mob qog noj ntshav yog ib yam kab mob uas tuaj yeem cuam tshuam rau leej twg. Tab sis! Tsis txhob ntshai thiab tso tseg, raws li cov tshuaj tsis sawv ntsug. Kev tsim kho tshiab thiab thev naus laus zis rau kev sib ntaus cov kab mob tshwm sim txhua hnub, thiab kev kho mob qog noj ntshav yog nyob rau theem tsim nyog.
Lub tswvyim ntawm "mob qog noj ntshav"
mob qog noj ntshav yog ib txoj hauv kev uas cov hlwb hauv lub cev loj tuaj thiab faib tsis tau, kis mus rau cov ntaub so ntswg thiab cov kabmob uas nyob sib ze, muab cov metastases. Lub hauv paus chiv keeb ntawm mob qog noj ntshav tam sim no tsis to taub tag nrho. Cov provoking yam yog: qhov kev txiav txim ntawm carcinogens, haus luam yeeb, tsis tu ncua kev sib cuag nrog cov teeb meem tshuaj, cov kab mob ntev uas irritate cov qauv ntawm cov cell noj qab haus huv, heredity, hormonal ntshawv siab, immunological kab mob, degeneration ntawm benign qog. Mob qog noj ntshav raug rhuav tshem los ntawm kev siv tshuaj khomob, angiogenesis, kev kho mob thiab hluav taws xob. Nov yog qee txoj hauv kev uas feem ntau siv los kho cov neeg mob.
Cov qauv thiab theem ntawm mob qog noj ntshav
Morphologically, cov kab mob qog noj ntshav hauv qab no tuaj yeem paub qhov txawv:
- medulla-ulcerative lossis saucer-shaped;
-skirr;
- papillary cancer;
- infiltrative-ulcerative form;
- mob qog noj ntshav;- mob qog noj ntshav yooj yim.
Kev faib tawm thoob ntiaj teb qhov txawv:
- adenocarcinoma;
- squamous cell carcinoma;
- undifferentiated cancer;- glandular squamous cell carcinoma;
- mob qog noj ntshav tsis paub.
Tseem kuj muaj kev faib tawm hais txog qhov theem ntawm cov qog. Kev kho mob qog noj ntshav nyob ntawm theem:
- Kauj Ruam 1 - cov qog tsis ntau tshaj 2 cm nyob rau hauv txoj kab uas hla, tsis loj hlob dhau ntawm thaj tsam ntawm cov mucosa thiab tsis metastasize.
- Theem 2 - cov qog muaj qhov loj ntawm 4 mus txog 6 centimeters, tuaj yeem loj hlob mus rau hauv lub submucosa lossis cov leeg nqaij, tej zaum yuav muaj ib qho metastases. Muaj ntau yam metastases hauv cov qog ntshav. Muaj ntau yam teeb meem.
- Theem 4 - cov qog mus txog qhov loj me thiab ua rau metastases, ntau qhov deb.
Kev nthuav qhia thiab kev tsis txaus siab tseem ceeb
Yog tias peb xav txog daim duab kho mob, nws muaj ntau haiv neeg. Nws tag nrho nyob ntawm qhov cuam tshuam ntawm lub cev, theem, qib, kev noj qab haus huv ntawm tus neeg mob, nrog rau qib ntawm lability rau kev kho mob. Muaj cov kab mob zoo li no thiab cov tsos mob cuam tshuam rau lawv:
1. thaum ntxov los yog thaum ntxov. Cov neeg mob yws yws ntawm qhov tsis muaj zog, tsis qab los noj mov, poob phaus sai. Nrog rau qhov chaw ntawm cov qog hauv lub ntsws: hnoos qhuav, ua tsis taus pa, mob hauv siab, tawm hws ntau dhau. Yog tias qhov teeb meem cuam tshuam nrog lub plab: xeev siab, ntuav,belching, mob plab los ntshav. Lub raum cuam tshuam muab cov ntshav tso rau hauv cov zis, cov tsos mob ntawm kev thawb thiab nyem cov kabmob uas nyob sib ze.
