Xa umhlaza uphathisa amathambo, le nto ibangelwa ngumhlaza ongenawo umfuyo oye waqala kwenye indawo emzimbeni aze asasaze, okanye athathwe ngamathambo. Ngokwahlukileyo, kugxininiswe apha kulawo maqhekeza aqalayo emathanjeni, awaziwa ngokuba ngamagciwane e-bone primary.
Umdlavuza wethambo lomsondeza ngokwenene uluhlu olubanzi, olubandakanya iintlobo ezininzi ezahlukeneyo zeentlondi, ezinye zazo ezingabonakaliyo; Noko ke, ezi zinto, i-osteosarcoma, i-chondrosarcoma, ne-Ewing sarcoma ziphakathi kwezona ziqhelekileyo.
Izizathu eziyaziwayo
Nangona iimbangela zesifo somhlaza wesifuba awaziwa ngokuchanekileyo, utshintsho kwi-DNA yeeseli zomhlaza lwaziwa lubalulekile. Kwiimeko ezininzi, olu tshintsho lwenzeka ngengozi kwaye alugqithwanga kubazali kubantwana.
Iingcali zenzululwazi ziye zafunda iipatheni zophuhliso ukuze zizame ukuqonda ingozi ebandakanyekayo. I-Osteosarcoma yintlobo yesithathu exhaphakileyo yesifo esichaphazelekayo esithinta amathambo kubantu abaselula, esandulele kuphela yi-leukemia kunye ne-lymphoma. I-Chondrosarcoma nayo isifo somhlaza wesifuba esiqhelekileyo, kodwa siqhelekileyo kubantu abadala kunokuba kubantwana nakwishumi elivisayo, abaneminyaka yobudala abanokuxilongwa ngeminyaka eyi-51. I-sarcoma i-Ewcarcoma idla ngoxhaswa kwintsholongwane, kwaye i-average age of diagnostic iminyaka eyi-15.
Iiprofayili zeengozi ze-Osteosarcoma
I-Osteosarcoma iyona mdlavuza wesifuba oqhelekileyo oqhelekileyo. Kukho imiqathango embalwa eyaziwayo ukwenzela ukwandisa iingxaki zokuphuhlisa. Abantu abanesifo esinqabileyo saso iso elibizwa ngokuba yi- retinoblastoma yelifa banomngcipheko ophezulu wokuphuhlisa i-osteosarcoma.
Ukongezelela, abo baye baphathwa ngonomdlavuza usebenzisa i-radiotherapy kunye ne-chemotherapy banomngcipheko wokwanda kwe-osteosarcoma kamva ebomini.
Ngokweqile, oogqirha abaninzi bavuma ukuba amathambo aphukileyo kunye nokulimala kwezemidlalo ayenzi i-osteosarcoma. Nangona kunjalo, ukulimala okunjalo kunokuzisa i-osteosarcoma esele sele ikhoyo okanye enye i-tumor ye-bone to therapy, ngoko kuyacaca ukuba unxibelelwano phakathi kwezi zibini-kukuba nje ukuba ukulimala kombane akubonakali kubangela i-osteosarcoma.
Ubudala, Ubundlobongela, kunye nezinto ezijongene nobungozi
I-Osteosarcoma ichaphazela ngokuthe ngqo amaqela amabini aphakamileyo-i-peak yokuqala ineminyaka yeshumi elivisayo kwaye owesibini uphakathi kwabantu abadala.
- Kwizigulane ezindala, i-osteosarcoma ivela kwi-bone engavamile, njengaleyo echaphazelekayo isifo sesifuba esasisigxina (umzekelo, isifo sikaPaget ).
- Phakathi kwabantu abancinci, i-osteosarcoma inqabile kakhulu ngaphambi kokuba ibe neminyaka emihlanu, kwaye iziganeko eziphakamileyo zenzeke ngexesha lokukhula kwentsha. Ngokomyinge, ummeli "ubudala obuqhelekileyo" we-osteosarcoma kwinani elincinane liyiminyaka eyi-16 kumantombazana kunye neminyaka eyi-18 ubudala kubafana.
