I-Ovarian Cancer iyafunyanwa njani

Kukho iimvavanyo kunye neenkqubo ezingasetyenziselwa ukuxilonga umdlavuza we-ovariya, kubandakanya ukuhlolwa kwe-pelvic; iimvavanyo zokucinga, ezifana ne-ultrasound yangaphandle, i-CT, i-MRI, okanye i-PET scan; kunye nokuhlolwa kwegazi, njenge-CA-125. Ukuze kwenziwe ukuxilongwa, i-biopy idla ngokufunekayo ukuze zombini iqinisekise ukuba ubunzima bubuhlungu (umdlavuza) kwaye zichonga uhlobo kunye ne-subtype yesifo.

Xa ukuxilongwa kwenziwa, ezi ziphumo kunye nemvavanyo eqhubekayo isetyenziselwa ukuchonga isigaba sesifo, esiza kunceda ekufumaneni ikhondo eliphambili lokonyango.

Uhlolo lokuzihlola / Uvavanyo lwekhaya

Ngelishwa, akukho zihlolisiso zomhlaza we-ovari. Ukongezelela, iimvavanyo ze-genetic kwi-home azinakucacisa ngokuqinisekileyo umngcipheko wakho wokuphuhlisa eso sifo. Kubalulekile ukuba bonke abafazi baqhelane neempawu kunye neempawu zabo kwaye bathethe noogqirha babo ukuba baneengxaki zeso sifo.

Uvavanyo lweMzimba

Akukho zikhokelo zokucima i-ovarian umdlavuza. Nangona kunjalo, ukuhlolwa kwesiqhelo se- pelvic eyenziwa ngugqirha wakho (okanye omnye oqhutywe ngenxa yobungqina beempawu) unokubona ubunzima kwindawo yakho ye-ovary, ekubhekiselwe kuyo njenge-adnexal mass. Nangona kunjalo, le ngcaciso iyanciphisa.

Uvavanyo luqhutywe ngokubambisana ngesandla esinye kwisisu sakho kunye nesinye esiswini sakho. Ekubeni ugqirha uvakalelwa nge-ovary phantsi kweethambo ezinamafutha, ukuhlolwa akukona okuchanekileyo ekuboniseni ubunzima kubantu abakhulu kakhulu.

Kwaba besetyhini abancinci, uvavanyo lwe-pelvic lungakwazi ukulahleka kalula izicubu ezincinci ze-ovarian.

Kubalulekile ukuba uqaphele ukuba iPap smear yedwa (ngaphandle kokuhlolwa kwe-bimanual), ngelixa iluncedo ekufumaneni umdlavuza wesibeleko, akunakunceda kakhulu ekufumaneni umdlavuza we-ovari.

Ukucinga

Ukuhlola iimvavanyo kuyadingeka kokubili ukufumana amancinci ama-ovarian amancinci kunye nokuqonda ngokubanzi imimandla enokuthi ivezwe ngokuhlolwa.

Khetha ziquka:

Ultrasound Transvaginal

I-ultrasound ye-pelvic ngumvavanyo osebenzisa amaza omsindo ukudala umfanekiso wezitho zeplasvic. Ngokuqhelekileyo uvavanyo lokuqala luqhutyelwa ukuvavanya ubunzima be-ovari kunye kwaye alubonakalisi abantu kwiimitha. Inqubo inokwenziwa nokuba isisu (iprobethi ifakwe phezulu kwesikhumba sakho) okanye i-transvaginally (iprobeyi ifakwe kwisiswini ukuze ifikelele kwi-ovary). Nangona kunjalo, loo yangaphambili ayifanelekanga njengolu hlobo lokugqibela ekucaciseni izihlwele ze-ovari, ngakumbi ezo zincinci.

I-ultrasound inganika uqikelelo lobungakanani bobunzima, kunye nokugqiba ukuba i-cyst elula, i-cyst eyinkimbinkimbi, okanye iqinile. I-cysts elula ihlala ibheda. I-cyst eyinkimbinkimbi inokuba yingozi, kodwa iphakamisa inkxalabo malunga nokuba ngumhlaza xa iqukethe i-nodules okanye i-excrescences (ukukhula okungavamile). I-ultrasound inokukhangela kwakhona ukukhupha okukhululekileyo kwi-pelvis, into edlalwa ngamathumbu aphezulu.

