I-pancreatic oncology

Ukwakheka emzimbeni wamaseli ane-DNA eshintshiwe kungenzeka kunoma yisiphi izicubu noma kunoma yisiphi isitho. Lokhu kwenzeka kaningi, kepha izivikeli mzimba zibulala lawo maseli ngokuhamba kwesikhathi. Kodwa-ke, ngokwehla kwezinga lokungazeleleki, nangaphansi kwethonya lezinye izinto ezimbi, ezinye zazo zingaphikelela futhi ziqale ukuhlanganyela ngesivinini esikhulu. Lokhu kuholela ekwakhekeni kwama-neoplasms ahlukile ngesakhiwo nezakhiwo ezivela ezicutshini zesitho, lapho aqala khona ukukhula kwawo.

Igatsha lezokwelapha elifunda ngezimpawu zama-neoplasms, izinhlobo zazo nezigaba zezifundo, kanye nezindlela zokulwa nazo, ibizwa ngokuthi yi-oncology. Kukhulu kakhulu, ngoba kucubungula konke okuhlobene nama-neoplasms amabi nakuzo zonke izakhi zomzimba. Indawo ehlukile yalesi sayensi, ebizwa ngokuthi yi-pancreatic oncology (pancreas), ifunda izimbangela zokwenziwa kwama-tumors kulesitho, ukubonakaliswa kwazo okujwayelekile, izindlela zokutholwa kusenesikhathi nokwelashwa. Ngakolunye uhlangothi, igama elithi "i-pancreatic oncology" libuye lisho nje iqembu le-pathologies elenziwa ngokwakhiwa kwe-neoplasms, futhi kaningi kakhulu - umdlavuza we-pancreatic.

Izici Zezimpawu

Ukulimala kwe-pancreatic frequency kusendaweni ye-4 phakathi kwazo zonke ezinye izinhlobo zomdlavuza wezitho zangaphakathi futhi kubonakaliswa inani eliphakeme lokufa kweziguli. Lapho ukwakheka kwesimila kusenzeka ngokushesha, lapho kuqala ukuqala ukuhlanganisa (ukusabalalisa amaseli awo kwamanye izicubu nezitho zomzimba), kuba nzima ngokwengeziwe ukubhekana nazo ngezindlela ezikhona zokwelapha kanye nokulimala okungaphezulu.

Ukwehlukanisa amaseli we-atypical ngokushesha kwenza ukugxila kwe-tumor

Izimpawu ze-pancreatic oncology zincike hhayi kuphela ohlotsheni nasezakhi zamangqamuzana asele eguqukile futhi akha isimila. Banqunywa futhi ukwenziwa kwasendaweni kwesimila kumanyikwe, izinga lokuthuthuka kwalesi sifo, kanye nezimpawu zomzimba wesiguli. Ngokuvamile, zonke izinto ezakha ngokubonakalayo noma ngokungaqondile inkimbinkimbi yokubonakaliswa kwezifo ezingama-neoplasms zinganqunywa ngokulandelayo:

• uhlobo lwamaseli aba "ukhokho" womdlavuza we-pancreatic (ekhiqiza ama-enzymes wokugaya noma ama-hormone ahambelana nalawo ama-ducts noma ama-cysts akha i-organ capsule);
• indawo ye-anatomical yesitho (umzimba, umsila noma inhloko yama-pancreas);
• isigaba sokuthuthuka kwenqubo ebabayo noma engaqondile (ezigabeni zokuqala, izimpawu zomtholampilo zincane);
• iminyaka yesiguli (umuntu omdala, ukwehla okulimaza kakhulu kwezicubu ze-pancreatic, izehlakalo eziphakeme kakhulu - ubudala obudala kuneminyaka engama-70);
• isimo sasemuva somzimba (i-pancreatitis esekhona noma i-cysts esevele ikhona, isifo sikashukela, ukukhuluphala, izifo zesisu namathumbu, imikhuba emibi, umsoco nge-predominance yokudla okuthosiwe nokunamafutha).

Ngaphezu kwalokho, umdlavuza we-pancreatic uhlukaniswa ngekhono lawo lokukhula ngokushesha futhi i-metastasize hhayi kuphela komakhelwane kepha nasezitho zangaphakathi ezihlukanisiwe.

