Umdlavuza emathanjeni udla ngenxa yokusasazeka, okanye i-metastasis, ukusuka kwesinye isifo somhlaza-isifo se- boneastases esisuka kumdlavuza wamaphaphu okanye umhlaza wesifuba, umzekelo. Ukuthatha isampula, okanye i- biopsy , kwindawo echaphazelekayo yethambo ayisebenzisi nje kuphela ukuhlula phakathi komhlaza wesifo kunye nemetastasis evela kwezinye iidumbu kodwa kunceda ukuchonga uhlobo oluthile lomhlaza wesifuba.
Xa ukuxilongwa komhlaza wesifuba, ithambo elithile elichaphazelekayo-kwaye indawo yesikhumba ngaphakathi kwethambo elithile-boba zibini ezibalulekileyo.
I-osteosarcoma, i-chondrosarcoma, kunye ne-Ewing sarcoma ziphakathi kwezifo zonyango eziqhelekileyo. Nangona kunjalo, umhlaza wesifuba awusona umdlavuza oqhelekileyo, kukho konke: ii-primary cancer zamathambo ziba ngaphantsi kwe -2 ekhulwini yazo zonke i-cancer.
I-Self-Checks / Ukuvavanywa Kwekhaya
Ngeli xesha, iimvavanyo zasekhaya zokuxilongwa komhlaza wesifo azizange zenziwe. Ukongezelela, iimpawu zokuqala zomhlaza womfuba zinokudideka kalula kwezinye iimeko eziqhelekileyo ezifana nokulimala kwezemidlalo, okanye okokuqala kunokuthi kubangelwa iicycle and pain pains.
Ekugqibeleni, uninzi lweengxaki zomhlaza wesifo luya kunyango ngenxa yeempawu kunye neempawu ezibandakanya iintlungu zethambo eziqhubeka zihlala ixesha elide. Ubuhlungu besifo somhlaza wesifuba sihlala sibi kakhulu ebusuku kwaye sihlala sihamba kunye nokuvuvukala kwendawo echaphazelekayo.
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Uvavanyo lweMzimba
Kwiimeko zesifo somhlaza wesifuba, ukuhlolwa komzimba okwenziwe ngugqirha kuya kuba yinto eqhelekileyo ngaphandle kokuba mhlawumbi ngenxa ye "tissue mass mass" e no kuvela kwiindawo eziphambili zomhlaza. Oku kunokubonakala njengengca, isilonda, okanye ukuvuvukala okuphuma kwithambo.
Umsebenzi weGazi
Uvavanyo lokuhlola i-laboratory, okanye umsebenzi wegazi , lunokuba luncedo, nangona ngokungaqhelekanga ukutyhila i-diagnostic ethile. Amanqanaba amabini ama-biomarkers ngokukhethekileyo-alkaline phosphatase kunye ne-lactate dehydrogenase-aphakanyisiwe kwinxalenye enkulu yezigulane ezineengculaza. Nangona kunjalo, eli nqanaba alihambelananga kakuhle kangakanani na ukuba isifo sisabele kangakanani emzimbeni.
Biopsy
Kwimeko yamathambo e-bone, isilwanyana esincinci siya kususwa kwaye sihlolwe phantsi kwe-microscope. Kuthathwa njengokuhlinzwa okulula, kwenziwa phantsi kwe-anesthhetic jikelele, kwaye uya kuxoxwa ngayo ngaphambili naphakathi kwenkqubo. I-biopsy iya kubonisa ukuba iiseli zomhlaza zikhoyo kwithambo.
Ukucinga
X-ray
Usolo lwe-osteosarcoma kaninzi luvela kubonakala kwitheko elichaphazelekayo kwi-imaging.