Isisu kunye / okanye iPlayvic CT Scan

I-scan scan isebenzisa uluhlu lwe-X-ray ukudala umfanekiso wesisu okanye i-pelvis. Ingasetyenziswa ekuncedeni ukuxilongwa, kodwa isetyenziswe rhoqo kumhlaza wesigidi. Luvavanyo olulungileyo ukuvavanya i-lymph nodes, intumbo, isibindi kunye nemiphunga (isitifiketi se-CT scan) naluphina ubungqina bokuba umdlavuza usasazekile (i- metastasized ).

Imiqathango ongayibona kwingxelo yakho ibandakanya i-ascites (ukwakheka kwamanzi kwisisu); ii-metastases (iindawo zokusasazeka); i-carcinomatosis (iindawo ezixhaphakileyo); ikhekhe e-omental (ukunyuka kwe-omentum, isalathisi esinamafutha eselunxwemeni); i-fat stranding (ukuvuvukala kwezicubu ezinamafutha esiswini); kunye nokuchithwa (ukwakhiwa kwamanzi). Kwakhona, i- lymph nodes ingachazwa njengeyandisiwe. I-lymph nodes ephakamileyo idla ngokuphakama kune-2 cm (malunga no-1 intshi) ububanzi kwaye ingaba nemimandla ye-necrosis ephakathi (ukufa kweeseli) ukuba umhlaza ukhona.

MRI

I- MRI (imagination magontic resonance) ingasetyenzwa ngendlela efana ne-CT scan kodwa ayibandakanyi imisebe ye-radiation, eyenza uvavanyo olukhuselekileyo ngexesha lokukhulelwa.

I-MRI ivame ukuba ngcono kune-CT ekuchazeni ukungaqhelekanga kwezicubu kwaye ingasetyenziselwa ukucacisa ukufunyaniswa kwezinye iimvavanyo.

PET scan

Ngethuba i-CT, i-MRI, kunye ne-ultrasound ziyi-test imagination (zijonga ukungaqhelekanga ngokomzimba), ukukhangela kwe-PET kukuvavanya ukusebenza, okuyimilinganiselo yomsebenzi. Olu vavanyo olubucayi lukhangele ubungqina beemastastase (ukusasazeka) naphi na emzimbeni kwaye luncedo ekucaleni phakathi kwesikhumba kunye nomhlaza.

Nge-PET scan, inani elincinci le-sugaractive e-radioactive lijojowe kwigazi. Iskena sisenziwa emva kokuba ushukela linalo ixesha lokungena kwiiseli. Amanye amaseli akhula ngokukhulayo, afana namaseli esifo somhlaza, aya kukhanya kulo mfanekiso, oqhele ukuhlanganiswa ne-CT.

IiLabs kunye novavanyo

Ukongezelela kwizifundo zokucinga kunye nokuhlolwa, kwenziwa umsebenzi wegazi ukukhangela ubungqina bokuba ukungaqhelekanga kufumaneka kwiimvavanyo kunye / okanye ukucinga ngomdlavuza okanye cha. Uvavanyo lunokuquka:

Igazi liSebenze ukuThola iMarcer Detection

Iimvavanyo ezithile zegazi ziyakwazi ukubona iiprotheni ezaziwa njengezimpawu zobumnyama. Ezinye zazo ziveliswa ngamaseli aqhelekileyo kunye nomhlaza wesifo somhlaza, ngoko umdlavuza we-ovariya uboniswe ukuba izixa ezikhoyo egazini ziphezulu kunezinye eziqhelekileyo. Ezinye iimpawu zentlungu ziveliswa ngamaseli e-ovari ayenomdlavuza kwaye ayabonakali kubantu abangenayo umdlavuza we-ovari, ngoko ukuba khona kwabo yedwa kuluphawu lwesifo.

Ukuchonga aba bamatshwayo be-tumor kwiisampuli zegazi akuyona indlela ephumelelayo yokukhusela umdlavuza we-ovari, kodwa kunokunceda ekwenzeni ukuxilongwa nokulandela impendulo yala ma-khansa kunyango.

Ezinye iimvavanyo zeGazi

Ezinye iimvavanyo zegazi ezinokukunceda ekwenzeni ukuxilongwa zibandakanya inani elipheleleyo legazi (CBC), i-LDH, i-alkaline phosphatase, kunye ne-sed sed okanye i-pro-protein test test (ekhangele ukuvuvukala).

