Non-Hodgkin's lymphoma yog ib hom mob qog noj ntshav uas cuam tshuam ntau pua tus neeg thoob ntiaj teb. Yuav kom nkag siab txog yuav ua li cas thiaj paub txog tus kab mob thiab kho nws, koj yuav tsum xub nkag siab tias nws yog dab tsi.
Non-Hodgkin's lymphoma yog ib lub tswv yim sib sau ua ke, nws hais txog tag nrho pawg ntawm cov kab mob oncological uas cov hlwb tsis zoo cuam tshuam rau cov ntaub so ntswg lymphoid. Hauv lwm lo lus, pawg no suav nrog txhua hom lymphomas uas twb muaj lawm nrog kev zam ntawm Hodgkin's lymphoma. Ib qho tshwj xeeb ntawm qhov tom kawg yog qhov muaj cov hlwb hloov pauv thiab ntau lub hlwb hauv cov ntaub so ntswg cuam tshuam.
Tus yam ntxwv ntawm tus kab mob
Non-Hodgcon's lymphomas suav nrog txog 80 yam kab mob sib txawv uas sib txawv hauv kev ua phem thiab hauv zos.
Ntawm cov neeg mob, muaj kwv yees li tib tus txiv neej thiab poj niam, txawm hais tias qee hom kab mob tseem muaj kev vam meej ntawm poj niam txiv neej. Raws li rau pawg hnub nyoog, cov neeg laus muaj qhov pheej hmoo siab me ntsis ntawm kev txhim kho oncology. Meanwhile, tus kab mob no feem ntau kuaj tau rau menyuam yaus.
Vim tias tsis yog-Hodgkin's lymphomas tsis yog ib qho, tab sis ntau yam kab mob sib koom ua ke los ntawm ib tus yam ntxwv, ntau hom thiab ntau yam yuav tsum tau txiav txim siab ib zaug. Xws li cov yam ntxwv raws li lub sijhawm thiab kev siv ntawm cov chav kawm ntawm kev kho mob, kev kho mob thiab cov kab mob sib kis tau ncaj qha nyob ntawm tus yam ntxwv ntawm tus kab mob.
B-cell form
Hom kev faib tawm ntau tshaj plaws tuaj yeem suav tias yog ib qho tau txais los ntawm World He alth Organization. Nws yog raws li qhov tseeb ntawm cov cellular muaj pes tsawg leeg ntawm oncology. Muaj 2 pawg dav: B-cell thiab T-cell lymphomas. Txhua tus ntawm lawv yuav tsum tau hais kom ntxaws ntxiv.
Dab tsi yog B-cell non-Hodgkin's lymphoma? Qhov no yog kab mob malignant ntawm cov ntaub so ntswg lymphoid, uas B-lymphocytes raug cuam tshuam. Lawv lub luag haujlwm tseem ceeb yog tsim cov tshuaj tiv thaiv kab mob, yog li ntawd, lawv kuj koom nrog hauv kev tiv thaiv kab mob humoral teb. Muaj ntau hom lymphomas ntawm no:
- Nodal thiab splenic. Cov hom no yog tus yam ntxwv ntawm kev loj hlob qeeb.
- Burkitt's lymphoma. Raws li kev txheeb xyuas kev kho mob, nws yog cov txiv neej uas muaj hnub nyoog 30 xyoo uas muaj feem yuav raug mob los ntawm tus kab mob no. Cov kws kho mob tsis nrawm los muab cov txiaj ntsig zoo: nrog Burkitt's non-Hodgkin's lymphoma, kev ciaj sia ntawm cov neeg mob rau 5 xyoos tsuas yog 50%.
- Follicular. Feem ntau, tus kab mob oncological no tshwm sim qeeb, tab sis nws tuaj yeem hloov mus rau hauv daim ntawv diffuse, uas yog tus cwj pwm los ntawmkev loj hlob sai.
