Yog vim li cas mob plab hnyuv feem ntau pom nyob rau theem lig yog vim qhov kev noj qab haus huv ntawm qhov teeb meem. Cov neeg txaj muag thiab tsis xav mus ntsib kws kho mob nrog cov tsos mob ntawm hom mob qog noj ntshav. Hmoov tsis zoo, xws li kev ntshai, tuaj yeem ua rau lawv lub neej. Yog li dab tsi yog cov cim qhia ntxov ntawm kev mob plab hnyuv? Yuav ua li cas nkag siab rau koj tus kheej tias nws tsim nyog tau txais kev kuaj mob los ntawm tus kws kho mob oncologist?
mob qog noj ntshav yog dab tsi
Cancer feem ntau hu ua txhua yam qog nqaij hlav. Tab sis muaj ntau ntau yam ntawm lawv, qhov txaus ntshai tshaj plaws ntawm lawv yog carcinoma, uas txhais tau tias "crab" hauv Greek. Tab sis hom mob qog noj ntshav hauv qab no tseem cuam tshuam rau txoj hnyuv:
- adenocarcinoma;
- colloidal;
- cricoid cell;
- squamous.
Lwm yam tsis txawv ntawm kev mob qog noj ntshav kuj tuaj yeem tshwm sim.
Ntawm nws lub hauv paus, mob qog noj ntshav yog qhov tsis muaj kev tswj hwm ntawm cov hlwb tsis zoo, uas ua rau muaj kev cuam tshuam hauv lub cev, qee zaum tsis sib haum nrog lub neej. Tab sis yog vim li cas nws thiaj litshwm sim tias lub cev pib tua nws tus kheej?
Kev faib cell txuas ntxiv hauv tib neeg lub cev yog qhov qub. Txij thaum pib ntawm ib tug neeg lub neej, txhua hom hlwb hauv nws lub cev yuav sib faib tas li, ua ntej rau kev loj hlob, thiab tom qab ntawd rov ua dua tshiab. Tab sis qhov tshwj xeeb ntawm kev loj hlob ntawm cov qog nqaij hlav cancer yog tias lawv pib loj hlob qhov twg qhov xwm txheej tsis npaj siab, thiab qhov no tshwm sim los ntawm qhov ua tsis tiav.
Kev loj hlob ntawm cov hlwb no hu ua qog. Lawv tuaj yeem yog benign lossis malignant. Yog hais tias ib tug benign qog pib cuam tshuam rau lub neej los yog kev noj qab haus huv ntawm ib tug neeg, ces nws tsuas yog txiav tawm. Tab sis nrog cov qog malignant, qhov xwm txheej yog qhov nyuaj dua, nws muaj peev xwm ua kom rov ua dua thiab metastases. Nws tsis yog yooj yim kom tshem tau ntawm nws, thiab nws yog infinitely tsis yooj yim sua kom txiav tawm cov qog, tshwj xeeb tshaj yog txij li thaum lawv loj hlob nyob rau hauv lub cev. Metastasis yog lub peev xwm ntawm cov qog nqaij hlav qog nqaij hlav "mus ncig" thoob plaws lub cev. Muaj peb hom metastases:
- Implantation - loj hlob mus rau hauv lub cev nyob sib ze.
- Lymphagenic - "mus ncig" hla cov qog ntshav.
- Hematogenous - "mus ncig" los ntawm cov hlab ntshav.
Cov metastases muaj zog npaum li cas thiab seb lawv tsis rov tshwm sim yog nyob ntawm ntau yam. Thiab ib qho ntawm cov tseem ceeb tshaj plaws yog qhov pom tias mob qog noj ntshav thaum ntxov. Yog tias koj pib kho thawj zaug thiab txawm tias theem thib ob, nws yog qhov ua tau kom txuag tau tus neeg thiab tso cai rau nws mus ua lub neej ntev. Tab sis nyob rau lub thib peb thiab plaub, qhov no yog ua tau tsuas yog ua tsaug rau ib tug txuj ci tseem ceeb, thiab tag nrho cov kev kho mob yog aimed ntawm kev sib ntaus sib tua rau xyoo ntxiv.life.
