Infiltrative cancer ntawm lub plab, paub nyob rau hauv cov tshuaj raws li endophytic, yog ib yam ntawm cov kab mob oncological txaus ntshai tshaj rau tib neeg. Nta ntawm localization, qhov tshwj xeeb ntawm kev loj hlob ntawm thaj chaw atypical yog qhov kev kuaj mob ntawm pathology thaum ntxov yog qhov nyuaj heev. Feem ntau ntawm cov neeg mob tuaj yeem txheeb xyuas tau tsuas yog thaum tus kab mob tau nce zuj zus lawm. Feem ntau, histological tsom xam tso cai rau kev kuaj mob ntawm scirrhus, vim hais tias infiltrative cancer thiab scirrhus raug suav hais tias los ntawm ntau tus neeg yog tib yam kab mob. Qhov tseeb, thawj lub tswv yim yog dav dua, ntxiv rau skirra, nws suav nrog qee yam ntawm oncology.
Study problems
Nyob ntawm kev sab laj nrog tus kws kho mob oncologist (muaj ntau tus kws tshaj lij hauv Moscow, St. Petersburg thiab lwm lub nroog), tus kws kho mob yuav xyuam xim tshwj xeeb rau qhov mob ntawm cov mucosa. Yog tias muaj kev xav tias mob qog noj ntshav infiltrative, nws yog ib qho tsim nyog los ntsuas qhov kev pab cuam thiab qib ntawm nws qhov sib txawv ntawm cov qauv. Ntawm qee theem ntawm txoj kev loj hlob, infiltrative cancer yog nyob rau hauv nruj me ntsis nyob rau hauv lub submucosal txheej, uas ua rau nws tshwj xeebua tib zoo saib xyuas qhov mob ntawm tus neeg mob hauv tsev kho mob.
Yog tias tus neeg mob muaj mob qog noj ntshav hauv plab, cov qog nqaij hlav yuav zoo li noj qab nyob zoo rau lub sijhawm ntev. Koj tuaj yeem xav tias muaj kab mob oncological los ntawm kev ruaj ntseg ntawm cov ntaub so ntswg - nws yog qhov tsis muaj qhov sib txawv uas tuaj yeem qhia tus kws kho mob seb nws yuav tsum tau ua li cas. Qee lub sij hawm tus kab mob no tshwm sim raws li qhov xwm txheej sib txawv - cov hlwb atypical tau nyob hauv thaj chaw ntawm lub cev uas tsis muaj folds. Txawm li cas los xij, nyob rau hauv feem pua ntawm cov neeg mob feem ntau, kev kawm ntawm cov mucous daim nyias nyias ntawm lub cev tsis tuaj yeem ua tsis tau vim muaj zog ntawm cov phab ntsa hauv plab.
Tau nthuav dav
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Yog tias tus neeg mob tau tsim mob qog noj ntshav nyob rau sab sauv thib peb ntawm lub plab, cov kab mob ntawm lub cev tseem pom meej, lawv tseem zoo heev. Lub aperist altic cheeb tsam yog pronounced. Cov yam ntxwv no ua rau nws yooj yim dua los txiav txim txog thaj tsam ntawm tus kab mob. Nws qhov kev kuaj pom yog ib qho tseem ceeb hauv kev qhia meej txog cov kab mob qog noj ntshav.
Xyaum qhia tau tias daim ntawv txiav txim siab ntawm oncology yog ib qho nyuaj tshaj plawsrau kev kuaj mob los ntawm txoj kev muaj rau cov kws kho mob niaj hnub. Kev ua yuam kev hauv kev kuaj mob muaj ntau heev. Qhov no siv rau txoj kev tshawb fawb ntawm cov neeg mob ob qho tib si nrog kev pab ntawm X-rays thiab los ntawm lub endoscope. Kev ntsuas rau infiltrative gastric cancer yog qhov tsis zoo. Cov txiaj ntsig ntawm kev kho mob feem ntau yog nyob ntawm theem uas tau kuaj pom tus kab mob. Qhov zoo tshaj plaws, tau kawg, yog tias koj pib kho twb nyob rau thawj theem.
