Hom kab mob ntawm cov tawv nqaij feem ntau yog basalioma ntawm lub ntsej muag, uas yog basal cell carcinoma, basal cell carcinoma. Cov qog neoplasm no yuav siv sij hawm nws pib ntawm cov kab mob epithelial txheej. Cov yam ntxwv tshwj xeeb tshaj plaws rau basalioma yog kev loj hlob qeeb thiab tsis tshua muaj metastasis. Feem ntau cov oncologists nyiam ntaus nqi xws li cov txheej txheem qog rau semi-malignant neoplasms.
Kev piav qhia ntawm pathology
Basal cell carcinoma yog qhov txawv ntawm nws cov kev kawm tsis tu ncua. Feem ntau, kev ntxeem tau tshwm sim nyob rau hauv yuav luag tag nrho cov tawv nqaij txheej, nrog rau qhov tob tshaj plaws. Cov txheej txheem no tuaj yeem ua rau lub ntsej muag ua haujlwm tsis zoo ntawm daim tawv nqaij. Cov neeg muaj hnub nyoog sib txawv raug cov kab mob, txawm li cas los xij, raws li kev txheeb cais, txhua tus neeg thib plaub ua ntej thiab tom qabhnub nyoog 50 xyoo uas rhiab heev rau tshav ntuj thiab muaj tawv nqaij ncaj.
Txoj kev sib cav
Yam uas tuaj yeem ua rau kev loj hlob ntawm basalioma ntawm lub ntsej muag suav nrog:
- hnub ci raug;
- ionizing factor;
- raug rau cov tshuaj ntawm cov tshuaj lom neeg, piv txwv li, arsenic, hydrocarbon derivatives;
- mob heev rau ntawm daim tawv nqaij.
Basal cell carcinoma originates nyob rau hauv lub tob txheej ntawm daim tawv nqaij. Tom qab ntawd, nws maj mam nce mus rau qhov chaw ntawm daim tawv nqaij pib.
Signs
Basalioma (duab hauv qab no) tuaj yeem pom nws tus kheej hauv ntau hom kev kho mob:
- Nodular-ulcerative. Daim ntawv no feem ntau yog nyob rau sab hauv ntawm qhov chaw ntawm lub qhov muag, ntawm qhov muag ntawm daim tawv muag, hauv nasolabial folds. Saum toj no ntawm daim tawv nqaij, xws li ib tug basalioma tshwm raws li ib tug liab los yog liab liab ntom tsim ntawm ib tug nodular zoo. Qhov saum npoo ntawm qhov tsim yog ci iab. Maj mam nce, cov node pib ulcerate, ib tug greasy txheej ntaub ntawv nyob rau hauv qab ntawm lub rwj. Nyob rau saum npoo ntawm lub pob, cov yam ntxwv vascular expansions (telangiectasias) yog tsim. Nws tseem ua tau cov tsos ntawm cov tawv nqaij tawv nqaij, uas yog puag ncig los ntawm cov menyuam cov xim tuab heev.
- Perforating basalioma ntawm lub ntsej muag. Daim ntawv no ntawm basal cell carcinoma yog qhov tsawg heev, nws yog tus cwj pwm los ntawm kev nkag mus sai heev. Nws cov tsos zoo li tsis txawv ntawm daim ntawv nodular-ulcerative ntawm basalioma.
- Exophytic, warty, papillary. Basalioma cov ntaub ntawv ntawm daim tawv nqaijtshwm nyob rau hauv daim ntawv ntawm ntom ntom nodules uas zoo li cauliflower nyob rau hauv tsos. Daim ntawv no tsis yog tus cwj pwm los ntawm kev nkag mus.
- Loj nodular nodular. Cov qog no yog tus cwj pwm los ntawm ib qho chaw nyob ntawm nodular neoplasm. Cov cim qhia ntawm telangiectasia tau pom tseeb ntawm qhov chaw.
- Pigmentary basalioma (muaj ib daim duab hauv kab lus). Cov tsos mob ntawm xws li neoplasm yog zoo ib yam li melanoma. Qhov sib txawv tseem ceeb yog qhov node muaj qhov tsaus nti sab hauv pigmentation, cov hlaws xim xim ib puag ncig nws.
- Atrophic cicatricial. Cov duab ntawm xws li ib tug basalioma yog tiaj, ulcerated, surrounded los ntawm ib tug ntom cushion uas muaj ib tug pearl xim. Ib tug yam ntxwv txawv ntawm daim ntawv no ntawm basal cell carcinoma yog qhov erosive qhov chaw loj hlob nyob rau lub caij thaum caws pliav tshwm sim nyob rau hauv qhov chaw.
