Izinqubo ezinobungozi kumanyikwe zisendaweni yesithathu ku- "isilinganiso" sawo wonke amakhanseli wepheshana lesisu. Umdlavuza wesisu kuphela no-rectum ubakhipha emvamweni wokuthuthuka. Ukushona okuvela emathunjini e-pancreatic emadodeni kusendaweni yesine phakathi kwezinye izimbangela, nakwabesifazane ngolwesihlanu.
Izimpawu nokubonakaliswa kwalesi sifo e-United States of America kutholakala minyaka yonke kwiziguli ezintsha ezingaba ngamashumi amathathu. Ngeminyaka yamashumi ayisishiyagalolunye yekhulu leminyaka eledlule, imvamisa yawo emazweni ezwekazini laseYurophu naseNyakatho Melika yayicishe iphindwe kabili uma iqhathaniswa namashumi amathathu.
Ezweni lethu, ukubonakaliswa komdlavuza we-pancreatic cishe kuyizimo ezingama-8.5 kubo bonke abantu abayizinkulungwane eziyikhulu. Ngakho-ke, kubaluleke kakhulu kuwo wonke umuntu ukuba azi ukuthi yiziphi izimpawu zokuqala zalesi sifo ezingaba yiso, ukuthi siziveza kanjani esikhathini esizayo, nokuthi ungasisingatha kanjani.
Izimpawu zomdlavuza we-pancreatic
Ukubonakaliswa komtholampilo kwalesi sifo esibi kunqunywa ngosayizi we-neoplasm, kanye nendawo okuyona. Ngomdlavuza wekhanda le-gland ekuqaleni, izimpawu cishe zingabonakali futhi zincishiswa kuphela ekuphazamisekeni okuvamile.
Umuntu uzizwa ebuthakathaka, usinda esiswini, ukuqunjelwa. Kwesinye isikhathi isifo sohudo singakhula, okukhombisa ukuthi umsebenzi oyimfihlo wangaphandle we-gland ukhubazekile.
Ezinye zezimpawu zokuqala zomdlavuza yilezi zimpawu ezilandelayo:
- Ubuhlungu esiswini esingenhla;
- ukunciphisa umzimba;
- amahlumela amaningi;
- ukwanda kwesibindi;
- ukwephulwa komsebenzi osebenzayo wamanyikwe;
- i-belching, ukuntuleka kwesifiso sokudla, isicanucanu.
Kwezinye izimo, isibonakaliso sokuqala esisobala salesi sifo esibi, ikakhulukazi kubantu asebekhulile, ukuhlaselwa okukhanyayo kwe-pancreatitis ngaphandle kwesizathu.
Izimpawu zomdlavuza we-pancreatic ngezigaba ezikude kakhulu
Ngemuva kwesikhathi esithile, izimpawu zalesi sifo ziyabonakala, njengobuhlungu obuphansi besisu obuqhubekayo obutholakala endaweni efanele i-hypochondrium noma esifundeni se-epigastric. Kwesinye isikhathi izinhlungu ezinjalo zingaphendula ngemuva, ziphansi emuva, noma zibe yimvelo yebhande (kaningi lokhu kwenzeka lapho isimila sikhula sibe yi-celiac plexus of nerves).
Cishe i-20% yeziguli ezinendlela ejwayelekile yomdlavuza inezimpawu zomtholampilo zesifo sikashukela esisanda kutholakala, eziqinisekiswa izifundo zaselebhu. Zonke lezi zimpawu zomdlavuza we-pancreatic azicaciswanga nakancane futhi zingaba nephutha ngezimpawu ze-osteochondrosis zomgogodla noma i-pancreatitis engamahlalakhona.
Kubantu abaningi, kaningi, ukuphela kophawu lwesimila esifundeni senhloko yamaphaphu kungaba yinqaba ye-jaundice, ekhula ngaphandle kobuhlungu besibeletho esiswini. Kancane kancane, i-jaundice iyaqhubeka futhi ukulunywa kanzima kwesikhumba kuyayijoyina futhi konke lokhu kuyizimpawu zomdlavuza we-pancreatic.
