Cov kab mob Precancerous ntawm daim tawv nqaij thiab cov nqaij mos yog ob pawg sib txawv uas yuav tsum tau txiav txim siab cais. Lawv cov yam ntxwv zoo ib yam yog qhov nyuaj ntawm cov kab mob no tshwm sim los ntawm qhov tshwm sim ntawm malignant qog. Nws muab faib ua ob pawg: obligate (high degree ntawm malignancy) thiab facultative (nrog xaiv malignancy).
Kev piav qhia ntawm kab mob no
Cov kab mob ntawm daim tawv nqaij Precancerous yog tus cwj pwm los ntawm ib leeg lossis ntau qhov nodules, kev loj hlob, foci ntawm hyperkeratosis, papules, hnub nyoog me ntsis lossis foci ntawm khaus ntawm cov xim sib txawv, duab thiab ntau thiab tsawg. Kev kuaj mob yog tsim los ntawm kev ntsuam xyuas thiab cov txiaj ntsig ntawm kev tshawb fawb histological. Kev kho mob - phais tshem tawm, kws khomob, kev kho mob cryotherapy, interferon therapy.
Cov kab mob ntawm daim tawv nqaij Precancerous yog neoplasms ntawm epithelial keeb kwm ntawm benign xwm thiabpathological tej yam kev mob ntawm daim tawv nqaij ntawm ib tug uas tsis yog-mob xwm, nrog ib tug nyiam hloov mus rau ib tug malignant qog. Kev pheej hmoo ntawm kev yug dua tshiab tuaj yeem sib txawv heev. Daim duab ntawm tus kab mob ntawm daim tawv nqaij precancerous tau nthuav tawm saum toj no.
Qhov laj thawj tseem ceeb ntawm kev ua phem
Qhov laj thawj tseem ceeb ntawm kev mob qog noj ntshav yog qhov ua rau sab nraud tsis muaj qhov tshwj xeeb (insolation, mechanical friction, temperature effect), tsis kho raws sijhawm thiab ntau yam endogenous yam. Cov kab mob no feem ntau cuam tshuam rau cov neeg laus thiab cov hnub nyoog nruab nrab. Kuj tseem muaj qee qhov kev mob tshwm sim ntawm hom no, uas feem ntau cuam tshuam rau cov hluas thiab menyuam yaus. Kev kuaj mob ntawm cov kab mob ntawm daim tawv nqaij ua ntej thiab kev kho mob yog ua los ntawm cov kws kho mob hauv thaj chaw dermatology thiab oncology.
Pathologies ntawm mucous daim nyias nyias ntawm lub qhov ncauj thiab lub ntsej muag ntaub so ntswg
Cov kab mob ntawm cov cheeb tsam no muaj xws li Manganotti cheilitis, localized hyperkeratosis, warty precancer. Hom kab mob precancerous ntawm daim tawv nqaij ntawm lub ntsej muag thiab liab ciam teb ntawm daim di ncauj muaj xws li keratoacanthoma, tawv nqaij horn, papilloma.
Kuj suav nrog papillomatosis ntawm palate, hyperkeratotic thiab erosive-ulcerative daim ntawv ntawm lichen planus thiab lupus erythematosus, erosive-ulcerative thiab verrucous cov ntaub ntawv ntawm leukoplakia.
Kev faib tawm ntawm cov kab mob ua ntej ntawm daim tawv nqaij ntawm lub ntsej muag thiab qhov ncauj mucosa suav nrog:
- Cov tawv nqaij hneev taw yog thaj tsam txwv ntawm hyperplasia nrog hnyav hyperkeratosis, uas muaj cov duab ntawm lub horn protrusion. Zoo sib xws hearthtxwv, xim av-grey thiab mus txog 1 cm inch.
- Keratoacanthoma yog ib qho mob qog nqaij hlav qog nqaij hlav hauv daim ntawv ntawm qhov tsis mob hemispherical node nrog qhov ntom ntom ntom ntom. Nyob rau hauv nws lub hauv paus seem muaj ib tug funnel-puab lub tswv yim ntawm ib tug me me loj, uas muaj horny ntom pawg ntawm ib tug dawb hue. Cov qog yog mobile, tsis cuam tshuam nrog cov ntaub so ntswg. Cov neoplasm no zoo ib yam li squamous cell carcinoma ntawm daim tawv nqaij thiab feem ntau hloov mus ua mob qog noj ntshav.
- Papilloma ntawm ciam teb liab ntawm daim di ncauj yog txwv los ntawm cov ntaub so ntswg ib puag ncig. Nws nto yog ntxhib los yog villous, qee zaum npog nrog cov qauv horny. Pathology yog tus cwj pwm los ntawm kev loj hlob ntawm exophytic thiab endophytic, uas, raws li ntau tus kws tshawb fawb, coj nws los ze zog rau mob qog noj ntshav.