Tus yam ntxwv ntawm tus kab mob
Infiltrative daim ntawv ntawm plab mob qog noj ntshav yog tsim los ntawm lub plab epithelium. Hauv kev tshuaj xyuas qhov muag, nws pom nws tus kheej yog qhov mob ntawm qhov tob tob (tshwj xeeb tshaj yog nyob rau theem kawg). Hauv qab ntawm qhov tsim yog ntom, npog nrog tubercles. Germination tshwm sim tob rau hauv lub plab phab ntsa. Tus kab mob yog tus yam ntxwv los ntawm kev nce qib ntawm malignancy. Cov qog loj hlob sai, kis mus rau cov ntaub so ntswg ntawm lub cev. Feem ntau, kev mob qog noj ntshav hauv lub cev ntawm lub plab yog qhov tshwm sim los ntawm ntau qhov txhab, vim tias qhov chaw muaj kab mob npog lub cev tag nrho.
Atypical hlwb kis nyob rau hauv submucosal txheej. Qhov no ntawm lub plab yog qhov txawv los ntawm ntau cov hlab ntsha rau cov kua dej ntws, thiab cov kab mob tuaj yeem kis tau sai sai thoob plaws lub cev los ntawm cov kab mob lymphatic. Daim ntawv infiltrative ntawm tus kab mob yog tus cwj pwm los ntawm qhov tshwm sim thaum ntxov ntawm metastases.
Kev nce qib ntawm pathology cuam tshuam nrog kev puas tsuaj ntawm cov ntaub so ntswg hauv plab thiab nthuav dav ntawm phab ntsa ntawm lub cev. Lub peev xwm ntawm lub plab ua haujlwm tau maj mam inhibited kom txog thaum ua tiav kev ua haujlwm.
qhov teeb meem tuaj qhov twg?
BTam sim no, infiltrative gastric cancer tsis tau kawm zoo txaus, yog li nws tsis tuaj yeem hais meej tias txhua qhov ua tau ntawm kev txhim kho pathology tau pom. Nws paub tias malignancy yog yam ntxwv ntawm cov ntaub so ntswg cuam tshuam los ntawm cov kab mob ntev los yog gastritis, uas yog tus cwj pwm los ntawm cov txheej txheem atrophic hauv cov ntaub so ntswg. Cov kev tshawb fawb kho mob qhia tau hais tias qhov degeneration ntawm cov cheeb tsam ulcerated mus rau malignant sawv daws yuav ua tau nyob rau txhua theem ntawm tus kab mob.
Nyob rau qee kis, mob qog noj ntshav hauv plab tshwm sim vim muaj cov caj ces ua ntej. Feem ntau ntawm cov neeg no dhau los ua cov neeg mob ntawm oncology department thaum tseem hluas. Muaj kev pheej hmoo ntawm mob qog noj ntshav nrog kev noj zaub mov tsis txaus thiab noj ntau dhau ntawm haus luam yeeb, ntsim, nrog rau kev tsim txom ntsev. Qhov tshwm sim ntawm tus mob neoplasm yuav nce ntxiv yog tias ib tus neeg suav nrog tsawg dhau thiab ob peb txiv hmab txiv ntoo thiab zaub hauv cov ntawv qhia zaub mov.
Yuav ceeb toom li cas?
Ib qho kev phom sij ntawm infiltrative-ulcerative daim ntawv ntawm mob qog noj ntshav plab yog lub sij hawm ntawm lub sij hawm tsis muaj tsos mob. Tsis ntev los sis tom qab, tus neeg mob ntsib teeb meem uas qhia tias tsis muaj zog ntawm plab hnyuv ua haujlwm. Nws yog ib qho nyuaj tsis yog tsuas yog txiav txim siab muaj mob qog noj ntshav hauv lub sijhawm, tab sis kuj tseem txiav txim siab txog thaj tsam ntawm cov nqaij mos malignancy.
