Umdlavuza izingono: izimpawu, ukwelashwa

Cancer - inkinga yangempela wokuphila emkhakheni wamuva wezokwelapha. Kusenzima ayitholakalanga umuthi kungaba 100% ukusebenza kahle ukuze kufe lamaseli ebulalayo. Ngo izibhedlela, odokotela bayaqhubeka wafaka le uphethwe wesabeka kuwo iziguli zabo.

Kukhona okuningi umdlavuza. Noma isiphi isitho kanye nanoma yimuphi izicubu zomzimba womuntu zingase ngokuzumayo yamukelwa inqubo sokugembula. Omunye amasayithi okungenzeka kwasendaweni - ingono on amabele sowesifazane. Lesi sifo oncological kwezokwelapha ibizwa ngokuthi isifo Paget sika.

Imininingwane kawonkewonke izingxoxo eziphathelene nokugula

Ulwazi lokuqala ku isifo Paget sika uvele ekhulwini XIX. Kuyaziwa ukuthi 1856 by udokotela ohlinzayo French futhi anatomist S. Velpeau wathola izinguquko sokugembula we ingono-areolar eziyinkimbinkimbi. Ngo 1874, J. Paget, kuyinto udokotela ohlinzayo waseBrithani futhi sezifo, esifundweni enemininingwane lesi sifo. Yingakho igama lakhe kwathiwa u ukugula.

J. Paget isifo Ucwaningo luveza ukuhambisana phakathi kwesifo izinguquko sokugembula we ingono-areolar eziyinkimbinkimbi wamabele carcinoma. Isiphetho esinjalo wazenza imiphumela 15 kokuma. Onguchwepheshe abesifazane ngalubona ushintsho olukha phezulu ukuvuvukala. Kuwo lo nyaka, zonke iziguli bebeye umdlavuza ingono webele. J. Paget futhi wasikisela ukuba ukuvuvukala olukha phezulu kuthinta nezicubu eziseduze, futhi izinguquko esiwohlozayo kuzo ngenxa kubangele ukuthuthukiswa neoplasia.

idatha yamanje ku lesi sifo kanye ngezimpawu zesifo

Ulwazi mayelana isifo ngo-2011, baqoqa Umtholampilo "Mayo" (USA). Ochwepheshe sinqume ukuthi original cishe kuzo zonke izimo, izinguquko sokugembula we ingono edalulwa. Nge inchubekelembili kwaleso sifo enqubeni kuhilela isikhumba ezizungezile. Futhi, imininingwane eyethulwa, imitholampilo, kungaba kuqashelwe ukuthi iqoqo umlando umdlavuza webele Paget ukuze okuzobe kudlalelwa okuyikona kungathatha kusuka 6 kuya kwezingu-8.

Yini izimpawu isici kule umdlavuza? Abesifazane abakade umdlavuza izingono, ukugubha ekushintsheni nozwela ndawo. Ezimweni eziningi, iziguli esekhala ukulunywa, evutha isasasa. Ngenxa izingubo phezu ingono futhi areola zenzeka endaweni ububomvu. Le ndawo ethintekile zingase ziqale opha. Ezigabeni kamuva kukhona luningi ngopha ingono (lapho umdlavuza kuvamile). I ingono edonswa. Ivame ukutholakala waphawula aba ukukhula izimila ebulalayo.

Yokudlanga izimbangela zezifo

Isakhiwo zonke neoplasias ekhona mammary share umdlavuza Paget eyabelwe 0.5-5%. Ngenhlanhla, kungcono izifo ezingavamile. Ngo intsha, ngokuvamile ayitholiwe. Ngokuvamile sifo e abadala zokugula kwabesifazane postmenopausal (iminyaka 50-60). Isilinganiso sobudala abagulayo - ngonyaka 54.

Izimbangela umdlavuza Paget asikwazi ngokuthi. Njengezinye izinhlobo zomdlavuza, basuke akukaqondwa. Nokho, kukhona ezizathwini. Ngaphambili ukubeka phambili imfundiso yokuthi umdlavuza eba ngenxa yokufuduka amaseli atypical kanye ulwelwesi engaphansi Amapayipi ku ingono epidermis.