- Sclerodermiform basal cell carcinoma. Yooj yim rau caws pliav thiab ulceration. Cov theem pib ntawm txoj kev loj hlob yog tus cwj pwm los ntawm cov tsos ntawm cov me me ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom nrog vascular translucence.
- Pagetoid superficial qog. Daim ntawv no ntawm basalioma ntawm lub ntsej muag yog tus cwj pwm los ntawm cov tsos ntawm ntau neoplasms uas muaj cov duab tiaj tus. Cov qog mus txog qhov ntau thiab tsawg. Hauv qhov no, cov plaques tau tsa cov npoo uas tsis nce saum daim tawv nqaij. Cov xim tuaj yeem sawv cev los ntawm txhua qhov ntxoov ntxoo ntawm scarlet. Heev feem ntau nrog cov tsos ntawm ntau yam diffuse txheej txheem, piv txwv li, nyob rau hauv daim ntawv ntawm ib tug cyst nyob rau hauv lub cheeb tsam ntawm lub puab tsaig.
- Turbanbasalioma. Nws tsuas cuam tshuam rau ntawm tawv taub hau. Nws cov xim yog violet-pink, lub hauv paus yog dav, txog 10 centimeters. Txoj kev txhim kho yuav siv sij hawm ntev. Daim duab kho mob yog benign.
Basalioma theem
Kev faib tawm ntawm cov kab mob los ntawm theem yog ua raws li cov yam ntxwv uas tshwm sim hauv daim duab kho mob, xws li thaj tsam ntawm qhov txhab, qhov tob ntawm qhov germination, cov cim ntawm kev puas tsuaj, thiab lwm yam. Raws li cov yam ntxwv no, nws yog ib txwm ua kom paub qhov txawv plaub theem ntawm basal cell carcinoma:
- Thawj theem ntawm basalioma yog tus cwj pwm los ntawm cov tsos mob ntawm neoplasms, qhov loj ntawm qhov tsis ntau tshaj ob centimeters. Lawv nyob hauv cheeb tsam txwv thiab tsis muaj sijhawm los loj hlob mus rau cov ntaub so ntswg nyob sib ze.
- Nodular hlav, qhov loj ntawm ntau tshaj ob centimeters, yog nyob rau theem ob ntawm tus kab mob. Muaj cov cim qhia tias basalioma tau loj hlob mus rau txhua txheej ntawm daim tawv nqaij, tab sis cov ntaub so ntswg rog tseem tsis cuam tshuam.
- Neoplasms ntsuas peb lossis ntau dua centimeters yog nyob rau theem thib peb. Nyob rau theem ntawm kev loj hlob no, cov qog loj hlob mus rau cov pob txha.
- Basaliomas ntawm theem plaub yog neoplasms uas cuam tshuam rau pob txha thiab pob txha mos.
Cov cim qhia ntawm thawj theem ntawm basalioma
Ib yam ntxwv ntawm cov qog yog nws qhov chaw nyob hauv ntau qhov chaw ntawm caj dab thiab lub ntsej muag. Localized ntawm daim tawv nqaij ntawm lub qhov ntswg, uas kuj tsis tshua muaj. Thaum pib, qog manifests nws tus kheej nyob rau hauv daim ntawv ntawm me me thiab tsis mob nodules uas phim cov xim ntawm daim tawv nqaij. Feem ntau lawv tshwm sim ntawm lub hauv pliaj lossis hauvnasolabial quav thiab zoo li pob txuv zoo tib yam.
Thaum pib, lub basalioma zoo li lub me me pearly nodular tsim. Tom qab ib ntus, nws pib ntub dej, thiab cov crust pib tsim rau ntawm qhov chaw, uas koj tuaj yeem paub qhov txawv ntawm qhov ulcerated nto.
Mob thiab tsis xis nyob tsis muaj. Xws li nodules tuaj yeem tshwm sim hauv txhua pab pawg thiab tom qab ntawd sib koom ua ke. Yog li ntawd, ib qho angiitis plaque yog tsim, uas muaj ib tug lobed nto. Qhov ntawd yog qhov basalioma yog.
yam ntxwv
Ib tus yam ntxwv tshwj xeeb yog cov cim telangiectasic tshwm rau saum npoo ntawm cov quav hniav, uas yog, stains tsim los ntawm me me capillaries. Tom qab ib co sij hawm, ib tug npuas edging yog tsim nyob rau hauv lub perimeter ntawm lub tsim, uas ces tig mus rau hauv ib tug edging ntawm ib tug ntom qauv. Nws yog qhov no cov menyuam uas yog ib tug yam ntxwv feature ntawm basal cell carcinoma. Yog tias koj sim ncab daim tawv nqaij ntawm qhov chaw ntawm neoplasm, koj yuav pom tseeb lub nplhaib ntawm qhov mob, uas muaj xim liab.