2. Lub sij hawm pom tseeb kev kho mob tshwm sim ntawm tus kab mob. Tag nrho cov tsos mob phem zuj zus tuaj, cov xwm txheej ntawm tus neeg mob hnyav zuj zus. Cov txheej txheem metastasis yuav pib. 3. Lub sijhawm kawg. Qhov tseem ceeb tshaj plaws thiab nyuaj rau tus neeg mob. Muaj ib qho kev tawg ntawm cov qauv ntawm cov qog nqaij hlav cancer ntawm ib sab thiab nws cov active germination nyob rau hauv cov khoom nruab nrog cev ntawm lwm tus. Cov txheej txheem purulent thiab los ntshav loj tuaj yeem tsim. Cov paj hlwb raug cuam tshuam, muaj qhov poob ntawm ib lossis lwm qhov haujlwm ntawm lub cev.
Kev kuaj mob thiab kuaj mob
Kev kuaj mob thiab kev kho mob qog noj ntshav hauv peb lub sijhawm yog nyob rau theem siab. Cov kab mob oncological raug kuaj raws li cov ntsiab lus hauv qab no:
- sau cov ntaub ntawv anamnesis;
- daim duab kho mob ntawm tus kab mob;
- ntsuas ntsuas; - cov txiaj ntsig ntawm kuaj kuaj.
Ntau zaus siv txoj kev kuaj X-ray. Txoj kev endoscopic siv biopsy yog nrov. Txhawm rau kuaj mob, cov kws kho mob tshwj xeeb siv echography thiab suav tomography. Kev soj ntsuam nrog kev qhia txog cov khoom siv hluav taws xob kuj tseem siv tau. Cov teeb meem nyuaj tshwj xeeb thiab muaj teeb meem yuam kev tshawb nrhiav laparotomy.
Txoj kev kho thiab lawv cov txiaj ntsig
Txoj kev kho mob qog noj ntshav nyob ntawm ntau yam, xws li qhov xwm txheej ntawm cov qog, nws qhov chaw nyob, qhov xwm txheej ntawm tus neeg mob, qhov tsis muaj lossis muaj teeb meem. Feem ntau siv thiab siv tauKev kho mob yog suav tias yog kev phais. Nws tso cai rau koj tshem tawm tag nrho cov conglomerate ntawm qog hlwb, yog hais tias nws localization tso cai rau nws. Tshem tawm tsis tau tsuas yog cov qog xwb, tab sis kuj nyob ze cov ntaub so ntswg. Lwm lub tswv yim cuam tshuam nrog txoj kev kho mob no yog kev kho mob palliative. Thaum tus neeg mob tsis tuaj yeem pab tau kom rov zoo tag nrho, tab sis nws tuaj yeem txo qhov loj ntawm cov qog nws tus kheej thiab txo qis theem ntawm lub sijhawm mob.
Nyob rau hauv qhov chaw thib ob ntawm qhov muaj koob meej thiab kev ua tau zoo - kev kho hluav taws xob. Qhov no yog ib qho kev kho mob uas rhuav tshem cov qog nqaij hlav cancer nyob rau hauv qhov kev txiav txim ntawm rays. Tsis tas li ntawd, muaj ntau cov qog uas tshwj xeeb tshaj yog rhiab rau hom kev kho no. Piv txwv li, liposarcoma thiab nws cov metastases. Kev kho hluav taws xob yog siv ua ke nrog kev kho mob thiab phais. Feem ntau siv tom qab phais ib leeg kom tshem tawm cov metastases.
Tshuaj khomob
Kev kho mob qog noj ntshav nrog tshuaj - ob leeg ib leeg thiab ua ke nrog lwm txoj hauv kev - kuj muaj ntau heev. Kev siv tshuaj khomob nrog kev pab ntawm cov co toxins tshwj xeeb muaj kev cuam tshuam rau cov qog nqaij hlav qog noj ntshav, pab txhawb kev puas tsuaj sai. Muaj cytotoxic (kev puas tsuaj ntawm tes) thiab cytostatic (tso nws txoj kev loj hlob) chemotherapy. Nws yog kev cai siv ntau tshaj ib hom tshuaj oncological profile, tab sis kom muab tso rau hauv cov "kev kho mob cocktails". Qhov no ua rau muaj kev pheej hmoo ntawm kev ua tiav cov kab mob qog noj ntshav. Cov tshuaj yuav muab tso rau hauv cov hlab ntsha, tsis tshua sivntsiav tshuaj cov ntaub ntawv. Hauv cov xwm txheej tshwj xeeb, cov khoom siv tshuaj khomob yog siv rau hauv intrathecally (rau hauv cov kua cerebrospinal) lossis ncaj qha hauv qab ntawm daim tawv nqaij. Txhua yam nyob ntawm txhua qhov tshwj xeeb ntawm tus kab mob.
