Iiphakamileyo zeBanga eliPhakamileyo kunye neNcinci ye-Neuroendocrine ye-Colon
Ukuba wena okanye othandekayo sele ufunyanwe ukuba unesifo esibi okanye esiphezulu se-neuroendocrine ye- colon okanye i-rectum mhlawumbi uloyiko kunye nokudideka. Iimvumi ezixhamla nge-neuroendocrine aziqhelekanga kunezinye zezinye i-cancer. Ukongezelela, baqhelekanga ukungazi kakuhle kwaye kubalulekile ukuba ngummeli wakho ukuba unaloo mzimba.
Yintoni esiyayazi malunga nale khansela, njani baphathwa ngayo, kwaye yintoni na isilumkiso?
Ziziphi iindumbu ze-Neuroendocrine?
Izicubu ze-Neuroendocrine ziyi-tumors eziqala kwiiseli ze-neuroendocrine. Zingenzeka kwi-digestive tract, imiphunga, okanye ingqondo. Kwindlela yokugaya ingabandakanya isisu, i-pancreas, intambuzane encinci, i-colon, ne-rectum.
Kwi-colon kunye ne-rectum, i-tumors neuroendocrine i-akhawunti ye-2 ekhulwini okanye ngaphantsi kwee- cancer e-colorectal . Ngelishwa, ngokungafani nezinye iindidi zomdlavuza wekoloni, ukuhlaziya isitshintshi kakhulu kwiminyaka yakutshanje kunye nokuhlolwa komhlaza wekolon.
Iimvumi ze-Neuroendocrine zanda, ngokunyuka kwama-5 okunyuka ukusuka ngo-1973 ukuya ku-2004 kunye nokunyuka okuqhubekayo ukususela ngelo xesha. Akuqinisekanga ukuba kutheni okwenzekayo ngeli xesha.
Ukuxhatshazwa ngokubhekiselele kumxholongwane oMdaka
Iimvumi ze-Neuroendocrine ziqala ngokuhlula kwiibini eziphambili ezixhomekeke ekuhlaseleni kwezicubu.
- Isisombululo esikhulu samabakala kunye neeseli ezincinci ze-neuroendocrine zibuhlungu. Ezi zicubu zivame ukukhula ngokukhawuleza kwaye zihlasele ezinye izicubu
- Iimvumba zeCarcinoid yekolon zibhekwa njengento engafanelekanga. Zivame ukukhula ngokukhawuleza kwaye zingenasiphelo esincinci kunokuba zikhulu kunye neeseli ezincinci ze-neuroendocrine.
Kubalulekile ukuhlukanisa izicubu ezinobundlobongela kunye nezidakamizwa njengezonyango ezifanelekileyo kunye kunye nokuhlengahlengiswa kwemvelo kuyahluka kakhulu.
Amaseli amakhulu kunye neeNcinci zeSeli ezincinane
Ibanga eliphezulu, okanye ulaka, i-neuroendocrine izihlamba ziye zahlulwa zibe zikhulu zeeseli ezincinci kunye nezincinci, ezahluke ngokusekeke kwimilo phantsi kwe-microscope. Zomibini iintlobo zomhlaza zibhekwa kakhulu "ezingabonakaliyo" oko kuthetha ukuba iiseli zivela ezinxulumene nezihlobo eziqhelekileyo zeeselendocrine kwaye ziziphatha ngokugqithiseleyo. Kwixesha elidlulileyo kwakucatshangelwa ukuba izilwanyana ezinkulu ziqhelekileyo, kodwa uphando lwango-2016 lufumene ukuba iipesenti ezingama-89 zeesisu zazincinci zesifo se-neuroendocrine tumors.
Ngandlela-thile, izilonda eziphezulu ze-neuroendocrine zifana nomhlaza wesifo somnxeba omncinci, kwaye zihlala ziphendulela unyango olufanayo, kodwa zincinci ukuba zinxulumane nokutshaya kunezonyana zamancinci zamaphaphu kwaye zingenakunokwenzeka ukuba zibe nama- bonesastatic amathambo kunye nengqondo.
Ezinye iziphumo ziye zafumanisa ukuba iimvumi zenzeka ngokuqhelekileyo kwicala lasekunene lekholoni (okwenyuka kolonon) ngoxa uphando olutshanje lufumene ukuba indawo eqhelekileyo yezi zihlamba yi-rectum ne-sigmoid colon.
Ukuveliswa komdlavuza weColon akuzange kubangele ukwanda okwenyukayo kwezi zihlamba, nangona uphando olulodwa, iipesenti ezingama-30 zezifo zifunyenwe zidibaniswa ne- adenomas .
Uninzi lwesifo (ama-64 ekhulwini) sisigaba 4 okanye imetastatic ngexesha lokuxilongwa.
Iimpawu
Iimpawu zeendumbu ze-neuroendocrine zekholoni zinokuquka ukutshintsha kwimizimba yesilonda, njengesifo sohudo, intlungu yesisu, kunye neqondo eliphakamileyo okanye elinciphileyo legazi le-glucose. Ekubeni ezi zicubu zivame ukufumaneka kwiinqanaba ezizayo, iimpawu zomhlaza ophezulu njengento engafanelekanga yokulahlekelwa kwesisindo .
