Squamous cell carcinoma ntawm txoj hlab pas: cov tsos mob, kev kuaj mob thiab kev kho mob nta

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Squamous cell carcinoma ntawm txoj hlab pas: cov tsos mob, kev kuaj mob thiab kev kho mob nta
Squamous cell carcinoma ntawm txoj hlab pas: cov tsos mob, kev kuaj mob thiab kev kho mob nta

Video: Squamous cell carcinoma ntawm txoj hlab pas: cov tsos mob, kev kuaj mob thiab kev kho mob nta

Video: Squamous cell carcinoma ntawm txoj hlab pas: cov tsos mob, kev kuaj mob thiab kev kho mob nta
Video: Tshuaj theem vim li cas thiaj tau nqi ?/ Siv kho mob dab tsi?/paris polyphylla use for? 2024, Lub Xya hli ntuj
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Raws li kev txheeb xyuas kev kho mob, txog li 90% ntawm cov neeg mob qog nqaij hlav hauv plab yog squamous cell carcinoma ntawm txoj hlab pas. Qhov kev kwv yees rau qhov kev kuaj mob no ncaj qha nyob ntawm theem uas tau kuaj pom tus kab mob. Qhov kev cia siab zoo tshaj plaws yog rau cov neeg uas tig mus rau lub tsev kho mob raws sij hawm thiab muaj lub cib fim mus rau txoj kev kho mob tshiab.

Kev faib tawm dav dav

Qhia kev faib cov xwm txheej rau hauv pawg raws li cov nuances ntawm cov qauv ntawm cov hlwb atypical. Muab faib ua ntau yam sib txawv ntawm squamous cell carcinoma ntawm txoj hlab pas, nrog rau cov mob uas muaj qhov sib txawv nruab nrab thiab qis. Rau thawj hom, cov txheej txheem ntawm keratinization yog ntau yam ntxwv. Kev nce qib ntawm tus kab mob yog nrog los ntawm kev tsim ntawm horn pearls. Maj mam, cov cim qhia ntawm keratinization dhau los ua cov lus tshaj tawm: qhov tshwm sim kis tau los ntawm qhov nruab nrab mus rau qhov nruab nrab. Polymorphism ntawm cov hlwb thiab nuclei rau daim ntawv ntawm tus kab mob no yog tus yam ntxwv tsuas yog rau ib qho me me xwb.

Ib yam ntawm cov piav qhiaqeb ntawm pathology - verrucous cancer. Nws qhov zaus ntawm qhov tshwm sim yog qhov tsawg heev. Daim ntawv no ntawm neoplasm yog yam ntxwv los ntawm ib hom papillary faib.

Tsis zoo sib txawv squamous cell carcinoma ntawm txoj hlab pas yog ib hom kab mob, uas feem ntau tshwm sim los ntawm qhov tsis ua tiav ntawm keratinization. Tej zaum tsuas muaj cov cim qhia me ntsis ntawm kev ua txhaum cai li no. Nyob rau hauv sib piv rau qhov sib txawv raws li saum toj no, lub atypicality ntawm hlwb yog heev ho qhia, lawv yog yus muaj los ntawm polymorphism. Thaum kawg, qhov sib txawv me ntsis squamous cell carcinoma ntawm txoj hlab pas yog ib daim ntawv uas yog qhov sib txuas nruab nrab ntawm cov uas tau piav qhia.

invasive squamous cell carcinoma ntawm esophagus
invasive squamous cell carcinoma ntawm esophagus