- MALT lymphoma ntawm thaj chaw marginal. Daim ntawv no kis mus rau lub plab thiab nce qeeb. Nrog rau tag nrho cov kev kho no, nws yog qhov nyuaj heev los kho.
- Primary mediastinal (los yog mediastinal). Tus kab mob no feem ntau cuam tshuam rau cov poj niam, 5-xyoo txoj sia nyob tom qab kho yog 50%.
- Lymphocentric me cell. Kev loj hlob qeeb, tab sis tus nqi kho tau qis heev.
- Primary CNS lymphoma.
- Diffuse loj uas tsis yog-Hodgkin's lymphoma. Qhov ntau yam no hais txog cov kab mob oncological sai sai.
Hom tsis-Hodgkin's T-cell lymphoma
T-cell lymphoma yog ib hom kab mob malignant uas muaj kev loj hlob ntawm T-lymphocytes uas tsis tswj tau. Lawv ntau lawm tshwm sim nyob rau hauv lub thymus thiab lawv txhawb cellular (los yog barrier) tiv thaiv ntawm daim tawv nqaij thiab mucous daim nyias nyias.
- Lymphoblastic form. Feem ntau cov neeg mob nrog qhov kev kuaj mob no yog cov txiv neej hluas hnub nyoog qis dua 40 xyoo. Qhov txiaj ntsig zoo ntawm kev kho mob tsuas yog kwv yees yog tias cov pob txha pob txha tsis koom nrog hauv cov txheej txheem.
- Loj cell non-Hodgkin's lymphoma anaplastic. Feem ntau, tus kab mob no tshwm sim hauv cov tub ntxhais hluas, tab sis nrog kev kuaj mob raws sij hawm, nws teb tau zoo rau kev kho mob.
- Extranodal NHL. Hom kab mob no cuam tshuam rau T-killers, nws qhov kev ua phem tuaj yeem sib txawv.
- Sezary syndrome (los yog tawv nqaij). Daim ntawv no feem ntau hu ua fungal mycosis thiab yog tsim feem ntauhauv cov neeg laus (50-60 xyoo).
- YLymphoma nrog enteropathy. Nws tau pom tias hom mob qog noj ntshav no yog qhov zoo rau cov neeg uas muaj gluten intolerance. Tus yam ntxwv yog txhoj puab heev thiab nyuaj kho.
- Angioimmunoblastic. Hom no nyuaj rau kev kho, thiab yog li ntawd cov kws kho mob tsis ua kom muaj txiaj ntsig zoo rau lub neej.
- Non-Hodgkin's lymphoma panniculitis-zoo li. Xws li oncology tsim nyob rau hauv cov rog subcutaneous. Ib tug yam ntxwv feature ntawm daim ntawv no yog rhiab heev rau chemotherapy, uas ua rau cov kev kho mob tsis zoo.
Txiv los ntawm kev txhoj puab heev
Lwm qhov kev xaiv rau kev faib tawm Neodzhkin's lymphomas yog kev faib raws li kev ua phem ntawm cov txheej txheem. Qhov no yooj yim heev rau cov kws kho mob, vim nws tso cai rau lawv xaiv qhov kev kho mob thiab kev soj ntsuam zoo.
- Ntxhais NHL. Hom no suav nrog cov kab mob oncological nrog kev loj hlob sai, kev sib kis tau zoo, thiab qee zaum muaj kev tiv thaiv rau kev siv tshuaj khomob. Qhov kev kwv yees ntawm kev kho mob ntawm no tuaj yeem ua tau raws li theem ntawm oncology uas tsis yog Hodgkin's lymphoma tau kuaj pom. Kev rov tshwm sim ntawm cov kab mob no tshwm sim ntau zaus.
