Tam sim no, muaj kev mob qog noj ntshav sai sai. Ua ntej tshaj plaws, qhov no cuam tshuam rau neoplasms hauv plab hnyuv. Yog li ntawd, nws yog ib qho tseem ceeb kom paub tias qhov kev ntsuam xyuas yuav pab ua qhov kev kuaj mob no. Tom qab tag nrho, mob qog noj ntshav tsis yog kev tuag. Nrog rau lub sijhawm teem sijhawm ntawm kev kho mob, kev tso siab ruaj khov tuaj yeem ua tiav.
Ib txoj hauv kev zoo rau kev kuaj mob qog noj ntshav yog kev tshuaj xyuas cov kab mob hauv plab hnyuv.
Lub ntsiab lus ntawm kev tshawb fawb
Cov kab mob hauv plab hnyuv yog cov molecules loj uas muaj lipids, carbohydrates thiab cov proteins. Lawv tuaj yeem raug tsim los ntawm ob qho tib si ncaj qha los ntawm cov khoom nruab nrog cev uas tau ua rau mob qog noj ntshav, thiab los ntawm cov nqaij mos ntawm lub cev. Hauv qhov thib ob, kev tsim cov tshuaj no yog cov lus teb rau kev mob qog noj ntshav.
Feem ntau ntawm cov oncomarkers yog nyob rau hauv pawg neeg tshwj xeeb. Ntawd yog, kev tshawb pom ntawm ib yam khoom tshwj xeeb hauv cov ntshav qhiakev puas tsuaj rau ib lub cev.
Tab sis nws yuav ncaj ncees hais tias qhov nce ntawm cov qog qog tsis tas yuav qhia txog kev txhim kho ntawm cov txheej txheem qog nqaij hlav. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tau ua qhov kev ntsuam xyuas dua thiab saib xyuas cov kev hloov pauv ntawm cov ntsuas lub sij hawm.
Indications rau kev xeem
Kev tsom xam rau cov neeg mob plab hnyuv rau txhua tus tsis yog. Tom qab tag nrho, raws li twb tau hais lawm, hauv cov neeg noj qab haus huv lawv qib tuaj yeem nce ntxiv. Kev kuaj xyuas yam tsis muaj laj thawj tsim nyog tuaj yeem ua rau qhov kev kuaj mob tsis raug, uas yuav ua rau muaj kev puas siab puas ntsws ntawm tus neeg.
Yog li ntawd, ua ntej teb cov lus nug ntawm seb cov qog qog yuav tsum tau coj mus rau cov kab mob ntawm txoj hnyuv, nws yuav tsum tau piav qhia cov lus qhia rau txoj kev kuaj no:
- precancerous pathological txheej txheem hauv cov hnyuv, plab, pancreas thiab siab;
- tus kws kho mob muaj qhov xav tias mob qog noj ntshav loj;
- tom qab kev phais kom kuaj xyuas seb cov qog nqaij hlav puas tau raug tshem tawm tag nrho;
- thaum ua tshuaj tiv thaiv kab mob los ntsuas nws cov txiaj ntsig;
- txhawm rau kuaj mob qog noj ntshav lossis rov tshwm sim ua ntej cov tsos mob tshwm sim;
- los twv seb qhov kev loj hlob ntxiv ntawm cov txheej txheem qog.
Yog li, kev teem caij ntawm lub plab zom mov cov cim hauv qog noj ntshav yog tsim nyog rau ob qho tib si kuaj mob thiab kuaj mob.
Npaj rau thiab ua qhov kev tshuaj ntsuam
VimKev txiav txim siab ntawm qib ntawm cov cim qog ntshav yog ua tiav hauv cov ntshav, tom qab ntawd kev npaj rau qhov kev tshuaj ntsuam no yog xyaum tsis txawv ntawm lwm yam kev kuaj ntshav. Txhawm rau kom qhov kev txheeb xyuas kom muaj txiaj ntsig zoo tshaj plaws, koj yuav tsum ua raws li cov cai hauv qab no:
- ntshav pub rau sawv ntxov ua ntej noj mov;
- tsis kam noj yam tsawg 8 teev ua ntej kev xeem;
- tsawg kawg ib hnub ua ntej kev soj ntsuam, tsis txhob noj khoom hnyav: rog, kib, haus luam yeeb;
- tam sim ua ntej kev tshuaj ntsuam, nws raug tso cai haus dej zoo tib yam, tsis yog carbonated.
ntshav ntshav yog coj mus kuaj mob qog. Txhawm rau ua qhov no, tus kws saib xyuas mob ua ntej kho qhov chaw txhaj tshuaj nrog paj rwb swabs nrog antiseptic. Tom qab ntawd, nws siv ib lub syringe sterile pov tseg thiab maj mam nqus cov ntshav los ntawm cov hlab ntsha. Daim ntawv lo nrog tus neeg mob cov ntaub ntawv raug muab khi rau hauv lub raj mis ntshav, thiab cov ntshav raug xa mus rau lub chaw kuaj mob txhawm rau suav cov lej ntawm cov qog qog.