Nyob rau hauv cov ntaub ntawv ntawm kev raug mob ntev ntawm papillomatosis ntawm lub qhov ncauj mucosa, ulceration, o, thiab foci ntawm necrosis tsim. Lub foob tsim ntawm lub hauv paus ntawm papilloma yog ib qho ntawm cov tsos mob ntawm malignancy.
Cov kab mob hauv qab muaj xws li dermatitis, actinic, huab cua thiab tom qab hluav taws xob cheilitis, kab nrib pleb thiab rwj ntawm tus ciam teb liab ntawm daim di ncauj thiab qhov ncauj mucosa, tiaj leukoplakia.
Cov neeg mob uas muaj cov kab mob ua ntej ntawm daim tawv nqaij thiab cov mucous daim nyias nyias, raws li txoj cai, raug rau kev kho mob phais (kev txiav tawm yog ua nrog cov tawv taub hau ib txwm siv lossis los ntawm laser excision, phais diathermy, laser coagulation, cryogenic raug).
Kev cuam tshuam kev phais tso cai rau tsis yog tsuas yog kho radical xwb, tab sis kujmorphological pov thawj ntawm cov ntaub so ntswg uas raug tshem tawm thaum lub sij hawm nws cov txheej txheem.
Cov neeg mob uas muaj cov kab mob ua ntej ua ntej - xws li cutaneous horn, papilloma, keratoacanthoma, papillomatosis, erosive-ulcerative thiab verrucous forms of leukoplakia - kuj raug phais. Cov neeg mob uas muaj leukoplakia nyob rau qee kis tuaj yeem kho tau zoo (raws li cov lus qhia). Cov neeg mob nrog lupus erythematosus, lichen planus, keeb kwm pathologies ntawm lub qhov ncauj mucosa yog raug rau tib txoj kev kho.
Kev faib cov kab mob ntawm daim tawv nqaij ua ntej
Raws li tau sau tseg saum toj no, muaj ob pawg ntawm cov kab mob precancerous: obligate thiab facultative. Nws yuav tsum tau muab sau tseg tias xws li ib tug faib yog arbitrary. Muaj cov kab mob uas qee tus kws kho mob xa mus rau cov mob ua ntej ua ntej, thiab lwm tus yog xaiv tau. Yog li, pawg ntawm cov kab mob ntawm daim tawv nqaij ntawm thawj hom suav nrog Paget's kab mob, Bowen's kab mob thiab Queyre's erythroplasia, uas yog hom mob qog noj ntshav ntawm daim tawv nqaij - mob qog noj ntshav hauv situ, cov txheej txheem oncological hauv zos uas tsis ntev dhau ntawm daim tawv nqaij. Tsis tas li ntawd, xeroderma pigmentosum yog suav tias yog obligate precancer.
Cov kab mob ntawm daim tawv nqaij precancerous yog senile keratosis thiab lwm yam kab mob uas tsis yog tshwj xeeb. Qhov tshwm sim ntawm malignant hloov pauv ntawm degeneration ntawm senile keratosis yog kwv yees li 10%. Radiation dermatitis ntawm cov ntaub ntawv ntev, arsenic hyperkeratosis, tuberculous thiab syphiliticdaim tawv nqaij mob yog malignant nyob rau hauv li ntawm 6% ntawm cov neeg mob. Fistulas nyob rau hauv osteomyelitis, trophic ulcers (ntev ntev) thiab ntau nti tom qab kub hnyiab ua malignant nyob rau hauv 5-6% ntawm cov neeg mob. Cov kab mob ntawm daim tawv nqaij nyob rau hauv lupus erythematosus tig mus ua qog nqaij hlav hauv li 2-4% ntawm cov neeg mob.
Cia peb mus saib cov kab mob precancerous ntawm daim tawv nqaij ntawm lub ntsej muag thiab qhov ncauj mucosa.
Bowen's disease
Qhov no yog ib qho tsis tshua muaj kab mob, tau piav qhia xyoo 1912. Nws tuaj yeem tshwm sim ntawm hnub nyoog 20 thiab 80 thiab muaj sib npaug ntawm cov txiv neej thiab poj niam. Lub ntsiab yam tseem ceeb predisposing rau txoj kev loj hlob ntawm tus kab mob no yog tib neeg papillomas, kab mob, kab mob, ultraviolet hluav taws xob thiab kev sib cuag nrog tshuaj lom (tar, tar, arsenic). Precancerous pathology tuaj yeem tshwm sim ntawm txhua qhov chaw ntawm daim tawv nqaij, tab sis qhov chaw mos thiab lub cev feem ntau cuam tshuam.