I-Osteosarcoma ingaba neembonakalo ezahlukeneyo kwi-imaging: i-thinned "okanye idliwe" ebonakalayo kwiindawo zethambo zibizwa ngokuba ngumzekelo we-lytic. Ngaphandle koko, ithambo lingabonakala linyanyisiwe, njengokungathi liqiniswe ngetemu elongezelelweyo, kwaye oku kuthethwa njengomzekelo weskrini. Umhlaza wesifo unokudala umzekelo odibeneyo (i-lytic-sclerotic) kwi-imaging.
Oogqirha bafunda malunga ne-classic radial okanye "sunburst" 'iphethini ye-osteosarcoma, apho izicubu ezijikelezayo zithatha ukubonakala kwincinci yethambo kwi-radiating, i-spokes-from-hub, i-sunburst pattern; nangona oku kufumananga akukodwa kwi-osteosarcoma kwaye akuzona zonke i-osteosarcomas eziza kubonisa uhlobo olunjalo.
CT kunye neMRI
Uphando luhlala luyinxalenye yonyango, kwaye ke kubalulekile ukubaluleka kwindlela i-osteosarcoma eqhuba ngayo amathambo kunye nezicubu ezinotshontsho. Oku kubonakala ngokugqithiseleyo ngamagcisa okucatshulwa kwinqanaba elifana ne-computed tomography (CT) okanye i-imagery magnetic resonance (MRI).
I-MRI yinkqubo esebenzisa umbane, amaza omsakazo, kunye nekhompyutha ukwenza uluhlu lwemifanekiso ecacileyo yamacandelo omzimba, kubandakanya indawo yokwakheka kwesisu. Ukusebenzisa i-MRI ukuchaza ubungakanani besisu esiye senziwe sibonakaliswe ngokuchanekileyo kweso sifo njengokuba kunqunywe ngexesha lotyando.
I-Radionuclide Bone Scan
Izifundo ezahlukeneyo ze-radiographic zisetyenziswe njengenxalenye yokuvavanya uvavanyo lomhlaza wesifuba ukucacisa ubungakanani beendawo ezikude kunye nezifo ngexesha lokuxilongwa.
I-radionuclide ithempyutheni yokukhangela, usebenzisa isincinci ye-technetium 99m injected in a vein, isetyenziselwa ukuchaza ubungakanani be-tumor yokuqala. Kwaye, ekubeni ukufunyanwa kwayo kudla ngokunyuka ngaphaya komda we-tumor, kunceda oogqirha ukuba bacwangcise ukususwa kwe-tumor.
Olu hlobo lwe-radionuclide lokutshekisha kwethambo luye luncedo ekufumaneni indawo ezongezelelweyo zomhlaza ngaphakathi kwethambo elifanayo (okubizwa ngokuba yi-skip lesions) kunye neenthambo ezikude. Olu vavanyo luluncedo kuba luyakubonisa lonke isifuba kanyekanye. I-positron emission tomography (PET) iyakwazi ukubonelela ngolwazi olufanayo, ngoko ukuhlolwa kwethambo kungenakufuneka ukuba i-PET iskripthi yenziwe.
I-Positron Imission Tomography (PET)
Kwi-PET scan, ifomu le-sugaractive eyaziwa nge-radio (eyaziwa njenge- FDG ) ifakwe kwigazi. Ngamaxesha amaninzi amangqamuzana omhlaza emzimbeni akhula ngokukhawuleza kwaye athabatha ininzi enkulu yeshukela, ekwakheni umfanekiso obonisa i-FDG ukufumana emzimbeni kwimimandla yomdlavuza. Umfanekiso awunakucaciswa njenge-CT okanye i-MRI scan, kodwa inika ulwazi oluncedo malunga nomzimba wonke.
Ukuhlolwa kwe-PET kunokunceda ukubonisa ukusasazeka kwe-osteosarcomas kumaphaphu, amanye amathambo, okanye ezinye iindawo zomzimba, kwaye kunokukunceda ekuboneni ukuba umhlaza uphendule kangakanani unyango.