- Txhob Cia Siab. Tsis zoo li daim ntawv yav dhau los, cov qog nqaij hlav hauv plab tsis loj hlob qeeb thiab metastasizes. Qee zaum cov qog nqaij hlav ntawm daim ntawv no yuav tsis tshwm sim rau lawv tus kheej rau ntau xyoo (uas yog, lawv tsis ua rau mob thiab lwm yam tsos mob ntawm pathology hauv ib tus neeg). Feem ntau, nrog kev kho mob raws sij hawm ntawm non-Hodgkin's lymphoma, qhov kev tshwm sim ntawm no yog qhov zoo heev.
- Intermediate. Xws lihom kab mob pib maj mam, tab sis nce nyob rau hauv lub sijhawm dhau los, ua rau ntau dua rau cov ntaub ntawv nruj.
Vim txoj kev loj hlob
Txog tam sim no, cov kws kho mob tseem tsis tuaj yeem txheeb xyuas qhov tseeb uas ua rau muaj kev loj hlob ntawm non-Hodgkin's lymphoma ntawm txhua yam. Txawm li cas los xij, cov ntsiab lus hauv qab no yuav tsum tau coj mus rau hauv tus account ntawm no. Raws li nws keeb kwm, tus kab mob tau muab faib ua:
- primary - oncology feem ntau cuam tshuam rau cov ntaub so ntswg lymphoid (kev ua kom pom tseeb), thiab tom qab ntawd metastasizes rau lwm lub cev;
- secondary - nyob rau hauv cov ntaub ntawv no, tus kab mob no ua raws li metastases, yog li lub xub ntiag ntawm malignant hlwb nyob rau hauv lub cev yuav hu ua qhov ua rau.
Yog tias peb tham txog qhov ua rau thawj lymphoma, ces hauv cov tshuaj muaj ntau yam:
- Kab mob hauv lub cev. Tus kab mob siab C, kab mob HIV, lossis tus kab mob herpes tib neeg (hom 8) tuaj yeem ua rau cov kab mob tshwm sim. Tus kab mob Epstein-Barr feem ntau ua rau Burkitt's lymphoma, lossis daim follicular ntawm tus kab mob. Cov neeg raug tus kab mob Helicobacter pylori (uas ua rau mob plab) muaj qhov pheej hmoo ntawm kev tsim MALT lymphoma.
- Qee yam kab mob caj ces. Ntawm lawv yog: ataxia-telangiectasia syndrome, Chediak-Higashi syndrome, thiab Klinefelter's syndrome.
- Ionized tawg nyob rau hauv ib koob.
- Kev cuam tshuam ntawm benzenes, tshuaj tua kab, tshuaj tua kab thiab ntau lwm yam mutagens lossis tshuaj carcinogens.
- Kab mob ntawm qhov xwm txheej autoimmune. yam ntxwvIb qho piv txwv yuav yog mob caj dab rheumatoid lossis kab mob lupus erythematosus.
- siv sijhawm ntev ntawm ntau yam tshuaj tiv thaiv kab mob.
- Hnub nyoog hloov pauv hauv cov ntaub so ntswg hauv lub cev. Nrog lub hnub nyoog, qhov kev pheej hmoo ntawm kev tsim cov qog ntshav qog ntshav tsis yog Hodgkin nce ntxiv. Tus kws kho mob cov lus pom zoo kom txo qhov kev pheej hmoo no yog mus kuaj mob tsis tu ncua. Qhov no yuav ua rau nws muaj peev xwm txheeb xyuas tus kab mob thaum ntxov thiab pib kho raws sijhawm.
- Ntau tshaj.
Nws yog ib qho tsim nyog sau cia: qhov muaj ib lossis ob peb yam los ntawm cov npe saum toj no tsis txhais tau tias qhov tseem ceeb ntawm kev loj hlob ntawm cov kab mob oncological. Lawv tsuas ua rau muaj kev pheej hmoo ntawm qhov tshwm sim.
theem ntawm lymphomas
Tag nrho lub sijhawm ntawm cov kab mob oncological feem ntau muab faib ua 4 theem (theem), thiab lymphoma hauv qhov no tsis muaj kev zam.