Ukuhluka izinguquko sokugembula

umdlavuza Ingono kungase bathuthuke okukodwa kokukhethwa kukho kungenzeka:

1. Samuntu sokuqala siyenzeka phakathi izinqubo sokugembula kule ingono futhi areola kuphela. Ezinye izinguquko kungukuthi itholiwe.
2. Ngo samuntu emdlavuzeni yesibili itholwa izimpawu osolisayo ku ingono-areolar eziyinkimbinkimbi. Yiziphi izimpawu ezibonakala kungase kubonise umdlavuza ingono? Izithombe lesi sifo, okuyinto kungabonwa ezincwadini ezihlukahlukene nezihloko zezokwelapha kubonise ububomvu, uyakekela, ulceration. Ngaphezu lezi zimpawu, induration palpable, isigaxa ebeleni.
3. Ngo samuntu lwesithathu, izinguquko isikhumba kungukuthi uyalandelwa. Esikhathini luhlolo emitholampilo wembula ukuthi unesimila ebeleni futhi, ngesikhathi luhlolo histological wembula umdlavuza Paget (njengombiko okungahleliwe).

Umdlavuza wamaphaphu ingono: izimpawu, kuncike izinhlobo isifo

ezihlukahlukene zimpawu zingatholakala umdlavuza. Kuye isithombe yomtholampilo, umdlavuza Paget sika kungenziwa labizwa ngokuthi elandelayo:

• eczematid ezingamahlalakhona;
• eczematid acute;
• ifomu psoriatic;
• ifomu pigmentary.

Kanjani ingono e yomdlavuza webele? Impendulo yalo mbuzo incike kundlela lesi sifo. Ngo eczematid ezingamahlalakhona owesifazane isikhathi eside kukhona ingono eczema. On nasemaceleni ke soma. Lapho ayanyamalala, indawo yabo iba lubonakale ukukhala ebusweni. Ngo eczematid acute imakwe hyperemia. Imbudumbudu esihle phezu, oozing, ulceration Kuphinde sici yalesi sifo, efana Paget sika isifo (noma umdlavuza ingono). Izimpawu ifomu psoriatic esikhumbeni kuvele njengamadiski ishq exfoliated, kuyilapho ifomu sombala - ngesimo izindawo ngaphesheya areola.

Komdlavuza

Lapho esolwa izinqubo abulalayo okwenzeka indlala mammary, odokotela linqume mammography. Lolu cwaningo non-koda umdlavuza webele, okuyiwona-X-ray, ultrasound ingasetshenziswa. Ngokuhamba ke kungatholakala izimila. Enye indlela uphethwe - MRI. Ngenxa wakhe, ochwepheshe embule izinguquko ingono, okuyinto emtholampilo alibonakali.

Labo besifazane esolwa yomdlavuza webele ingono waphawula isifo emitholampilo isithombe Paget sika, wabelwa ingono futhi areola biopsy salo lonke ukushuba. Lesi sihloko sizoqinisa uvumela uhlelo ukusazi ngokunembile isifo esikuphethe, ukuqinisekisa noma zingamanga khona umdlavuza.

Izici wokwelapha isifo somdlavuza we ingono

Ukwelashwa Specialist inquma kuncike wathola imiphumela zokuxilonga. Lapho biopsy alivumi, it is eyenziwa ukuqapha ashukumisayo yesiguli sami esithile. Uma lesi sifo izenze wazizwa, ebonakaliswa izimpawu, a biopsy yesibili.

Lapho isiqinisekiso isifo Paget sika, ukuhlinzwa ukuze asuse isimila nezicubu ezizungezile, noma ngokuphelele kulo lonke webele. Ngemva kwalokho babelwe ukwelashwa eyengeziwe, okuvumela ekugcineni abhubhise amaseli angavamile.

Ukuze uthole olunye ulwazi mayelana nokwelashwa kuhlinzwa

Ukusebenza kuyisinyathelo esibalulekile futhi ezidingekayo yokwelapha inhlanganisela umdlavuza ezifana nomdlavuza ingono webele. Ochwepheshe isikhathi eside akakwazanga ukuza noma isiphi isiphetho ngokuqondene nalokho ukwelashwa okusebenza ngempumelelo. Izifundo ezihlukahlukene. I-University of Michigan ihlaziye imiphumela nokwelashwa kweziguli 36. Bonke bamangazwa bahlinza isitho. Esikhathini esizayo, ukuze isiguli zazinesilinganiso seminyaka izinyanga 113. Ngo 11% abesifazane waba Ukuphinda.