Ukuqinisekisa ukuchongwa okufanelekileyo
Uphando lubonisa ukuba izicubu ezinomtshatshazo ze-neuroendocrine zivame ukuthotyelwa ngokungenakucingwa njengezidumbu ze-carcinino. Lona iphutha elibi ngenxa yokuba i-carcininoids ikhula ngokukhawuleza kwaye ingaqhelekanga.
Ukuba utshelwe ukuba unesifo se-carcininoid, qi Ukwenza oko kuya kufuna ukuba ucele ugqirha wakho imibuzo ethile ebalulekileyo:
- Ingaba i-pathologist ithathe inxaxheba ekufundeni kokugqibela kweso sifo?
- Ingaba i-pathologist yafumana ukwahlula phakathi kweentlungu ezigwenxa kunye nezidakamizwa ezingenayo i-neuroendocrine?
- Ingaba i-pathologist ivakalise ukungathandabuzeki ngokuxilongwa kwam?
Ukuba iimpendulo azikho ewe, ewe, kwaye akukho (okanye uqobo olukufutshane naloo nto), iqela lakho lezokwelapha linomsebenzi omningi ukwenza ngaphambi kokukunika ukuxilongwa ngokucacileyo.
Unyango
Akukho okwangoku naluphi na unyango oluqhelekileyo lweengxwavane ezinoburhado ezinomtsalane zekolon kunye neerite. Noko ke, unyango luya kuxhomekeka kwisigaba se-tumor. Ukuba enye yezi zicubu zifunyenwe kumanyathelo okuqala, ukuhlanganiswa kokuhlinzwa, unyango lwe-radiation kunye ne-chemotherapy kunokuqwalaselwa.
Kwiimpawu eziphezulu eziphezulu ze-neuroendocrine, i- chemotherapy yonyango olukhethiweyo kwaye lunokubangela ukuba kubekho ixesha elide. Ii-regimens ze-Chemotherapy zifana nezo zisetyenziselwa ukunyanga umdlavuza omncinci wamangqamu omncuba , ngokuqhelekileyo zibandakanya izidakamizwa zeplatinum ezifana nePlatinol (cisplatin) okanye iParaplatin (carboplatin.)
Uphando olubandakanya ukuprofetwa kwama-genomic kwezi zihlamba linikeza ithemba lokuba, kwixesha elizayo, iipilisi ezijoliswe kuzo zifumaneke ukunyanga kwesi sifo.
Prognosis
Izidumbu ze-neuroendocrine ezivuthayo zivame ukufunyaniswa kwizigaba eziphambili, imeko evame ukuphumela kwisifo esichengileyo. Unyango kuphela oluye lwabonakaliswa ngoku ukuphucula ukusinda luyi-chemotherapy.
Ngethuba langoku, ukusinda komlambo (ubude bexesha emva kwesiqingatha sabantu baswelekileyo kunye nesiqingatha besaphila) ziinyanga ezili-13 ukuya kwe-15, kunye ne-2-year survival rate ye-23 ekhulwini kunye nokuhlala kweminyaka emi-8 kuphela. pesenti.
Ukujamelana
Ukufunyaniswa ukuba ne-grade high neuroendocrine isifo nje kuphela, kodwa kunokudideka kakhulu njengoko imeko ayiqhelekanga. I-prognosis ye-tumor iye, ngelishwa ayitshintshanga kakhulu kwiminyaka yamuva nje, kodwa inkqubela phambili kwonyango, njengokufika kwezilwanyana ezijoliswe kuyo kunye ne- immunotherapy , inika ithemba lokuba unyango olutsha luya kufumaneka kwikamva elitsha.
Thetha ugqirha wakho malunga nokukhethwa kwezilingo zekliniki ezivavanya ezi zonyango. Yiba ngummeli wakho ekunyamekelweni komhlaza kwaye ubuze imibuzo. Cela uncedo kubathandekayo bakho kwaye ubavumele ukuba bancede. Ukongeza, abantu abaninzi bakuthola kuncedo ukufikelela kwiinkxaso zoluntu kwi-intanethi. Nangona iimvumi ezinomdla eziqhelekileyo aziqhelekanga kwaye akunakwenzeka ukuba unayo iqela lokuxhasa kulo lommandla wakho, intanethi ikuvumela ukuba udibanise nabanye abajongene nezinto ezifanayo kwihlabathi jikelele.
Imithombo:
Conte, B., George, B., Overman, M. et al. I-High-Grade Neuroendocrine Colorectal Carcinomas: I-Retrospective Study of 100 Izigulane. Cancer Colorectal Cancer . 2016. 15 (2): e1-7.
UHammond, W., Crozier, J., Nakhleh, R., noK. Mody. I-Genomic Profiling ye-High-Grade Large-Cell Neuroendocrine Carcinoma yeColon. Umbhalo we-Oncology . 2016. 7 (2): E22-4.
Shafgat, J., Ali, S., uShabhab, uMnu, no-A. Oszewski. Ukusinda kwabagulayo abane-Neuroendocrine carcinoma ye-Colon kunye ne-Rectum: Uhlalutyo olwenziwa ngabantu. Izifo zeColon kunye neRectum . 2015. 58 (3): 294-303.
USmith, J., Reidy, D., Goodman, K., Shia, J., noG. Nash. Ukuhlaziywa kwakhona kwe-Retrospective Review ye-126 ye-High-Grade Neuroendocrine Carcinomas yeColon neRectum. I-Annals ye-Oncology yokugada . 2014. 21 (9): 2956-62.