I-Osteosarcoma ayifumaneki iqhathaniswa nezinye i-cancer. Kulinganiselwa ukuba kuphela abantu abangama-400 abangaphantsi kweminyaka engama-20 ubudala abanokuthi bafumane i-osteosarcoma minyaka yonke e-United States. Abafana bachaphazeleka rhoqo kwiinkalo ezininzi, kwaye iziganeko zolutsha lwaseAfrika ziphakamileyo kakhulu kunabamhlophe.
Izinto ezinobungozi ezifunekayo kubantu abancinci
- Ubukho bemithi ethile engavumelekanga yomhlaza we-genetic
- Ubudala phakathi kweminyaka eyi-10 no-30
- Ubude obude
- Ngokwesini
- Uhlanga lwase-Afrika kunye noomerika
- Ubukho bezinye izifo zethambo
Izinto ezinobungozi ezifunekayo kubantu abadala
Izifo ezithile zethambo ezifana nesifo sikaPaget , ngokukodwa emva kwexesha, zidibene nomngcipheko ophezulu we-osteosarcoma.
Sekunjalo, umngcipheko omkhulu uphantsi, kunye neepesenti enye zalabo abanePaget isifo esakha i-osteosarcoma.
Ukuchazwa kweerhasi kuyimpawu ebungozi, kwaye ngenxa yokuba ikhefu phakathi kwe-irradiation yomhlaza kunye nokubonakala kwe-osteosarcoma ngokuqhelekileyo (ngokukodwa, iminyaka eyi-10 okanye ngaphezulu), oku kudla ngokubhekiselele kumaqela asebekhulile.
Izidalwa zeGenesis
Ukuqulunqa ama-genetic syndromes kwi-osteosarcoma kubandakanya:
- Isifo seBloom
- I-anemia yaseDamond-Blackfan
- Li-Fraumeni syndrome
- Isifo sePaget
- Retinoblastoma
- I-Rothmund-Thomson syndrome (ebizwa ngokuba yi-poikiloderma congenitale)
- Werner syndrome
- Ukulahlekelwa komsebenzi we-p53 kunye ne-retinoblastoma i-tumor suppressor geni kukholelwa ukuba inendima ebalulekileyo ekuphuhlisweni kwe-osteosarcoma.
Nangona i-germline (iqanda ne-sperm) iinguqu ze-p53 kunye ne-retinoblastoma izakhi zezinto ezingaqhelekanga, ezi zityalo ziguqulwa kwisininzi seesampuli ze-osteosarcoma, ngoko kukho ukudibanisa nophuhliso lwe-osteosarcoma. Ukuguqulwa kwesigxina kwi-gene ye-p53 kunokukhokelela kumngcipheko ophezulu wokuphuhlisa izigulane kuquka i-osteosarcoma echazwe njenge- Li-Fraumeni syndrome .
Nangona ukuguqulwa kwimizimba yesifo somzimba kunye ne-oncogenes kuyimfuneko ukuvelisa i-osteosarcomas, akucaci ukuba zeziphi iziganeko ziqala kuqala kwaye kutheni okanye kwenzeka njani.
I-Osteosarcomas kulabo abanezifo zePaget
Kukho i-subset eqhelekileyo ye-osteosarcomas enesifo esibi kakhulu. Iimvumi zivame ukuvela kubantu abangaphezu kweminyaka engama-60. Izidumbu zikhulu ngelixesha lokubonakala kwazo kwaye zivame ukuba zibhubhise kakhulu, zenze kube nzima ukufumana uphuculo olupheleleyo (ukususwa) kunye nemitha ye-lungastas zihlala zikhona ekuqaleni.
Iprofayili yengozi yileliqela elidala. Bakhula malunga neepesenti enye zabantu abanePaget isifo, ngokuqhelekileyo xa amathambo amaninzi achaphazelekayo. Iimvumi zivame ukuvela kwi-hipbone, isangqa elisondele kwintshontsho, kunye nasesigxeni sesangqa eduze kwegxala; Kunzima ukunyanga i-optic, ikakhulu ngenxa yengxaki yesigulane kunye nobungakanani besisu.