Pros and cons of chemotherapy
Ntau tus neeg mob ntshai ntawm txoj kev hu ua "chemotherapy". Kev tshuaj xyuas qhia tias qhov no yog vim muaj ntau yam teeb meem thiab teeb meem tshwm sim thaum lub sijhawm kho.
Vim tias cov hlwb noj qab haus huv tau cuam tshuam loj heev hauv txhua lub cev, cov neeg mob ntsib teeb meem ntau:
- plaub hau poob;
- ntshav muaj pes tsawg leeg hloov;
- teeb meem plab hnyuv;
- mucosal puas;
- xeev siab; - ntuav;
- daim siab ua haujlwm raug mob, uas yog yuam kom ua txhua yam co toxins thiab tshuaj khib nyiab;
- daim duab zoo sib xws tshwm sim nrog raum;
- kev tiv thaiv yog txo qis thiab yog li ntawd on.
Cia peb nco txog qhov zoo ntawm cov txheej txheem xws li kev kho mob. Kev tshuaj xyuas ntawm cov neeg mob uas tau kho nrog txoj kev no ua kom pom tseeb tias nws tsim nyog ua rau muaj kev cuam tshuam tsis zoo rau kev rov zoo. Kev kho kom tiav lossis txo qis hauv cov qog yog qhov tshwm sim uas koj tuaj yeem txaus siab rau.
Kev kho mob qog noj ntshav: kauj ruam rau kev noj qab haus huv
Tsis ntev los no, ib txoj kev tshiab ntawm kev kho mob qog noj ntshav tau tshwm sim. Qhov no yog hom phiaj kho. Qhov no yog qhov tseeb tshwj xeeb kev txhim kho tsim los tiv thaiv mob qog noj ntshav. Cov yam ntxwv sib txawv ntawm cov hom phiaj kho mob thiab lwm yam kev kho mob tseem ceeblies nyob rau hauv nws cov kev ruaj ntseg kiag li nyob rau hauv relation mus noj qab nyob zoo hlwb ntawm lub cev. Tsis tas li ntawd, qhov kev kho no muab kev puas tsuaj sai tshaj plaws ntawm cov hlwb puas tsuaj. Raws li kev tshawb fawb ntev thiab kev paub txog cov txheej txheem ntawm kev tsim thiab kev ua haujlwm tseem ceeb ntawm cov qog nqaij hlav cancer, cov tshuaj tau raug tsim los ua tshwj xeeb hauv cov chaw ntawm kev loj hlob ntawm tes. Ib zaug ntxiv, txoj kev kho lub hom phiaj yog ob qho tib si kev kho mob ib leeg thiab ib qho ntxiv rau lwm yam kev kho mob.
Hmoov tsis zoo, txawm tias txoj kev tshiab ntawm kev tawm tsam mob qog noj ntshav muaj ntau qhov tsis yooj yim rau cov neeg mob. Txawm hais tias nws tsis ua haujlwm zoo li kev siv tshuaj khomob classic, cov tshuaj no kuj tau nqa los ntawm cov hlab ntsha thoob plaws lub cev. Ntawm qhov tod tes, qhov no ua kom lawv cov txiaj ntsig zoo hauv kev sib ntaus tawm tsam metastases nyob deb. Ntawm qhov tod tes, qhov concentration hauv qhov chaw raug txo qis. Feem ntau, cov tshuaj ntawm hom no yog ntsiav tshuaj, uas tso cai rau tus neeg mob nyob hauv tsev thiab txuas ntxiv kev kho mob. Xav txog cov txiaj ntsig ntawm kev kho mob rau qee yam mob qog noj ntshav.