Uphando lufumene ukuba ukuhlanganiswa kwesinye sezibheno zegazi ezibomvu , ezibizwa ngokuba yi-red-cell distribution distribution (RDW), kunye nomthamo weplatelet (MPV) unokuba luncedo ekuqikeleleni ukuba iziphi izicubu ze-ovari zinomdlavuza kwaye ezingekho. (I-RDW ihlala iphezulu kwaye i-MPV iphantsi nomhlaza we-ovari.)

Index Index Risk

Ininzi yemingcipheko eyahlukeneyo yeendleko zeentlekele zijonga ukudibanisa kwezinto ezifunyenwe kwiimvavanyo kunye nokucinga ukuqikelela ukuba ingxaki ingaba ngumhlaza womhlaza kunye nokuba ngaba i-biopsy iyadingeka. Nangona ezi zinokuba luncedo, amanyathelo enjongo yokuqikelela umngcipheko achanileyo xa esetyenziselwa kunye nokuhlolwa okuzimeleyo kweengcali, ezifana ne-oncologicalist gynecological.

Ukutshiza i-Biopsy

I-biopsy ye-lesion yesohlwayo idla ngokuqhutywa ngophenyo. Ngamanye amaxesha, inaliti ye-needle (apho inaliti ifakwe ngesikhumba) ingaqwalaselwa, kodwa icingelwa ukuba ukuba umhlaza we-ovariya ukhona, oku kungakhokelela ekuthiwa yi-seeding (ukusasazeka kwe-tumor).

I-biopsy yokugada ingenziwa okanye i-laparoscopy, utyando apho kwenziwa khona izinto ezimbalwa ezincinci kwiisisu kunye neprojekthi kunye nekhamera kunye nezixhobo ezifakiwe, okanye i-laparotomy, apho kuqhutywe khona isilwanyana esiswini. I-biopsy (isampuli) ithathwa kwaye ithunyelwe kwi-pathologist ukuqinisekisa ukuba ingumhlaza, kwaye ukuba kunjalo, uhlobo.

Ukuba unayo i-biopsy, u-pathologist uza kujonga isampuli njengemigangatho efunyenweyo kunye namaqabunga ayo. Kwiingxelo zakho, isampuli iya kuchazwa njengento enobungozi (engeyomhlaza) okanye eyingozi (engeyomhlaza). Jonga ngezantsi ukuze uthole ulwazi olungakumbi malunga nokuvavanya iingxelo ze-pathology emva kokutyunjwa komhlaza we-ovarian.

Ukuxilongwa okuhlukeneyo

Ubunzima obuthatywayo kummandla we-ovary kunye ne-fallopian tube kwiimvavanyo okanye kwiimvavanyo ze-imaging kubhekiswa njengongxowankulu lwe- adnexal . Izimbalwa zezizathu ezinokwenzeka (zininzi) zingabandakanya ezi zinto zilandelayo, ezingathi ziqwalaselwe ngokunyuka kwi-ovarian umdlavuza:

Uvavanyo lweSiteyi

Ukuba ukuxilongwa komhlaza we-ovari, kwenziwa isinyathelo esilandelayo. Olunye ulwazi olufunekayo kwisiteji lungabuthwa kwiimvavanyo zengcamango kunye ne-biopsy, kodwa ngokugqithiseleyo utyando (ukususa ii-ovari kunye nezisimboko ezongezelelweyo ezongezelelweyo) kuyadingeka ukuze kulungiswe ngokuthe ngqo umhlaza. Ukuqaphela isigaba somhlaza kubaluleke kakhulu ekukhetheni ukhetho olungcono lwempilo.

Emva kokuhlinzwa, ugqirha wakho uya kuthumela nayiphi na isishu esasuswe kwi-pathologist. Oku kungabandakanya ii-ovari, ii-tublopian tubes, uterus, kunye nezicubu kunye ne-biopsies ezithathwe kwezinye iindawo ezisiswini sakho. Ngaphantsi kwe-microscope, uya kugqiba ukuxilongwa kwakho komhlaza we-ovari kunye nokufumana ukuba yeyiphi iisampuli ezinomdlavuza.

Zomibini iimvavanyo kunye nokuhlinzwa kunokuncedisa ukuba umhlaza usasazeke kuma-lymph nodes okanye kwezinye iindawo zomzimba. Kwii-cancer ze-ovarian eziphambili, ii-biopsies zidlalwa kwi-lymph nodes, i-omentum (i-fatty, i-carpet-like structure overlying the intestine), kwaye ihlala iindawo ezininzi ze-peritoneum (iimbumba ezihamba nomgca wesisu). Udokotela ogqirha uya kususa okanye enze inqaku laso nasiphi na isigxina esikhankqalaza okanye ezinye izihlwele. Ukuba umhlaza wawuyi-mucinous, isihlomelo siya kususwa.