1 theem. Non-Hodgkin's lymphoma nyob rau theem no yog sawv cev los ntawm kev swb ntawm ib lub qog ntshav los yog cov tsos ntawm ib qho kev ua kom pom tseeb. Tseem tsis tau muaj kev tshwm sim hauv zos.
2 theem. Cov theem no suav nrog cov qog nqaij hlav malignant uas tau kis mus rau ob lossis ntau dua cov qog ntshav qab zib thiab tseem mus dhau ntawm cov qog ntshav qab zib, tab sis tsuas yog nyob rau ntawm ib sab ntawm lub diaphragm. Yog li, cov qog tuaj yeem kis tau tsuas yog hauv plab kab noj hniav lossis hauv siab xwb.
3 theem. Cov theem tom ntej ntawm txoj kev loj hlob yog lub xub ntiag ntawm foci ntawm ob sab ntawm lub diaphragm.
4 theem. Qhov theem ntawm kev loj hlob ntawm lymphoma yog suav tias yog qhov kawg. Lub sijhawm no, qhov txhab txuas mus rau cov pob txha pob txha, pob txha pob txha thiab hauv nruab nrab lub paj hlwb. Qhov no theemtsis nyob rau hauv vain yog suav tias yog qhov kawg thiab nyuaj tshaj plaws rau tus neeg mob. Ib qho ntawm qhov tshwm sim yog qhov mob hnyav tas li, uas tsis tuaj yeem tso tseg nrog kev pab ntawm cov tshuaj ua kom zoo li qub.
daim duab kho mob
Cov tsos mob ntawm non-Hodgkin's lymphoma muaj ntau haiv neeg thiab nyob ntawm seb hom kab mob thiab thaj chaw. Ib qho kev tshwm sim ntawm qhov mob qog nqaij hlav qog nqaij hlav qog nqaij hlav yog qhov nce hauv cov qog ntshav qog ntshav (feem ntau lossis hauv zos) thiab mob hauv cheeb tsam no. Tus mob no yog nrog los ntawm cov tsos mob ntawm kev puas tsuaj rau ib lub cev lossis cov cim qhia ntawm kev qaug dab peg ntawm lub cev.
T-cell cov ntaub ntawv feem ntau tshwm sim lawv tus kheej raws li hauv qab no:
- lymph nodes nce;
- muaj qhov nce ntawm tus po thiab ua txhaum nws txoj haujlwm;
- ntsws thiab daim tawv nqaij puas.
Muaj ntau cov tsos mob uas yog yam ntxwv ntawm cov qog ntshav qog ntshav tsis yog Hodgkin, tab sis tsis muaj nyob hauv Hodgkin's lymphoma. Ntawm lawv:
- ua rau cov qog nqaij hlav ntawm cov mediastinum (qhov chaw ntawm lub hauv siab kab noj hniav), muaj qhov o ntawm lub ntsej muag thiab hyperemia (cov ntshav ntau dhau mus rau qee qhov ntawm lub cev);
- yog cov hlwb tsis zoo tsim nyob rau hauv thymus, ua tsis taus pa nquag thiab hnoos;
- nce hauv pelvic lossis retroperitoneal lymph nodes provokes lub raum tsis ua hauj lwm los yog hydronephrosis (gradual atrophy ntawm ob lub raum).
Tib lub sijhawm, nws tsis tuaj yeem tsis nco qab cov tsos mob uas nrog rau ib qho twgkab mob oncological. Nrog non-Hodgkin's lymphoma, lawv pib tshwm sim ntawm theem 2 ntawm tus kab mob thiab maj mam ua kom ci:
- txo qis hauv kev ua tau zoo, zoo li tsis muaj zog thiab qaug zog;
- tsis qab los;
- poob phaus;
- tshwm sim ntawm chim siab, apathy;
- tawm hws hnyav tas li feem ntau thaum hmo ntuj;
- kos npe ntawm anemia.
