Neuroblastoma yog mob qog noj ntshav ntawm lub paj hlwb sympathetic. Feem ntau, tus kab mob no raug kuaj pom hauv cov menyuam yaus. Kev tshawb pom raws sij hawm ntawm nws tuaj yeem ua rau muaj feem yuav rov qab los zaum kawg. Los ntawm cov ntaub ntawv ntawm kab lus no koj yuav kawm txog cov laj thawj tseem ceeb ntawm cov kab mob pathology, cov cim qhia dab tsi uas nws tau nrog, thaum kho yuav tsum tau ua.
Qhov xav tsis thoob ntawm neuroblastoma hauv tus menyuam
Neuroblastoma yog cov qog nqaij hlav ntau tshaj plaws. Nws suav txog li 15% ntawm tag nrho cov neeg mob ntawm cov neonatal neoplasms, nrog rau thaum yau. Cov kws kho mob tshwj xeeb feem ntau kuaj pom cov qog nqaij hlav hauv cov menyuam yaus hnub nyoog qis dua 5 xyoos, tab sis muaj cov kab mob hauv cov tub ntxhais hluas hnub nyoog 11 thiab 15 xyoos. Raws li tus me nyuam loj hlob thiab loj hlob, qhov tshwm sim ntawm ntsib tus kab mob insidious no txo qis txhua xyoo.
Ib kab mob neuroblast, raws li kws kho mob, tau txais txiaj ntsig nrog lub peev xwm zoo. Nws yog nruj heev thiabnyiam metastasize rau txhua qhov ntawm lub cev. Feem ntau, cov pob txha thiab lymphatic systems raug kev txom nyem los ntawm nws cov haujlwm tseem ceeb. Qee lub sij hawm cov kws kho mob sau txog kev loj hlob ntawm foci ntawm neuroblasts, lawv faib, ua raws li kev tsim cov qog. Nws thawj zaug muab metastases, thiab tom qab ntawd nres nws txoj kev loj hlob thiab pib regress. Cov qog nqaij hlav malignant ntawm ntau hom tsis muaj qhov tshwm sim zoo li no.
Neuroblastoma ntawm lub hlwb hauv cov menyuam yaus yog thawj zaug tshawb fawb los ntawm German kws tshawb fawb, Rudolf Virchow xyoo 1865. Tus kws kho mob hu lub qog ua glioma. Ob peb xyoos tom qab ntawd, tus kws tshawb fawb Asmeskas James Wright tau kawm txog cov neoplasm kom ntxaws ntxiv thiab piav qhia meej txog cov txheej txheem ntawm nws qhov tsim.
Kev txhim kho ntawm neuroblastoma los ntawm theem
Zoo li lwm yam oncological neoplasms, neuroblastoma hauv cov menyuam yaus dhau los ntawm ntau theem ntawm kev loj hlob, lub ntsiab lus uas tso cai rau koj los sau tshuaj kho tau zoo:
- Stage 1. Tus yam ntxwv los ntawm qhov muaj cov qog ua haujlwm, qhov loj ntawm qhov tsis pub tshaj 5 cm, thiab tsis muaj metastases hauv cov qog ntshav.
- Stage 2A. Qhia txog cov qog hauv zos, feem ntau yuav tsum tau muab tshem tawm.
- Stage 2B. Muaj qhov mob metastatic ntawm cov qog nqaij hlav unilaterally.
- Kauj Ruam 3. Tus yam ntxwv ntawm qhov tshwm sim ntawm ob sab qog.
- Ntu 4 (A-B). Cov neoplasm loj hlob, metastasis rau cov pob txha pob txha, daim siab thiab cov qog ntshav tau pom.
Cais, peb yuav tsum xav txog yuav ua li cas neuroblastoma txhim kho hauv cov menyuam yaus thaum kawg. Theem 4 txawvCov yam ntxwv lom neeg tsis yog yam ntxwv ntawm lwm yam neoplasias, muaj qhov pom zoo, thiab nrog kev kho raws sij hawm muab feem pua ntawm cov ciaj sia taus.
Qhov laj thawj tseem ceeb ntawm kev loj hlob ntawm qog
Neuroblastoma, zoo li lwm yam mob qog noj ntshav, tsim tawm tsam keeb kwm ntawm kev hloov caj ces hauv lub cev. Tam sim no, cov kws tshaj lij tsis tuaj yeem hais qhov tseeb ua rau muaj kev cuam tshuam rau cov kev hloov pauv no. Nws tau xav tias qhov hu ua carcinogenic yam, uas yog, tshuaj thiab hluav taws xob, ua lub luag haujlwm. Cov hlwb uas tshwm sim los ntawm kev hloov pauv pib nce zuj zus, tsim cov qog. Ib tug malignant neoplasm yog tus yam ntxwv los ntawm lub peev xwm los faib, uas distinguishes nws los ntawm ib tug benign ib.
