Pancreatic oncology

Kupanga kwa thupi la maselo okhala ndi DNA yosinthika kumatheka mu minofu iliyonse ndi chiwalo chilichonse. Izi zimachitika pafupipafupi, koma chitetezo cha mthupi chimapha maselowo nthawi. Komabe, pakuchepa kwambiri kwa chitetezo chokwanira, komanso motsogozedwa ndi zinthu zina zoyipa, ena a iwo amatha kulimbikira ndikuyamba kugawana nawo mwachangu kwambiri. Izi zimapangitsa kuti pakhale ma neoplasms omwe amasiyana pakapangidwe kazinthu zina ndi ziwalo, komwe adayamba kukula.

Nthambi ya zamankhwala yomwe imasanthula mawonekedwe a neoplasms, mitundu yawo ndi magawo a maphunzirowa, komanso njira zokuthana nawo, amatchedwa oncology. Ndiwowonjezera kwambiri, chifukwa imaganizira zonse zokhudzana ndi ma neoplasms oyipa komanso opweteka m'thupi lonse. Dera losiyana la sayansi iyi, lotchedwa pancreatic oncology (kapamba), limasanthula zomwe zimayambitsa mapangidwe a zotupa mu chiwalochi, mawonekedwe awowonekera, njira zodziwira matenda oyamba ndi chithandizo. Kumbali ina, mawu akuti "pancreatic oncology" amatanthauzanso gulu la ma pathologies omwe amapezeka ndi kukula kwa neoplasms, ndipo nthawi zambiri - khansa ya pancreatic.

Zinthu Zizindikiro

Ma pancreatic malignancies pafupipafupi ali pamalo a 4 pakati pa mitundu ina yonse ya khansa ya ziwalo zamkati ndipo amadziwika ndi kufa kwakukulu kwa odwala. Pamene chotupa chikupangika msanga, nthawi yomweyo chimayamba kugundana (ndikufalitsa maselo ake ndi ziwalo zina), ndizovuta zake kupirira ndi njira zomwe zilipo ndikuthandizira kwambiri matendawo.

Kugawaniza mwachangu maselo a atypical kumayambitsa chotupa

Zizindikiro za pancreatic oncology zimangotengera mtundu ndi katundu wa maselo omwe adasintha ndikupanga chotupa. Amatsimikizidwanso ndi kufalikira kwa chotupa mu kapamba, kuchuluka kwa matendawa, komanso mawonekedwe a thupi la wodwalayo. Pazonse, zinthu zonse zomwe zimapanga molunjika kapena m'njira zina zovuta za neoplasms zitha kutsimikiziridwa motere:

• mtundu wa maselo omwe adakhala "kholo" la khansa ya pancreatic (kupanga ma enzymes kapena michere yomwe imayendetsa ma ducts kapena ma cysts omwe amapanga kaphatikizidwe kazinthupi;
• gawo lamatumbo a chiwalo (thupi, mchira kapena mutu wa kapamba);
• gawo lachitukuko cha vuto loyipa kapena loyipa (koyambirira, zizindikiro zamankhwala ndizochepa);
• zaka odwala (munthu wamkuluyo, kupweteka kwambiri kwa minyewa ya pancreatic, kuchuluka kwake - okalamba kuposa zaka 70);
• maziko amakono a thupi (kale pancreatitis kapena organ cysts, matenda a shuga, kunenepa kwambiri, matenda am'mimba ndi matumbo, zizolowezi zoipa, zakudya zopatsa thanzi ndi predominance ya nyama yokazinga ndi mafuta).

Kuphatikiza apo, khansa ya pancreatic imasiyanitsidwa ndi kuthekera kwake ndikukula msanga komanso metastasize osati oyandikana nawo komanso ziwalo zamkati zopatukana.

Zizindikiro za pancreatic oncology zimayamba kutchulidwa pamlingo wa zotupa zomwe zimapangidwa kale, koma nthawi zambiri matenda, kuopsa kwa matenda ake sikugwirizana ndi kukula kwa zizindikirazo. Ndiye kuti pamaso pa magawo awiri kapena atatu a khansa, Zizindikiro zimatha kukhala zodziwoneka ngati chithunzi cha matenda enanso owopsa. Pokhapokha ndi khansa ya pancreatic ya digiri ya 4, zizindikiro zake nthawi zambiri zimakhala zambiri.