Izimpawu ze-pancreatic oncology ziba sezwakaliswa kakhulu ezikhungweni zezimila esezivele zakhiwa futhi zisebenza ngentshiseko, kodwa ezimweni eziningi zokwelashwa, ubukhulu kanye nengozi ye-pathology ayihambelani nobukhulu bezimpawu. Okusho ukuthi, lapho kunezinhlobo ezimbili noma ezintathu zomdlavuza, izimpawu zingashesha futhi zizifihle njengesithombe sezinye izifo, ezingenangozi kangako. Kuphela ngomdlavuza we-pancreatic we-4th degree, izimpawu zawo zivame ukuba zimpawu.

Lapho uhlola indlala ngaphansi kwesibonakhulu, kutholakala amaseli e-tumor ahlanganiswe esilondeni futhi anezici ezifanayo.

Isifunda se-anatomical sesitho, lapho kwaqala khona ukwakhiwa kwesimila, sinomthelela omkhulu ekubonakalisweni kwe-pathology. Ngakho-ke, ngomdlavuza wekhanda noma umsila wamanyikwe, izikhalazo zesiguli nezimpawu ezithile zingahluka. Isimo somtholampilo sibuye sincike ekutheni yimaphi amangqamuzana esibeletho asungule uguquko futhi aqala ukwenza i-neoplasm: i-epithelial noma ikhiqiza ama-enzyme namahomoni. Kepha kunezimpawu ezivela kungakhathalekile ukuthi hlobo luni lweseli noma indawo yesimila. Ukuba khona kwabo, nokunaka isiguli kuye nokuhambela kwakhe uchwepheshe ngesikhathi esifanele, kuyasiza ekuhlolweni kwesifo kwangaphambili.

Izimpawu ezijwayelekile kuzo zonke izinhlobo zomdlavuza we-gland

Ukuthuthukiswa kwamathumbu amlimazayo we-pancreatic kudlula ngezigaba ezi-5, kuqala kusuka ku-0 (zero) degree bese kuphetha ngelesine. Ngaphezu kwalokho, ama-1 no-2 degrees asenezinto ezimbili esikhundleni (A no-B). Isigaba ngasinye sokuthuthuka sinezimpawu ezingakhombisa ubukhona bomdlavuza.

Ngezinga le-0, isimo sesiguli asiphazamiseki, ngoba amangqamuzana amabi asanda kuqala ukwakha futhi kusele ambalwa kuwo. Zihlala ngaphakathi emzimbeni futhi zingangeni emithanjeni yegazi nemithambo yegazi. Isiguli asenzi izikhalazo.

Ukwanda kwenani lamaseli we-atypical kuholela ekwakhekeni kokugxila kwe-tumor kuze kufike ku-2 cm ubukhulu, okujwayelekile ebangeni 1. Izimpawu zemitholampilo zivame futhi ukungabikho, kepha, ngokuthola umdlavuza womkhawulo emngceleni wamanyikwe kanye ne-duodenum noma endaweni yomsila wesitho, isiguli singaphawula ukuba khona kwenhliziyo, ukuhlukunyezwa kobuhlungu esiswini kanye ne-hypochondrium yesobunxele.

Ngomdlavuza we-2nd degree, ukukhula okuqhubekayo kwe-tumor kuyaqhubeka futhi i-metastasis yayo kwizitho zomakhelwane iqala. I-neoplasm ingena kwezicubu zesisu, amathumbu, ama-bile ducts. Ama-tumor cell angena emithanjeni yegazi nemithambo ye-lymph. Kulesi sigaba, izimpawu zesifo kanye nezikhalazo zeziguli nazo azicaciswanga futhi zingakhombisa ama-pathologies amaningi esibindi, amabele enyongo, amathumbu, isisu. Ngakho-ke, iziguli zikhononda ngobuhlungu besisu, ukugabha kanye nenausea, ushintsho lwesitulo nombala wesikhumba, ukuphazamiseka kwengqondo, ukwehla kancane kwesisindo.

Izinga lesithathu lomdlavuza we-pancreatic libonakaliswa ukwanda okukhulu kwezinhlayiya ze-tumor emzimbeni wonke kanye nokwakheka kwama-metastases ashiwo, kepha kuze kube manje kwasendaweni ezakhiweni eziseduze (amathumbu, isisu). Isigaba sokugcina se-pathology, esesine, sivezwa isithombe esithambile somtholampilo, esibonisa ukubhujiswa okukhulu kwamanyikwe yi-tumor eyinhloko kanye nezitho eziningi zangaphakathi ngenxa yokwakheka kwe-metastatic foci.