Ntseeg mob plab hnyuv
Cov hnyuv yog ib qho tseem ceeb hauv lub cev uas yog ib feem ntawm txoj hnyuv. Muaj cov ntu hauv qab no:
- duodenum;
- rectum;
- caecum thiab appendix;
- colon;
- jejunum;
- ileum;
- sigmoid nyuv;
- colon.
Thoob plaws hauv nws qhov ntev, cov hnyuv yog kab los ntawm sab hauv nrog glandular epithelium. Thiab neoplasms originate precisely ntawm lub hlwb ntawm no epithelium. Los ntawm implantation los ntawm txoj hnyuv, metastases feem ntau nkag mus rau hauv cov kabmob hauv qab no:
- womb (poj niam);
- siab;
- plab;
- ovaries (hauv poj niam);
- qog prostate (hauv txiv neej).
Qhov kev pheej hmoo siab tshaj plaws ntawm mob qog noj ntshav hauv cov neeg muaj hnub nyoog tshaj 50 xyoo. Feem ntau, nws cuam tshuam cov ntu xws li duodenum thiab qhov quav. Qhov ua tsis tau zoo tshaj plaws rau kev kuaj mob thiab kev kho mob yog sigmoid colon cancer. Qhov tsawg tshaj plaws qhov chaw ntawm malignant neoplasm nyob rau hauv txoj hnyuv yog caecum.
Ntau zaus, cov qog nqaij hlav ntawm txoj hnyuv yog degenerated adenomatous polyps. Xws li kev yug dua tshiab tshwm sim nyob rau nruab nrab tshaj li 7 xyoo thiab yog vim muaj cov caj ces tsis ua haujlwm. Nws yog ib qho tseem ceeb kom nkag siab tias mob qog noj ntshav yog ib yam kab mob uas tshwm sim, thiab yog tias cov niam txiv muaj keeb kwm mob qog nqaij hlav hauv plab, ces qhov no yog qhov laj thawj uas yuav tsum tau kuaj mob qog noj ntshav tsis tu ncua.
Stages
Txhua yam mob qog noj ntshavTus kab mob no nce mus rau 4 theem. Kev faib tawm TNM tau txais thoob ntiaj teb, raws li theem ntawm cov qog yog txiav txim siab los ntawm peb qhov ntsuas hauv qab no:
- Qhov loj ntawm cov qog, uas ntsuas hauv T (cov qog).
- Presence / absence of metastases, ntsuas hauv M (metastasis), qhov twg 0 tsis tuaj thiab 1 yog tam sim no.
- Qhov degree ntawm kev loj hlob mus rau cov kab mob sib ze thiab cov ntaub so ntswg, ntsuas hauv N (node).
Tom qab txiav txim siab tag nrho peb qhov ntsuas, koj tuaj yeem teeb tsa theem:
- Cov tsos mob ntawm tus mob neoplasm nyob rau hauv cov hnyuv mucosa, nws loj tsis ntau tshaj 2 cm, tseem tsis tau muaj metastases.
- Kev tsim ntau tshaj qhov loj ntawm 2 cm, ua kom cov txheej txheem inflammatory, pib ntawm germination nyob rau hauv ib puag ncig cov ntaub so ntswg.
- Cov qog nqaij hlav loj hlob, ua rau cov kabmob nyob ze.
- Cov qog mus txog qhov loj me, cov kab mob metastases kuj dhau los ua malignant thiab nquag loj hlob.
Nyob rau theem 4, qee lub sijhawm, qog nqaij hlav thiab metastases ua rau tus neeg mob tsis haum rau lub neej, thiab kev tuag tshwm sim. Qee zaum qhov no tuaj yeem tshwm sim ntawm theem 3, txhua yam nyob ntawm qhov chaw ntawm neoplasm. Lub qog txav sai npaum li cas los ntawm ib theem mus rau lwm qhov yog lub sijhawm ntawm tus kheej. Rau ib tug neeg, tag nrho peb theem dhau los hauv ib xyoos xwb, thaum rau ib tus neeg tsuas yog thawj theem tuaj yeem kav peb xyoos lossis ntau dua.
Stage 1 cov tsos mob
Ib qho cim qhia tias mob plab zom mov thaum ntxov yog raws plab raws li ib txwm muaj lossis lwm yam kab mob ntawm txoj hnyuv. Nws yog lawv ntau zaustag nrho thiab tsis quav ntsej, tsis txuas nrog txhua txoj hauv kev uas tuaj yeem tsim mob qog noj ntshav.