Mukamayang'ana chofufumitsa pansi pa makina oonera tinthu tating'onoting'ono, maselo otupa amapezeka omwe amagwirizana mu zotupa ndipo ali ndi zofanana.

Dera lokhazikika la chida, pomwe mapangidwe oyamba a chotupa, amathandizira pakuwonetsa kwa matenda. Chifukwa chake, ndi khansa ya mutu kapena mchira wa kapamba, madandaulo a wodwalayo ndi zizindikiro zina zimatha kukhala zosiyanasiyana. Chithunzi cha chipatalachi chimatanthauzanso kuti ndi ma cell ati a gland omwe adasinthika ndikuyamba kupanga neoplasm: epithelial kapena kupanga michere ndi mahomoni. Koma pali zizindikiro zomwe zimawoneka mosasamala mtundu wa khungu kapena malo a chotupacho. Kupezeka kwawo, ndi chidwi cha wodwalayo komanso kuyendera katswiri pa nthawi yake, zimathandiza pakuwazindikira matendawa.

Zizindikiro zodziwika bwino zamtundu uliwonse wa khansa ya England

Kukula kwa zotupa zoyipa za pancreatic kudutsa masiteji 5, kuyambira 0 (zero) digiri ndikutha ndi wachinayi. Kuphatikiza apo, madigiri 1 ndi 2 akadali ndi malo awiri (A ndi B). Gawo lililonse la kupita patsogolo limakhala ndi zizindikilo zomwe zimatha kuwonetsa kukhalapo kwa khansa.

Pa degree 0, mkhalidwe wodwala sukusokonekera, popeza maselo owopsa ayambanso kupanga ndipo alipo ochepa. Amakhala mkati mwa thupi ndipo samalowa m'magazi ndi m'mitsempha ya m'mimba. Wodwala samadandaula.

Kuwonjezeka kwa maselo a atypical kumabweretsa kuti pakhale chotupa chokwanira mpaka masentimita awiri, chomwe chimafanana ndi giredi 1. Zizindikiro zamankhwala nthawi zambiri zimapezekanso, koma, ndi kufalikira kwa khansa pamalire a kapamba ndi duodenum kapena malo a mchira wa chiwalo, wodwalayo amatha kuzindikira kupezeka kwa nseru, kupweteka kosasimbika pamimba ndikusiya hypochondrium.

Ndi khansa ya digiri yachiwiri, kukula kwa chotupa kukupitilizabe ndipo metastasis yake kufupi ndi ziwalo zoyandikana nayo iyamba. Mitsempha imalowa m'matumbo am'mimba, matumbo, bile ducts. Maselo a tumor amalowa m'magazi ndi m'mimba. Pakadali pano, zizindikiro za matendawo ndi madandaulo a odwala sizili zachindunji ndipo zimatha kuwonetsa zambiri za chiwindi, chikhodzodzo, matumbo, m'mimba. Chifukwa chake, odwala amadandaula za kupweteka kwam'mimba, kusanza ndi mseru, kusintha kwa chopondapo ndi khungu lake, kusokonezeka kwa magazi, kuchepa pang'ono.

Mlingo wachitatu wa khansa ya pancreatic amadziwika ndi kufalikira kwakukulu kwa tinthu tambiri m'thupi lonse komanso kapangidwe ka metastases, koma pakadali pano m'magawo apafupi (matumbo, m'mimba). Gawo lomaliza la pathology, chachinayi, likuwonetsedwa ndi chithunzi chowoneka bwino cha chipatala, chomwe chikuwonetsa kuwonongeka kwakukulu kwa kapamba ndi chotupa chachikulu ndi ziwalo zambiri zamkati chifukwa cha kupangidwe kwa metastatic foci.