Iimpawu zePET kunye ne-CT ziza kudibaniswa ngexesha elifanayo ( PET / CT scan ) ukuvumela indawo eziphezulu kwi-PET ukucatshangiswa ukuba zifaniswe nembonakalo ebonakalayo yaloo ndawo kwi-CT scan.
Ukukhangela iMetastases
Nangona isifuba se-X-rays sivumela ukufumanisa i-lungast metastases kwininzi yamatyala, i-CT inokukhathazeka kakhulu ekufumaneni imiphunga yeemiphunga kwaye ibe yinkqubo yokuzicingela. Kukho iimeko ezintle, nangona kunjalo, xa kukho iziphumo ezincinci kwimiphunga, ngoko-biopsy ukuqinisekiswa kunokufuneka.
Ukuxilongwa ngokungafani
Ukuxilongwa ngokungafani kwezifo zethambo zalolu hlobo kubandakanya oku kulandelayo:
- Sulelo
- Ezinye izicubu:
- Aneurysmal bone cyst
- Ewing sarcoma
- ICondrosarcoma
Indawo yesikhumba kwisithambo kunye nendawo yamathambo kusiza ukuhlula i-osteosarcoma kunye ne-Ewing sarcoma, eyona yesibini inambuzane edlalwa rhoqo kwiqela elidala.
Uluhlu lwezinto ezinokuthi lunokuphinda luchukunyiswe yindawo yokuhlala i-tumor. Ngokomzekelo, ukuhlula ulwahlulo lwe-jaw leonon encinci kubandakanya iintlobo ezahlukeneyo zokugqithiswa kwezinyo, i-osteomyelitis (intsholongwane) yesithambo somhlathi, kunye nezinye izilonda ezinobunqunu ezingabonakaliyo (ezifana ne-ossification fibromas kunye nezicubu ezibomvu ze-hyperparathyroidism).
Uhlolo-nkcazo
Icandelo lokuxilongwa komhlaza wesifo kubandakanya ukufakwa kwesigxina. Isitatimende sithetha ukujonga ubungakanani kunye nendawo yesikhumba esinamandla, ukuba sisasazeka, nalapho sisasazeka khona. Isiteji sinceda ukunqumla unyango, kwaye oogqirha banokuqwalasela isigaba somhlaza xa bexoxa ngeenkcukacha zobomi.
Indawo yaseMetastatic
Isitatimende sisekwe kwiimvavanyo zenyama, iimvavanyo zokuzibona, kunye naliphi na i-biopsies eyenziwe. I-Osteosarcoma ingaba isigaba I, II, okanye ii-ii-sub-stages.
Enye into ebalulekileyo ekuqwalaseleni isiteji kukuba ingaba umhlaza "uphezulu" okanye "i-metastatic." Ukuba indawo, i-osteosarcoma ibonakala kuphela kwithambo eyaqala kuyo kwaye mhlawumbi izicubu ezibhekiselele kwithambo, njenge-muscle, tendon, okanye i-fat.
Ngokwe-American Cancer Society, malunga ne-4 kwi-5 ye-osteosarcomas kubonakala ukuba yindawo yakuyo xa ifunyenwe kuqala. Nangona kunjalo, nangona xa iimvavanyo zengqondo zingabonakali ukuba umhlaza usasazeke kwiindawo ezikude, ezininzi izigulane zinokuba neendawo ezincinci zentsholongwane zomhlaza ezingenakufumaneka kwiimvavanyo.
Ubungakanani be-metastases ezincinci ngenye yezizathu zokuthi i-chemotherapy yinto ebalulekileyo yonyango kwi-osteosarcomas ezininzi. Okokuthi, umhlaza unakho ukubuyela emva kokuhlinzwa ukuba akukho khemotherapy inikwe.
Amaziko e-osteosarcomas afakwe kwiindawo ezimbini:
- Iidumbu ezinokutsha zikhona apho zonke izicubu ezibonakalayo zinokususwa ngokuhlinzwa.