Futhi, esifundweni sokukhetha seSewula Korean lwenziwe. Imiphumela ngokuzuzisayo aphatha ngayo abesifazane 104 nomdlavuza ingono. ochwepheshe Mastectomy babelwe iziguli 92, abangu-12 yachitha imisebenzi isitho. Ngemva kwalokho 3 Ukuphinda kutholwe ngemva mastectomy nokukodwa emva yesibili kukho ukwelashwa. Ucwaningo luye lwabonisa ukuthi imisebenzi isitho musa ukwandisa hhayi ithuba lokuthuthukisa ukubuyela ngokuphelele ekubhemeni abesifazane. Le ndlela yokwelashwa inikezwe iziguli resection eyinkimbinkimbi ingono-areola.

ukwelashwa ngemisebe

ukwelashwa okuphumelelayo umdlavuza - kuyinto ukwelashwa ngemisebe. umsebenzi wayo ukuba abhubhise amangqamuzana akha focus sokugembula. ukwelashwa ngemisebe ukubhekana nakho, kodwa ngenxa yokuphathwa unesifo hhayi kuphela isimila nendlala okuthiwa i kodwa futhi amaseli enempilo. Ngenxa imiphumela emibi emzimbeni kunemiphumela emibi:

• Local - ezimise ukusha ngemisebe, kukhona encane ukopha ebalulekile ngenxa yokwanda fragility yegazi;
• uhlelo - Iziguli ezingamadoda esekhala isicanucanu, ukuhlanza, ubuthakathaka, ukukhathala.

Amakhemikhali okwelapha umdlavuza we ingono

Ukwelashwa ngamakhemikhali nokushiswa kuhilela ekuphathweni kwe-anticancer izidakamizwa ethize ukuvimbela ukukhula amangqamuzana abulalayo futhi kungaba yingozi kubo. Ukuphathwa kanjalo lomdlavuza ingono yakhelwe ukwenza imisebenzi elandelayo:

• ukuvimbela izifo metastatic;
• ithonya iphumelela isimila ngoba isicelo alandelayo zokwelapha wendawo (ukuhlinzwa noma ngemisebe).

Ukwelashwa ngamakhemikhali nokushiswa ukwelashwa ngemisebe kanye, ephelezelwa engemihle. Ngo-80% amacala isicanucanu nokuhlanza. Futhi, ngenxa nokwelashwa ngamakhemikhali, izinwele iqala ukuba iwe, babe izipikili ziyaqothuka ngaphezulu, isifiso eziwohlokayo, ukunambitheka ushintsho imikhuba.

Ukwelapha i-hormone

Ukuphathwa kanjalo kwelekelela khona izimila ama-hormone engaphansi emzimbeni. Nokho, umdlavuza Paget sika isikhathi eside akazange basonta izimila ezinjalo. Ngo-1949 kwaba uphakamise okokuqala ukuthi isifo angaphendula i-hormone nokwelulekwa, kodwa ngaphansi kwemibandela ethile. Kamuva ucwaningo kwafakazela ukuthi lokhu. ukwelashwa kwama-hormone i-isifo esinjengo umdlavuza esifubeni kuye kwaphumelela ngo khona neoplasm ebulalayo of progesterone receptor futhi estrogen.

Njengamanje, isidingo ukwelashwa kwama-hormone, iziguli iphathwa "Tamoxifen", "Zitazonium ',' Nolvadex '. Basuke njenge "izinga legolide" e impatho enjalo. Nokho, kukhona isimo lapho le mithi ingasetshenziswa: isimila kufanele abe receptor-hormone steroid (> 10 fmol / mg amaprotheni). Isidingo ukuchaza ekwelapheni hormone izidakamizwa ochwepheshe.

Onalesi sifo lomdlavuza ingono

Umdlavuza izifo enkulu yingozi. Iyathinteka kanye nomdlavuza izingono webele. Siyoba yini umphumela ukwelashwa? Izibikezelo incike inhlanganisela yezici:

• nesigaba lesi sifo;
• engu-ogulayo;
• inani lymph bazibandakanye;
• degree of umdlavuza;
• khona izici ezingezinhle morphological.

Odokotela bazi Ezimweni eziningi lapho ingono abantu ababulawa umdlavuza. Ukufa, ngokuvamile ezitholakala emabangeni ngasekupheleni, ezimweni ezithuthukile, ulaka begazi futhi umdlavuza. Ngakho, lapho izimpawu asolisayo cha mukela lo Ukuvakashela udokotela. Ukushesha uhlola isazi, ngokushesha uyobhala uphethwe yini futhi linqume ukwelashwa kudingekile.