Ngamanye amaxesha ukuxothwa kuyimfuneko, ngakumbi xa ithambo liphuka ngenxa yomhlaza, oko kwenzeka rhoqo.
I-Parosteal ne-Periosteal Osteosarcomas
Le ngqamaniso ebizwa ngokuba yindawo yayo ngaphakathi kwethambo; Ngokuqhelekileyo i-osteosarcomas ezinokuzondla eziphakamileyo phezu kwethambo ngokubambisana nobuncwane beethambo ezijikeleze ithambo, okanye i-periosteum. Akunakwenzeka ukungena kwiingxenye zangaphakathi zethambo kwaye ngokungaqhelekanga ziba yi-osteosarcomas ezinobungozi.
Iprofayili yengozi ye-osteosarcoma ye-parosteal ihluke kwi-osteosarcoma ye-classic: ixhaphake kakhulu kubafazi kunabesilisa, ixhaphake kakhulu kwiqela elidala elineminyaka engama-20 ukuya kwe-40 ubudala, kwaye ivela ngokubanzi emlenzeni wesangqa, kufuphi nexolo , nangona nasiphi na ithambo emasakeni lingathinteka.
I-Osteosarcoma Progress
Imiba yengozi idibaniswe nokubhekiselele kokubhetele kunye nokugqithiseleyo, kodwa ngelishwa, le miba efanayo ayizange ibe luncedo ekuboniseni izigulane ezinokuzuza kwiirhulmeni ezinzulu okanye ezingaphantsi kweempawu zonyango ngelixa zigcina iziphumo ezigqwesileyo. Izinto eziziwa ngokuba neziphumo ziquka ezi zilandelayo.
Site Primary Tumor
Iimvumba ezenza kwiingalo nasemilenzeni, ezo ezikude kunye nomzimba womzimba, okanye i-torso, zineziphumo ezingcono.
Iimvumi eziphambili ezifake kwi-crake kunye nomnxeba zidibene nomngcipheko omkhulu wokuqhubela phambili nokufa, ngenxa yokuba kunzima ukuphumeza ukukhutshwa okupheleleyo komhlaza kule ndawo. Intloko kunye nentamo ye-osteosarcomas kwindawo yomhlathi kunye nomlomo unesiphelo esingcono kunezinye iindawo eziphambili entloko nasentanyeni, mhlawumbi ngenxa yokuba ziye zaqwalaselwa kwangaphambili.
I-Hipbone osteosarcomas yenza ama-7 ukuya kwiphesenti anesithoba kuwo onke ama-osteosarcomas; Izinga lokusindisa izigulane ziyi-20 ukuya kuma-47 ekhulwini.
Izigulane nge-osteosarcoma e-multitifocal (ezichazwe njengezilonda zamathambo amaninzi ngaphandle kwesisu esiqhekezayo esicacileyo) zihlasele kakhulu.
Iindawo ezixhomekeke kummandla weMetastatic Disease
Izigulane ezinezifo ezisekuhlaleni (akukho ndawo isasazeka kwiindawo ezikude) zinokugqithiswa kangcono kunokuba zizigulane zizifo zesifo se-metastatic. Amanqaku angama-20 ezigulane azakufumana iimpawu ezibonakalayo kwizicatshulwa zokuxilongwa, kunye nomphunga kuba yindawo eqhelekileyo. Ukugxekwa kwezigulane ezinezifo ze-metastatic kubonakala kugqitywa ngokubanzi ngamasayithi e-metastases, inani leemastastas, kunye nokukhankanywa kwezifo zesifo se-metastatic.
Kulabo abanesifo se-metastatic, i-prognosis ibonakala ibhetele ngeendlela ezincinci zeemiphunga kunye nokuba isifo sisasaze kwenye imiphunga kuphela, kunokuba zombini imiphunga.
I-Tumor Necrosis Emva kweKhemotherapy
I-tumor necrosis apha ibhekisela kwizicubu zomhlaza eziye "zafa" ngenxa yonyango.
Emva kwekhemotherapy kunye nokuhlinzwa, i-pathologist ihlola i-tumor necrosis kwisisu esisusweyo. Izigulane ezine-90% ze-necrosis kwi-tumor yokuqala emva kwe-chemotherapy zineziphumo ezingcono kunezigulane ezine-necrosis encinci.