Forms and types

Nws paub tias nyob rau hauv tib yam kab mob pathological, cov tsos ntawm cov hlwb ntawm ntau theem ntawm kev sib txawv yog ua tau. Qee lub sij hawm cov neeg mob raug kuaj xyuas nrog spindle cell scenario rau txoj kev loj hlob ntawm pathology. Raws li lub npe implies, lub neoplasm nyob rau hauv cov ntaub ntawv no yog tsim los ntawm cov hlwb zoo ib yam li ib tug spindle. Hom kab mob squamous cell carcinoma ntawm txoj hlab pas zoo ib yam li sarcoma, uas tuaj yeem ua rau misdiagnosis. Txhawm rau kom paub meej qhov tshwm sim, nws yuav tsum tau kawm cov qauv ntaub so ntswg nyob rau hauv lub tshuab ntsuas hluav taws xob txhawm rau txiav txim siab qhov xwm txheej ntawm thaj chaw malignant. Kev kuaj xyuas ntawm qhov ntim loj txaus ntawm cov qauv yuav qhia meej cov chaw uas muab lub tswv yim tseeb ntawm qhov xwm txheej ntawm tus kab mob. Rau qhov no, txoj kev siv lub teeb microscopy yog siv.

Lwm daim ntawv ntawm tus kab mob squamous cell carcinoma ntawm txoj hlab pas zoo ib yam li cov kab mob basalioma. Qhov ntau yam no tsis tshua muaj, nws yog tsim los ntawm cov qauv monomorphic ze rau basaloid sawv daws yuav. Xws li ib tug qog yog tus yam ntxwv los ntawm meej ciam teb. Nws muaj peev xwm dilute basaloid hlwb nrog horn pearls. Hauv qee qhov chaw, cysts, strands tuaj yeem tsim. Qhov no tso cai rau koj los sib piv cov duab ntawm tus kab mob nrog basalioma ntawm mucous hom, adenoid.

Suab thiab hom: tsis tshua muaj thiab tsis tshua muaj

Qee zaum, squamous cell carcinoma ntawm txoj hlab pas yog tsim nyob rau hauv foci, nrog rau cov txheej txheem necrotic ntawm hom eosinophilic. Ib txheej nyias ntawm cov qauv atypical yog pom nyob ib ncig ntawm xws li foci. Daim ntawv no zoo ib yam li basaloid, kuaj pom hauv qhov quav.

Daim ntawv sib txawv heev feem ntau txhim kho hauv thaj chaw, complexes, thiab rau qhov sib txawv tsawg, ib hom kev loj hlob thiab kev tsis sib haum xeeb yog cov yam ntxwv ntau dua.

squamous cell carcinoma ntawm esophagus
squamous cell carcinoma ntawm esophagus

Nuances of case

Kawm txog cov kev xav sib txawv, suav nrog kev txheeb cais, sau cov ntaub ntawv kho mob ntawm kev kho mob squamous cell carcinoma ntawm txoj hlab pas, cov kws tshawb fawb tau pom tias theem ntawm kev teb rau kev kho hluav taws xob feem ntau yog nyob ntawm qhov sib txawv ntawm qhov tshwm sim hauv ib kis.. Muaj tseeb tiag, cov ntaub ntawv tshawb fawb tau luam tawm nyob rau lub sijhawm tam sim no yog qhov tsis sib xws, tsis muaj cov ntaub ntawv ntseeg siab thiab tsis txaus ntseeg ntawm cov txheej txheem ntawm tus kab mob.

Nws tau raug tsim los tias kev kho hluav taws xob rau squamous cell carcinoma ntawm txoj hlab pas ua rau muaj kev hloov pauv hauv cov qog nqaij hlav. Nws muaj peev xwm ua tiav kev tuag ntawm cov hlwb atypical. Fields ntawm fibrosis yog tsim, cais foci -lymphoplasmacytic infiltrate, thiab saum npoo hloov mus rau hauv thaj chaw necrotic. Feem ntau, thaj chaw fibrous dhau los ua thaj chaw ntawm thaj chaw ntawm cov horny masses, granulomas, dystrophic hlwb, uas yog tus cwj pwm los ntawm hyperchromic nuclei. Qee zaum, cov neeg mob uas tau txais kev kho hluav taws xob ntawm squamous cell carcinoma ntawm txoj hlab pas muaj ib ntawm ob hom eosinophilic cytoplasm: homogeneous, nrog vacuoles.

