngokweqile) akufanele babonwe, lapho kutholakele, ama-pancreas kufanele ahlolwe i-oncology. Lapha, lesi sifo kungenzeka singabi yici yobungozi, kepha uphawu lwesimila noma enye i-pancreatic pathology. Ezimweni ezingavamile, umthombo walesi sifo ukuphazamiseka kwehomoni okuhambisana nokukhuluphala.
Izimpawu ezifakwe kuhlu ngaphambili zincike ohlotsheni lokulimala kwesitho nezici zesakhiwo se-neoplasm. Okuncane ngezansi kuyincazelo enemininingwane ye-typology yalesi sifo.
Ukuhlukaniswa kwe-pancreatic tumor
Okokuqala, i-pathanatomy ihlukanisa izimila ngezigaba ezimbili: i-benign ne-malignant.
Icala lokuqala lilinganiselwe emiphumeleni yalo emzimbeni futhi lingalapheka.
Isici saso ukwahlukanisa amaseli. Ikuvumela ukuthi unqume izicubu kusuka lapho ukwakheka kukhula khona. Kweminye imithombo kubizwa ngokuthi i-polyp, lena imiqondo efanayo.
Umdlavuza we-pancreatic we-Benign uhlukaniswa ngalezi zindlela ezilandelayo:
- I-Fibroma (izicubu ezithintekayo).
- IHemangioma (imithambo yegazi).
- I-Neurinoma (uhlelo lwezinzwa).
- I-Lipoma (izicubu ze-adipose).
- ICystoma (i-capsule egcwele uketshezi; etholakala ezindaweni ezahlukahlukene).
Inketho ephephe kakhulu i-hemangioma. Imvamisa, lokhu ukwakheka kwe-epithelial ezinganeni ezivame ukuwohloka ebuntwaneni zisencane. Kwesinye isikhathi kwakheka esibindini, akufani kuma-pancreas. I-neoplasm enjalo ibizwa nge-cavernous hemangioma. Izindlela zokwelapha zivamile kwe-oncology.
I-tumor enobungozi yicala elingasebenziseki ngokusakazwa kwe-metastases. Ukungakwazi ukwelashwa kungenxa yokukhula kwe-neoplasm. Kungakhula ngaphakathi emzimbeni, kuguqula amaseli anempilo abe amaseli womdlavuza, noma akhule abe izicubu ezizungezile. Kulokhu, isimila singabhubhisa konke okuza ngendlela.
Umdlavuza we-pancreatic we-malignant ngokusho kwe-ICD-10 unqunywa yisayithi lesion:
- ikhanda lamanyikwe, umzimba noma umsila;
- i-pancreatic duct;
- amaseli we-islet;
- kwasendaweni enezindawo.
Indawo ye-neoplasia ikakhulukazi inquma izimpawu zayo kanye nokwelashwa. Itholakala ekhanda, izosakazekela esibindini nase-duodenum, ibangele ukuphazamiseka kwe-dyspeptic kanye ne-jaundice. Ukusuka emsileni, ingasakazeka kubanzi.
Ukwakha uphawu lwe-pathological kule ndawo, kubangela ama-ascites kanye ne-hypersplenism. Amaseli e-Islet angumthombo owengeziwe we-insulin namanye ama-hormone. Ukwehluleka kwabo ukulahlekelwa okukhulu kohlelo lwe-endocrine.
Izindlela zokuthola lesi sifo
Izimpawu azanele ukwenza ukuxilongwa.
Kuyadingeka ukwenza izivivinyo ezijwayelekile futhi ubukeze umlando wezokwelapha. Bazokwazi ukukhombisa imbangela yomdlavuza.
Ukuhlolwa kokuqala kufaka i-interviewing isiguli kanye nokutholwa komthombo okungaqondile.
I-Oncologist yenza:
- Ukuhlaziywa komlando wezokwelapha (isikhathi kanye nohlobo lokugula).
- Ukucatshangelwa umlando wempilo (okunquma ukuba khona kwezinto eziyingozi ezichazwe ngenhla).
- Ihlola amacala e-oncology ezihlotsheni zeziguli.
- Ukuqinisekiswa kwezimpawu.
Ngemuva kokuhlolwa kokuqala, kutholakala ukuxilongwa okuphelele. Ukuhlaziywa kwenziwa:
- igazi (inani); ukuntuleka kwe-hemoglobin (anemia) nolunye ushintsho kuyatholakala;
- igazi (biochemical); ikakhulukazi, amazinga kashukela, uhlobo lwe-1 yesifo sikashukela noma i-insulomas kubhekwa;
- indle; okwenziwa ngempela nge-discoloration yayo (uphawu lokungabikho kwe-stercobilin);
- umchamo nge-jaundice, isilinganiso se-urobilinogen, esakhiwa kusuka ku-bilirubin, silinganiselwa;
- izimpawu zesimila CA 19-9, KEA (amaprotheni akhombisa ubukhona bomdlavuza).
