Lymphoma yog ib yam kab mob uas cov qog nqaij hlav lymphatic cuam tshuam. Nyob rau tib lub sijhawm, cov lymphocytes cuam tshuam pib sib faib thiab provoke malfunctions nyob rau hauv ib txwm ua hauj lwm ntawm lub cev ntawm tib neeg lub cev. Muaj cov kab mob zoo li no: lymphogranulomatosis (los yog hu ua Hodgkin's disease) thiab non-Hodgkin's lymphomas (xws li follicular non-Hodgkin's lymphoma).
Lymphatic system. Dab tsi yog
Ib feem ntawm kev tiv thaiv kab mob ntawm peb lub cev yog cov lymphatic, lub luag haujlwm tseem ceeb ntawm kev tiv thaiv txhua yam kab mob thiab lwm yam kab mob. Nws yog lub network ntawm cov channel uas cov kua tshwj xeeb txav - lymph. Nyob rau hauv lub capillaries, cov qog nqaij hlav qog tau pom, uas cov qog ntshav tau ntxiv nrog cov hlwb tshwj xeeb - lymphocytes. Muaj ob peb subspecies. B-lymphocytes yog lub luag haujlwm rau kev tiv thaiv kab mob sib kis. Sib cuag nrog cov kab mob pathogenic, lawv tshem tawm nws qhov kev ua thiab khaws cia rau hauv lawv lub cim xeeb. B-lymphocytes yog cov neeg ua haujlwm tseem ceeb hauv kev tsim cov txiaj ntsig zoo ntawm kev txhaj tshuaj. Feem ntau (80%) ntawm cov qog ntshav yog T-lymphocytes. Lawv yog lub luag haujlwm rau kev rhuav tshemtxhua yam kab mob thiab kab mob. NK-lymphocytes muaj nyob rau hauv cov qog ntshav hauv me me (txog 10%). Lawv lub luag haujlwm tseem ceeb yog kev puas tsuaj ntawm lawv tus kheej cov hlwb (xws li cov kab mob xws li follicular lymphoma).
Yuav ua li cas cov txheej txheem malignant tsim nyob rau hauv lymphatic system
Cov txheej txheem qog pib tsim los ntawm cov hlwb ntawm cov kab mob lymphatic (B-lymphocytes). Tus kab mob no feem ntau yog nyob rau hauv cov neeg laus, nyob rau hauv cov me nyuam nws tshwm sim nyob rau hauv kev sib cais. Follicular lymphoma tau txais nws lub npe los ntawm qhov tseeb tias cov plaub hau follicle yog thawj zaug cuam tshuam. Feem ntau, neoplasms tau pom nyob rau hauv caj dab, armpits, puab tais. Ib yam ntawm cov lymphoma no yog cov neeg mob nrhiav kev pab lig. Cov lymphocytes cuam tshuam nkag mus rau hauv txhua yam hauv nruab nrog cev, cuam tshuam lawv txoj haujlwm. Txawm hais tias follicular lymphoma iiiia teb tau zoo rau kev kho mob, kev kuaj mob lig tsis tuaj yeem ua kom tshem tau tus kab mob tag nrho.
Yuav ua rau muaj kab mob
Cov kws tshaj lij tsis tuaj yeem sau cov laj thawj tseeb uas ua rau muaj kev loj hlob ntawm cov kab mob oncological. Txawm li cas los xij, muaj ntau yam uas ua rau muaj cov qog nqaij hlav malignant. Ib ntawm lawv yog kev hloov pauv ntawm cov noob, chromosomes. Ua haujlwm nyob rau hauv cov xwm txheej tsis zoo, kev sib cuag tsis tu ncua nrog cov tshuaj phem tuaj yeem ua rau muaj kev cuam tshuam rau kev loj hlob ntawm tus mob xws li follicular lymphoma. Cov laj thawj ntawm tus kab mob tuaj yeem ua raws li hauv qab no:hluav taws xob, immunodeficiency tsis muaj zog ntawm lub cev, kab mob autoimmune. Qee tus kws tshaj lij kuj txheeb xyuas qhov xwm txheej xws li haus luam yeeb, noj qee yam tshuaj, thiab txawm tias rog.