Yog tias yav tom ntej atypical hlwb pib loj hlob dua, thaj chaw khaws cia los ntawm thawj ntu muaj ntau tus lej mitotic, thiab saib cov tshuaj anaplastic thaum kuaj.

Cov ntaub ntawv xav paub thiab cov nuances tseem ceeb

Los ntawm cov ntaub ntawv kho mob nws paub tias squamous cell carcinoma ntawm txoj hlab pas (keratinizing thiab non-keratinizing) feem ntau yuav tshwm sim rau cov neeg muaj hnub nyoog siab heev. Ntawm cov neeg mob ntawm cov chaw kho mob, qhov nruab nrab, muaj ntau tus txiv neej. Hauv pawg hnub nyoog qis dua 30 xyoo, malignant neoplasms hauv txoj hlab pas yog qhov tsawg heev. Qhov ua rau cov txheej txheem mob qog noj ntshav yog malignancy ntawm cov hlwb noj qab haus huv. Tus kab mob no feem ntau nyob hauv thaj chaw qis ntawm txoj hlab pas lossis qhov nruab nrab ntawm lub cev.

thawj cov tsos mob uas tso cai rau koj xav tias muaj ib yam dab tsi tsis zoo rau koj txoj kev noj qab haus huv yog qhov nyuaj ntawm nqos. Maj mam, qhov kev mob tshwm sim, thiab nyob rau theem kawg, squamous cell carcinoma ntawm txoj hlab pas (nrog thiab tsis muaj keratinization) yog vim li cas rau qhov tsis muaj peev xwm noj txawm tias mos. Tawm tsam keeb kwm yav dhau los ntawm qhov tshwm sim, tus neeg mob poob phaus ntau.

low-grade squamous cell carcinoma ntawm txoj hlab pas
low-grade squamous cell carcinoma ntawm txoj hlab pas

txheej txheem tsim kho thiab nthuav tawm

Thaum thawj theem, tus kab mob tsis tshwm sim nws tus kheej yog cov tsos mob tseem ceeb, yog li tus neeg mob tsis zoo li xav tias muaj teeb meem kev noj qab haus huv. Nws tuaj yeem kuaj pom squamous cell carcinoma ntawm txoj hlab pas (tsis yog keratinizing, keratinizing) tsuas yog yog tias ib tus neeg tau txais kev tiv thaiv los yog tuaj rau hauv tsev kho mob nrog lwm cov kab mob, thaum lub sijhawm qhia meej ntawm nws raug xa mus rau kev kuaj tshwj xeeb. Instrumental cov tswv yim los pab tsim kom muaj cov hlwb atypical: CT, ultrasound, endoscopy.

Nyob rau hauv squamous cell carcinoma ntawm txoj hlab pas, kev ciaj sia yog ncaj qha ntsig txog theem ntawm kev nce qib ntawm tus mob. Qhov kev tshwm sim phem tshaj plaws yog rau cov neeg uas nrhiav kev pab nyob rau theem plaub: tsis muaj cov xwm txheej paub tias yuav xaus rau hauv kev kho kom tiav. Txhawm rau kom paub meej txog qib ntawm kev loj hlob, cov qauv ntawm cov ntaub so ntswg degenerate raug coj mus rau kev tshuaj xyuas histological. Nyob rau theem kawg, tus kab mob kis mus rau cov ntaub so ntswg thiab cov kab mob nyob ze - qhov no yog yam ntxwv ntawm tag nrho cov txheej txheem malignant. Kev puas tsuaj rau trachea, vascular system, bronchi. Metastases tsis tsuas yog nyob rau hauv lub sternum xwb, tab sis kuj nyob deb ntawm lub cev.