Nangona kunjalo, abaphandi baqaphele ukuba i-necrosis encinane ayifanelekanga ukuba ithetha ukuba i-chemotherapy ayizange iphumelele; ukunyanga amazinga kwizigulane ezincinane okanye ezingekho necrosis emva kokufakelwa kwe-chemotherapy ephezulu kakhulu kunezinga lokunyanga kwizigulane ezingenayo i-chemotherapy.
Iprofayili yengozi yeCondrosarcoma
Esi sisifo esibuhlungu seeseti ezivelisa i-cartilage, kwaye limele malunga neepesenti ezingama-20 zazo zonke izicubu zeethambo eziphambili . I-Chondrosarcoma ingavela ngokwayo okanye okwesibili, kwinto eyaziwa ngokuthi "ukuchithwa kakubi" kwezicubu ezinobungozi (njenge-osteochondroma okanye i-enchondroma enobungozi). Imiba yengozi iquka:
- Ubudala: Ngokuqhelekileyo kwenzeka kubantu abangaphezu kweminyaka engama-40 ubudala; nangona kunjalo, kwenzeka kwakhona kwiqela elincinane, kwaye xa lenza, ludla ukuba lunobungozi obuphezulu obukwazi ukuhlaziywa.
- Ubulili: Kubakho ngokuphindaphindiweyo ngokuphindaphindiweyo kwezibini zesini.
- Indawo: Inokwenzeka nakwephi na ithambo, kodwa kukho ukuthambekela kokuphuhliswa kwi-hipbone kunye ne-thighbone. I-Chondrosarcoma ingavela kwamanye amathambo aphantsi, njenge-scapula, izibambo kunye ne-gawulu.
- I-Genetics: Izifo ezininzi ze-exostoses syndrome (ngamanye amaxesha zibizwa ngokuba zizifo ezininzi ze-osteochondromas syndrome) yimeko ezuze ilifa elibangela izibonda ezininzi emathanjeni omntu, okwenziwe yi-cartilage. I-Exostoses ingaba buhlungu kwaye iholele ekuphumeni kwethambo kunye / okanye i-fractures. Isifo sisifo somzimba (esibangelwa ukuguqulwa kweyiphi na i-3 yeezityalo ze-EXT1, EXT2, okanye i-EXT3), kwaye izigulane ezile meko zinomngcipheko ophezulu we-chondrosarcoma.
- Ezinye izibilini ze-Benign: I- enchondroma yintsholongwane enesifo se-cartilage ekhula esithambo. Abantu abafumana ezininzi zezi mbola baneemeko ezibizwa nge-enchondromatosis ezininzi. Kwakhona banomngcipheko okhulayo wokuphuhlisa i-chondrosarcoma.
I-Ewing Sarcoma Risk Profile
Oku ixhaphake kakhulu kubantu abamhlophe (mhlawumbi abangabantu beSpeyinti okanye amaSpeyin) kwaye abaqhelekanga phakathi kwabase-Asia baseMerika kunye nabangqabileyo kakhulu phakathi kwabase-Afrika baseMerika. Ukukhupha izibilini kunokwenzeka nanini nayiphi na ubudala, kodwa baqhelekileyo kubantwana kwaye abaqhelekanga kubantu abadala kunye nabantwana abancinci. Azinqabile kubantu abadala.
Phantse zonke iifom ze-tumor zineenguqu ezibandakanya i-gene ye-EWS, efumaneka kwi-chromosome 22. Ukusetyenziswa kwe-gene e-EWS kubangela ukugqithisa kweeseli kunye nokuphuhliswa kwalo mhlaza, kodwa indlela echanekileyo eyenzekayo kucace.
> Imithombo:
> I-American Cancer Society. Uvavanyo lwe-Osteosarcoma. https://www.cancer.org/cancer/osteosarcoma/detection-diagnosis-staging/how-diagnosed.html.
> INational Caner Institute. I-Osteosarcoma ne-Malignant Fibrous Histiocytoma ye-Bone Treatment (PDQ®) -I-Professional Professional Version. https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq.