Inkcazo kunye nePrognosis ukusuka kwisigaba 0 ukuya kwisigaba IV
I-Melanoma yindlela enomdla kakhulu yomhlaza wesikhumba . I-Melanoma isiteji esisetyenziselwa ukuchonga ubukhulu be-tumoromoramu kunye nalapho idibene khona. I-Melanoma ihlukaniswe ngamagatya ukusuka kwi-0, eyona nqanaba eliphantsi kakhulu, ukuya ku-IV, elona nqanaba eliphezulu. Ukubaluleka kubalulekile kuba kunceda iqela lakho lononophelo lwezempilo lucwangcisa unyango olufanelekileyo.
Igalari yomfanekiso we-melanoma ibonisa ezinye zezigaba kwiifoto. Fumana oku ngakumbi malunga nokuba kuthetha ukuthini isigaba esithile se-melanoma.
I-TNM Isalathiso seMelanoma
Abaqeqeshi bezempilo baye beza ngeendlela ezahlukeneyo zokunyusa iisomhlaza. Eli nqaku isebenzisa iNkqubo ye-TNM ka-2009 ephakanyiswa yi-American Joint Commission kwiCarcer. Yona ndlela isetyenzisiweyo kakhulu kwisistim ehlabathini.
Kwi-TNM inkqubo, iileta T, N, kunye neM M zibhekisela ku:
- T = i-tumor: T ilandelwa nenani elihambelana nobukhulu be-tumor.
- I = node: N ilandelwa yinkalo ehambelana nomlinganiselo wokubandakanyeka kwe-lymph node .
- M = i-metastasis (ukusasazeka ngokukude): M ilandelwa nenani elihambelana nomlinganiselo we-metastasis.
Ugqirha wakho unokunika kwakhona i- Clark kunye ne-Breslow number -measurements of the tumor yokungena kunye nobukhulu, ngokulandelanayo-ukuqhubela phambili i-melanoma yakho kunye nokucacisa ukuhlaselwa kwakho.
Ukongeza, "T" ingalandelwa "a" engabonakali isilonda, okanye "b" ebonisa isilonda.
Ukulinywa, okubonisa izifo ezinzima kwaye kuboniswe phantsi kwe-microscope, kwenzeka xa i-melanoma ihlasela isikhumba esiphezulu.
Ngokuqhelekileyo, umlenze osisigxina kunye nangaphezulu ukuba umhlaza usasazeke, isigaba esiphezulu esabelwe. Ephakamileyo kwinqanaba, ukugqithisa ngakumbi ixesha elide.
Funda kabanzi malunga nazo zonke izigaba ezahlukeneyo ze- melanoma kunye noko zibonisa, ngezantsi.
Isigaba 0
Xa i-melanoma ibanjwa kwinqanaba elingaphambili kwaye lingena ngaphantsi kwesikhumba, iyaziwa ngokuba yi-melanoma in situ. Iyanconywa kakhulu kwaye ibizwa ngokuba yi-stage 0 okanye ayiniki isigaba.
Isigaba I
Amanqanaba okunyanga aphezulu kakhulu ekukhutshweni okukhutshwayo ngenxa yokuba la ma-melanomas ayinokwenzeka ukuba asasazeka.
- Isigaba 1A (T1aN0M0): I-tumor ayizange isasaze kwiindawo. Ingaphantsi kwe-1 mm kwaye ayilwanga. Iminyaka emihlanu yokusinda iipesenti ezingama-95.
- Isigaba IB (i-T1bN0M0 okanye i-T2aN0M0): I-tumor ayizange isasaze kwiindawo. Ingaphantsi kwe-1 mm, kodwa isilonda okanye iphakathi kwe-1.01 no-2 mm kodwa ayilwanga. Ukusinda kweminyaka emihlanu kuma-89 ekhulwini ukuya kuma-91 ekhulwini.