Lezi zimpawu zimi ngokulandelayo:

• i-cachexia yomdlavuza (ukukhathala okukhulu kwesiguli);
• ukuntuleka kokudla;
• ubuhlungu besisu obukhulu, obuvame ukuzungeza;
• ukukhuphuka kosayizi besisu ngenxa yesibindi nobubanzi nokwakhiwa kokuvuvukala;
• blanching noma kuphuzi kwesikhumba nolwelwesi lwama-mucous;
• ushintsho esimweni nombala wezindunduma, kumnyama umchamo (onama-metastases esibindini);
• ukuphazamiseka kwemizwa nokomqondo okunama-metastases entanjeni yomgogodla nobuchopho.

Ukudangala komuntu ngokuzumayo kuwuphawu lomdlavuza osheshayo

Njengoba kungabonakala kulolu hlu lwezimpawu, izimpawu eziningi ze-pancreatic oncology azijwayelekile kule pathology, okungukuthi, ziqinisekise ngokuphelele ukuba khona kwayo. Zingakhombisa ezinye izifo, hhayi kuphela indlala uqobo. Ngakho-ke, kubaluleke kakhulu ukunaka ukubukeka kwezinye, izimpawu ezithile, ezicacisiwe, ezinqunywa ukutholwa kokugxilwa kwe-tumor noma imvelaphi yayo (uhlobo lwamaseli).

Izimpawu zomdlavuza, ezinqunywa yindawo okuyo

Uhlobo oluvame kakhulu lwe-pancreatic malignant pathology umdlavuza wekhanda lesitho. Ukuvezwa kwayo kuncike esigabeni senqubo ye-pathological, kepha ezinye izici zingaqokonyiswa okufanele zidonse ukunaka kwesiguli nodokotela:

Ngabe ama-pancreas asusiwe

• Ubuhlungu obunezimpawu zokubhinca, obubonakaliswa ukukhuphuka ngamandla ebusuku, ngandlela-thile butholakala esikhundleni sombuso ngemilenze eyelulelwe esiswini;
• ngezikhathi ezithile athuthukise i-phlebitis (ukuvuvukala kwemithambo) yemikhawulo ephezulu noma ephansi;
• ukwehla kwesisindo okuqhubekayo, ngaphandle kokudla kanye nezinye izindlela zokunciphisa umzimba;
• ukwakheka kwesifo sokudakwa (isifiso esibi sokudla, ukozela, ubuthakathaka);
• isicanucanu nokuhlanza
• Izimpawu ezinqunywa ngumdlavuza womdlavuza wekhanda lesibindi kanye nesinye sezinyongo (ukukhanya nokubengezelayo (okunamafutha), umchamo omnyama, uphuzi wesikhumba nesikhumba, ukulunywa kwesikhumba okungapheli).

Uma isimila esiyinhloko sesakhe emsileni noma emzimbeni wamanyikwe, khona-ke sinomthelela omkhulu kunqubo yokukhiqiza ukuthungwa kokugaya nokuqedwa kwaso. Ngaphezu kwalokho, ukukhuphuka komsila wesitho ngenxa yesimila kungathinta izinso kanye nama-ureters. Ngakho-ke, kufanele kuqashelwe izimpawu zesici esibonakalayo kule ndawo ye-pathology:

• ukuthuthukiswa kokuphazamiseka kwengqondo e-dysuric (umchamo owengeziwe, ukwanda kokuchama);
• Izimpawu ezijwayelekile ukuqala kwesifo sikashukela (ukoma, umlomo owomile, ukukhuphuka kwezikhathi zobusuku);
• ukunciphisa umzimba ngokushesha;
• izihlalo okuxekethile ezinokuqukethwe okunamafutha amaningi (ngenxa yokuthi kukhishwa kabi ethoyilethi lapho lintanta);
• ukuphazamiseka kwe-hormonal (ukuguquguquka komjikelezo wokuya esikhathini, ukunciphisa i-libido);
• Izinguquko ku-dermographism, ithoni ye-vascular, i-microcirculation kanye ne-izicubu trophism (amabala abomvu okwesikhashana esikhunjeni, ukufiphala, imizwa yokuflash, izilonda zesikhumba).

Umdlavuza wekhanda we-pancreatic uyindlela ejwayelekile kunazo zonke yamathumba esitho.

Okubaluleke kakhulu ekwakhekeni kwesithombe somtholampilo uhlobo lwamaseli abhekana nokuguqulwa kwezakhi futhi aqala ukwakha isimila. Uma lawa ngamangqamuzana akhiqiza i-insulin, i-insulinoma ephumelelayo inomthelela wokusebenzisa umzimba weglucose emzimbeni. I-Glucagon, ekhiqiza i-glucagon ngokweqile, futhi "yenza". I-Gastrinoma, equkethe amaseli akhiqiza i-gastrin ye-hormone, iqala ukuphazamisa ukulawulwa kwemisebenzi yesisu. Ngakho-ke, phakathi kwenani eliphelele lezimpawu zomdlavuza we-pancreatic, ezinye izici ezihambisana nalokhu ama-neoplasms zingabonakala.