Kev kuaj mob lymphomas
Kev nce hauv cov qog ntshav qhia tsis tau tsuas yog muaj kab mob oncological xwb, tab sis kuj muaj kev kis kab mob hauv tib neeg lub cev. Yog tias xav tias muaj cov kab mob sib kis, tus neeg mob tau muab tshuaj tsim los tshem tawm qhov ua kom pom tseeb. Tom qab qee lub sijhawm, kev tshuaj xyuas rov qab ua dua. Yog tias tsis pom muaj kev txhim kho, muaj ntau qhov kev sim kuaj thiab cov txheej txheem kuaj mob. Cov hauv paus ntsiab lus thiab cov txheej txheem ntawm kev kho mob uas tsis yog-Hodgkin's lymphoma tus kws kho mob yuav xaiv raws li cov txiaj ntsig ntawm kev kuaj mob.
- Kev kuaj ntshav txhawm rau txiav txim siab lub xeev ntawm lub cev thiab tshawb nrhiav kab mob.
- lub hauv siab x-ray. Raws li qhov tshwm sim ntawm cov txheej txheem no, qhov mob ntawm cov qog nqaij hlav hauv siab tau tshwm sim.
- CT - xam tomography muab cov ntaub ntawv hais txog cov xwm txheej ntawm tag nrho cov qog ntshav qab zib thiab qhov muaj peev xwm ntawm metastases hauv lwm lub cev.
- MRI. Siv cov duab sib nqus resonance, cov kws kho mob txiav txim siab txog lub xeev tam sim no ntawm tus txha caj qaum thiab lub hlwb thiab muaj peev xwm muaj cov hlwb tsis zoo hauv lawv.
- PET. Nyob rau hauv cov nqe lus no yog cov txheej txheem kuaj mob ntawm positron-emission tomography. Thaum lub sij hawm nws, ib tug tshwj xeeb tshuaj yog txhaj rau hauv tus neeg mob cov hlab ntsha, uas yuav pab txheeb xyuas tag nrho cov qog nqaij hlav foci nyob rau hauv cov ntaub so ntswg.
- Gallium scan. Txoj kev no muaj txiaj ntsig zoo ntxiv rau PET, vim nws tshawb pom cov hlwb tsis zoo hauv cov pob txha.
- Ultrasound muab cov ntaub ntawv hais txog lub xeev ntawm cov kabmob sab hauv.
- Biopsy. Qhov kev kuaj mob no yog kev tshem tawm cov qog hlwb thiab lawv txoj kev kawm ntxiv hauv chav kuaj. Kev kuaj ntshav biopsy tuaj yeem ua tau ntau txoj hauv kev, yog li muaj kev phais, kev txiav tawm, puncture, txhav txhav thiab pob txha pob txha aspiration.
Kev kho mob
Nyob rau hauv txhua rooj plaub, cov kev kho mob tau sau rau hauv tus account qhov tshwm sim ntawm kev kuaj mob. Qee hom lymphomas tsis xav tau kev kho mob thaum xub thawj (qhov no suav nrog hom qog nrog kev loj hlob qeeb thiab tsis muaj cov tsos mob tshwm sim).
Tshuaj kho mob. Nrog non-Hodgkin's lymphoma, ob peb chav kawm ntawm kev kho mob tau muab tshuaj. Cov nyhuv kho tau tiav nrog kev siv cov tshuaj tiv thaiv kab mob muaj zog, uas yog tsim los thaiv kev loj hlob thiab kev loj hlob ntawm cov kab mob pathological. Lub sijhawm nruab nrab ntawm cov chav kawm yog li 2 lossis 4 lub lis piam. Dosage form: cov tshuaj txhaj tshuaj los yog ntsiav tshuaj.