Ukuhlamba kunokukwenziwa kwakhona, apho ugqirha ugqirha i-saline kwisibilini aze ahoxise umkhuhlane ukuze afune ubungqina beeseli zomhlaza.

Iziphumo ezikunceda ukufumana isigaba zibandakanya:

Uhlobo kunye ne-subtype: Ukwazi uhlobo kunye ne-subtype yesifo somhlaza we-ovari anganika ulwazi malunga nokugwenxa okulindelekileyo kwe-tumor nokuba ingaba ikhawuleza okanye ikhula ngokukhawuleza.

Ibanga elixhamlayo: Lo ngumlinganiselo wokugonywa kwesisu. Ngomdlavuza we-ovarian endometrioid, i-cancer yanikezwa ibanga le-tumor phakathi kwe-1 no-3:

Izibilini ze-Serous zinikezelwa enye yezinto ezimbini zokubala: ibakala eliphantsi okanye ibakala eliphezulu.

Amanqanaba

Umdlavuza we-ovariya usetyenziswe ngokusebenzisa iindlela ezilula okanye ezipheleleyo zeendlela zeFIGO. Iziphumo zi no kuchazwa njengomhlaza we-ovarian umhlaza. Nangona ezi zingaphantsi zixhalabele ugqirha wakho, kunokuba luncedo njengoko usebenza ukuqonda ukuba zeziphi iindlela zokonyango ezifanelekileyo.

Umhlaza we-Ovarian Cancer

Amanqamana e-ovarian asemngciphekweni yilawo anesakhono esiphantsi. Ezi zivame ukuqala izidumbu kwaye zivame ukuba zingabuyi emva kokuhlinzwa. Ezi zicubu ziyakunikwa isigaba ukuba ugqirha wakho awuqinisekanga ngexesha lotyando ukuba ingaba umhlaza wesigaba esiphakamileyo ukhona, okanye ukuba kubonakala ukuba kwasasazeka kwesisu.

Elula

Ukufumana umfanekiso obanzi weentlukwano phakathi kweesiteji, ezi zinokudilizwa zingena:

I-FIGO epheleleyo

I-FIGO epheleleyo, ebizwa ngokuba yi-International Federation ye-Gynecology kunye ne-Obstetrics, yinkqubo yokucwangcisa ukusetyenziswa kwezibalo zamaRoma ngamanqanaba (ukuqikelela ukuhlaziya) kunye neencwadana zamanqaku afanelekileyo (oko kukuncedisa unyango lwezonyango).

> Imithombo:

> I-American Society of Clinic Oncology. I-Ovarian, i-Fallopian, kunye neCeritoneal Cancer: amaNqanaba kunye namaBakala. Cancer.Net. Updated 08/16. https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/stages-and-grades

> Henderson, J., Webber, E., noG. Sawaya. Ukuhlolwa kwesifo se-Ovarian: INgxelo yoBungqina obuHlangeneyo kunye noVandlakanyo oluHloniphekileyo kwi-US Force Preventive Services Task Force. JAMA . 2018. 319 (6): 595-606.

> INational Cancer Institute. I-Ovarian Epithelial, iTallopian Tube, kunye ne-Primary Peritoneal Cancer Treatment (PDQ). Ukuhlaziywa 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq

> Qin, Y., Wu, Y., Xian, X. et al. Ukusetyenziswa koLuntu oluMnye kunye oludibanisiweyo lweBlack Red Distribution Distribution, Umthamo wePlatelet, kunye ne-Cancer Antigen 125 yokuchongwa ngokubanzi kweCarry Ovarian kunye ne-Benign Ovarian Tumors. Umbhalo woPhando lwe-Ovari . 2018. 11 (1): 10.

> Soletormos, G., Duffy, M., Othman, S. et al. Ukusetyenziswa Kwezonyango zeCancer Biomarkers kwi-Epithelial Cancer Cancer: Izikhokelo ezihlaziyiweyo ezivela kwiQela laseYurophu kwiMark Markers. I-International Journal yeGynecological Cancer . 2016. 26 (1): 43-51.