Inkqubo inokuqikelela ukuba unakho ukuhlaziya umhlaza wesibeletho
Inkqubo ye-D'amico yokuhlukanisa enye yeendlela ezisetyenziswa kakhulu zokuhlola ingozi yomhlaza wesifo somhlaza. Ekuphuhlisweni kwasekuqaleni ngo-1998 ngumphandi wezokwelapha ogama lingu-D'amico, le nkqubo yenzelwe ukuhlalutya ingozi yokuphindaphinda emva kwonyango lwe-prostate yomnxeba. Ikwahlula izigulane zibe ngamaqela amathathu aphindaphinda-mngcipheko: eziphantsi, eziphakathi kunye nezingozi eziphezulu, usebenzisa amanyathelo afana namanqanaba e-PSA yegazi, amanani aseGleason kunye nezigaba zesisu ngeT-izikolo
Umsebenzi kunye nokubaluleka kweNkqubo yoLungiso lwe-D'amico
Inkqubo yokuhlukanisa iqela lika-D'amico yenziwe ukuba iqikelele amathuba okuphindaphinda kwiphina isigulane usebenzisa isethi yamarameters kwaye isetyenziswa ngokubanzi njengolunye lwezixhobo zokuhlola izingozi. Olu hlalutyo luza kunceda abo bahlaselwa ngumhlaza wesibeletho ukuba benze isigqibo esinolwazi malunga nokunyango lwabo.
Xa uchaza umdlavuza wakho weprotate njengengxenye yenye yeqela elithathu, le nkqubo inokukunceda wena kunye nodokotela wakho wenze izigqibo zonyango olongezelelweyo. Kukho izinto ezininzi zokuqwalasela xa usenza isigqibo malunga nokunyangwa komhlaza weprotate , okubandakanya umgangatho wesikhathi eside wobomi kunye nezinye izinto ezinobungozi okanye izimo zempilo ezingapheliyo onokuzenza. Zonke izifo zonyango lomhlaza zithatha inqanaba lomngcipheko weengxaki okanye iziphumo zecala. Ngaba ubunzima obu bunzima buyahlukahluka kumntu kumntu, kodwa kubalulekile ukugcina engqondweni xa ukhetha isicwangciso sonyango.
Indlela iSebenza ngayo
Okokuqala, kubalulekile ukuqokelela amanani akho:
- I-PSA: Uzakufuna iziphumo zovavanyo lwe-PSA , uvavanyo lwegazi olufumanisa i-antigen-specific antigen-protein eyenziwa ngama-cell prostate yakho.
- Isiphumo seGleason: Iziphumo zengxelo yakho yeGleason , enikezelwe ngokubhekisele kwindlela yokubonakala kwimizimba yakho yomhlaza.
- Isigaba seZiklinikhi Iimpawu zeT: kunye ne- T yakho yesigaba , ubungakanani besisu sakho njengoko kubonwe kwi-ultrasound okanye ngexesha lokuhlolwa kwemirhumo.
Ukusebenzisa la manani, umngcipheko wakho ungabelana ngokuthi:
- Umngcipheko ophantsi: Labo abanePSA abangaphantsi okanye abalingana no-10, umlinganiselo we-Gleason ngaphantsi okanye ulingana no-6, okanye abakwinqanaba lesikliniki T1-2a
- Umngcipheko ophakathi: Amadoda anePSA phakathi kwe-10 no-20, isikolo se-Gleason esi-7, okanye sekliniki yeT2b
- Umngcipheko ophezulu: Abano-PSA abangaphezu kwama-20, isiGleason silingana okanye sikhulu kune-8, okanye sisekliniki yeT2c-3a.
Oko Uphando olukushoyo malunga neNkqubo
Izifundo ezimbini ezibandakanya iziganeko ezingaphezulu kwe-14,000 zomhlaza zengcinezelo zikhangele ukukwazi ukuxela kwangaphambili ukukhula komhlaza kunye neendawo eziqhubekayo zokusinda kunye neklinikhi ebaluleke kakhulu kwinkqubo yokubeka ingozi esekelwe kwiyeza langoku.
Ezi zifundo ziqikelelwa kwiirhafu zokuphila emva kokuhlinzwa kunye nendlela ebizwa ngokuba yi-Kaplan-Meier. Olu hlalutyo lubalwa ukusinda kokungenasiphelo kwe-biochemical-freed-free (BRFS), okuthetha intsholongwane yomhlaza wesibeletho ngaphandle kwenqanaba eliphezulu le-PSA ukuba libize ukuphindaphindwa komhlaza, amazinga kwizigulane kwizigaba ezahlukeneyo zomhlaza. Lezo ziphumo ezichaziweyo zokusinda zaza zafaniswa neemeko zangempela ukuba zibone ukuba ukusebenzisa uhlelo lwe-D'amico-based based classification kwandula isigulane senze isigqibo sonyango olongezelelekileyo kwaye ke amathuba okunyuka.
Ezi zifundo zafumanisa ukuba amadoda ayenolwazi olongezelelweyo lokufumana ingxelo (njengoluhlu lwe-D'amico-based classification system) lwamazinga amaninzi aphezulu okusinda emva kwonyango lwe-prostate yabo, ikakhulukazi abo bantu abanengozi enkulu yokuphindaphinda.
Nangona kunjalo, le nkqubo ayikwazi ukuvavanya ngokuchanekileyo ingozi yokuphindaphinda kulabo abaneengxaki ezininzi. Njengengxaki yomhlaza wesifo seprotate enezinto ezinobungozi ezininzi eziphakanyisiweyo, inkqubo ye-D'amico classification ayinakufaneleka kubantu abanomdlavuza wesibeletho kunye noogqirha babo njengenye indlela yokuhlola.
> Imithombo
- IBoorjian SA, uKarnes RJ, uRangel LJ. Ukuqinisekiswa kwe-Mayo Clinic yohlu lwamacandelo e-D'amico lokubeka ingozi ekuchazeni ukusinda ngokulandela i-prostatectomy enkulu. J Urol. 2008 kuMatshi; 179 (4): 1354-60; ingxoxo 1360-1. Epub 2008 uMar 4.
- Gabriele, D., Jereczek-Fossa, B., Krengli, M. et al. Ngaphandle kwee-Class Amanqanaba okubeka ingozi ngenxa yokubikezela ukuphindaphinda emva kwe-radiotherapy yangaphandle ye-prostate yomhlaza: i-Candiolo classifier, i- Radiation Oncology . 2016. 11 (1): 23.
- Hernandez DJ, Nielsen ME, Han M. Ukuhlaziywa kwangoku kwinqanaba lomngcipheko we-D'amico we-prostate umdlavuza. Urology. 2007 Nov; 70 (5): 931-5.
- Yuh, B., Artibani, W., Heidenreich, A. et al. Indima ye-prostotectomy e-radical prostatectomy kunye ne-pelvic lymph node dissection ekulawuleni umdlavuza ophezulu wesifo sonyango: ukuhlolwa okucwangcisiweyo. Urology yaseYurophu . 2014. 65 (5): 918-27.