Qhov kev hloov pauv uas ua rau muaj kev tsim ntawm neuroblastoma tshwm sim thaum lub sijhawm kev loj hlob ntawm tus menyuam hauv plab lossis tam sim tom qab yug menyuam. Yog li ntawd, cov neeg mob feem ntau yog cov me nyuam mos. Lub hauv paus chiv keeb ntawm cov qog pib hauv neuroblasts. Cov no yog cov paj hlwb tsis paub qab hau uas tau tsim nyob rau hauv fetus thaum lub sij hawm nws txoj kev loj hlob intrauterine. Thaum lub sijhawm cev xeeb tub, neuroblasts ua haujlwm ntawm cov paj hlwb lossis ua lub luag haujlwm rau kev tsim cov qog adrenal.
Thaum tus me nyuam yug los, feem ntau twb tau tsim. Cov hlwb tsis paub tab feem ntau ploj mus. Hauv cov txheej txheem pathological ntawm cov txheej txheem no, neuroblasts tig mus rau hauv cov qog. Qhov tsuas yog paub tseeb qhov tshwm sim ntawm qhov tshwm sim ntawm qog noj ntshav yog ib qho genetic predisposition. Txawm li cas los xij, kev pheej hmootxoj kev loj hlob ntawm tus kab mob tsis pub tshaj 2%.
Feem ntau, cov kws kho mob kuaj pom cov kab mob retroperitoneal neuroblastoma, qhov chaw nyiam hauv cheeb tsam uas yog cov qog adrenal. Raws li txoj cai, cov qog tuaj yeem tshwm sim hauv txhua qhov ntawm lub cev. Neuroblastoma ntawm qhov chaw retroperitoneal nyob rau hauv cov me nyuam tshwm sim nyob rau hauv 50% ntawm cov neeg mob, nyob rau hauv 30% ntawm cov neeg mob cov neoplasm tsim los ntawm cov hlab ntsha ntawm lub lumbar cheeb tsam, nyob rau hauv tas li ntawd mus 20% nws xaiv lub tsev me nyuam thiab thoracic cheeb tsam rau localization.
qog nqaij hlav tshwm sim li cas?
Thaum thawj theem ntawm cov txheej txheem pathological, tsis muaj cov tsos mob tshwj xeeb. Yog li ntawd, cov qog feem ntau pom tau tias yog lwm yam kab mob uas muaj hnub nyoog no.
Cov tsos mob ntawm neuroblastoma hauv cov menyuam yaus tshwm sim nyob ntawm qhov chaw ntawm neoplasm, thaj chaw ntawm kev sib kis ntawm metastases thiab qib ntawm cov tshuaj vasoactive. Feem ntau qhov chaw ntawm cov qog yog nyob rau hauv qhov chaw retroperitoneal, ntau precisely nyob rau hauv cov qog adrenal. Muaj tsawg zaus, nws nyob hauv lub caj dab lossis hauv mediastinum.
Nyob rau hauv cov me nyuam li cas? Cov tsos mob ntawm tus kab mob yog tshwm sim los ntawm kev tso tawm cov tshuaj hormones los ntawm cov qog nqaij hlav cancer los yog lub siab tsis tu ncua ntawm neoplasm ntawm ib lossis lwm lub cev. Qee zaum nws txoj kev loj hlob cuam tshuam rau kev ua haujlwm ntawm cov hnyuv thiab zais zis. Vim yog nyem cov hlab ntsha, cov neeg mob tau o ntawm lub scrotum thiab qis extremities.
Reddish lossis bluish me ntsis ntawm daim tawv nqaij kuj yog cov cim qhia ntawm neuroblastoma hauv menyuam yaus. Lawv cov tsos mob qhia txog kev koom tes ntawm cov hlwb hauv cov txheej txheem pathological.epidermis. Thaum cov qog nkag mus ncaj qha rau hauv cov pob txha pob txha, tus menyuam yuav qaug zog, feem ntau mob. Hauv qhov no, txawm tias qhov txhab me me tuaj yeem ua rau los ntshav ntau.