Koj tuaj yeem xav tias muaj ib hom mob qog nqaij hlav hauv plab infiltrative-ulcerative yog tias thaj chaw no cuam tshuam los ntawm qhov mob uas tsis cuam tshuam nrog zaub mov. Tsis muaj kev zam txim, thiab acidity ntawm cov kua txiv hmab txiv ntoo uas ua los ntawm cov kab mob plab yuav qis dua. Tus neeg mob cuam tshuamkub hnyiab, xeev siab, thiab plab hnyuv txav nrog nrog pom. Feem ntau, lawv qhov ntim tsis tseem ceeb, yog li nws yuav tsis tuaj yeem pom muaj cov ntshav los ntawm qhov muag, tab sis kev kuaj sim yuav muab qhov tseeb. Tus neeg mob nrawm nrawm nrawm, yog li lub qab los noj mov maj mam qis kom txog thaum nws ploj tag. Tawm tsam keeb kwm yav dhau los no, muaj qhov poob phaus, anemia. Tu siab ua luaj li os.
Nyob rau hauv qhov mob qog nqaij hlav hauv plab, ua raws li kev noj zaub mov nruj tuaj yeem txo cov tsos mob rau lub sijhawm luv. Qhov kev txhim kho ib ntus no tsis qhia txog kev kho.
Qhia meej txog kev kuaj mob
txhawm rau txheeb xyuas qhov mob qog noj ntshav hauv plab lossis txiav txim siab lwm qhov laj thawj uas piav qhia txog kev tsis zoo ntawm tus neeg mob, nws yog thawj zaug uas yuav tsum tau txais cov ntshav mus kuaj. Nrog rau cov kab mob oncological, ESR Performance index nce, qhov concentration ntawm leukocytes, nws muaj peev xwm mus ntes cov cim tshwj xeeb uas qhia tias muaj cov hlwb atypical hauv lub cev.
Tus neeg mob raug xa mus rau x-ray siv tus neeg sawv cev sib txawv. Siv barium sulfate nyob rau hauv daim ntawv ntawm kev ncua. Cov txheej txheem no tso cai rau kev ntsuam xyuas lub plab nyem, kuaj pom muaj cov txheej txheem pathological thiab ntsuas seb thaj chaw loj npaum li cas los ntawm nws. Nws yog ib qho tsim nyog yuav tau kuaj xyuas ultrasound kom pom cov yam ntxwv ntawm lub cev. Nrog rau txoj kev tshawb no, nws muaj peev xwm ntsuas qhov ceev ntawm cov phab ntsa hauv plab thiab txheeb xyuas cov metastases, yog tias muaj, tau pom nyob rau hauv peritoneum.
Hauv txhua qhov chaw kho mob oncology ntseeg tau hauv peb lub tebchaws (thiab tshwj xeeb tshaj yog nyob rau hauv Moscow), kev sib tham ntawm oncologist xaus nrog kev tshaj tawm kev xa mus rau kev kuaj xyuas siv qhov endoscope. Gastroscopy yog ua raws li txoj hauv kev kom tau txais cov ntaub so ntswg rau kev kuaj histological hauv chav kuaj. Thaum kawg, xam tomography yog xav tau. Tam sim no, qhov no yog qhov tseeb tshaj plaws thiab muaj txiaj ntsig zoo rau kev ntsuas qhov loj thiab thaj chaw ntawm cov txheej txheem qog. CT tso cai rau koj los txiav txim seb qhov muaj metastases nyob rau hauv ntau qhov chaw ntawm lub cev, txawm tias lawv me me.
Diagnosis paub tseeb! Yuav ua li cas?
Kev kho mob ntawm cov kab mob hauv plab-ulcerative daim ntawv mob qog noj ntshav yog ua nyob rau hauv 3 txoj hauv kev: phais, tshuaj kho mob, hluav taws xob. Lub ntsiab tseem ceeb tshaj plaws yog kev phais. Ua tiav raws sijhawm, nws tso cai rau koj kom txo qis qhov kev pheej hmoo los ntshav. Raws li kev txheeb cais qhia, nws yog qhov teeb meem uas ua rau muaj kev tuag nyob rau hauv feem ntau ntawm infiltrative gastric cancer. Xaiv qhov kev cuam tshuam, ntsuas theem ntawm tus kab mob. Muaj ob txoj hauv kev tseem ceeb: palliative, radical. Thawj qhov kev xaiv muaj feem cuam tshuam yog tias daim ntawv infiltrative-ulcerative ntawm gastric cancer ntawm qib 3 lossis 4th yog tsim los - nws yog tsom rau kev txo cov tsos mob thiab muab tus neeg mob lub neej ntev tshaj plaws.