moderately txawv squamous cell carcinoma ntawm txoj hlab pas
moderately txawv squamous cell carcinoma ntawm txoj hlab pas

chav kawm thiab ntau yam

Qhov kev faib ua qis-, siab-, nruab nrab sib txawv squamous cell carcinoma ntawm txoj hlab pas (nrog thiab tsis muaj kev cuam tshuam) tau qhia saum toj no. Tsis tas li ntawd, txhua tus neeg mob feem ntau raug faib ua exophytic, thaum kis tau tshwm sim nyob rau hauv lub lumen ntawm lub cev, thiab endophytic, thaum atypical hlwb kis nyob rau hauv lub thickness ntawm lub cev los yog submucosal txheej. Nrog kev sib xyaw ua kekab mob ib txhij cuam tshuam rau txhua txheej ntawm phab ntsa ntawm txoj hlab pas. Daim ntawv no yog tus cwj pwm los ntawm qhov tshwm sim sai ntawm ntau qhov txhab thiab cov txheej txheem necrotic nquag.

Kev muaj sia nyob zoo tshaj plaws rau cov kab mob esophageal squamous cell carcinoma. Lub qog yog ib qho chaw erosive los yog cov quav hniav tsim ntawm phab ntsa esophageal. Xws li ib tug neoplasm tsis loj hlob mus rau qhov loj heev. Qhov kev cia siab rau daim ntawv tob tob yog qhov phem dua. Malignancy npog cov ntaub so ntswg tob hauv txoj hlab pas. Hauv cov duab, cov qog no zoo ib yam li cov kab mob fungus los yog tsim nyob rau hauv daim ntawv ntawm cov kab mob sib sib zog nqus. Cov txheej txheem yog tus cwj pwm los ntawm kev sib kis ceev ceev ntawm cov metastases mus rau lub ntsws thiab lub plawv.

Hom thiab rooj plaub: nuances of forms

Kawm txog cov neoplasm siv cov cuab yeej niaj hnub no feem ntau tso cai rau koj kom tau txais daim duab ntawm kev loj hlob nyob ib puag ncig. Feem ntau, cov qog nqaij hlav cancer tsim ib lub nplhaib ntawm sab hauv ntawm txoj hlab pas. Maj mam, malignancy npog ntau thiab ntau qhov chaw, lub lumen ntawm lub cev nqaim, thiab cov duab kho mob raug tsim.

Qee zaum, mob qog noj ntshav tshwm sim hauv daim ntawv ntawm polyp.

Nws tau raug tsim los hais tias hauv cov poj niam tus kab mob feem ntau pib mus rau hauv qis ntawm txoj hlab pas, maj mam nce mus. Cov txiv neej feem ntau yuav tsim cov hlwb atypical nyob rau hauv qhov chaw hloov ntawm txoj hlab pas mus rau lub plab.

Cornation: yog lossis tsis yog?

Daim ntawv uas tsis yog keratinizing feem ntau yog nrog los ntawm kev cuam tshuam ntawm lub plab zom mov vim qhov txo qis hauv lumen ntawm txoj hlab pas. Teeb meem nrog rau cov txheej txheem nqos - qhov no siv tsis tau tsuas yog rau noj,tab sis kuj taug txuj kev nyuaj raws lub plab zom mov ntawm qaub ncaug. Qee lub sij hawm tus neeg mob yog tus cwj pwm los ntawm regurgitation.

Keratinizing hom kab mob hloov cov mucous daim nyias nyias ntawm txoj hlab pas. Cov hlwb ua horny, cov phab ntsa ua qhuav, daim duab kho mob yog ho aggravated. Lub neoplasm loj hlob sai, tab sis qeeb tsim ntawm vascular phab ntsa ua rau tsis muaj cellular khoom noj khoom haus. Qhov no provokes thaj chaw necrotic. Endoscopic kuaj pom lawv nyob rau hauv daim ntawv ntawm ulceration zones.

Kev txheeb cais tsis tu ncua: dab tsi tos tus neeg mob?