Cov txiaj ntsig tau muab rau tus neeg mob hnub tom ntej. Nyob rau hauv rooj plaub no, tus qauv qhia raws li cov ntaub ntawv ntawm ib lub chaw kuaj mob, thiab ib sab ntawm nws yog qib ntawm cov tshuaj pom nyob rau hauv tus neeg mob cov ntshav.
Qhov kawg txhais ntawm qhov tshwm sim thiab kev kuaj mob yog tsim los ntawm tus kws kho mob tuaj koom. Nws soj ntsuam cov ntaub ntawv tsom xam rau cov cim qhov rai, cov txiaj ntsig ntawm kev ntsuas cov txheej txheem ntawm kev ntsuam xyuas thiab cov kev kho mob tshwm sim ntawm tus kab mob hauv txoj kev nyuaj. Tsuas yog nrog txoj hauv kev no rau kev kuaj mob tuaj yeem kuaj pom tseeb.
Nyob hauv plab hnyuv qog markers
Dab tsi oncomarkers ntawm plab hnyuv noj nyob rau hauv lub xub ntiag ntawm saum toj nolus tim khawv? Cov hom hauv qab no muaj tus nqi kuaj mob loj tshaj plaws:
- CA 242;
- CA 125;
- SA 19-9;
- SA 72-4;
- SA 15-3;
- hCG - tib neeg chorionic gonadotropin;
- AFP - alpha-fetoprotein;
- CEA - mob qog noj ntshav embryonic antigen.
Chorionic gonadotropin thiab alpha-fetoprotein yog cov khoom uas ib txwm muaj nyob rau hauv tib neeg. Lawv yog cov cim qhia ntawm cev xeeb tub. Cov nqi me me yog siv tau rau cov poj niam uas tsis cev xeeb tub thiab cov txiv neej. Tab sis lawv cov lej siab thiab kev loj hlob sai qhia txog kev loj hlob ntawm cov txheej txheem qog.
CA 242 and CA 19-9
Thaum teb cov lus nug ntawm cov kab mob qog nqaij hlav hauv plab yog cov ntaub ntawv tshaj plaws rau kev kuaj mob, nws tsim nyog sau cia CA 242 thiab CA 19-9. Feem ntau ob yam khoom no tau txhais ua txoj hauv kev nyuaj.
Cov concentration ntawm CA 242 yog nce hauv cov ntshav hauv cov qog nqaij hlav qog nqaij hlav thiab cov hnyuv. Nws nrhiav pom ntawm lub qog ntawm lub qhov quav yog qhov tshwj xeeb tshaj yog cov yam ntxwv. Tab sis qib ntawm cov qog nqaij hlav tuaj yeem nce ntxiv nrog cov txheej txheem inflammatory hauv plab thiab hnyuv, nrog rau kev loj hlob ntawm cov qog nqaij hlav. Yog li, thaum kuaj mob qog noj ntshav, tus cim oncological no tsis tau txiav txim siab nyob rau hauv kev sib cais, tab sis ua ke nrog CA 19-9.
Kev tsim tawm ntawm CA 19-9 tshwm sim hauv cov hlwb epithelial ntawm txoj hlab pa thiab plab hnyuv. Nws qib hauv cov ntshav nce nrog mob qog noj ntshav ntawm qhov quav, plab thiab gallbladder. Kev nce me ntsis ntawm nws cov nyiaj kuj tseem ua tau nrog lwm cov txheej txheem uas tsis yog oncological:
- cirrhosis ntawm daim siab;
- cholecystitis;
- kab mob siab;
- kab mob gallstone;
- Ypancreatitis.
Kev loj hlob ntawm mob qog noj ntshav yog pov thawj los ntawm kev nce qib ntawm cov qog nqaij hlav hauv plab, nrog rau lawv cov kev loj hlob zuj zus.
CA 125, CA 72-4 and CA 15-3
CA 125 yog tsim los ntawm cov epithelium ntawm lub plab zom mov thiab cov kab mob ua pa hauv tus menyuam hauv plab, thiab hauv cov neeg laus tsuas yog hauv lub ntsws. Nws qhov nce ntxiv yog qhov tshwj xeeb tshaj plaws ntawm kev mob qog noj ntshav pancreatic. Nws kuj tau txiav txim siab nyob rau hauv malignant neoplasms ntawm daim siab, plab hnyuv, thiab plab. Nws qhov nce me ntsis yog pom thaum cev xeeb tub, kab mob siab hnyav, mob pancreas thiab txheej sab hauv ntawm lub tsev menyuam.
Kev txiav txim siab ntawm qib ntawm cov neeg mob plab hnyuv CA 72-4 yog ua tiav hauv kev kuaj mob ntawm tus txiav thiab lub plab hnyuv. Nws yog tsim los ntawm cov hlwb epithelial ntawm cov kwj dej alimentary. Txoj kev loj hlob ntawm cov txheej txheem malignant yog qhia los ntawm kev nce hauv CA 72-4 nrog rau CA 19-9, CA 125 thiab CEA. Kev sib cais nce ntxiv hauv CA 72-4 tuaj yeem ua tau nyob rau hauv cov mob uas tsis yog mob qog noj ntshav:
- benign mis qog;
- benign zes qe menyuam;
- benign neoplasms ntawm lub ntsws thiab daim siab;
- thaum cev xeeb tub.