Pom cov tsos mob ntawm neuroblastoma, cov niam txiv yuav tsum mus ntsib kws kho mob. Kev kuaj pom mob qog noj ntshav thaum ntxov tuaj yeem cawm tus menyuam txoj sia.
Retroperitoneal neuroblastoma
Ib qho neoplasm los ntawm cov ntaub so ntswg ntawm cov hauv paus chiv keeb neurogenic, uas tshwm sim hauv qhov chaw retroperitoneal, yog tus cwj pwm los ntawm kev loj hlob sai. Nyob rau hauv ib lub sij hawm luv luv, nws nkag mus rau tus txha caj qaum, tsim cov qog ntom ntom uas tuaj yeem kuaj pom los ntawm palpation.
Adrenal neuroblastoma hauv cov menyuam yaus pib tsis muaj cov tsos mob tshwj xeeb kom txog thaum nws ncav cuag qhov loj thiab pib muab cov ntaub so ntswg uas nyob ib sab. Cov tsos mob ntawm qog nqaij hlav yog dab tsi?
- Nyob rau hauv lub plab mog.
- Puffiness ntawm tag nrho lub cev.
- Tsis xis nyob thiab mob hauv cheeb tsam lumbar.
- poob phaus.
- Kub nce.
- Kev hloov ntshav suav qhia tias muaj ntshav liab.
- Ntshai, tuag tes tuag taw ntawm qis extremities.
- Kev tsis txaus siab ntawm lub peev xwm ua haujlwm ntawm lub plab zom mov thiab excretory system.
Lwm qhov chaw ntawm cov qog nqaij hlav neurogenic
Neuroblastoma ntawm posterior mediastinum hauv cov menyuam yaus yog nrog los ntawm kev poob qis, nyuaj nqos, ua pa nyuaj. Qee zaum, mobua rau muaj kev hloov pauv ntawm lub hauv siab.
qog nqaij hlav ntawm qhov chaw extraocular tsis tshua muaj, tab sis paub ntau ntxiv txog lawv. Qhov no yog vim lub fact tias tag nrho cov cim qhia ntawm cov txheej txheem pathological yog pom ntawm qhov muag liab qab. Lub neoplasm yog tus cwj pwm los ntawm cov tsos ntawm ib qho chaw tsaus ntawm lub qhov muag, uas zoo li ib qho nqaij tawv nqaij. Lwm cov tsos mob ntawm neuroblastoma yog daim tawv muag droopy. Nws npog lub qhov muag tsis pom kev tsis zoo.
Shape of neuroblastoma
Tam sim no, cov kws tshaj lij paub qhov txawv ntawm plaub hom neuroblastoma, txhua qhov muaj qhov tshwj xeeb thiab cov yam ntxwv tshwj xeeb.
- Medulloblastoma. Lub neoplasm pib tob rau hauv lub cerebellum, uas yog vim li cas nws tshem tawm yog tsis yooj yim sua los ntawm kev phais. Pathology yog tus cwj pwm los ntawm metastasis sai. Thawj cov tsos mob ntawm cov qog yog tshwm sim los ntawm kev sib koom ua ke ntawm kev txav mus los.
- YRetinoblastoma. Qhov no yog mob qog nqaij hlav uas cuam tshuam rau retina hauv cov neeg mob hluas. Tsis muaj kev kho mob ua rau tag nrho qhov muag tsis pom thiab lub hlwb metastasis.
- Neurofibrosarcoma. Cov qog no nyob rau hauv lub plab kab noj hniav.
- Sympathoblastoma. Qhov no yog ib tug qog ntawm ib tug malignant xwm, uas xaiv lub sympathetic paj hlwb thiab cov qog adrenal ua nws "tsev". Ib tug neoplasm yog tsim nyob rau hauv lub fetus thaum nws intrauterine kev loj hlob. Vim tias qhov loj ntawm tus mob sympathoblastoma nce sai, tus txha caj qaum tuaj yeem cuam tshuam, uas ua rau tuag tes tuag taw.
Yuav ua li cas thiaj paub txog neuroblastoma?
Thaum xub thawj, tus kws kho mob tau sau tshuaj ntsuam ntshav thiab zis yog tias xav tias muaj kev kuaj mob neuroblastoma. Hauv cov menyuam yaus, cov tsos mob ntawm tus kab mob no zoo ib yam li lwm yam kab mob, thiab kev tshawb fawb hauv chav kuaj ntawm cov khoom siv roj ntsha ua rau nws muaj peev xwm tshem tawm lwm yam ua tau. Qib siab ntawm catecholamine cov tshuaj hormones hauv cov zis qhia pom muaj oncology.