Thiab uas tawm tsam mob qog noj ntshav
Yog tias peb xav txog qhov tseem ceeb ntawm qhov tsos mob qog noj ntshav, ntawm no yog qhov ua rau muaj kev hloov pauv ntawm VHL noob. Kev hloov pauv ua rau muaj kev zais ntawm cov protein ntau, uas txhawb kev loj hlob ntawm cov qog nqaij hlav cancer. Cov tshuaj yuav tsum thaiv kev loj hlob thiab kev loj hlob ntxiv ntawm cov qog. Cov tshuaj nrov tshaj plaws thiab tam sim no siv: Votient, Nexavar (Sorafenib), Sutent, Bevacizumab (Avastin), Everolimus (Afinitor), Aksinitib (Inlyta ). Lawv siv txawm nyob rau theem kawg ntawm kev kho mob. Hmoov tsis zoo, ib tus yuav tsum tau npaj rau qhov tshwm sim ntawm qhov tsis zoo li qhov tshwm sim ntau ntxivntshav siab, raws plab, lossis muaj kev hnov mob hauv qhov kawg. Cia wb mus saib ze dua ntawm cov tshuaj kho mob.
- Cov tshuaj "Sorafenib" ("Nexavar") - ua haujlwm qeeb qeeb ntawm kev loj hlob ntawm cov qog nqaij hlav cancer. Blocks angiogenesis thiab ua haujlwm ntawm kev siv cov molecules loj hlob. Ua nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj. Tej zaum koj yuav ntsib kev phiv: pob khaus, raws plab, kub siab, o thiab qaug zog.
- Bevacizumab (Avastin) yog siv rau hauv cov hlab ntsha. Muaj peev xwm ua kom qeeb ntawm kev loj hlob ntawm cov hlab ntsha ntawm kev txiav txim tshiab. Feem ntau ua ke nrog interferon-alpha. Qhov no txhim kho qhov zoo ntawm kev kho mob. Ua tau zoo heev los ntawm cov neeg mob, me ntsis kub siab thiab ntshav txhaws tau.
- Cov tshuaj "Everolimus" ("Afinitor") - ua tiav cov txheej txheem mTOR protein. Nws tau noj ib zaug ib hnub hauv daim ntawv ntsiav tshuaj. Siv los tawm tsam mob qog noj ntshav ntawm cov theem kawg ntawm kev kho mob. Hmoov tsis zoo, muaj ntau yam tshwm sim.
- Cov tshuaj "Temsirolimus" ("Torisel") - tus neeg mob tau txais kev pab los ntawm kev txhaj tshuaj intravenously. Zoo sib xws hauv nws qhov kev nqis tes ua thiab teeb meem rau kev kho yav dhau los.
- Cov tshuaj "Sunitinib" ("Sutent") - zoo thaiv cov haujlwm ntawm qee cov tyrosine kinases. Cov kev mob tshwm sim tsawg dua, tab sis qhov txiaj ntsig zoo ntawm kev kho mob me ntsis qis dua li lwm cov tshuaj.
Cov lus pom zoo
Txoj kev kho mob uas siv cov tshuaj no tau txais txiaj ntsig ntaucov neeg mob qog noj ntshav. Cov kev tshuaj xyuas yog qhov zoo tshaj plaws. Cov neeg mob hais tias qhov txo qis hauv qhov hnyav ntawm cov tsos mob tau pom yuav luag tam sim ntawd. Lub xeev ntawm kev noj qab haus huv tau txhim kho, thaum cov kev mob tshwm sim zoo tsis cuam tshuam rau tag nrho lub sijhawm ntawm kev kho mob. Ntau tus neeg tsom mus rau txoj kev kho mob nyob deb ntawm lub tsev kho mob - nws yog qhov yooj yim ntawm lub cev thiab kev coj ncaj ncees, nws yooj yim dua rau tus neeg mob kom tiv taus cov teeb meem ntawm tus kab mob hauv tsev dua li hauv tsev kho mob pawg ntseeg. Txij li thaum feem ntau cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, qhov no kuj tau sau tseg los ntawm cov neeg mob raws li ib tug yooj yim. Ntau tus neeg zoo siab rau lub sijhawm kom zam kev mob thiab tsis xis nyob.