Kev kho hluav taws xob. Cov ntsiab lus ntawm kev kho mob los ntawm kev cuam tshuam rau tib neeg lub cev ntawm ionized rays, uas ua rau muaj mob qog noj ntshav. Xws li kev kho mob ntawm non-Hodgkin's lymphoma nyob rau qee kis yog qhov tseem ceeb, tab sis feem ntau nws tau ua kenrog kws khomob.
Kev phais. Nyob rau hauv cov ntaub ntawv ntawm lymphomas, phais yog siv heev tsawg, vim nws tsis tshua muaj efficiency. Nws qhov kev teem caij ua rau kev txiav txim siab tsuas yog thaum muaj qhov txwv tsis pub kis ntawm cov qog.
Immunotherapy. Kev kho mob ntawm non-Hodgkin's lymphoma feem ntau ua nrog cov tshuaj uas muaj interferon, monoclonal antibodies thiab tshuaj kho mob. Lub ntsiab ntawm qhov kev cuam tshuam no yog muab lub cev nrog cov tshuaj uas tib neeg lub cev tsim tawm ntawm nws tus kheej hauv cov xwm txheej ib txwm muaj. Cov tshuaj no txo qis qhov loj ntawm cov qog, ua rau nws txoj kev loj hlob qeeb thiab ua rau tib neeg kev tiv thaiv kab mob ntau ntxiv.
pob txha pob txha hloov. Txoj kev kho no yog tig mus rau thaum lwm hom kev kho mob tsis ua haujlwm. Ua ntej hloov pauv, tus neeg mob tau txais kev siv hluav taws xob ntau los yog siv tshuaj khomob. Kev hloov pauv tom ntej yog yuav tsum tau vim tias cov koob tshuaj hluav taws xob ntau lossis tshuaj tua tsis tau tsuas yog cov qog nqaij hlav cancer xwb, tab sis kuj tseem muaj cov ntaub so ntswg noj qab haus huv. Nws yog rau kev kho cov pob txha pob txha uas transplantation yog sau.
Qhov tseem ceeb! Kev noj tshuaj rau tus kheej nrog qhov kev kuaj mob no yog txwv tsis pub! Lymphomas ntawm txhua yam thiab xwm tsis kho nrog pej xeem tshuaj, qhov no yuav tsum muaj kev tshaj lij thiab kev ntsuas los tshem tawm cov qog.
Huab cua
Raws li kev txheeb xyuas kev kho mob thiab kev tshuaj xyuas kev kho mob qhia, tsis yog Hodgkin's lymphoma tau kho tau zoo nyob rau theem 1 thiab 2 ntawm txoj kev loj hlob. Hauv qhov no, kev ciaj sia ntawm cov neeg mob hauv 5 xyoos tom ntej no yog li 80%. Qhov no yog ib daim duab siab heev muab qhov hnyav ntawm tus kab mob. Nyob rau hauv cov ntaub ntawv ntawm kev kho mob ntawm cov neeg mob nrog theem 3 oncology, qhov ciaj sia taus tus nqi yog qis dua, vim hais tias cov qog muaj sij hawm mus kis tau deb tshaj qhov kev tsom xam, thiab nws yog heev nyuaj rau tiv nrog nws. Nyob rau theem 4, qhov ciaj sia taus tsawg - tsuas yog 20%.
Cov kws kho mob tshwj xeeb tshaj tawm: txawm tias qhov kev txhim kho tas li thiab kev tshawb fawb hauv cheeb tsam no tsis tso cai kho cov kab mob oncological nrog 100% kev ua tau zoo. Tias yog vim li cas ntau nyob ntawm tus neeg mob nws tus kheej. Kev tshawb pom ntxov ntawm cov tsos mob ntawm tus kab mob thiab tiv tauj lub tsev kho mob ua rau muaj kev pheej hmoo ntawm kev rov zoo tag nrho.