Ib tug nab npawb ntawm cov neeg mob tuaj txog ntawm lub tsev kho mob nyob rau hauv ib tug mob uas phais yog contraindicated. Hauv qhov no, tsuas yog kev kho mob nrog tshuaj thiab hluav taws xob yog ua tau. Hoob no yog tsom rau txo qhov ntim ntawm neoplasm thiab txo cov tsos mob ntawm tus kab mob.
Kev kho mob hluav taws xob
Tshuaj khomob yog siv thaum tus neeg mob tau contraindicated hauv kev phais, nrog rau tom qab thiab ua ntej kev phais. Tom qab ua haujlwm, qhov kev kho mob hu ua adjuvant yog xyaum ua ntej - tsis yog adjuvant. Nyob rau theem kawg ntawm tus kab mob no, cov tshuaj tau muab tshuaj raws li txoj hauv kev los txo tus neeg mob tus mob thiab txhim kho nws lub neej txhua hnub.
Irradiation raws li ib txoj hauv kev kho mob rau kev mob plab hnyuv tsuas yog siv los ua cov txheej txheem pabcuam. Nws tso cai rau koj kom ua tau zoo ntawm cov tshuaj thiab kev phais mob, txhim kho tus neeg mob qhov kev cia siab.
Kuv tuaj yeem ceeb toom koj?
Nws yog tam sim no paub tias infiltrative gastric cancer feem ntau tsim tawm tsam keeb kwm ntawm gastritis, peptic ulcer. Yog li ntawd, nws muaj peev xwm txo qis qhov tshwm sim ntawm cov txheej txheem oncological yog tias, nrog rau cov kev kuaj mob zoo li no, kev kho kom tsim nyog tau pib raws sijhawm thiab kev kuaj xyuas kev tiv thaiv tau ua ob zaug ib xyoos ib zaug.
Ib tug neeg noj qab haus huv yuav tsum tau ntsuas kom txo qis kev pheej hmoo ntawm gastritis, atrophy ntawm gastric cov ntaub so ntswg, thiab yaig ntawm mucosa. Kev tiv thaiv ntawm cov kab mob pathological no yog txoj hauv kev zoo tshaj plaws ntawm kev tiv thaiv oncology. Nws tseem yog ib qho tseem ceeb uas yuav tsum tso tseg tus cwj pwm phem, noj kom raug, yog tias ua tau, noj tsawg li tsawg tau kom qab ntsev, cov kaus poom thiab haus cov nqaij, ntsim, zaub mov ceev.
Oncology: plab lesion
Tam sim no, mob plab hnyuv yog ib qho ntawm cov kab mob oncological feem ntaunrog rau kev puas tsuaj rau kev ua pa. Cov neeg tuag nrog qhov kev kuaj mob no hauv peb lub tebchaws yog qhov tshwj xeeb. Muaj ntau hom mob qog noj ntshav, tab sis nws yog infiltrative uas feem ntau tshwm sim. Nws sib tw nyob rau hauv prevalence nrog thawj ulcerative daim ntawv. Lwm hom kev ua phem raug kuaj pom tsawg dua.
Thaum muaj mob qog noj ntshav tau pom thrombosis, sclerosis nyob ib puag ncig cov kab mob ntawm cov hlab ntsha. Hauv qab cicatricial, cov qauv ntawm cov leeg nqaij cuam tshuam. Kev kuaj histological feem ntau tso cai rau koj los tsim cov qauv ntawm adenocarcinoma. Hom undifferentiated yog me ntsis tsawg dua.