Kev kho mob raum thiab mob qog noj ntshav
Nyob hauv peb lub sijhawm, cov kab mob qog noj ntshav uas cuam tshuam rau cov kab mob genitourinary tuaj yeem pom hauv txhua plaub. Cancer yog ib yam kab mob loj heev, txhoj puab heev, tawm tsam tib neeg lub cev. Nws loj hlob sai, thiab lub tshuab nqus tsev rau lub cev yog hnov los ntawm thawj lub hlis ntawm kev loj hlob ntawm tus kab mob. Kev kho mob qog noj ntshav hauv cov neeg mob no yog ua los ntawm kev saib xyuas ntawm oncologist-urologist. Muaj ib daim duab ntawm tus kab mob: cov ntshav nyob rau hauv cov zis, dysfunction ntawm lub cev, tsis xis nyob thiab mob nyob rau hauv lub raum cheeb tsam. Txog niaj hnub no, ntau tus neeg mob tau txais kev pab los ntawm cov tshuaj kho mob. Txhawm rau kom nkag siab qhov txiaj ntsig ntawm kev kho mob tuaj yeem ua tiav, koj yuav tsum nkag siab txog cov txheej txheem ntawm cov nyiaj no.
Txoj cai ntawm kev ua: qog loj hlob nyob ntawm tus nqi ntawm cov as-ham thiab muaj oxygen. Qhov no yog qhov tseeb tshwj xeeb rau cov qog nqaij hlav cancer. Targeted therapy tshuaj saib tsuas yog rau cov hlwb tsis zoo thiab ua rau cov txheej txheem molecular uas cov cell "phem" faib,inhibiting qog loj hlob thiab rhuav tshem nws. Kev kho mob raum mob qog noj ntshav muaj cov txiaj ntsig hauv qab no:
- tsis tas yuav mus pw hauv tsev kho mob tus neeg mob;
- tshuaj siv tau los kho cov neeg laus;
- tshuaj nres kev faib tawm ntawm tes thiab kev loj hlob ntawm cov qog nws tus kheej; - yog tias muaj kev phiv tshwm sim tsuas yog txo cov tshuaj koj siv.
Mob ntsws Cancer Therapy
Lwm qhov teeb meem tseem ceeb hauv ntiaj teb ntawm kev mob qog noj ntshav hauv tsev yog mob ntsws cancer. Cov tshuaj tsis zoo hauv kev tsim khoom, kev haus luam yeeb, carcinogens thiab kab mob ntev ua rau muaj kev sib kis ntawm cov qog nqaij hlav cancer hauv cov qauv ntawm lub ntsws.
Kev kho mob rau lub ntsws cancer yog qhov kev kho mob yooj yim thiab nrov tshaj plaws. Cov tshuaj uas muaj txiaj ntsig zoo rau mob qog noj ntshav yog EGFR tyrosine kinase inhibitors, uas yog Erlotinib thiab Gefitinib. Nws tseem tsim nyog hais txog cov tshuaj tiv thaiv monoclonal tiv thaiv EGFR - cov tshuaj "Ceruximab" thiab "Panitumumab". Yam tsawg kawg ntawm kev tsis xis nyob thiab muaj txiaj ntsig sai heev - qhov no yog lub ntsiab lus tseem ceeb ntawm kev tshuaj xyuas txog kev kho mob.
mob plab
mob plab hnyuv yog ib yam kab mob uas muaj qhov tsis zoo thiab qhov tshwm sim tsis zoo. Tus kab mob no feem ntau mus sai heev. Tus neeg mob ntsib qhov mob thiab tsis xis nyob.
Ntau zuj zus, peb cov kws tshaj lij hauv tsev tau pib tig mus rau txoj kev kho mob raws li kev kho mob rau lub plab. Cov tshuaj ua tau zoo tshaj plaws tuaj yeem hu ua Imatinib (Glivec), siv rau cov qog nqaij hlav.plab hnyuv. Qhov no kuj muaj xws li cov tshuaj "Rituximab", uas yog tshwj xeeb tshaj yog zoo nyob rau hauv lub plab mob cancer, thiab nyob rau hauv cov kev tshwm sim ntawm non-Hodgkin's lymphomas. Ib yam li cov tshuaj Herceptin, uas tseem cuam tshuam rau mob qog noj ntshav.
Targeted cancer kho yog ib qho kev tsim kho tshiab. Nov yog lwm txoj hauv kev rau tib neeg kom kov yeej qhov zoo li tam sim no txoj kev tuag - mob qog noj ntshav.