Thaum pib, tus kab mob yog qhov chaw tsis sib xws, uas tom qab hloov mus rau hauv cov quav hniav liab nrog lub ntsej muag velvety. Nws nthuav tawm thaj chaw ntawm hypo- thiab hyperpigmentation. Qee lub sij hawm qhov chaw ntawm qhov chaw no yog them nrog cov nplai qhuav tsis sib xws, vim tias qhov kev tsim no zoo ib yam li cov quav hniav psoriatic. Formations tuaj yeem yog ib leeg thiab ntau yam, uas sib koom ua ke. Feem ntau muaj kev kawm ntev ntawm cov txheej txheem pathological, cov quav hniav tuaj yeem nyob mus ob peb xyoos.
Thaum tsis muaj kev kho mob, cov kab mob ntawm daim tawv nqaij precancerous hloov mus ua squamous cell carcinoma. Kev kuaj mob yog tsim los ntawm lub hauv paus ntawm histologicalkev tshawb fawb. Kev kho mob yog phais tshem tawm nrog rau cov ntaub so ntswg noj qab nyob zoo. Tsis tas li ntawd, feem ntau siv cryodestruction, electrocoagulation lossis laser coagulation.
Erythroplasia ntawm Queira
Nov yog ib hom kab mob Bowen tus kab mob uas cuam tshuam rau ntawm daim tawv nqaij ntawm noov. Cov txiv neej hnub nyoog 40-70 raug kev txom nyem los ntawm pathology. Tus kab mob yog ib tug reddish du plaque nrog ib tug velvety moist nto. Kev kawm maj mam loj hlob ntau xyoo, thaum kawg nws qhov kev mob qog noj ntshav tau sau tseg.
Page's disease
Tus kab mob precancerous ntawm daim tawv nqaij no feem ntau nyob hauv thaj chaw areola. Hauv kwv yees li 20% ntawm cov neeg mob, cov qog no tuaj yeem nyob hauv lwm qhov chaw: sab nraub qaum, ntsej muag, ncej puab, perineum, pob tw, ntawm qhov chaw mos. Hauv qee qhov kev faib tawm kho mob, tus kab mob no suav tias yog ib hom mob qog noj ntshav mis. Nws raug kuaj pom hauv ob leeg poj niam thaum muaj hnub nyoog 50-60. Nyob rau hauv cov txiv neej, qhov no pathology tsim tsawg zaus, tab sis yog ntau malignant. Nyob rau theem pib, tus kab mob precancerous no zoo li qhov txhab zoo li eczema, uas yog nrog khaus, kub hnyiab, tingling thiab mob.
Nyob rau yav tom ntej, thaj chaw cuam tshuam nce ntxiv, yaig, nplai thiab ulcerations ntawm qhov tsim. Lub retraction ntawm lub txiv mis yog kuaj, qhov tsos ntawm pathological tawm yog ua tau. Xws li tus kab mob precancerous mus rau ntau xyoo thiab kis mus rau cov ntaub so ntswg nyob sib ze. Nws kuj tau sau tsegmetastasis thiab kev loj hlob hauv zos infiltrative. Kev kuaj mob ntawm daim tawv nqaij precancerous yuav tsum tau raws sijhawm. Kev kho mob yog radical resection los yog mastectomy ua ke nrog hormonal therapy, radiotherapy thiab chemotherapy.
YPigmented xeroderma
Nov yog ib yam kab mob uas tsis tshua muaj tshwm sim los ntawm daim tawv nqaij precancerous. Manifested nyob rau hauv daim ntawv ntawm nce rhiab heev rau ultraviolet hluav taws xob. Cov txheej txheem pathological tshwm sim hauv 3 theem. Thawj tshwm sim thaum muaj hnub nyoog 2-3 xyoos, feem ntau nyob rau lub caij ntuj sov, tawm tsam keeb kwm ntawm txawm me ntsis insolation. Liab, pob khaus tshwm rau ntawm qhov chaw ntawm tus menyuam lub cev. Tom qab ntawd, thaj chaw ntawm qhov tsis sib xws hyperpigmentation tshwm sim hauv lawv qhov chaw. Txhua qhov raug rau lub hnub yog nrog los ntawm cov tsos ntawm cov kab mob tshiab thiab nce cov cim qhia ntawm hyperpigmentation.