Kubalulekile ukuba uqaphele ukuba i-tumor ingaba ngaphantsi kwe-1 mm kwaye ingabi nesilonda kodwa kungenakucingwa ukuba isigaba se-IA-ukuba sinezinga eliphezulu lika-Clark lokuhlasela. Ngokufanayo, i-tumor ingaba yi-T1b kwaye ingaphantsi kwe-1 mm ngaphandle kwesilonda xa inqanaba eliphezulu likaClak.
Isigaba II
I-Melanomas inokunyangwa, kodwa izinga lokuphumelela lilahla emva kweSigaba I kuba inani elincinci leeseli zomhlaza lingasasazeka kwiindawo ezikude. Ukongeza kwindlela yokuhlinzwa, ezinye iindlela zonyango zinokucetyiswa.
- Isigaba IIA (T2bN0M0 okanye i-T3aN0M0): I-tumor ayizange isasaze kwiindawo. Iphakathi kwe-1.01 no-2 mm kwaye isilonda, okanye i-2.01 ukuya kwi-4 mm ngaphandle kwesilonda. Ukususela kwiminyaka emihlanu i-77 iphesenti ukuya kuma-79 ekhulwini.
- Isigaba IIB (T3bN0M0 okanye T4aN0M0): I-tumor ayizange isasaze kwiindawo. Iphakathi kwe-2.01 no-4 mm kwaye ixiliswe okanye ikhulu kune-4 mm ngaphandle kwesilonda. Ukusinda kweminyaka emihlanu kungama-63% ukuya kuma-67 ekhulwini.
- Isigaba se-IIC (T4bN0M0): I-tumor ayizange isasaze kwiindawo. Inkulu kune-4 mm kwaye isilonda. Ukusinda kweminyaka emihlanu ngama-45 ekhulwini.
Isigaba III
Ekubeni i-tumor isiqalile ukukhawuleza, izinga lokusinda kwezi zigaba liphantsi kunezo zangaphambili.
- Isigaba IIIA (T1a-4a, N1a-N2a, M0): I-tumor ayiyilonda. Liye lasasazeka ukuya kwii-nodes ezintathu, kodwa azinakwandiswa. Ukusabalaliswa kwe-nodal kubonakala kuphela kwi-microscopic examination, kungekhona kwiimviwo zeklinikhi. Ukusinda kweminyaka emihlanu ku-63% ukuya kuma-69 ekhulwini.
- Isigaba IIIB: Le nqanaba elinzima kunye neemeko ezininzi ezinokwenzeka:
- I-T1b-T4b, i-N1a-N2a: I-tumor isilonda. Liye lasasazeka ukuya kwii-nodes ezintathu, kodwa azinakwandiswa. Ukusabalaliswa kwe-nodal kubonakala kuphela kwi-microscopic examination, kungekhona kwiimviwo zeklinikhi.
- T1a-T4a, N1b-N2b: I-tumor ayilwanga. Liye lasasazeka ukuya kwii-nodes ezintathu, kwaye iinamba ziyakwandiswa ngenxa ye-melanoma.
- I-T1a / b-T4a / b, i-N2c: I-tumor ingaba nesilonda okanye ayikho. Isiqhumane sisasazeke kwesikhumba esiseduze ne-melanoma (i-metastasis yesathelayithi) okanye kwii-lymph channels eziseduze ( kwi-metastasis ye-transit ), kodwa i-lymph nodes aziqukethe i-melanoma.
Ukuphela kweminyaka emihlanu yokusinda kweli nqanaba ngamaphesenti angama-30 ukuya kuma-59 ekhulwini.
- Isigaba IIIC:
- I-T1b-T4b, i-N1b okanye i-N2b: I-tumor isilonda. I-melanoma isasazeke ukuya kwii-lymph nodes ezintathu, ezikhuliswa ngenxa yomhlaza.
- Nayiphi na i-T, i-N3: I-tumor ingaba naluphi na ubukhulu kwaye ingaba nesilonda okanye cha. I-melanoma isasaze kwiindawo ezine ezisezantsi okanye ezikufutshane, okanye zikhona izihlunu (matted) kunye ne-melanoma yazo, okanye zikhona i-satellites okanye i-transitases ezithengayo kunye nomhlaza usasazeke kwii- lymph node eziseduze.