Tab sis tsis txhob khiav mus rau tus kws kho mob oncologist nrog txhua qhov zawv plab? Tsis yog, mob raws plab thiab tsis xis nyob ntev txawm tias muaj kev noj haus kom raug yuav tsum ua rau muaj kev txhawj xeeb. Nov yog cov npe tag nrho ntawm cov tsos mob thaum ntxov thiab cov tsos mob ntawm theem 1 mob qog noj ntshav:
- plab thiab hnyav hauv plab;
- poob ceeb thawj lossis hnyav nce;
- tsis qab los;
- ntshav hauv quav;
- foomy Chair;
- yam tsis zoo rau tus neeg ua kom nrawm nrawm;
- tsis piav qhia cem quav thiab raws plab;
- hloov lub rooj zaum xim;
- kev tsis zoo ntawm kev noj qab nyob zoo;
- cim ntawm anemia yam tsis muaj laj thawj zoo.
Ib qho piv tsis tau nce hauv lub cev kub thaum yav tsaus ntuj thiab tsis yog tsuas yog ib qho ntawm thawj cov tsos mob ntawm plab hnyuv thiab oncology feem ntau.
Thaum thawj theem, tseem tsis tau muaj qhov mob tshwm sim, thiab cov teeb meem hauv plab hnyuv, zoo ib yam li kev zom zaub mov, yog tib yam uas yuav tsum tau qhia txog kev kuaj mob. Txhawm rau pib, koj tuaj yeem sim palpate cov hnyuv koj tus kheej. Tab sis nws yog qhov zoo dua los tso siab rau tus kws kho mob tshwj xeeb uas yuav sau cov ntawv xeem tsim nyog. Ib qho ntawm cov cim qhia feem ntau yuav yog kev sib tsoo, tab sis yog tias nws mob ntev lossis muaj ntau tshaj ob ntawm lawv, ces nws yuav tsis yog superfluous rau kev kuaj mob. Cov neeg uas raug cuam tshuam los ntawm qhov tshwm sim yuav tsum tau saib xyuas kev noj qab haus huv ntawm lawv cov hnyuv. Rau qhov tseem ceeb ua rau muaj kev pheej hmoo ntawm kev mob qog noj ntshav:
- hnub;
- mob plab hnyuv nrog rauCov txheej txheem inflammatory;
- muaj cov benign neoplasms;
- predisposition;
- kev tiv thaiv tsis muaj zog;
- raug rau carcinogens.
Cov cim qhia pom tseeb ntawm kev mob qog noj ntshav yog cov quav sib xyaw nrog cov hnoos qeev. Hauv cov theem ntxov tshaj plaws, tag nrho cov kev tshwm sim no yuav luag imperceptible yog tias koj tsis xyuam xim rau nws. Tab sis thaum lub qog loj hlob tuaj, tag nrho cov tsos mob yuav zuj zus. Yog, thiab kev noj qab haus huv feem ntau yuav pib cuam tshuam. Tab sis qhov tu siab tshaj plaws yog qhov mob uas ua rau koj tam sim ntawd khiav mus rau tus kws kho mob feem ntau tshwm sim nyob rau theem thaum nws yuav luag tsis muaj peev xwm cawm tau txoj sia.
Cov cim qhia ntxov ntawm kev mob plab hnyuv hauv cov txiv neej
Tag nrho cov tsos mob uas tau hais yog ib yam rau txiv neej lub cev. Tsis muaj cov cim qhia tshwj xeeb thiab cov tsos mob ntawm kev mob plab hnyuv rau cov txiv neej. Raws li kev txheeb cais, lawv muaj feem yuav mob qog noj ntshav ntau dua li cov poj niam, tab sis vim qhov tseeb tias lawv tau ntsib nrog cov tshuaj phem ntau dua, lawv haus thiab haus luam yeeb ntau dua, thiab tsis yog vim muaj cov yam ntxwv ntawm lub cev.
Tom qab 60 xyoo, txhua tus txiv neej muaj kev pheej hmoo ntawm mob qog noj ntshav prostate, thiab lub cev no nyob ze rau cov hnyuv. Mob qog noj ntshav prostate yog ib qho ntawm cov qog nqaij hlav metastatic tshaj plaws, thiab lub plab zom mov, nrog rau lub zais zis thiab cov noob qes, yog thawj lub hom phiaj rau metastasis.
