mob qog nqaij hlav qog noj ntshav yog hom kab mob oncological uas cov txheej txheem malignant tshwm hauv cov qog ntshav thiab feem ntau hauv cov kab ke no.
Hauv tib neeg lub cev, kev tiv thaiv kev ua haujlwm feem ntau yog muab rau cov kab mob lymphatic. Nws muaj lymph nodes thiab ib tug branched vascular network. Nws nyob ntawm no tias cov kab mob tiv thaiv kab mob tshwj xeeb raug tsim - lymphocytes, uas tsim cov teeb meem tseem ceeb thaum kis kab mob los yog kab mob nkag mus rau hauv lub cev.
Qhov siab tshaj plaws ntawm cov qog ntshav qab zib tau pom nyob hauv thaj chaw axillary, inguinal thiab ncauj tsev menyuam. Malignant puas rau lub cev no yog kwv yees li 4% ntawm tag nrho cov qog nqaij hlav. Tus kab mob tuaj yeem ua kom muaj zog hauv ib lossis ntau lub pob.
Ntau yam
Nws yuav tsum nco ntsoov tias lo lus "mob qog noj ntshav" yog hais txog yam tsawg kawg peb caug hom qog tsim.
- Hodgkin's lymphoma. Nws suav txog li 25-35% ntawm lymphomas uas twb muaj lawm. Thaum kuaj, nwsNws yog txiav txim los ntawm lub xub ntiag ntawm nws kim heev Ridge-Berezovsky-Strenberg cov ntaub so ntswg nyob rau hauv lub lymph nodes. Nws tseem hu ua lymphogranulomatosis.
- Non-Hodgkin's lymphomas - tag nrho lwm hom qog nqaij hlav qog nqaij hlav hu ua li ntawd. Lawv suav txog 65-75% ntawm cov neeg mob ntxiv. Kev kuaj mob tuaj yeem ua tau tsuas yog tom qab kuaj histological ntawm tag nrho cov ntaub so ntswg kuaj thiab cov hlwb tsim.
Qhov muaj cov qog nqaij hlav qog nqaij hlav hauv cov qog nqaij hlav yog ib qho teeb meem ntawm ntau cov qog nqaij hlav. Cov tsos mob ntawm qog nqaij hlav qog nqaij hlav hauv caj dab tau tham hauv qab no.
Hauv yuav luag txhua qhov xwm txheej, qhov chaw nyob hauv cheeb tsam lossis lymphogenous tau dhau los ua txoj hauv kev tseem ceeb, tom qab ntawd cov nodes nyob deb tau cuam tshuam. Qhov no tshwm sim thaum cov qog nqaij hlav cancer kis thoob plaws lub cev. Feem ntau, cov qog tshwj xeeb kuj tsim nyob rau hauv cov qog nqaij hlav.
Cas ntawm no pathology
Muaj plaub txoj kev xav tseem ceeb ntawm qog qog noj ntshav:
- kev npau taws heev;
- kev sib cuam tshuam nrog cov carcinogens;
- HIV, tus kab mob Epstein-Barr thiab human papillomavirus;
- kab mob hauv tib neeg lub cev.
Risk factors
Cov yam pheej hmoo suav nrog:
- haus luam yeeb (nyob ntawm qhov kev paub dhau los, qhov tshwm sim ntawm kev tsim cov qog ntshav qog ntshav thiab qog ntshav qog ntshav ntawm cov hlab ntsha loj zuj zus);
- phom sij ntawm kev tshaj lij, piv txwv li, ua haujlwm nrog cov tshuaj mutagenic (cov tshuaj tua kab mob) thiab hluav taws xobloads;
- hluas (txog kaum tsib mus rau nees nkaum-tsib) thiab hnub nyoog laus, uas yog rhiab heev rau kev cuam tshuam ntawm kev puas tsuaj ib puag ncig vim tsis muaj kev ruaj ntseg ntawm kev tiv thaiv kev tiv thaiv;
- yug lig thiab nyuaj heev tuaj yeem cuam tshuam lub homeostasis ntawm tib neeg lub cev nrog tsim cov txheej txheem qog nqaij hlav;
- genetic predisposition (tshwj xeeb tshaj yog nyob rau hauv thawj kab txheeb ze) rau lymphoid qog.
Cov tsos mob ntawm qog qog noj ntshav
Ntau zaus, cov neeg mob xav paub seb cov qog nqaij hlav puas mob cancer? Cov kev xav tsis zoo, raws li txoj cai, tsuas yog tshwm sim vim lawv qhov nce, txij li nws tau nrog los ntawm kev tawg ntawm fiber ntau nyob ib puag ncig lawv, nrog rau cov receptors hauv nws. Cov txheej txheem inflammatory hauv cov qog nqaij hlav qog nqaij hlav cancer pib thaum muaj kab mob txuas rau nws lossis tawm tsam keeb kwm ntawm kev tiv thaiv kab mob.
Muaj cov tsos mob ntawm cov qog nqaij hlav qog nqaij hlav:
- Nce lub cev kub, tshwj xeeb tshaj yog subfebrile thaum yav tsaus ntuj. Kev loj hlob kuj tseem cuam tshuam nrog kev nce mus rau 39-40 °, tawm hws hmo ntuj thiab kub taub hau.