Unyaka oneminyaka emihlanu ukususela kuma-24 ukuya kuma-29 ekhulwini.
Isigaba IV
Eli nqanaba le-melanoma linxulumene ne- metastasis ngaphaya kweengingqi ze-lymph node kwiindawo ezikude emzimbeni onjengomphunga, isibindi, okanye ingqondo, okanye kwiindawo ezikude zesikhumba. Ayikho imeko ye-lymph node okanye ubukhulu obucatshangelwayo. Ukususela kwiminyaka emihlanu ukususela kuma-7 ukuya kuma-19 ekhulwini.
Isishwankathelo samaNqanaba
| Isigaba | Iimpawu |
| IA | I-tumor ≤ 1.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; akukho ziphumo ezikude |
| IB | I-tumor ≤ 1.0 mm kunye nesilonda okanye i-Clark level IV okanye V; i-1.01-2.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; akukho ziphumo ezikude |
| IIA | Ukubola 1.01-2.0 mm ngesilonda; isisu 2.01-4.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; akukho ziphumo ezikude |
| IIB | I-Tumor 2.01-4.0 mm nesilonda |
| IIB | Ukuqhuma> 4.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; akukho ziphumo ezikude |
| IIC | I-Tumor> 4.0 mm kunye nesilonda; ukubandakanyeka koxinzelelo; akukho ziphumo ezikude |
| IIIA | Ukuxhamla kwanoma yibuphi ubungqimba ngaphandle kwesilonda ngesinye se-lymph node |
| IIIB | Ukuxhamla kwanoma yibuphi ubungqimba ngaphandle kwesilonda kunye ezimbini ukuya kweyesithathu zinezitho zomoya ezintle |
| IIIC | I-tumor yeyiphi na i-lymph nodes okanye i-lymph nodes okanye i-nodes matted okanye i-transit (s) / i-satellite (s) ezingenazo i- lymph nodes okanye idibanti ye-transit (s) / satellite (s), OKANYE i- melticoma yesifo kunye ne- lymph node (s) ye- metastatic |
| IV | Ukuxhamla kwanoma yibuphi ubungakanani kunye naluphi na amanqaku kunye naziphi na izidumbu ezikude |
ILizwi Ngokusindiswa kweeRhafu ngeSigaba
Unokuvakala ukwesaba ngamazinga okusasazwa apha ngentla, kodwa gcina oku okulandelayo engqondweni. Izibalo zibalo, kungekhona abantu. Baxela ukuba yintoni umphumo wesiganeko, kodwa bathi kancinci malunga nendlela wena, njengomntu ngamnye, uza kuphendula ngayo unyango . Ukongezelela, unyango luya kuphucula. Unyango olutsha luye lwavunywa, kwaye ezinye zivavanywa ngokutsha kwiimvavanyo zeclini. Izibalo zisoloko ziyiminyaka emininzi ubudala, kwaye zingabonakali indlela umntu oya kuphendula ngayo kunyango namhlanje.
IziCwangciso zonyango
Njengoko kuphawuliwe ngaphambili, unyango lwe-melanoma luxhomekeke kakhulu kwizinga elithile. Amanqaku alandelayo achaza iindlela zokonyango ngokusekelwe kwinqanaba:
- Ukwelashwa kweMelanoma yasekuqaleni (Isigaba I kunye neSigaba II)
- Izinyathelo zokwelapha zeMelanoma (Isigaba III kunye neSigaba IV)
> Imithombo:
> Balch, C., Gershenwald, J., Soong, S. et al. Inkcazelo yokugqibela yo-2009 ye-AJCC yokuSetyenzwa kweMelanoma nokuHlulwa. Umbhalo we-Clinical Oncology . 2009. 27 (36): 6199-6206.
> Mahar, A., Compton, C., Halabi, S. et al. I-CriticalAssessment yeeTekisi zeProjekthi zoLungiso kwiMelanoma. I-Annals ye-Oncology yokugada . 2016. 23 (9): 2753-61.