Kev kuaj pom tus kab mob hauv thawj theem yog cuam tshuam nrog qhov zoo tshaj plaws ntawm qhov tshwm sim zoo. Tus neeg mob tau qhia txoj kev kho mob. Kev ciaj sia nyob rau hauv kev ntsuam xyuas ntawm tsib xyoos ntawm qhov nruab nrab yog kwv yees li 80%. Nyob rau hauv lub neej yav tom ntej, nws muaj peev xwm ua hauj lwm txuas ntxiv yog tias txoj haujlwm tsis xav tau kev siv zog ntawm lub cev.

Yog tias pom mob qog noj ntshav nyob rau theem siab, cov kev tshawb fawb tuaj yeem kuaj pom cov metastases nyob deb, kev kho mob tsuas yog ua tau nyuaj heev. Txawm tias kev siv cov txheej txheem zoo tshaj plaws thiab niaj hnub no tsis tas yuav pab kom ua tiav yam tsawg kawg ib qho kev nce qib tseem ceeb.

qhov teeb meem tuaj qhov twg?

Tam sim no, cov kws kho mob tseem tsis tuaj yeem tshawb pom txhua qhov laj thawj uas tuaj yeem ua rau mob qog noj ntshav ntawm txoj hlab pas. Raws li txoj cai, tus kab mob no tshwm sim yog tias ib tug neeg raug cuam tshuam los ntawm ntau yam carcinogenic yam. Qhov ntau pab pawg no, cov ntaub so ntswg malignancy ntau dua.

Kev txheeb cais qhia tias squamous cell carcinoma ntawm txoj hlab pas feem ntau pom hauv cov neeg haus luam yeeb nrog ntau xyoo dhau los. Cov luam yeeb yog nplua nuj nyob rau hauv carcinogens,accumulating rau ntawm phab ntsa esophageal thiab provoking atypical cell hloov. Qhov nruab nrab, qhov kev pheej hmoo ntawm mob qog noj ntshav nrog keeb kwm ntev ntawm kev haus luam yeeb yog plaub zaug ntau dua li lwm pab pawg.

Tsis muaj kev phom sij tsawg cuam tshuam nrog kev haus dej ntau zaus thiab hnyav. Cov dej haus no hlawv cov mucous daim nyias nyias ntawm txoj hlab pas, provoking kev loj hlob ntawm lub epithelium, uas yuav mus raws li ib tug atypical scenario. Qhov tshwm sim ntawm squamous cell malignancy nyob rau hauv cov neeg haus dej cawv ntev yog 12 npaug ntau dua li ntawm lwm pab pawg.

esophageal squamous cell carcinoma ciaj sia tus nqi
esophageal squamous cell carcinoma ciaj sia tus nqi

Yam thiab nuances: dab tsi tseem ceeb?

Nrog cov kev phom sij loj ntawm squamous cell carcinoma, kev noj zaub mov tsis txaus thiab kev noj zaub mov tsis zoo yog cuam tshuam. Kev siv ntsev, kub, pickled, ntsim heev - tag nrho cov no tuaj yeem ua rau cov txheej txheem malignant. Cov tais diav uas nplua nuj nyob rau hauv cov pwm pwm tsis zoo cuam tshuam rau phab ntsa ntawm txoj hlab pas. Ib qho tsis zoo yog qhov tsis muaj cov khoom cog tshiab. Tag nrho cov yam ntxwv ntawm cov khoom noj niaj hnub no feem ntau yog rau cov neeg nyob hauv thaj av Central Asian thiab Far East, nrog rau qee thaj tsam Siberian. Cov ntaub ntawv txheeb xyuas tau lees paub tias ntawm cov neeg no qhov tshwm sim ntawm mob qog noj ntshav siab dua li lwm thaj chaw, kaum ob, thiab qee zaum txawm ntau pua zaus.