Ngaphezu kwalokho, kusetshenziswa amathuluzi alandelayo wokuthola isimila:
- Ukuhlolwa kwe-Ultrasound (ultrasound).
- Icwecwe le-computer tomography (CT).
- Magnetic resonance imaging (MRI).
- I-Endoscopic retrograde chalangiopancreatography (ERCP).
- I-Magnetic resonance pancreatocholangiography (MRPC).
- I-Scintigraphy.
- I-Angiography.
- I-Biopsy
I-Ultrasound yindlela elula kunazo zonke. Inendleko ephansi, kepha iphephe ngokuphelele. Inquma ushintsho lwe-morphological kwezicubu, izinga lazo lokuqina kwezimpawu.
I-CT ibeka usayizi, indawo yesimila, nokubandakanyeka kwezitho eziseduze. Iqondile, kepha isebenza ngesisekelo sama-x-ray.
I-MRI iphephe ukwedlula indlela yangaphambili, kepha ibiza kakhulu. Ibonisa ukuthi i-neoplasm ihluma kanjani nemiphumela yako, ukufakwa kolwelwesi lwama-mucous kanye nokuwohloka kwesimo se-motility.
I-ERCP ihlola izindunduma ze-bile. Zigcwaliswa ngophakathi ophakathi kanti kuthathwa i-x-ray. Lesi sakamuva sikhuluma ngoshintsho lwe-morphological kule ndawo, ngokwesibonelo, ukuthambisa kanye nokuba khona kokuvinjwa.
I-MRPHG ihlola ama-ducts we-bile kanye ne-pancreatic. Isimo sabo nesimo sabo, izimpawu zomzimba ezindongeni zamashubhu zinqunywa.
I-Scintigraphy inquma indawo nezinye izici zesimila njengokwethulwa kwezinto ezinomsakazo emzimbeni.
I-Angiography ukuhlolwa kwe-x-ray kwemithambo yegazi. Indawo yokugcina, lapho kungekho idatha ngemuva kwe-CT ne-MRI.
I-biopsy ukuhlonza okuhlukile kokungafani, okungukuthi, kunquma ikhwalithi yesimila. Kwenziwa ngokuthatha isampula yezicubu kusuka e-lesion.
Ukwelashwa kwe-pancreatic tumor
Lezi zimo ezilandelayo ziyadingeka ekwelashweni kokuhlinzwa komdlavuza we-pancreatic: ubuntu, ubukhulu besimila budlula isentimitha, ukwanda okungapheli kwezemfundo ngaphezu konyaka kanye nokuba khona kwezimpawu.
Kujwayelekile ukususa isigaxa se-pancreatic usebenzisa i-resection ejwayelekile yezicubu ezithelelekile.
Uma kungenzeka, ingashintshwa ezinye izindlela:
- ukuhlinzwa kwe-laparoscopic;
- ukwelashwa ngemisebe;
- chemotherapy.
Ukuhlinzwa kwe-pancreatic yendabuko kubandakanya ukususwa kwengxenye yesitho. Isibonelo, resection ye-pancreatoduodenal ukususwa kwekhanda lendlala kanye ne-duodenum. Ngokwemvelo, ngemuva kokuba isiguli esinjalo singaphili isikhathi eside. Kuhlongozwa indlela yokuqhekeka kwama-islet cell tumors.
I-Laparoscopy inqubo yokuhlinzwa enenombolo encane yokufikelwa. Kulokhu, akuvamile ukusetshenziswa, kaningi ekwelapheni ama-hemangiomas ebuntwaneni bezelwe. Le ndlela yesimanje yokusebenza, imvamisa isebenzisa i-laser.
Ukwelashwa ngemisebe kuhloswe kuphela ukubambezela ukusakazeka kwalesi sifo. Isimo sezulu kuleli cala asiduduzeki: isikhathi sokuphila sinwetshwa izinyanga eziyi-12-16.
I-Chemotherapy nayo ayiyona i-arhente yokwelapha, kepha ihloselwe ekubuyiselweni komdlavuza kwengxenye. Ngezinye izikhathi izidakamizwa ze-cytotoxic ukuphela kwendlela yokuphuma.
Ochwepheshe bazokhuluma ngama-pancreatic tumors kuvidiyo kule ndatshana.