Rau cov txiv neej, qhov kev kuaj mob yog qhov nyuaj los ntawm qhov tseeb tias lawv puas siab puas ntsws tsis npaj mus rau palpation ntawm lawv cov hnyuv los ntawm lwm tus thiab rub mus rau qhov kawg. Tom qab 50 xyoo, txhua tus txiv neej yuav tsum ua nws txoj cai ib xyoos ib zaugraug kuaj los ntawm tus kws kho mob thiab kws kho mob urologist thiab ua txhua yam kev ntsuam xyuas tsim nyog los tswj lub xeev kev noj qab haus huv.
Cov cim qhia ntxov ntawm kev mob plab hnyuv hauv cov poj niam
Cov poj niam tshwj xeeb tshaj yog muaj kev pheej hmoo thaum lub sijhawm lawv hloov pauv hormonal. Nws tshwm sim rau lawv ntawm lub sijhawm hauv qab no:
- pubberty;
- xeeb tub;
- lub sijhawm thiab qhov kawg ntawm lactation;
- climax.
Txhua lub sijhawm no rau cov poj niam yog lub sijhawm muaj kev pheej hmoo ntawm kev pib lossis rov pib qhov kev loj hlob ntawm cov hlwb malignant. Thiab koj yuav tsum tau saib tag nrho cov tsos mob kom pom tias muaj.
Ib qho ntawm thawj cov tsos mob thiab cov tsos mob ntawm plab hnyuv hauv cov poj niam yog ib qho kev ntxub ntxaug rau cov zaub mov feem ntau lossis qee yam khoom noj, xws li ntsim thiab nqaij liab. Feem ntau cov poj niam coj qhov no tsis yog rau cov tsos mob txaus ntshai, tab sis rau kev foom koob hmoov. Tab sis nws yog tsim nyog nco ntsoov tias yog hais tias ib tug poj niam ib txwm muaj ib tug zoo qab los noj mov thiab dheev nws mam li nco dheev ploj, thiab kev xav ntawm fullness tuaj sai dua li niaj zaus, ces qhov no tsis yog vim li cas rau kev xyiv fab, tab sis rau kev txhawj xeeb. Vim hais tias hauv lub neej muaj ib yam dab tsi tseem ceeb tshaj li lub cev yuag, piv txwv li, kev noj qab haus huv thiab lub neej.
Vim tias muaj cov qauv sib txawv ntawm cov kabmob hauv thaj chaw pelvic, cov poj niam muaj tus yam ntxwv tsuas yog rau lawv cov tsos mob thaum ntxov ntawm plab hnyuv. Lawv yog cov hauv qab no:
- tso zis tsis txaus;
- mob thaum sib deev ntawm txoj hnyuv;
- tawm roj, tso zis thiab quav los ntawm qhov chaw mos.
Tab sis muaj qhov ua tau zoo tsis muaj qhov mob receptors hauv tsev menyuam, thiab yog li metastasis hauv qhov nolub cev yuav mus tsis tau pom dua.
Rau cov poj niam, mob qog noj ntshav hauv plab yog qhov txaus ntshai vim tias vim muaj ntau yam txheej txheem hormonal uas nrog lawv tag nrho lawv lub neej, lawv tau siv los ua qhov tsis xis nyob hauv thaj chaw pelvic thiab qhov chaw mos. Thiab thawj cov cim qhia ntawm kev mob plab hnyuv hauv cov poj niam muaj ntau txoj hauv kev zoo ib yam li cov tsos mob ntawm cev xeeb tub. Qhov no ua rau nws nyuaj heev rau cov poj niam kom kuaj tau ntxov thiab ua rau lawv muaj kev pheej hmoo tshwj xeeb.
Diagnosis
Yog tias tus neeg mob txhawj xeeb txog cov tsos mob thiab cov tsos mob ntawm tus mob qog noj ntshav, lawv yuav tsum mus rau tus kws kho mob-oncologist tam sim ntawd. Ua ntej tshaj plaws, ntawm kev txais tos, nws yuav palpate, thaum tus kws kho mob pom cov hnyuv nrog nws ob txhais tes ntawm sab nraud thiab sab hauv.