Ngakho-ke, nge-insulinoma ephazamisa ukwelashwa kwe-carbohydrate metabolism, isikhumba siyoma bese sikhubazekile, “amafamu” (imifantu esemakhondeni omlomo) ifomu likhula, i-eczema noma i-dermatitis liyakhula, futhi nolimi luba bushelelezi futhi lube ngesipele. IGastrinoma ihlinzeka ngokubonakala kwezimpawu ezinjengobuhlungu ngemuva kokudla esiswini, ushintsho kumvamisa kanye nohlobo lwesitulo, isicanucanu, nokuhlanza.

Lapho likhuphuka izinga lokukhula nokuthuthuka kwe-neoplasm, amangqamuzana atypical ahlala kwezinye izitho, okwenza kube nokuqalwa okusha kwe-tumor, isithombe esithe xaxa kanye nesimilo. Ubunzima balezi zibonakaliso buyisisekelo sokuxilongwa kwe-neoplasms, kepha izindlela ezengeziwe zokuhlolwa ezinganikeza impendulo yokugcina mayelana nefomu le-pathology.

Izici zokuxilongwa nokwelashwa

Inani elibaluleke kakhulu lokuxilonga yincazelo ye- "markers" ye-neoplasms ebulalayo. Ungafunda okuningi ngalokhu kusuka kule ndatshana. Ngaphezu kwale ndlela, isiguli sithatha igazi ukutadisha inani le-glucose, ama-enzyme nama-hormone. Ukuhlaziywa okujwayelekile kwendabuko kwegazi nomchamo, ukuzimisela kokuhlangana kanye nemingcele yokusebenza kwesibindi kuyenziwa. Ngaphezu kwalokho, ngokwezinkomba, izindlela ezinamandla zenziwa kulokhu okulandelayo: i-ultrasound, i-CT, i-MRI, i-endoscopy ene-Mediep ephakathi nendawo, i-laparoscopy, i-biopsy ngokuhlolwa kwesibonakhulu.

I-Pancreatic MRI inikeza ulwazi olubucayi lokuxilongwa

Ukukhethwa kokwelashwa kweziguli kunqunywa yizici eziningi. Lolu uhlobo lwesimila, ukwenziwa kwaso indawo, isigaba sentuthuko, ubudala besiguli, ukuba khona kwe-pathologies yangemuva. Zingaki iziguli ezihlala ngemuva kokutholwa kwe-neoplasm kuncike kuzo.

Imvamisa, kukhethwa indlela ehlangene, kufaka phakathi:

• ukungenelela kokuhlinzwa ngezinhloso zokwelapha (ukususwa kwesimila ngengxenye yesitho, isisu, ingxenye yamathumbu noma ukususwa ngokuphelele kwama-pancreas);
• ukuhlinzwa kwe-palliative, lapho isimila singasebenzi, kepha kungenzeka ukuthi sandise impilo yesiguli (ngokwesibonelo, ama-metastases asuswa ukubuyisa ubunikazi bamathumbu noma izindunduma ze-bile);
• i-chemotherapy, noma ukuqokwa kwemithi egxile ku-cytostatic (kuvimbela ukukhula kwama-cell cell hhayi kuphela, kepha namanye izicubu); lokhu kufaka nokwelashwa okuqondisiwe ngokuqokwa kwezidakamizwa ezisebenza kuphela esiswini;
• ukwelashwa ngemisebe (ukuchayeka emisebeni ye-gamma);
• ukudla okhethekile okwenzelwe ukunciphisa imiphumela yokwelashwa ngamakhemikhali nokwelashwa ngemisebe.

Ngeshwa, ama-pathologies we-oncological we-pancreas anesifo esingesihle esikhathini esiningi samacala. Ingxenye yesihlanu kuphela yeziguli ekwazi ukuphila eminye iminyaka eminingana ngesikhathi sokwelashwa, noma isitholile lesi sifo. Ezinye iziguli, ngaphandle kokuhlinzwa, amakhemikhali nokwelashwa ngemisebe, zinikezwa izinyanga eziyisithupha kuphela. Ngakho-ke, kubaluleke kakhulu ukwazi izimpawu eziphambili ze-oncology futhi uphendukele kochwepheshe ngesikhathi.