Lwm qhov nuance uas tuaj yeem ua rau muaj kev cuam tshuam rau malignancy yog qhov kub hnyiab ntawm qhov chaw ntawm lub cev, provoked los ntawm ingress ntawm kub heev ib yam khoom los yog ib tug active tshuaj compound. Qee zaum qhov kub hnyiab uas ua rau mob qog noj ntshav yog kev puas tsuaj ntev vim yog siv ntau zaus ua zaub mov.zaub mov kub heev. Muaj cov xwm txheej thaum, tawm tsam keeb kwm yav dhau los ntawm kev sib tsoo ntawm cov ntsiab lus alkali rau hauv lub plab zom mov, kuaj pom tus mob neoplasm hauv ib tus neeg tom qab ob peb xyoos.

squamous cell carcinoma ntawm esophagus prognosis ciaj sia taus
squamous cell carcinoma ntawm esophagus prognosis ciaj sia taus

pab pawg pheej hmoo thiab phom sij

Ntau dua cov nqaij mos malignancy nrog tsis muaj cov vitamins hauv lub cev. Nrog beriberi, mucous txheej tsis tau txais retinol thiab tocopherol, tsis muaj kev ua haujlwm zoo thiab kev loj hlob tsis tuaj yeem. Cov vitamins no tsim cov txheej txheem tiv thaiv ntawm txoj hlab pas. Yog tias lawv qhov tsis txaus tau pom ntev ntev, maj mam cov qauv ntawm tes tau rov qab los.

Nws paub tias cov neeg txheeb ze ze tau mob oncology feem ntau yuav mob qog noj ntshav. Kev kho mob ntawm tus kab mob yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv tus account yam tsis tau poob. Nws tau raug tsim los hais tias kev hloov pauv ntawm cov noob p53 ua rau cov txheej txheem ntawm cov protein txawv txav uas cuam tshuam lub ntuj tiv thaiv kev ua haujlwm ntawm cov hlab ntsha hauv cov hlab ntsha. Tawm tsam keeb kwm yav dhau los ntawm cov txheej txheem no, qhov tshwm sim ntawm malignant degeneration yog qhov siab dua.

Kev kuaj mob thiab kev phom sij

Nws paub tias nyob rau hauv cov neeg mob uas muaj tus kabmob squamous cell carcinoma ntawm txoj hlab pas, kuaj pom tus kab mob papillomavirus. Cov kws tshawb fawb qhia tias HPV tej zaum yuav yog ib qho ua rau mob qog nqaij hlav.

Esophagitis yog xav tias yog ib qho ua ntej rau mob qog noj ntshav. Cov kab mob pathological ua rau kom tsis tu ncua ntawm hydrochloric acid rau hauv txoj hlab pas. Qhov no tsis zoo cuam tshuam rau lub mucous daim nyias nyias, irritates nws thiab provokecell hloov. Esophagitis feem ntau pom tawm tsam keeb kwm yav dhau los ntawm qhov hnyav dhau thiab kab mob plab. Nws tuaj yeem ua rau muaj teebmeem kev kho mob xws li Barrett's esophagus. Lo lus no piav qhia txog kev nce qib ntawm tus kab mob nrog kev degeneration ntawm multilayer epithelial cov qauv rau hauv cov cylindrical.

squamous cell carcinoma ntawm esophagus nrog keratinization
squamous cell carcinoma ntawm esophagus nrog keratinization

thawj tshwm sim

Nws tuaj yeem xav tias yuav tsum tau mus ntsib kws kho mob yog tias tus neeg poob phaus sai, uas yog nrog cov teeb meem nqos. Ua tau cachexia. Tus neeg mob xav tias tsis muaj zog. Dysphagia yog thawj zaug pom thaum sim noj cov khoom noj khoom haus, thiab kev ruaj khov tuaj yeem ua tiav yog tias cov khoom tau nquag ntxuav nrog kua. Maj mam, qhov mob hnyav zuj zus, muaj teeb meem hauv kev noj zaub mov thiab kua zaub. Dysphagia yog lub ntsiab thiab tas li tshwm sim ntawm ib tug malignant neoplasm nyob rau hauv txoj hlab pas. Maj mam nws thiaj li hais tau ntau.

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