Cov ntaub so ntswg tawg ntawm qhov chaw ntawm cov qog provokes cov txheej txheem erosive lossis ulcerative. Yog hais tias koj tshem tawm cov crust npog lub rwj, nws yuav nthuav tawm kev nyuaj siab nyob rau hauv daim ntawv ntawm ib tug crater los yog ib tug uneven hauv qab nyob rau hauv nws. Cov qog zoo li no tuaj yeem ua rau qee qhov caws pliav, npog nrog pob zeb, tab sis txawm tias qhov no, txuas ntxiv mus qeeb, yam tsis ua rau muaj kev tsis xis nyob.
Kev loj hlob qeeb qhia tus kab mob hauv 80% ntawm cov neeg mob. Nyob rau tib lub sijhawm, yog tias kuaj pom tus kab mob raws sijhawm, ces qhov kev ntsuas tau zoo heev: hauv 98% ntawm cov neeg mob, tus kab mob tuaj yeem kho tau tag nrho.
Kev kho mob ntawm basalioma ntawm lub ntsej muag nrog cov tshuaj pej xeem siv, tab sis tsuas yog nyob rau theem pib thiab ua ke nrog lwm txoj hauv kev.
kab mob lig kev loj hlob
Lub sijhawm lig ntawm kev loj hlob ntawm carcinoma yog tus cwj pwm los ntawm nws cov germination nyob rau hauv cov khaubncaws sab nraud povtseg ntawm daim tawv nqaij, ua rau muaj kev nyuaj siab nyob rau hauv daim ntawv ntawm ib tug crater. Cov qauv ntawm ulceration ua ntom thiab tsis hloov mus rau sab thaum kuaj. Hauv qab ntawm qhov txhab ua oily thiab ci ntsa iab, rwj nws tus kheej yog ib puag ncig los ntawm cov hlab ntsha kom pom tseeb.
Raws li peb tau hais lawm, basal cell carcinoma loj hlob nyob rau lub sijhawm ntev thiab yog tus cwj pwm los ntawm kev loj hlob hauv qhov tob, thiab tsis nyob hauv cheeb tsam. Hauv qhov no, tom qab kev kho mob ntawm basalioma nyob rau theem tom ntej, cov neeg mob muaj qhov pom kev zoo nkauj heev, uas nyuaj rau kho tom qab.
Ntau tus neeg mob muaj mob qog noj ntshav.
Kev pheej hmoo ntawm basalioma thiab xav tau tshem tawm
Cov txheej txheem ntev ntawm cov qog nqaij hlav provokes nws nkag mus tob rau hauv lub cev, ua rau muaj kev puas tsuaj thiab kev puas tsuaj ntawm cov nqaij mos, pob txha thiab pob txha mos. Cellular kev loj hlob ntawm neoplasm tshwm sim raws cov hlab ntsha fibers, nyob rau hauv cov khaubncaws sab nraud povtseg ntawm cov ntaub so ntswg thiab nyob rau saum npoo ntawm lub periosteum.
Yog basal cell carcinoma tsis raug tshem tawm raws sijhawm, kev puas tsuaj yuav cuam tshuam tsis yog cov ntaub so ntswg xwb.
Kev nyuaj siab
Basalioma tuaj yeem cuam tshuam thiab deform lub qhov ntswg thiab pob ntseg vim kev puas tsuaj ntawm cov pob txha thiab pob txha mos. Tus kab mob no yuav exacerbated los ntawmtxheej txheem, uas nws muaj peev xwm txuas tau ntau yam kab mob. Ntxiv thiab, nws muaj peev xwm:
- -lesion ntawm cov lus qhia txog qhov ntswg hauv lub qhov ntswg;
- kev hloov ntawm cov txheej txheem qog rau hauv qhov ncauj;
- kev puas tsuaj thiab kev puas tsuaj ntawm cov pob txha pob txha ntawm lub cranium;
- qhov muag qhov muag puas;
- pom qhov muag tsis pom kev thiab lag ntseg.
Kev qhia cov qog rau hauv pob txha taub hau, uas tshwm sim los ntawm cov kab noj hniav thiab qhov, tshwj xeeb tshaj yog txaus ntshai.
Nyob rau hauv cov xwm txheej zoo li no, lub paj hlwb puas thiab kev tuag tom qab ntawm tus neeg mob tau dhau los ua qhov kev zam. Txawm hais tias qhov tseeb tias basalioma raug suav hais tias yog cov qog uas tsis yog metastasizing, muaj txog ob puas tus neeg uas tau piav qhia tias nws tau ua metastasize.