- Ib khaus ntawm daim tawv nqaij, feem ntau tshwm sim, tab sis khaus ntawm lub hauv siab, tawv taub hau, xib teg thiab ko taw kuj tshwm sim.
- Xav txog kev tawg ntawm cov ntaub so ntswg thiab lub siab ntawm qhov chaw ntawm qhov chaw ntawm cov qog ntshav qog. Cov tsos mob ntawm cov qog nqaij hlav qog nqaij hlav (duab pathology tau tshaj tawm hauv kab lus) feem ntau yog qhov tshwj xeeb.
Non-specific complaints
Nrog lymphomas, kuj tseem muaj cov kev tsis txaus siab tshwj xeeb,ex:
- kev tsis taus ntawm tus neeg mob vim muaj kev xav tsis muaj zog thiab tsis muaj zog;
- kev qab los noj mov;
- nce kab mob fungal thiab kab mob;
- ua pa nyuaj;
- ntshav qab zib;
- tsis zoo hauv kev ua ntawm lub plab zom mov;
- poob phaus.
Cov qog nqaij hlav qog nqaij hlav hauv caj dab qee zaum nyuaj rau txheeb xyuas. Cov qog nqaij hlav loj loj tsis yog yuav tsum nruj heev. Qhov no tshwm sim tsuas yog ib nrab ntawm lub sijhawm.
Cov lus tsis txaus siab uas tau teev tseg saum toj no yog qhov muaj thoob ntiaj teb ntau dua, lawv nrog mob qog noj ntshav, tab sis cov txheej txheem autoimmune thiab cov tshuaj tiv thaiv kab mob tsis suav nrog.
theem ntawm qog nqaij hlav qog noj ntshav
Qhov sib txawv ntawm plaub theem ntawm tus kab mob yog nyob ntawm seb tus kab mob kis tau zoo npaum li cas. Nyob rau tib lub sijhawm, qhov kev puas tsuaj rau thaj chaw ntawm lymphatic hom, nrog rau cov kabmob zoo sib xws, tau sau tseg. Raws li qhov no, kev kuaj mob tau ua.
- Nyob rau hauv thawj theem ntawm cov qog nqaij hlav qog nqaij hlav, ib cheeb tsam tshwj xeeb raug cuam tshuam (nrog rau cov qog nqaij hlav qog nqaij hlav ntawm cov qog mammary lossis ntawm caj dab) lossis ib qho khoom nruab nrog sab nraud ntawm cov kab ke nthuav tawm.
- Hais txog theem tom ntej, uas yog, mob qog noj ntshav ntawm qib thib ob, peb tuaj yeem hais tias nws yog tus yam ntxwv los ntawm kev mob qog nqaij hlav ntawm ob lossis ntau thaj chaw ntawm ib sab ntawm lub diaphragm lossis ib qho khoom nruab nrog sab nraud. lymphatic system.
- Rau mob qog noj ntshav ntawm cov qog ntshav thib pebdegree, tag nrho cov o ntawm lub diaphragm tshwm sim, uas dhau mus nrog kev puas tsuaj rau ib lub cev sab nraum lub lymphatic system los yog tag nrho cov cheeb tsam, thiab tus po. Qee zaum, kev tshwm sim ib txhij tuaj yeem pom.
4 theem
theem plaub yuav tsum tau sau tseg nyias. Nws yog tus cwj pwm los ntawm kev puas tsuaj rau ib lossis ntau cov ntaub so ntswg sab nraum lub cev lossis cov kab mob lymphatic. Hauv qhov no, cov qog ntshav qab zib tuaj yeem koom nrog hauv cov txheej txheem pathological, lossis yuav tsis cuam tshuam. Nws nyob ntawm qhov tshwj xeeb ntawm tus neeg mob lub cev.
Ib lymphoma kuaj tau nyob rau theem plaub qhia tias tus kab mob twb tau mus deb heev. Cov theem no yog tshwj xeeb los ntawm:
- Tsis tu ncua o nrog kev tso rau ntawm qhov chaw ntawm cov pob txha, pancreas, siab, ntsws, lub hlwb kuj tuaj yeem cuam tshuam;
- nrawm nrawm nrawm nrawm;
- mob qog noj ntshav hnyav heev (piv txwv li, mob qog noj ntshav pancreatic, mob ntsws cancer, mob qog noj ntshav ntawm daim tawv nqaij, mob qog noj ntshav squamous cell carcinoma, myeloma thiab lwm yam kab mob oncological);
- ib pob txha tsis ua haujlwm.
Yog vim li cas qhov tshwm sim ntawm tus neeg mob rov zoo nyob rau theem plaub thiab theem thib peb tsis siab dhau piv rau thawj zaug thiab thib ob.