Cov tsos mob ntawm lymphoma
Follicular lymphoma muaj cov tsos mob me me, tshwj xeeb tshaj yog cov theem pib. Ua ntej tshaj plaws, qee qhov loj ntawm cov qog nqaij hlav tuaj yeem raug sau tseg. Txawm li cas los xij, lawv nyob twj ywm tsis mob. Nws yog tus yam ntxwv uas qhov o me me ib ntus ploj mus, tom qab ntawd rov tshwm sim. Qhov tseeb no yuav tsum ceeb tshwj xeeb. Cov nodes hauv lub sternum kuj nce. Outwardly, qhov no tuaj yeem tshwm sim nws tus kheej li hnoos, ua tsis taus pa. Tej zaum yuav muaj o me ntsis ntawm lub ntsej muag. Qee zaum, tus po kuj raug kev txom nyem. Follicular lymphoma cov tsos mob tuaj yeem tshwm sim: poob phaus, qaug zog, qaug zog ntawm lub cev. Txawm li cas los xij, cov cim no yog qhov tshwj tsis yog txoj cai, lawv tau pom nyob rau hauv tsuas yog ib tus neeg mob ntawm kaum. Cov theem hnyav ntawm tus kab mob no tshwm sim los ntawm kev puas tsuaj rau lub paj hlwb, tshwj xeeb tshaj yog cov pob txha pob txha. Tib lub sijhawm, kiv taub hau, xeev siab, thiab tsis nco qab yog ua tau.
Kev faib tawm thiab theem ntawm kev mob qog noj ntshav
Muaj ntau hom lymphomas. Thawj yog follicular. Cov ntsiab lus ntawm follicles hauv qhov no yog 75%. Yog tias nws nyob hauv thaj tsam ntawm 25-75%, ces qhov no yog follicular-diffuse subspecies. Nrog hom diffuse, tsawg dua 25% ntawm cov follicles tau sau tseg. Follicular lymphoma (iiiia) tshwm sim hauv ntau theem. Thaum pib, tsuas yog ib cheeb tsam ntawm cov qog nqaij hlav raug cuam tshuam. Thib obtheem yog tus cwj pwm los ntawm kev koom tes ntawm ob lossis ntau qhov chaw hauv cov txheej txheem pathological (tab sis ntawm ib sab ntawm lub diaphragm). Hauv qib peb, cov cheeb tsam ntawm ob sab ntawm lub diaphragm raug cuam tshuam. Qhov nyuaj tshaj plaws theem plaub. Kev hloov pauv kuj tshwm sim hauv cov kab mob hauv nruab nrog cev thiab cov kab ke (pob txha pob txha, daim siab, thiab lwm yam). Qee lub sij hawm cov ntawv sau ntxiv rau tus lej tsim los ntawm theem ntawm lymphoma: A lossis B. Qhov no qhia seb puas muaj cov qog ntshav qog ntshav qog ntshav muaj cov tsos mob hauv qab no: "B" - muaj kev hloov pauv hauv lub cev kub (nce ib ntus), poob phaus, hws thaum hmo ntuj. Lymphoma nrog lub npe "A" - cov tsos mob no tsis tuaj.
Txoj kev kuaj mob qog ntshav qog ntshav
Ua ntej tshaj plaws, tus kws kho mob tshwj xeeb (onco-hematologist) ua qhov kev kuaj pom ntawm tus neeg mob. Kev kuaj histological ntawm tus qauv yog yuav tsum tau ua. Rau qhov no, biopsy yog ua. Ib daim ntawm cov qog nqaij hlav cuam tshuam raug tshem tawm thiab kuaj xyuas hauv lub tshuab tsom. Nws yog tsim nyog sau cia peb hom cytological ntawm tus kab mob uas yuav tsum tau kho ntau yam. Thawj hom yog tus cwj pwm los ntawm qhov muaj txog li tsib lub centroblasts nyob rau hauv qhov kev pom ntawm lub tshuab tsom, qhov thib ob - txog li 15 units. Qhov thib ob hom cytological yuav tsum tau siv tshuaj khomob poob siab, vim nws hnyav heev. Follicular lymphoma 3a cytological yam muaj qhov tsis txaus siab tshaj plaws. Kev nthuav dav neoplasms tuaj yeem pom hauv thaj chaw saib ntawm lub tshuab tsom. Tsis tas li ntawd, tus neeg mob yuav tsum pub ntshav (cov cim qog nqaij hlav, kev tsom xam dav dav), tau txais kev kuaj ultrasound ntawm cov kabmob sab hauv, CT lossis MRI. Los txiav txim seb qhov cuam tshuamLub hauv paus paj hlwb, tus txha caj qaum tau raug sau rau kev kuaj ntxiv kom pom muaj cov qog nqaij hlav cancer.
Follicular lymphoma. Kev kho mob
Tsis ntev los no, tus naj npawb ntawm cov neeg mob nrog qhov kev kuaj mob no tau nce ntau. Raws li txoj cai, cov neoplasms ua ntej tau pom, qhov muaj feem ntau tus neeg mob tau cawm nws txoj kev noj qab haus huv thiab lub neej. Lymphoma yog tus cwj pwm los ntawm kev kawm qeeb qeeb, yog li ntawd, hauv qee kis, cov kws kho mob xaiv tus cwj pwm tos-thiab-saib, saib txhua qhov kev hloov pauv hauv tib neeg lub cev. Qhov no yog vim lub fact tias ob qho tib si chemotherapy thiab phais tsis dhau yam tsis muaj ib tug kab thiab muaj lawv cov tsis zoo sab. Kev tshem tawm ntawm follicular lymphoma tuaj yeem kav ntau xyoo. Yog hais tias tus kab mob oncological pib nce, ces kev kho yuav tsum tau nqa tawm tam sim ntawd. Ntawm cov txheej txheem tseem ceeb ntawm kev kho mob, hluav taws xob, kws khomob, thiab tshuaj yuav tsum paub qhov txawv. Nyob ntawm seb hom lymphoma, lub cheeb tsam irradiation tuaj yeem tiv thaiv kev rov tshwm sim. Nyob rau thawj theem ntawm tus kab mob, kev tso cai mus sij hawm ntev tau sau tseg hauv cov neeg mob feem ntau.