Zizindikiro zake ndi izi:

• khansa ya khansa (kutopa kwakukulu kwa wodwala);
• kusowa kwa chakudya;
• kupweteka kwambiri pamimba, nthawi zambiri kozungulira;
• kuchuluka kwa m'mimba chifukwa cha chiwindi ndi ndulu ndi mapangidwe otupa;
• kuchekeka kapena chikasu pakhungu ndi mucous nembanemba;
• kusintha kwa chikhalidwe ndi mtundu wa ndowe, kuda mkodzo (wokhala ndi ma metastases pachiwindi);
• matenda amitsempha ndi amisala okhala ndi metastases mu chingwe cha msana ndi ubongo.

Kuchepa kwadzidzidzi kwa munthu ndi chizindikiro cha khansa yomwe ikukula msanga

Monga momwe tikuwonera pamndandanda uwu wazizindikiro, zizindikiro zambiri za pancreatic oncology sizachilendo kwa matenda awa, ndiye kuti, zimatsimikizira kwathunthu kukhalapo kwake. Amatha kuwonetsa matenda ena, osati chindoko chokha. Chifukwa chake, ndikofunikira kulabadira mawonekedwe ena, owonekera, omwe amatsimikiziridwa ndi kutulutsidwa kwa chotupa ndikuyang'ana kapena komwe adachokera (mtundu wa maselo).

Zizindikiro za khansa, zodziwika ndi malo ake

Njira yofala kwambiri yamatenda owopsa a pancreatic ndi khansa ya mutu wa chiwalo. Mawonekedwe ake amatanthauzanso gawo la njira ya pathological, koma mawonekedwe ena akhoza kuwunikidwa omwe ayenera kukopa chidwi cha wodwala ndi adokotala:

Kodi zikondazo zachotsedwa

• kupweteka ndi miyendo yomangira, yodziwika ndi kuwonjezeka kwamphamvu usiku, imatsika pamalo apamwamba ndi miyendo yolunjikitsa kumimba;
• Nthawi zina khalani phlebitis (kutukusira kwa mitsempha) yam'mphepete kapena m'munsi;
• kuwonda kosalekeza, popanda zakudya ndi njira zina zochepetsera thupi;
• mapangidwe a kuledzera matenda (kusowa kudya, kugona, kufooka);
• kusanza ndi kusanza
• Zizindikiro zotchulidwa ndi mphamvu ya khansa ya mutu wa kapamba pakhungu ndi chikhodzodzo (ndowe zopepuka ndi zonyezimira (mafuta), mkodzo wakuda, chikasu cha sclera ndi khungu, kuyabwa kwamuyaya khungu.

Ngati chotupa choyambirira chapanga mchira kapena thupi la kapamba, ndiye kuti imakhudza kwambiri njira yopangira chakudya cham'mimba komanso kuchotse kwake. Kuphatikiza apo, kuwonjezeka kwa mchira wa chiwalo chifukwa cha chotupa kumatha kukhudza impso ndi ureters. Chifukwa chake, ziyenera kudziwika kuti zikuwonetsa kwambiri malo amtunduwu:

• chitukuko cha matenda osokoneza bongo (kuchuluka kwamkodzo, kukodza pokodza);
• Zizindikiro zofala ndi kuyambika kwa matenda ashuga (ludzu, kamwa yowuma, kuchuluka usiku diuresis);
• kuwonda msanga;
• mapando otayirira okhala ndi mafuta ambiri (chifukwa amachotsedwa kuchimbudzi akakutuluka);
• kusokonezeka kwa mahomoni (kusintha kwa msambo, kusintha kwa libido);
• kusintha kwa dermographism, kamvekedwe ka mtima, ma microcirculation ndi minofu trophism (malo ofupika ofika pakhungu, kukomoka, kumverera kwa "kutentha kwa moto", zilonda zamkhungu).

Khansa yam'mutu ya pancreatic ndi mtundu wotchuka kwambiri wamatumbo.

Chofunikira kwambiri pakupanga chithunzi cha chipatala ndi mtundu wa maselo omwe amapanga masinthidwe ndikuyamba kupanga chotupa. Ngati awa ndi ma cell omwe amapanga insulin, insulinoma yomwe imayamba imakhudza kagayidwe kazakudya m'thupi. Glucagon, yomwe imatulutsa glucagon wachilengedwe kwambiri, "imachitanso". Gastrinoma, yopangidwa ndi maselo omwe amatulutsa timadzi tam'mimba, imayamba kukhumudwitsa kayendedwe ka m'mimba. Chifukwa chake, mwa chiwerengero chokwanira cha khansa ya kapamba, mawonekedwe ena omwe amapezeka mu neoplasms awa amatha kuzindikira.