Raws li cov ntaub ntawv tshiab, cov txheej txheem kho mob ntawm cov kab mob no tuaj yeem suav tias ua tiav. Nyob ib ncig ntawm 70-83feem pua ntawm cov neeg mob nyob rau hauv kev zam txim rau ib lub sij hawm ntawm tsib xyoos. Qhov nruab nrab, tus naj npawb ntawm relapses yog li ntawm 30 txog 35%. Nws nyob ntawm lub sijhawm pib kho, cov kev siv thiab hnub nyoog qeb.
Cov txheej txheem mob qog noj ntshav ntawm cov qog nqaij hlav ncaj qha nyob ntawm ntau yam tseem ceeb: qhov chaw ntawm cov qog, nws qhov ntev, theem, kab mob satellite, muaj metastases thiab lawv qhov chaw tshwj xeeb. Feem ntau ntawm cov xwm txheej, tus kws kho mob muab cov kev kho mob ib txwm muaj (cov no suav nrog ib lossis ob peb chav kho mob chemotherapy). Qhov no tuaj yeem yog kev teem caij ywj pheej lossis ua ke nrog kev kho hluav taws xob, nrog rau ua ntej lossis tom qab kev phais.
- Tshuaj khomob yog ib txoj kev kho mob thoob ntiaj teb rau cov kab mob no, uas tso cai rau txwv tsis pub cov txheej txheem ntawm cov qog loj hlob, rau qee qhov txo nws qhov loj me thiab rhuav tshem qee cov qog nqaij hlav cancer.
- Kev kho mob tom ntej yog kev kho hluav taws xob. Cov chav kawm zoo li no tuaj yeem kav ntev li ob peb lub lis piam mus rau ib hlis. Tshwj xeeb tshaj yog feem ntau, kev kho hluav taws xob tau muab rau tus neeg mob tom qab tshem tawm cov qog ntshav qab zib.
- Kev phais mob qog noj ntshav ntawm cov qog nqaij hlav yog kab tias txoj hauv kev zoo tshaj plaws. Nws yog, nyob rau hauv qhov tseeb, tag nrho tshem tawm ntawm cov kab mob qog nqaij hlav. Txhawm rau txo qhov tshwm sim ntawm qhov tshwm sim tshiab ntawm pathology, ob peb lub hauv cheeb tsam nodes tau rov kho dua ib txhij nrog txoj haujlwm no.
- Tau tsim thiab ntau txoj hauv kev niaj hnub kho mob qog noj ntshavlymph nodes, piv txwv li, ib qho pob txha pob txha hloov mus rau tus neeg mob los ntawm tus neeg pub dawb. Xws li kev kho mob yog ib qho kev lees paub ntawm qhov kev cia siab zoo, tshwj xeeb tshaj yog thaum hu rau tus kws kho mob thaum ntxov. Hauv qhov no, nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas qhov kev hloov pauv me ntsis hauv lub xeev kev noj qab haus huv, ua cov tshuaj ntsuam xyuas kom ntau li ntau tau.
Ua tsaug rau qhov no, nrhiav tau tus kab mob phem heev thaum lub sijhawm nws yuav muaj peev xwm tiv tau nws yam tsis muaj kev puas tsuaj loj rau tus neeg mob.
Txoj Kev Npaj Rau Tus Kab Mob
Cov neeg mob uas muaj tus kab mob zoo li mob qog noj ntshav tuaj yeem nyob ntev npaum li cas? Cov kws kho mob tshwj xeeb, raws li kev soj ntsuam mus sij hawm ntev, tau tsim lub International Prognostic Code, uas muaj txiaj ntsig zoo rau lymphomas ntawm txhua theem ntawm malignancy.
Muaj 5 yam uas cuam tshuam rau tus neeg mob ciaj sia:
- ua ntej, qhov no yog lub hnub nyoog ntawm cov neeg mob - tus neeg yau, nws lub cev muaj zog dua, raws li nws tau yooj yim dua nrog cov kab mob;
- tib neeg kev noj qab haus huv (raws li WHO cov qauv);
- LDH degree (qib serum, ib txwm lossis siab);
- kab mob uas pom sab nraum cov qog nqaij hlav;
- kab mob theem.
Points
Thaum mob qog noj ntshav ntawm cov qog nqaij hlav qog nqaij hlav, qhov kev tshwm sim yog ua los ntawm cov lej ntawm cov ntsiab lus uas tau txais hauv txhua ntu. Nruab Nrab Ciaj sia nyob Cov Lus Nugua nyob rau hauv ib pab pawg neeg mob. Piv txwv li, qhov ntsuas pom zoo tshaj plaws hauv tus neeg mob uas muaj follicular lymphoma tau pom nyob rau hauv cov xwm txheej hauv qab no:
- nws hnub nyoog yog 32;
- qib LDH ib txwm;
- first stage;
- qhia txog tus mob feem ntau - 1 taw tes, txwv tsis pub muaj peev xwm ua haujlwm.
Huab cua los ntawm theem
Los ntawm theem, qhov kev cia siab rau kev ciaj sia yog kwv yees li hauv qab no:
- Stage 1 - 5-xyoo kev kwv yees muaj sia nyob tus nqi ntawm 82%;
- theem thib ob - 88%;
- thib peb - 63%;
- theem plaub - txog 49%.