Ezigulini ezinezinhlobo ezivame ukwenzeka zomdlavuza we-pancreatic, kungahle kube nezimpawu zokuvinjwa kwamathumbu okubangelwa ukucindezelwa kwesigaba se-vertical (futhi kwesinye isikhathi esingezansi) se-duodenum.
Ama-neoplasms emzimbeni noma umsila we-gland imvamisa atholakala esivele esezigabeni zakamuva ngokubonakala kobuhlungu obukhulu esifundeni sangemuva noma se-epigastric.
Kuze kube manje, abanazibonakaliso zomtholampilo. Ubuhlungu buba bukhulu kakhulu uma isiguli silele emhlane wakhe, nalapho ehleli noma lapho eguqa phambili buthaka.
Uma isimila siqala ukucwilisa i-splenic vein, khona-ke i-thrombosis yaso iqala, ebonakaliswa yi-splenomegaly. Kwesinye isikhathi, ngomdlavuza we-pancreatic, ngenxa yokuthuthuka kwe-portal hypertension yendawo, imithambo ye-varicose ye-esophagus kanye ne-hemorrhage ngesikhathi sokuqhuma kuyabonakala.
I-Pancreatic Cancer Diagnosis
Lapho wenza ukuhlolwa kwenhloso, cishe ama-35% eziguli ezitholakala zinomdlavuza we-pancreatic zine-hepatomegaly, kuthi phansi yesigaxa sendlala igcotshwe. Ngokukhula kwe-jaundice evimbayo, kutholakala uphawu lwe-Courvoisier. Uma ama-ascites eba uphawu lomdlavuza, khona-ke lokhu kuphakamisa ukuthi inqubo yamathumbu isivele ivame kakhulu futhi ukuhlinzwa okulindelekile akunakwenzeka.
Ngomdlavuza osendaweni yezindlala ze-gland, imiphumela yocwaningo olucwaningayo inikela ngemininingwane emincane, isimila, kanye nokufakwa kwe-tumor, kungakhanywa kuphela ngenqubo ethuthuke kakhulu. I-Ascites ne-splenomegaly nazo zitholakala ezigabeni zakamuva.
Ngezinhlobo zokuqala zomdlavuza we-pancreatic, ukuhlolwa kwegazi okujwayelekile kuvame ukukhombisa ukungahambi kahle. Ezigabeni zakamuva, ukwanda kwe-ESR kanye ne-anemia elinganiselayo kungabonakala.
Kumasampula egazi we-biochemical, i-hypoalbuminuria ne-hypoproteinemia zivame ukutholwa, futhi lapho kukhona i-jaundice ethambisayo, i-hyperbilirubinemia. Izinga lama-phosphatases ama-alkaline kanye nama-transaminase nawo liyakhuphuka, kanye nokwanda kokuxhunywa kwe-phosphatase kubhekwa ngezinga elikhulu.
Ulwazi oluphawuleka ngokwengeziwe ekuxilongweni kwe-neoplasms enobungozi ukunqunywa kokuqukethwe kwezimpawu ze-tumor egazini. Enye yezimpawu eziqonde kakhulu futhi ezibucayi zale hlobo lomdlavuza yi-embryonic carbonic anhydrate glycoprotein. Ngaphezu kwalokho, udokotela udonsela ukunakekela ekushintsheni kwama-pancreas.
Ebantwini abanempilo, izinga layo legazi alifinyeleli ngaphezu kwamayunithi angama-37, futhi kumdlavuza we-pancreatic ukuhlushwa kwayo kukhuphuka ngamashumi wezikhathi (futhi ngezinye izikhathi ngamakhulu nezinkulungwane).
