Ukunyameka kweBreslow kusetshenziswe kwi-Melanoma Staging, i-Clark Level isetyenziswa kakhulu
Ugqirha wakho uthi i- melanoma yakho isigaba se-IIA (T2bN0M0) kunye noBreslow depth of 2 mm.
Uyazibuza ukuba ulwimi lwangaphandle lithetha ntoni-ngokwenene, i-melanoma jargon ingadideka kwaye idangele. Ukukunceda uqonde ukuba kutheni unyango oluthile lukhethwa kuwe, nantsi inkcazo emfutshane malunga nale migaqo ukuthini.
I-Melanoma Diagnosis
Ukuba ugqirha wakho ubona umlwanyana osolisayo ngexesha lokuphonononga kwesikhumba , isinyathelo esilandelayo yi- biopsy yolusu .
Ukuba i-biopsy ibonisa i-melanoma, i-pathologist iya kuhlola i-biopsy ukuchonga isigaba (ubukhulu) besifo ukuze kulungiswe kakuhle unyango lwakho.
Ngaphandle kwenombolo ye-TNM , unokuva ugqirha usebenzisa inombolo ye-Breslow okanye inombolo ye-Clark ukuchaza ukuxela kwakho (imbono). Ezi ndlela zombini ze-stan melanoma zisetyenziselwa ukuba i-melanoma ifihliwe, ithetha ukuba ayizange isakaze nakweyiphi i-lymph nodes okanye elinye iqumrhu emzimbeni. Inombolo yeClak ukuchaza ukuxela kwakho (imbono). Ezi ndlela zombini ze-stan melanoma zisetyenziselwa ukuba i-melanoma ifihliwe, ithetha ukuba ayizange isakaze nakweyiphi i-lymph nodes okanye elinye iqumrhu emzimbeni.
Nantsi indlela yokuyichaza:
Ubungqina obuhle
Okokuqala kubikwa nguAlexandro Breslow, MD, ngo-1970, ubukhulu beBreslow buchazwa njengobungakanani obuphezulu bomlenze we-melanoma, ukusuka phezulu kakhulu (obizwa ngokuba yi "granular layer") kwindawo ephantsi kokungena kwesikhumba.
Isixhobo esibizwa ngokuthi "i-micrometer ye-ocular" sisetyenziselwa ukulinganisa ubukhulu be-tumor esicacileyo (esuswe).
Ngokuqhelekileyo, ukuphakama kweBreslow thickness, ekugqithiseni ukugqithisa-ngamanye amazwi, ukugqithisa i-melanoma, ithuba elingakumbi lokusasazeka. Nazi iindlela zokusinda iminyaka emi-5 ezisekelwe kwi-Breslow thickness.
Gcina ukhumbule ukuba le mivuzo yokusinda iyimilinganiselo kwaye ayikwazi ukubonisa imeko yakho:
- ngaphantsi kwe-1 mm: ukusinda kweminyaka emi-5 kunamaphesenti angama-92 ukuya kuma-97 ekhulwini-kuthetha ukuba abantu abayi-92 ukuya ku-97 abantu abayi-100 baya kuphila emva kweminyaka emi-5 emva kokuba bafumene i-melanoma engaphantsi kwe-1mm ngobukhulu.
- 1.01 ukuya kwi-2 mm: ukusinda kweminyaka emi-5 kufikelela kuma-81 ukuya kuma-92 ekhulwini
- 2.01 ukuya kwi-4 mm: ukusinda kweminyaka emi-5 kufikelela kuma-70 ukuya kuma-81 ekhulwini
- ngaphezulu kwe-4 mm: ukusinda kweminyaka emi-5 ngama-53 ekhulwini ukuya kuma-70 ekhulwini
Ngenxa yokuchaneka kwayo kwiziphumo ezichazwe ngaphambili, ubukhulu beBreslow bufakwe kwinkqubo ye-TNM yokubeka isiteji se-melanoma. Enyanisweni, ubukhulu beBreslow bubaluleke kakhulu kwi-melanoma, kunye ne-tumor (T) isigaba, kunye nokukholiswa kwesilonda (isikhumba esiphukileyo, ukuphuma kwegazi, ukuvuvukala).
Nqanaba lika Clark
Inqanaba likaClak libhekisela ekujuleni kwe-tumor kuye kwangena kwiindawo zesikhumba . Le nkqubo yaqulunqwa ekuqaleni ngu-WH Clark, MD, ngo-1966. Amazinga kaClak achazwa ngokusemthethweni ngale ndlela:
- Inqanaba I: Kugcinwe kwi-epidermis (i-topmost layer of skin) ebizwa ngokuthi "in situ" i-melanoma
- Umgangatho wesi-II: Ukuhlasela kwamaphepha empapa (phezulu)
- Inqanaba III: Ukuzaliswa kwimihlathi yamaphepha, kodwa akukho sondlo kwi-dticis (esezantsi)
Oku kuthethwa konke, amazinga kaClak awanakuthi asetyenziswe ukubala ukuhlaziya ngoku. Oku kubangelwa uphando lubonakalise ukuba ungaphantsi kwesiphumo, ungaphantsi kancinci, kwaye ubekezele ngakumbi kunokwakheka kweBreslow. Ezinye izinto ezingenakulungelelaniso kule nkqubo yokubeka isistim kukuba kaninzi kunzima ukuhlula phakathi kweCalk Level II kunye neNqanaba III , kwaye ayikwazi ukusetyenziswa kwi-melanomas yeentendelezo kunye neengcambu.
Kukho umzekelo owodwa apho ama-Clark angasetyenziselwa ukuxela kwangaphambili ukugxekwa-kwizigulane ezincinci (ngaphantsi kwe-1.0 mm) i-melanoma.
Nangona kunjalo, isetyenziswe kuphela ngokungagqibekanga ukuba inani le-mitotic le-melanoma elincinci alinakunqunywa. Inqanaba le- mitotic libhekisela kwinani lomhlaza weseli ehlula. Umlinganiselo we-mitotic ophezulu ukhombisa ukuba umhlaza unako ukusasazeka.
ILizwi
Zama ukuba ungagxininiswa kwiinkcukacha ze-melanoma staging process. Kunoko, gxininisa kwinqanaba lomhlaza wakho lithetha ntoni unyango kunye nembono.
> Imithombo:
> I-American Cancer Society. (Meyi 2016). Amanqanaba omhlaza wesikhumba eMelanoma.
> I-American Cancer Society. (Meyi 2016). Izinga lokusinda kwi-melanoma yengqondo yomhlaza, ngesigaba.
> I-Balch CM kunye al. Inkcazelo yokugqibela ka-2009 i-AJCC yokuSetyenziselwa kweMelanoma nokuHlulwa. J Clin Oncol . 2009 I-20 ye-20; (36): 6199-6206.
> I-Balch CM, et al. Ukuhlalutya kwimeko yezigulane ezingama-17,600 ze-melanoma: ukuqinisekiswa kweKomiti yeZizwe eziManyeneyo kwi-Cancer. J Clin Oncol . 2001 Aug 15; 19 (16): 3622-34.