- Ii-osteosarcomas ezingenakuthengiswayo (okanye ezingenakulungiswa) azikwazi ukususwa ngokupheleleyo ngokuhlinzwa.
UkuGcina
Ukufakwa kwezinto kungabandakanywa kwisiteji kwaye kubhekisele ekubonakala kwimizimba yomhlaza phantsi kwe-microscope. Ukubamba kunika ingcamango yokuba umdlavuza ungakhawuleza njani.
- Iiseli zomhlaza zesigaba esiphantsi zihlala zikhula ngokukhawuleza kwaye zincinci ukusabalalisa.
- Amathumbu aphezulu aqulethwe ngamaseli omhlaza angakhula ngokukhawuleza kwaye asenokwenzeka ukuba asasazeke.
Uninzi lwama-osteosarcomas luphezulu, kodwa uhlobo olubizwa ngokuba yi-parosteal osteosarcoma ngokuqhelekileyo lusezingeni eliphantsi.
Systems Staging
Inkqubo ephezulu kakhulu yokusetyenziswa kwe-osteosarcoma ichaza izilonda zesifo esisifo esiphucukileyo ngamacandelo amabini kunye ne-anatomiki.
Bakala
Ibakala eliphantsi neliphezulu lingabonisa isigaba.
- Ibakala eliphantsi = isigaba I
- Ibanga eliphezulu = isigaba II
Ingingqi yaseAnatomic
- Ubume begumbi lugqityiwe ukuba ingaba i-tumor iyakwandisa i-cortex, indawo engaphandle yamathambo eyenza isalathisi sokukhusela ecaleni kwesango sangaphakathi
- I-Intracompartmental (akukho kwandiswa nge-cortex) = A
- I-Extracompartmental (ukwandiswa nge-cortex) = B
Kule nkqubo, oku kulandelayo kuyinyaniso:
- Iibakala eziphantsi, izidumbu zendawo ziyi-stage I.
- Amabanga aphakamileyo aphezulu, izidumbu zendawo zisesigaba II.
- Izidumbu zeMetastatic (kungakhathaliseki ibakala) zizigaba III.
Kukho ezimbalwa izilonda ze-intracompartmental lesions (isigaba se-IIA) ngenxa yokuba amaninzi e-osteosarcomas aphezulu aphuma kwi-cortex yesithambusana ekuqaleni kophuhliso lwabo.
Kwiqela elidala, ininzi ye-osteosarcomas ibanga eliphezulu; Ngoko ke, phantse zonke izigulane ziyi-IIB okanye i-III, ngokuxhomekeka kubukho okanye ukungabikho kwesifo se-metastatic.
Imizekelo ngeSigaba
- Isigaba IA: Umhlaza uphantsi kwebanga kwaye ufunyenwe kuphela kwengubo enzima yethambo.
- Isigaba IB: Umhlaza ungezantsi, ukhula ngaphandle kwethambo kunye nakwiindawo eziphathekayo ezixubileyo ezinemizila kunye nemithambo yegazi.
- Isigaba IIA: Umhlaza uphezulu kwaye uqulethwe ngokupheleleyo kwi-coating hard of the bone.
- Isigaba IIB: Umhlaza uphezulu kwaye usasaze ngaphandle kwethambo kunye nakwiindawo ezizenzekelayo ezinamaxhala kunye nemithambo yegazi. Uninzi lwe-osteosarcomas luyi-2B yesigaba.
- Isigaba III: Umhlaza unokuba ngumgangatho ophantsi okanye uphezulu kwaye ungatholakala kwisithambo okanye uphume ngaphandle kwethambo. Umhlaza usasazeke kwezinye iindawo zomzimba, okanye kwamanye amathambo angaxhunyiwe ngokuthe ngqo kwithambo apho i-tumor yaqala khona.
Ukuba umhlaza uphindela emva kokuqala unyango, oku kwaziwa ngokuba ngumhlaza okanye ophinde wabuyiselwa ngumhlaza.
> 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.