Cov kws kho mob kwv yees qhov tshwm sim ntawm plab hnyuv malignancy ntawm 7-10%, txawm hais tias qee cov kws tshaj lij ntseeg tias tus nqi tsis tshaj 2%. Qhov tshwm sim ntawm malignancy yog siab dua thaum pom ulcer thiab atrophic gastritis nyob rau tib lub sij hawm - ob qho tib si kab mob yog suav tias yog precancerous. Qee zaum, mob qog noj ntshav infiltrative tau piav qhia los ntawm epithelial dysplasia. Qee cov kws tshawb fawb tau ntseeg tias tam sim no tsis muaj cov ntaub ntawv txhim khu kev qha uas tso cai rau peb tham txog qhov muaj peev xwm ntawm kev mob plab hnyuv siab rau lub plab.
Ulcer: puas hloov mus ua qog?
Nws tuaj yeem xav tias qhov mob ntawm cov txheej txheem ulcerative yog qhov xwm txheej ntawm tus kab mob yav dhau los hloov pauv. Nrog rau qhov mob plab, feem ntau yog ib qho kev tshem tawm ntev, qhov zaus ntawm cov ntaub ntawv mob. Nrog rau kev hloov pauv ntawm tus kab mob, lub sijhawm ntawm kev tshem tawm txo qis, lub sij hawm ploj mus, lub voj voog ntawm tus neeg mob tsis tau pom, thiab qhov mob tshwm sim.tsis ntse, tab sis hnov tas li, tsis tau khi rau ib pluag mov. Tsis muaj laj thawj pom tseeb, tus neeg mob tsis muaj zog, thiab palpation hauv plab yog nrog los ntawm qhov mob tsawg dua ua ntej.
Yog tias mob qog noj ntshav tshwm sim tom qab ntawm qhov txhab, cov tshuaj thiab cov khoom noj kom zoo tuaj yeem ua rau muaj kev txhim kho ntawm tus mob kom txog rau thaum cov tsos mob tshwm sim ploj ntawm X-ray. Qhov no tsis qhia txog kev kho ntawm thaj chaw ulcerated, tab sis tsuas yog qhia txog kev loj hlob ntawm cov qog.
Yog tias kuaj pom qhov mob hauv tus neeg mob thaum muaj hnub nyoog siab heev, nws yuav tsum tau ua tam sim ntawd kuaj xyuas kom meej meej qhov tseeb ntawm qhov tsis zoo. Nws raug coj mus rau hauv tus account tias mob qog noj ntshav tuaj yeem pom tag nrho cov tsos mob ntawm benign ulceration thaum kuaj nrog x-ray lossis endoscope. Txhawm rau txiav txim siab tus neeg mob kom raug, nws yog ib qho tsim nyog yuav tsum tau kuaj cov ntaub so ntswg rau kev kuaj mob histological. Tau cov hlwb ntawm cov npoo ntawm thaj chaw muaj kab mob, hauv qab.
Huab cua thiab kev cia siab
Tau kawg, tej zaum cov lus nug tseem ceeb tshaj plaws rau cov neeg uas muaj mob qog noj ntshav hauv plab yog lawv nyob ntev npaum li cas nrog kev kuaj mob. Ntau yam nyob ntawm theem ntawm tus kab mob, tus yam ntxwv ntawm tus neeg mob, lub cev muaj peev xwm tawm tsam tus kab mob, nrog rau kev ua siab ntev ntawm cov tshuaj.
Nws ntseeg tias, qhov nruab nrab, yog tias kuaj pom mob qog noj ntshav nyob rau theem pib, qhov ciaj sia taus yog 90-100%, nyob rau theem thib ob - txog 87%, qhov thib peb - txog 60%. Ntawm cov neeg uas kuaj pom tus kab mob ntawm qib plaubkev loj hlob, tsib xyoos ciaj sia tsis tshaj 20%. Yog tias tom qab tsib xyoos tsis muaj tus kab mob rov qab los, tus neeg mob raug txiav txim siab kho. Feem ntau, pathology raug kuaj pom nyob rau theem thib peb. Qhov tshwm sim ntawm kev kho kom tiav yog siab dua yog tias tsis muaj metastases lossis tsis muaj ntau tshaj ob ntawm lawv.