Tus kws kho mob oncologist uas muaj kev paub dhau los tuaj yeem txiav txim siab qhov muaj cov neoplasm nrog txoj kev no nrog qhov tshwm sim ntawm 85%. Tab sis qhov no tsis siv rau txhua ntu ntawm txoj hnyuv. Nws yuav txhim khu kev qha tshaj plaws los ntxiv kev kuaj mob nrog cov txheej txheem kev tshaj lij. Hnub no muaj cov hauv qab no:
- Irrigoscopy yog kev kuaj x-ray ntawm txoj hnyuv, uas yog txhaj tshuaj barium rau hauv nws.
- Colonoscopy yog ib qho kev tshawb fawb ntawm txoj hnyuv thoob plaws nws qhov ntev uas siv lub colonoscope, tus qauv ntawm nws cov lus qhia, uas tus neeg mob zaum ntawm kev tshaib kev nqhis rau qee lub sijhawm.
- Retromanoscopy - ib txoj kev tshawb fawb uas siv cov kev taw qhia ntawm ib tug retromanoscope rau hauv txoj hnyuv mus rau qhov tob ntawm tsis ntau tshaj 35 cm, qhov no tso cai rau ib tug zoo soj ntsuam ntawm lub sigmoid nyuv.
- MRI - kev kuaj peb-dimensional ntawm txoj hnyuv, tsis pom zoo vim muaj ntau txheej txheej thiab khoov hauv lub cev, tab sis nyob rau hauvTej zaum yuav tsim nyog muaj xwm txheej ceev.
- Computed tomography - tso cai rau koj los txiav txim qhov etymology ntawm cov qog, feem ntau yog muab los txiav txim qhov xwm ntawm neoplasm twb pom nrog kev pab ntawm palpation.
Txhua txoj hauv kev qhia qee yam tshwj xeeb, vim tias lawv txhua tus cuam tshuam. Tab sis niaj hnub no feem ntau ntawm kev kuaj mob qog noj ntshav hauv plab yog colonoscopy. Tsuas yog nws tso cai rau koj los txheeb xyuas qhov muaj cov neoplasms nyob rau tag nrho qhov ntev ntawm lub cev ntev thiab winding li cov hnyuv. Rau feem ntau txoj kev, tus neeg mob yuav tsum tau ua raws li kev noj zaub mov rau qee lub sijhawm lossis tsis kam noj txhua. Ntau tus ntawm lawv yuav xav tau ib qho enema nrog cov tshuaj tsim tawm, uas muaj kev nyab xeeb rau kev noj qab haus huv.
Ntxiv rau cov kev tshawb fawb no, txhawm rau kuaj xyuas kom raug, cov quav hauv plab tau coj mus rau qhov muaj cov ntshav hauv lawv, kuaj ntshav dav dav rau qhov muaj cov kab mob latent thiab kuaj ntshav kom pom cov qog nqaij hlav.
Tumor markers
Lub npe yog ua ke ntawm ob lo lus: Greek ónkos - cargo thiab lus Askiv cim - cim. Kev kuaj ntshav rau cov qog nqaij hlav qhia cov ntsiab lus ntawm cov tshuaj uas loj hlob qog nqaij hlav qog noj ntshav tawm hauv cov ntshav. Muaj ntau tshaj 200 hom kev xeem no nyob rau hauv lub npe dav dav "cov cim qog".
Ib qho kev tshuaj ntsuam sib txawv yog xav tau rau txhua lub cev, qee zaum yuav tsum muaj kev sib txuas ntawm ob peb. Txoj kev xav, los ntawm kev pub ntshav rau txhua hom qog nqaij hlav, koj tuaj yeem paub seb puas muaj qog nqaij hlav hauv lub cev, thiab yog tias muaj, nws nyob qhov twg. Tab sis cov kev xeem lawv tus kheej tsis pheej yig thiab nws yuav tsis yooj yim kom dhau txhua yam ib zaug,yog, nws yog pointless. Nws yog qhov tsim nyog tshaj plaws los ua qhov kev ntsuam xyuas rau cov neeg ua lag luam nrog rau qhov tsis txaus ntseeg. Thiab koj yuav tsum nkag siab tias cov qog tsis tas ib txwm tso cov kab mob lwj hauv cov ntshav. Qhov ntawd yog, koj yuav tsum tsis txhob cia siab rau ib qho kev kuaj ntshav xwb. Feem ntau, kev ntsuam xyuas cov cim qog yog siv los saib xyuas cov qog rov ua dua.