Ntawm theem ob, ob peb xyoos tom qab pib cov tsos mob thawj zaug ntawm tus kab mob, thaj chaw ntawm atrophy thiab telangiectasia daim ntawv ntawm cov chaw cuam tshuam. Vim kab laug sab veins, qhov chaw tsis sib xws ntawm pigmentation, daim tawv nqaij ua motley, tawg, crusts, mob thiab warty loj hlob ntawm nws. Kuj tseem muaj cov kev hloov pauv pathological hauv cov ntaub so ntswg cartilaginous, uas feem ntau pom pom nyob rau hauv daim ntawv ntawm qhov ntswg deformity. Cov kab mob qhov muag kuj tshwm sim: corneal opacity, keratoconjunctivitis, o ntawm daim tawv muag, lacrimation thiab photophobia.
theem peb tshwm sim thaum lub sij hawm puberty los yog tom qab puberty. Ntawm thaj chaw cuam tshuam ntawm daim tawv nqaijMuaj cov qog nqaij hlav cancer mis: angiomas, fibromas, keratomas, basaliomas, melanomas, squamous cell carcinoma. Tshwj xeeb tshaj yog malignant yog cov qog uas tsim nyob rau hauv cheeb tsam ntawm warty loj hlob. Kwv yees li 60% ntawm cov neeg mob tsis nyob txog 15 xyoo. Qhov laj thawj tseem ceeb ntawm kev tuag yog nyob deb ntawm metastasis thiab infiltrative hauv zos loj hlob ntawm cov qog.
hnub ci keratosis
Tus kab mob ntawm daim tawv nqaij ua ntej no tseem hu ua actinic keratosis, kab mob uas tsis tshua muaj kev pheej hmoo ntawm malignant degeneration. Tus kab mob no tshwm sim los ntawm insolation ntau dhau. Nws feem ntau cuam tshuam rau xiav-eyed ncaj-tawv tawv blondes ntawm cov laus thiab nruab nrab hnub nyoog. Hauv cov poj niam, pathology raug kuaj pom tsawg dua. Qhib thaj chaw ntawm daim tawv nqaij raug cuam tshuam, qhov chaw yellowish pib tshwm. Nyob rau hauv lub neej yav tom ntej, nws yog them nrog ntom ntom. Kev kho mob - cryodestruction, laser tshem tawm, cytostatic tshuaj pleev. Nws tsis tsim nyog tias qhov no pathology yuav degenerate mus rau hauv mob qog noj ntshav. Qhov no tsuas yog tshwm sim yog tias qhov teeb meem tsis tu ncua los ntawm lub hnub raug ntau zaus.
Cov lus qhia kho mob rau cov kab mob txaus ntshai no
Cov lus pom zoo kho mob rau cov kab mob precancerous ntawm daim tawv nqaij, mucous membranes thiab cov ntaub so ntswg mos yog txhawm rau kuaj xyuas cov kab mob no, kho cov kab mob uas twb muaj lawm thiab tiv thaiv kev txhim kho ntawm foci tshiab ntawm cov txheej txheem pathological.
txhawm rau txo txoj kev pheej hmoo ntawm kev hloov pauv ntawm cov xwm txheej zoo li no rau cov qog nqaij hlav oncological, nws yuav tsum txwv lossis tshem tawm. Kev puas tsuaj rau ntawm daim tawv nqaij thiab mucous daim nyias nyias ntawm UV rays, electromagnetic tawg, ionizing hluav taws xob thiab tshuaj carcinogens.
Ntxiv rau, cov pej xeem thiab cov kws kho mob yuav tsum paub txog cov kev phom sij ntawm kev siv qee yam tshuaj hormonal (exogenous estrogens).
Lwm txoj kev taw qhia yog kev txheeb xyuas thiab kev kuaj mob ntawm cov neeg uas muaj qhov ua rau mob qog noj ntshav thiab dysplastic nevus syndrome.
Immunological kev taw qhia muaj txiaj ntsig zoo rau kev txheeb xyuas thiab kho cov neeg muaj ntau hom kev tiv thaiv kab mob, tiv thaiv kab mob, cov neeg mob hloov cov kabmob.
Kev tshuaj xyuas ntawm daim tawv nqaij yog tias xav tias muaj tus mob precancerous yog nqa tawm hauv chav kuaj thaum mus ntsib thawj tus kws tshaj lij. Kev tshuaj xyuas los ntawm tus kws kho mob oncologist yog ua nyob rau hauv thawj xyoo ntawm kev soj ntsuam txhua 3 lub hlis, tom qab ntawd, tom qab kev kho kom zoo, tsawg dua. Nws yog ib qho tseem ceeb rau nws tus kheej tshuaj xyuas koj lub cev kom pom cov moles tshiab lossis hnub nyoog me ntsis.