Txhawm rau txiav txim siab qhov loj ntawm cov qog, nws qhov chaw nyob, cov neeg mob me tau muab tshuaj CT, ultrasound thiab MRI. Biopsy yog ib txoj kev kuaj mob tseem ceeb. Thaum lub sijhawm txheej txheem no, tus kws tshaj lij sau cov qog nqaij hlav qog noj ntshav rau lawv txoj kev tshawb fawb tom ntej hauv chav kuaj, tshuaj xyuas histological.
Raws li cov txiaj ntsig ntawm kev sim, tus kws kho mob tsim kho cov tswv yim, muab cov lus pom zoo ntawm kev tswj hwm thiab kev ua neej ntawm tus neeg mob.
kev xaiv kho mob
Kev kho mob neuroblastoma hauv tus menyuam feem ntau yog ua tiav ib txhij los ntawm ntau tus kws kho mob ntawm oncology department (chemotherapist, kws phais neeg, kws kho hluav taws xob). Tom qab kawm cov yam ntxwv ntawm cov qog, cov kws kho mob tsim tactics rau kev puas tsuaj. Nws nyob ntawm seb qhov neoplasm teb li cas rau cov kev ntsuas, thiab ntawm qhov kev tshwm sim thaum lub sijhawm kuaj mob zaum kawg.
Feem ntau, kev kho mob neuroblastoma hauv cov menyuam yaus suav nrog cov hauv qab no:
- Tshuaj kho mob. Cov txheej txheem no suav nrog kev qhia txog tshuaj tiv thaiv kab mob raws li cov qauv tsim tshwj xeeb. Cov tshuaj muaj kev cuam tshuam tsis zoo rau cov qog nqaij hlav cancer, tiv thaiv lawv cov kev loj hlob. Lwm qhov chaw ntawm lub cev raug kev txom nyem nrog rau lawv,ua rau muaj kev phiv ntau heev (hais plaub hau, xeev siab, raws plab). Kev ua tau zoo ntawm txoj kev kho yog nce ntau zaus nrog rau kev hloov lub hlwb.
- Kev kho mob phais cuam tshuam nrog kev tshem tawm cov neoplasm. Cov kws khomob tau muab ua ntej ua haujlwm. Nws tso cai rau koj kom qeeb txoj kev loj hlob ntawm cov qog thiab ua rau cov regression ntawm metastases. Kev lees paub ntawm nws qhov kev tshem tawm tiav yog nyob ntawm qhov chaw thiab qhov loj me. Kev loj hlob me me ze ntawm tus txha caj qaum ua rau kev cuam tshuam txaus ntshai heev.
- Kev kho hluav taws xob tsis tshua siv hauv kev kho mob niaj hnub no. Nws tau raug hloov zuj zus los ntawm kev cuam tshuam kev phais, vim tias hluav taws xob tsis zoo thiab ua rau muaj kev hem thawj rau tus menyuam lub neej. Kev kho hluav taws xob tau pom zoo kom nruj raws li cov lus qhia, thaum tsis muaj kev ua tau zoo ntawm lwm txoj kev kho mob, nyob rau hauv cov ntaub ntawv ntawm inoperable neuroblastoma nyob rau hauv ib tug me nyuam.
Kev noj zaub mov tshwj xeeb rau qhov kev kuaj mob no tsis raug sau tseg rau cov neeg mob me. Ntau tus niam txiv, sim tawm tsam txhua txoj hauv kev rau lawv lub neej ntawm tus menyuam, kho nws cov zaub mov. Nws tau raug pov thawj tias qee cov khoom lag luam, qhov tseeb dua, cov tshuaj uas lawv muaj, ua kom lub cev tiv thaiv thiab ua rau cov qog loj hlob qeeb. Cov tshuaj no suav nrog zinc, hlau, betaine, ntau cov vitamins. Lawv nplua nuj nyob rau hauv citrus txiv hmab txiv ntoo, zaub ntsuab, carrots, taub dag.
Kev vam meej ntawm kev kho mob yog nyob ntawm qhov loj ntawm neuroblastoma hauv cov menyuam yaus. Ua rau ntawm pathology thiab theemkab mob kuj tseem ceeb. Kev siv cov txheej txheem radical ntawm thawj theem ntawm kev tsim cov qog ua rau muaj kev cia siab rau kev rov ua tiav. Txawm li cas los xij, qhov no tsis zam rau tus neeg mob me los ntawm kev mus ntsib kws kho mob thiab kuaj xyuas txhawm rau tiv thaiv qhov tshwm sim tuaj yeem tshwm sim.