Cancer marker CA 15-3 yog suav tias yog tshwj xeeb rau kev kuaj mob cancer mis. Tab sis nws nce, nrog rau lwm cov oncomarkers ntawm lub plab hnyuv ib ntsuj av, qhia txog kev loj hlob ntawm mob plab los yogtxoj hnyuv. Qhov tsawg kawg nkaus ntawm qhov concentration ntawm CA 15-3 tuaj yeem ua tau thaum cev xeeb tub, mob rheumatism, kab mob HIV, ua rau lub siab tsis zoo thiab lub raum ua haujlwm.
hCG, AFP thiab CEA
Chorionic gonadotropin yog ib yam tshuaj uas tsim los ntawm kev tsim me me hauv lub hlwb hu ua pituitary caj pas. Lub xub ntiag ntawm cov tshuaj hormone no yog qhov tsim nyog rau lub sijhawm cev xeeb tub. Ib qho kev nce ntxiv hauv cov tshuaj no hauv cov ntshav ntawm cov txiv neej lossis cov poj niam cev xeeb tub yog pom tias muaj carcinoma ntawm daim siab, plab lossis hnyuv. Hauv qee tus poj niam, qib nce siab thaum lub cev tsis muaj zog.
Alpha-fetoprotein yog ib yam khoom uas yog tsim los ntawm tus menyuam hauv plab los ntawm lub hnab yolk, thiab hauv cov neeg laus thiab menyuam yaus yog tsim los ntawm lub siab hlwb. Kev nce qib ntawm alpha-vetoprotein hauv cov ntshav, nrog rau kev nce ntxiv ntawm lwm cov qog nqaij hlav hauv plab, qhia tias mob qog noj ntshav lossis mob siab rau daim siab.
Cancer Embryonic Antigen
Kev sib txuas ntawm qog noj ntshav-embryonic antigen yuav tsum tsis muaj kiag li tom qab yug menyuam. Nws cov seem muaj nyob rau hauv lub epithelial hlwb ntawm lub plab thiab cov hnyuv, ua pa ib ntsuj av. Nws cov concentration nce nrog malignant neoplasms ntawm lub plab thiab qhov quav.
Kev nce me ntsis hauv nws qib yog ua tau nrog cov kab mob autoimmune ntawm cov ntaub so ntswg sib txuas (rheumatism, systemic lupus erythematosus), muaj cov hlwv hauv zes qe menyuam thiab cov qog mammary, kis kab mob ntawm lub ntsws. Nws qib kuj nce me ntsis hauv cov neeg haus luam yeeb.
Tshaj tawm kev tsom xam
Normaoncological markers nyob rau hauv cov ntshav yuav txawv nyob ntawm seb lub chaw soj nstuam nyob rau hauv uas qhov kev tshuaj ntsuam tau coj. Piv txwv li, nyob rau hauv qee lub chaw soj nstuam, tus qauv ntawm cov kab mob ntawm lub plab zom mov CA 242 yog txog 30 IU / ml, hauv lwm tus - txog li 20 IU / ml. Qhov nruab nrab cov nqi ib txwm muaj nyob rau hauv cov lus hauv qab no:
| CA 242 | mus txog 20 IU/ml |
| SA 19-9 | 40 IU/ml |
| CA 125 | 7 IU/mL |
| CA 72-4 | 20 - 30 IU/ml |
| SA 15-3 | 20 - 30 IU/ml |
| hcg | mus txog 10 IU/ml |
| AFP | 5 - 10 IU/ml |
| REA | 8 ng/ml |
txoj kev kho
Yog tias thaum lub sijhawm kuaj pom pom cov qog qog ntshav hauv cov ntshav nce siab, tus kws kho mob sau ntawv tshuaj ntsuam xyuas ntxiv: ultrasound, CT, scintigraphy. Tom qab kuaj pom zaum kawg, tus kws kho mob oncologist txiav txim siab txog kev kho mob. Kev kho mob ntawm malignant neoplasms ntawm lub plab zom mov yog nyob ntawm qhov muaj ntau thiab tsis saib xyuas ntawm cov txheej txheem, qhov tshwj xeeb hauv zos thiab hom qog.
Cov hauv qab no ntawm kev kho mob qog noj ntshav ntawm lub plab zom mov yog siv:
- phais kev kho mob - resection ntawm qhov cuam tshuam ntawm txoj hnyuv lossis plab, tshem tawm tag nrho lub cev, hloov daim siab;
- chemotherapy;
- radiotherapy;
- hormone therapy;
- targeted therapy.
Nyob rau theem kawg ntawm kev mob qog noj ntshav, kev kho mob palliative yog siv. Nws tsis tuaj yeem kho tus neeg mob kom tiav, tab sistxo cov tsos mob thiab txhim kho lub neej zoo.