Chifukwa chake, ndi insulinoma yomwe imasokoneza kagayidwe kazakudya, khungu limakhala louma ndikuwuma, "jams" (ming'alu m'makamwa) mawonekedwe, eczema kapena dermatitis imayamba, ndipo lilime limakhala losalala ndi rasipiberi. Gastrinoma imapereka mawonekedwe monga kupweteka mutatha kudya m'mimba, kusintha kwa pafupipafupi komanso chikhalidwe cha chopondapo, nseru, ndi kusanza.

Mokulira kukula ndi kukula kwa neoplasm, maselo a atypical amakhala kwambiri ziwalo zina, ndikupatsa chotupa chatsopano, chokhwima komanso chamtundu wazachipatala chimakhala. Kuphatikizika kwa zizindikiro izi ndiye maziko azidziwitso a neoplasms, koma njira zowonjezera zokha zowunika zomwe zingapereke yankho lomaliza ponena za mtundu wa matenda.

Zomwe zimapezeka ndi matenda komanso chithandizo

Mtengo wofunikira kwambiri wazidziwitso ndi tanthauzo la "zolembera" za neoplasms zoyipa. Mutha kuphunzira zambiri za nkhaniyi. Kuphatikiza pa njirayi, wodwala amatenga magazi kuti aphunzire kuchuluka kwa shuga, ma enzymes ndi mahomoni. Kupenda kwachikhalidwe kwamwazi ndi mkodzo, kutsimikiza kwa coagulability ndi magwiridwe antchito a chiwindi kumachitika. Kupitilira apo, monga momwe zikuwonetsera, njira zogwiritsira ntchito zimayikidwa pazotsatirazi: ultrasound, CT, MRI, endoscopy yotalikirana ndi sing'anga, laparoscopy, biopsy yofufuzira ma microscopic a minofu.

Pancreatic MRI imapereka chidziwitso chovuta pakuzindikira

Kusankha kwamankhwala kwa odwala kumatsimikiziridwa ndi zifukwa zambiri. Umu ndi mtundu wa chotupa, kutukuka kwake, gawo la chitukuko, msinkhu wa wodwalayo, kupezeka kwa matumizidwe am'mbuyo. Kuchuluka kwa wodwala kumatha kupezeka ndi neoplasm kutengera iwo.

Nthawi zambiri, njira yophatikizidwa imasankhidwa, kuphatikiza:

• opaleshoni kuchitapo kanthu zochizira (kuchotsa chotupa ndi gawo la chiwalo, m'mimba, gawo lamatumbo kapena kuchotsedwa kwathunthu kwa kapamba);
• opaleshoni yopanga, pamene chotupa sichikuyenda, koma amatha kutalikitsa moyo wa wodwalayo (mwachitsanzo, metastases amachotsedwa kuti abwezeretse matumbo kapena matumbo a bile;
• chemotherapy, kapena kuikidwa kwa mankhwala omwe ali ndi cytostatic focus (akuletsa kukula kwa maselo a khansa okha, komanso minyewa ina); Izi zimaphatikizaponso chithandizo chomwe chikuyang'aniridwa ndikusankhidwa kwa mankhwala omwe amangogwira chotupa;
• mankhwala a radiation (kukhudzana ndi cheza cha gamma);
• zakudya zapadera zomwe zimapangidwira kuti muchepetse zotsatira za mankhwala ndi mankhwala a radiation.

Tsoka ilo, ma oncological pathologies a kapamba ali ndi vuto labwino muzochitika zambiri. Ndi gawo limodzi mwa magawo asanu okha a odwala omwe amatha kukhala ndi moyo zaka zingapo pochiritsira, ngakhale atazindikira matendawa kale. Odwala ena onse, ngakhale atachitidwa opareshoni, mankhwala amagetsi ndi ma radiation, amapatsidwa miyezi 6-12 yokha. Chifukwa chake, ndikofunikira kwambiri kudziwa zizindikiro zazikulu za oncology ndikutembenukira kwa akatswiri nthawi.