Qhov muaj peev xwm rov qab los zaum kawg tsis suav nrog hauv theem thib ob, raug rau kev ua haujlwm tau zoo thiab siv tshuaj khomob.
Qee qhov teeb meem tshwm sim nyob rau theem kawg ntawm kev txhim kho cov kab mob xws li neuroblastoma. Hauv cov menyuam yaus, theem 4 mob qog noj ntshav feem ntau tuaj nrog qhov tsis zoo. Relapse yog ua tau tom qab tshem tawm cov qog, tiv thaiv keeb kwm yav dhau los zoo li rov qab. Tom ntej no tsim ntawm ib tug malignant xwm feem ntau tsim nyob rau hauv tib qhov chaw uas nws yog ua ntej. Qhov kev kwv yees nyob rau theem no yog 20% muaj sia nyob hauv tsib xyoos. Hauv qhov no, txhua yam nyob ntawm qhov tsim nyog ntawm cov kws kho mob tshwj xeeb, muaj cov khoom siv kho mob tsim nyog.
Huab cua
Tom qab kev kho mob oncology hnyav, qhov kev cia siab rau cov neeg mob feem ntau yog qhov zoo. Hauv cov menyuam yaus uas muaj cov txheej txheem qog nqaij hlav hauv zos, cov kws kho mob nco ntsoov qhov muaj feem yuav rov zoo sai li sai tau. Raws li rau pawg no ntawm cov neeg mob, cov neoplasm yuav ploj mus txawm tias tsis muaj kev phais, tab sis kev siv tshuaj ntau hauv qhov no yog qhov yuav tsum tau ua. Cov menyuam yaus uas muaj cov qog nqaij hlav siab heev muaj feem tsawg dua ntawm kev rov zoo. Ntxiv mus, cov neoplasm yuav rov tshwm sim.
Qhov tshwm sim ntawm kev kho mob feem ntau yog qhov thib obneuroblastoma nyob rau hauv cov me nyuam. Qhov kev kwv yees hauv qhov no tsis yog qhov zoo tshaj plaws. Cov qog yuav tshwm sim dua tom qab ob peb xyoos, suav nrog tom qab kev kho mob tiav. Cov txiaj ntsig zoo li no hauv cov tshuaj hu ua belated side effect. Tias yog vim li cas txhua tus neeg mob, yam tsis muaj kev zam, tom qab kev kho mob, nws raug nquahu kom saib xyuas los ntawm kws kho mob tas li.
ntsuas kev tiv thaiv
Cov kws kho mob tsis muab cov lus pom zoo tshwj xeeb hais txog kev tiv thaiv kev txhim kho ntawm cov qog nqaij hlav, vim tias qhov ua rau ntawm nws qhov kev tsim tseem tsis to taub, tshwj tsis yog qhov kev iab liam ntawm kev ua txhaum cai. Yog tias cov neeg txheeb ze tau ntsib nrog qhov kev kuaj mob tsis txaus ntseeg no, nws raug nquahu kom mus ntsib kws kho mob caj ces thaum lub sijhawm npaj cev xeeb tub. Tej zaum nws yuav pab kom tsis txhob muaj kev ntxhov siab cuam tshuam nrog kev yug me nyuam tsis zoo nyob rau yav tom ntej.
Hmoov tsis zoo, cov kab mob oncological niaj hnub no tau kuaj pom ntau ntxiv hauv cov neeg mob hluas, thiab neuroblastoma hauv cov menyuam yaus tsis muaj qhov tshwj xeeb. Cov duab ntawm pathology tuaj yeem pom hauv cov ntawv kho mob tshwj xeeb. Cov kws kho mob tsis tuaj yeem muab cov txheej txheem tshwj xeeb ntawm kev tiv thaiv vim qhov tsis meej etiology ntawm pathology. Nrog rau qhov tshwm sim ntawm thawj cov tsos mob qhia tau hais tias tus kab mob no, nws tseem ceeb heev kom nrhiav kev pab los ntawm kws kho mob. Tsuas yog tom qab dhau qhov kev kuaj mob tiav tuaj yeem txiav txim siab qhov xwm txheej ntawm neoplasm thiab txhim kho cov tswv yim kho mob. Qhov sai dua tus kws tshaj lij lees paub qhov kawgKev kuaj mob, qhov siab dua qhov yuav rov qab los. Noj qab nyob zoo!