Kodwa ezigabeni zokuqala zomdlavuza, okuqukethwe kwe-CA-19-9 kuvame ukuba ngaphakathi kwemikhawulo ejwayelekile, ngakho-ke le ndlela inemikhawulo ebalulekile ezihlolweni zokuhlola ukuthola izimpawu zokuqala zomdlavuza, noma ngabe iziguli zisengozini.
Eminyakeni yamuva nje, ulwazi luye lwavela ngokusebenza okuphezulu kwendlela yokuthola i-CA 494 antigen esegazini ukuthola ukuthi unomdlavuza wepancreatic, ikakhulukazi uma kudingeka ukuyihlukanisa ne-pancreatitis engamahlalakhona.
Izindlela zensimbi zokuthola umdlavuza we-pancreatic
Lezi zindlela ziphakathi kokuxilongwa kwama-pancreatic tumors.
I-X-ray esebenzisa ukuqhathanisa isisu ne-duodenum isiza ukuthola kuphela izimpawu ezithile zomdlavuza eziqondile ezenzeka lapho isimila sinwe yizitho zomakhelwane:
- ukuguquguquka kwesisu nokufuduka kwawo phambili;
- ukwenzeka nokushintshwa 'kwehhashi' le-duodenum;
- kufinyeza igatsha lehlelayo le-duodenum nokwenzeka kwesiphene sokugcwalisa emaphethelweni angaphakathi.
Njengoba kunesimila esikhulu, ukuhlolwa kwe-X-ray kungakhombisa ukuguquguquka ekugobeni okuncane kwesisu kanye nokuqina kwamagobongo we-mucosa ngokungena kule ndawo.
Ungase futhi uqaphele ukuncipha nokususa i-jejunum endaweni ye-Tretz ligament. Kodwa zonke lezi zibonakaliso zitholakala ziyizimpawu zomdlavuza osekupheleni kwesikhathi. Ama-X-ray futhi enza ukuthi sikwazi ukubona ukuncipha kwe-duodenum.
Izindlela ezifundisayo ezinamandla zokucwaninga zi-imagon resonance imaging kanye ne-compact tomography, kanye ne-ultrasound. Ngaphezu kwalokho, i-tomography iyindlela ebucayi kakhulu kune-ultrasound.
Ukuze kuqinisekiswe ukutholwa okwenziwe yi-X-ray, ukucwaswa kwenaliti eyi-biopsy ye-tumor kwenziwa ngokulawula okungeziwe kusetshenziswa i-ultrasound noma i-computer tomography. Ngaphezu kwalokho, ezigulini eziningi ezinomdlavuza (90-95%), ukuxilongwa kuqinisekisiwe morphologically.
Indawo yekhaya yomdlavuza we-pancreatic
Cishe ama-80% eziguli, ama-tumor kuma-pancreas asekhanda lesitho futhi kaningi engxenyeni ye-caudal noma emzimbeni wesibeletho.
Kuqabukela kakhulu ukuthola isikhundla se-multicentric of the tumor, kanye nefomu lokudlikiza lomdlavuza, elimboza wonke indlala ngokuphelele. Imvamisa, isimila siqala ukuvela kusuka ezicutshini zemikhonto ebunjiwe futhi esakhiweni sayo siveza i-adenocarcinoma ngesilinganiso esihlukile sokuhlukanisa. Futhi, ngesinye isikhathi ngesifundo se-morphological, i-acinar adenocarcinoma (isimila esikhula kusuka kumaseli e-acinar) noma i-squamous cell carcinoma sinqunywa.
Imvamisa, umdlavuza wepancreatic metastases oya kuma-lymph node ngemuva kwe-peritoneum noma ezindaweni ezikhona kwi-hepatoduodenal ligament. Ngegazi, ama-metastases angena esibindini, ezinso, emaphashini, emathanjeni, ezinjeni nase-adrenal futhi kuholele ekuphazamisweni kwazo zonke lezi zitho zomzimba.