Cov kev ntsuam xyuas tshwj xeeb twg yuav tsum tau ua thiab seb lawv yuav tsum tau coj mus rau qhov twg, tus kws kho mob oncologist yuav hais tom qab kuaj pom. Rau txoj hnyuv, qhov no feem ntau yog CEA, SA 19-9, SA 242, Tu M2-RK, CYFRA 21-1, SCC, LASA-P. Tsis yog txhua tus qog qog uas qhia tias mob qog noj ntshav hauv cov hnyuv tau teev tseg. Qee tus ntawm lawv "tshwj xeeb" tsuas yog ib ntu xwb, thaum lwm tus tsuas pom tias cov qog nyob hauv txoj hnyuv, yam tsis tau qhia ib ntu.
Kev kho mob
Kev kho mob thaum kuaj pom cov qog nqaij hlav, nws yog ib qho tsim nyog yuav tsum pib sai thiab ua tiav. Nov yog tib txoj kev uas yuav kov yeej mob qog noj ntshav.
Yog tias cov qog tau kuaj pom thaum ntxov, ces sim ua kom txwv tsis pub nws txoj kev loj hlob. Rau qhov no, siv tshuaj khomob thiab hluav taws xob kho mob, cov tshuaj hormonal muaj zog tau raug sau tseg. Qee zaum, qhov no yuav pab tau, thiab tom qab ntawd cov tsos mob thiab cov tsos mob ntawm kev mob plab hnyuv rov qab. Tom qab ntawd txhua yam uas tseem yuav tau ua yog xyuas seb puas muaj qhov rov tshwm sim dua, txhawm rau pib kho tam sim ntawd thiab rov ua kom cov qog loj hlob hauv lub paj. Yog tias tus qog tshiab tsis tau tshwm sim hauv tsib xyoos, ces tus neeg mob tau pom zoo.
Tab sis yog tias cov qog tau mus txog qhov loj, ces kev phais yog qhia. Thaum nws, los yogib feem lossis tag nrho ntu ntawm txoj hnyuv. Kev ua haujlwm yuav ua tiav zoo dua yog tias cov hnyuv tau npaj ua ntej nrog kev noj zaub mov tshwj xeeb. Nws yog nqa tawm nyob rau hauv ib txoj kev qhib - laparotomy, los yog nrog kev pab los ntawm puncture qhov - laparoscopy. Cov chaw kho mob qog noj ntshav zoo tshaj plaws yog nyob rau hauv Israel.
Kev Tiv Thaiv
Rau nws, ua ntej tshaj plaws, koj yuav tsum ua lub neej noj qab haus huv txhawm rau txhim kho lub cev tiv thaiv kab mob, thiab thib ob, tsis txhob raug hluav taws xob thiab carcinogens. Cov lus qhia hauv qab no tseem yuav pab txo koj txoj kev pheej hmoo:
- Kho cov kab mob inflammatory kab mob ntawm plab hnyuv mus rau qhov kawg.
- Tsis txhob zaum hauv ib qho chaw ntev, yog tias ua haujlwm tsis tu ncua, ua ntu zus thiab ua kom sov.
- Tsis txhob hnav ris tsho hauv qab lossis ris tsho nruj.
- paub tag nrho cov cim thiab cov tsos mob ntawm kev mob plab hnyuv.
- Ua cov ntshav, tso zis thiab quav tsis tu ncua.
- Qu cawv thiab haus luam yeeb.
- Tsis txhob noj ntau dhau, sim txwv koj cov zaub mov ntsim.
- Ntawm zaub muaj fiber ntau thiab nplej.
- Ua kom nquag plias, ua si kis las.
- Txhim kev haus dej kom raug thiab haus tsawg kawg 2 litres dej ib hnub.
Muaj ntau qhov kev tshawb fawb uas tau lees paub tias kev noj tsis txaus ntawm cov nqaij liab uas muaj cov fiber ntau hauv cov zaub mov ncaj qha cuam tshuam rau kev pheej hmoo ntawm kev mob qog noj ntshav.