Kev tswj cov tshuaj khomob
Tshuaj kho mob hnyav (feem ntau yog siv ntau yam tshuaj) nyob rau theem pib ntawm lymphoma tuaj yeem txo qhov kev pheej hmoo ntawm rov tshwm sim dua. Tau ntev, txoj kev no tau suav hais tias yog qhov tseem ceeb hauv kev kho mob qog noj ntshav. Kws khomob tsom mus tua cov qog hlwb thaum lawv sib npaug. Cov tshuaj sib xyaw ua ke tuaj yeem cuam tshuam cov txheej txheem ntawm kev faib cov theem sib txawv, yog li lawv siv tau zoo dua. Txawm li cas los xij, kev siv tshuaj khomob muaj kev puas tsuaj rau lwm yam kabmob (tawv nqaij, plaub hau, thiab lwm yam). Cov pob txha pob txha kuj raug kev txom nyem los ntawm cov tshuaj no. Thaum lub sij hawm kho mob, ib tug neeg yuav kis tau tus kab mob, ntau bruises yuav tshwm sim, raws li zoo raws li los ntshav. Feem ntau, kev kho tshuaj ua rau muaj kev tsim cov uric acid ntau ntxiv, uas ua rau tsim cov pob zeb raum. Txawm li cas los xij, tag nrho cov kev mob tshwm sim ploj mus ob peb lub lis piam tom qab qhov kawg ntawm chav kawm. Nws yog ib qho tsim nyog sau cia tias qee cov tshuaj siv tshuaj khomob tuaj yeem ua rau txo qis ntawm cov phev hauv cov txiv neej, ua rau muaj menyuam muaj menyuam hauv cov poj niam.
Kev kho mob nrog cov tshuaj tiv thaiv monoclonal
Follicular lymphoma kuj tau kho nrog cov tshuaj tshiab xws li cov tshuaj tiv thaiv kab mob monoclonal. Lawv lub hom phiaj tsuas yog ua kom cov qog lymphoma xwb. Cov txheej txheem no tshwj xeeb tshaj yog ua ke nrog kev siv tshuaj khomob. Monoclonal antibodies me ntsis txo cov tshuaj toxicity. Cov neeg mob muaj kev ncua ntev ntawm follicular lymphoma. Qee zaum, kev tsis haum tshuaj yog ua tau, yog li thawj cov tshuaj tiv thaiv kab mob yuav siv sij hawm ntev heev. Ua ntej pib kev kho mob, tus neeg mob xav tau ib chav kawm ntawm cov tshuaj antiallergic.
Rov qab los ntawm tus kab mob
Tus kab mob no yog tus yam ntxwv los ntawm qhov kev loj hlob qeeb nyob rau theem pib, lub sijhawm ntawm kev zam txim tuaj yeem kav ntev txog 20 xyoo. Ntau zausNyob rau hauv tag nrho, rov tshwm sim ntawm follicular lymphoma yog pom nrog 3a cytological hom. Hauv qhov no, yuav tsum tau hloov cov qia cell. Ob tus kwv tij (viv ncaus) thiab cov txheeb ze uas tsis yog ntshav tuaj yeem ua tus pub dawb. Cov txheej txheem yog ua rau cov neeg mob hnub nyoog qis dua 70 xyoo uas teb tau zoo rau kev kho mob thiab muaj kev noj qab haus huv txaus. Tom qab hloov pauv, kev txhim kho tau pom nyob rau hauv ib nrab ntawm cov neeg mob. Tus neeg mob ciaj sia nyob ntawm ntau yam. Ua ntej tshaj plaws, theem ntawm tus kab mob, morphology ntawm kev hloov pauv tseem ceeb (qhov kev tshwm sim ntawm follicular lymphoma nyob rau theem plaub yog qhov tsis zoo). Nws yuav tsum raug sau tseg tias cov tub ntxhais hluas tiv taus tus kab mob zoo dua. Nws yog ib qho tseem ceeb heev kom paub txog lymphoma nyob rau lub sij hawm, yog li tsis txhob tsis kam tiv thaiv kev ntsuam xyuas los ntawm cov kws tshwj xeeb.