Cia peb xav txog yuav ua li cas kho basalioma ntawm lub ntsej muag ua tiav.
Kev kho mob basal cell carcinoma
cov kev kho mob suav nrog:
- Kev kho tshuaj nrog tshuaj kho mob hauv zos siv tshuaj cytotoxic, xws li Cyclophosphamide. Nws tseem tuaj yeem siv cov ntawv thov nrog Fluorouracil thiab Methotrexate.
- Kev phais mob. Basalioma ntawm lub ntsej muag raug tshem tawm tag nrho. Nyob rau hauv rooj plaub no, cov ntaub so ntswg uas nyob ib sab yog ntes los ntawm 1-2 centimeters. Yog hais tias cov pob txha mos tau raug puas tsuaj, ces nws kuj raug resection.
Cov tshuaj pleev twg yuav tsum siv rau ntawm daim tawv nqaij basalioma?
Thaum pib los yog nrog kev rov qab los ntawm cov kab mob, cov tshuaj pleev hauv qab no tuaj yeem siv tau:
- "Omaine ointment".
- "Solcoseryl".
- Y"Curaderm Cream".
- "Iruksol".
- Metwix.
Lwm yam kev kho mob
Contraindications rau kev phais - complex keeb kwm pathology, muaj hnub nyoog siab heev, tsis muaj peev xwm siv tshuaj loog:
- Cryodestruction. Tso cai rau koj tshem tawm basalioma nrog kua nitrogen. Kev puas tsuaj ntawm cov qog nqaij hlav tshwm sim los ntawm qhov raug rau qhov kub thiab txias. Cov txheej txheem no tsuas yog tsim nyog rau kev puas tsuaj ntawm cov neoplasms me me uas nyob ntawm ob txhais ceg lossis caj npab. Yog hais tias lub qog loj, tob infiltration, los yog nyob rau ntawm lub ntsej muag, txoj kev no yog contraindicated.
- Kev kho hluav taws xob rau basalioma ntawm daim tawv nqaij ntawm lub ntsej muag. Nws tuaj yeem siv los ua txoj kev ywj pheej ntawm kev kho mob, lossis ua ke nrog lwm tus. Nws tuaj yeem siv los tshem tawm cov formations uas tsis ntau tshaj 5 centimeters nyob rau hauv loj thiab nyob rau saum npoo. Nyob rau hauv cov ntaub ntawv no, lub sij hawm txoj kev loj hlob yuav tsum ntxov, tab sis localization tsis muaj teeb meem. Cov txheej txheem no yog siv tau rau hauv kev kho mob ntawm cov neeg laus cov neeg mob thiab nyob rau hauv cov ntaub ntawv ntawm ib tug advanced daim ntawv ntawm tus kab mob. Kev kho mob tuaj yeem nyuaj, sib xyaw nrog cov tshuaj kho mob.
- Tshem tawm nrog carbon dioxide lossis neodymium laser. Kev siv cov txheej txheem no yog ua tau yog tias cov neoplasms me me. Txoj kev ua tau zoo heev, cov txiaj ntsig tau nce mus txog 85%.
- Photodynamic kho mob. Nws yog nqa tawm los ntawm exposing lub basalioma rau laser hluav taws xob. Ua ntejyuav tsum tau muaj kev taw qhia ntawm photosensitizer rau tus neeg mob.
Photodynamic kho yog dab tsi?
Lub txheej txheem ntawm kev txiav txim ntawm txoj kev tom kawg yog raws li hauv qab no: cov qog hlwb sau cov photosensitizer, vim tias raug rau lub laser, nws provokes kev loj hlob ntawm cov ntaub so ntswg necrosis ntawm basal cell carcinoma. Cov kab mob qog noj ntshav tuag yam tsis muaj kev puas tsuaj rau cov ntaub so ntswg. Txoj kev no hauv cov tshuaj niaj hnub no yog qhov nrov tshaj plaws thiab dav. Nws feem ntau yog siv los tshem tawm ob qho tib si cov qog nqaij hlav thiab cov uas rov tshwm sim dua, tshwj xeeb tshaj yog cov nyob ntawm daim tawv nqaij ntawm lub ntsej muag.
Huab cua
Txawm hais tias qhov tshwm sim ntawm cov qog no, qhov kev cia siab feem ntau yog qhov zoo. Nws tuaj yeem ua tiav qhov txiaj ntsig zoo hauv 80% ntawm cov neeg mob. Yog hais tias tus neoplasm muaj ib qho chaw hauv zos thiab tsis zoo heev, ces kev kuaj mob raws sij hawm thiab kev pib kho mob tuaj yeem kho tau tag nrho.
Peb tshuaj xyuas hauv kab lus no yog dab tsi basalioma yog.
