Khansa ya Pancreatic - Zizindikiro ndi Chithandizo

Khansa yapakansa
ICD-10	C 25 25.
ICD-10-KM	C25.0, C25.1 ndi C25.2
ICD-9	157 157
ICD-9-KM	157.1, 157.8, 157.0 ndi 157.2
Omim	260350
Diseasesdb	9510
Medlineplus	000236
eMedicine	med / 1712
Mesh	D010190

Khansa yapakansa - neoplasm yoyipa yochokera ku epithelium ya glandular minofu kapena ma pancreatic ducts.

Mitundu yakale

Chiwopsezo cha khansa ya kapamba chikukula chaka chilichonse. Matendawa ndi khansa yachisanu ndi chimodzi yodziwika bwino pakati pa anthu akuluakulu. Zimakhudza makamaka okalamba, nthawi zambiri amuna ndi akazi. Ku United States, khansa ya kapamba pakadali pano ndi malo achinayi pazomwe zimayambitsa kupha khansa. Malinga ndi kafukufuku woyambirira wa bungwe la American Cancer Society, mu 2015, chotupa chija chapezeka mwa anthu 48 960, ndipo odwala 40 560 afa. Chiwopsezo cha khansa mwa aliyense wokhala ku United States pa moyo ndi 1.5%.

Zomwe zimayambitsa khansa ya pancreatic ndi:

Matenda opatsirana ophatikizidwa ndi:

Nthawi zambiri, chotupa chimakhudza mutu wa ndulu (50-60% ya milandu), thupi (10%), mchira (5-8% ya milandu). Palinso kwathunthu kwa kapamba - 20-35% ya milandu. Chotupa ndi malo owuma kwambiri osakhala ndi malire omveka bwino; m'gawolo, ndi loyera kapena chikaso chopepuka.

Mtundu wapezeka posachedwa womwe umakhudza mawonekedwe a maselo apadera a pancreatic, omwe angatenge nawo gawo la khansa. Malinga ndi kafukufuku yemwe adalembedwako mu magazini yotchedwa Nature Communications, mtundu womwe umalinga ndi P1 protein kinase gene (PKD1). Mwa kuchitapo kanthu, zitha kulepheretsa kukula kwa chotupacho. PKD1 - imayang'anira kukula kwa chotupa ndi metastasis. Pakadali pano, ofufuza akutanganidwa kupanga PKD1 inhibitor kuti iyesedwe mopitilira.

Kafukufuku yemwe adachitika ku Langon Medical Center ku University of New York adapeza kuti khansa ya kapamba idali 59% yodziwika bwino mwa odwala omwe ali ndi tizilombo toyambitsa matenda pakamwa. Porphyromonas gingivalis. Komanso, chiopsezo cha matendawa chimakwera kawiri ngati wodwala wapezeka Aggregatibacter actinomycetemcomitans. Chiyeso chowunikira chikupangidwa chomwe chitha kudziwa mwayi wokhala ndi khansa ya kapamba.

Mitundu yakale yosintha |Zolemba zaukadaulo wazachipatala

Khansa ya pancreatic imachitika, malinga ndi magawo osiyanasiyana, mu 1-7% ya onse odwala khansa, nthawi zambiri mwa anthu azaka zopitilira 50, makamaka mwa amuna.

Pachaka, milandu 30,500 ya khansa ya kapamba, makamaka ductal adenocarcinoma, ndipo 29,700 amalembetsa ku United States. Zizindikiro za khansa ya pancreatic zimaphatikizapo kuchepa thupi, kupweteka kwam'mimba, komanso jaundice. Kuzindikira kumapangidwa ndi CT. Chithandizo cha khansa ya pancreatic imaphatikizapo resection ya upasuaji ndi radiation yowonjezera ndi chemotherapy. Matendawa alibe vuto, chifukwa matendawa nthawi zambiri amapezeka m'magulu otsogola.

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Zoyambitsa Khansa Yapancreatic

Makansa ambiri a pancreatic ndi zotupa zotuluka kuchokera ku ma duct ndi cell ya acinar. Zotupa za pancreatic endocrine zikukambidwa pansipa.

Exocrine pancreatic adenocarcinomas ochokera kumaselo am'mimba amapezeka nthawi 9 nthawi zambiri kuposa kuchokera ku maselo a acinar, ndipo mutu wa gland umakhudzidwa mu 80%. Adenocarcinomas amawonekera pafupifupi pa zaka 55 ndi 1.5-2 nthawi zambiri mwa amuna. Zina zomwe zimayambitsa ngozi zimaphatikizapo kusuta, mbiri ya chifuwa chachikulu, komanso mwina njira yayitali ya matenda ashuga (makamaka azimayi). Udindo wina umachitika mwachikhalidwe. Zakumwa zoledzeretsa ndi zakumwa za caffeine sizowopsa zomwe zimayambitsa ngozi.

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Zizindikiro za khansa ya pancreatic imawonekera mochedwa; akapezeka matenda, 90% ya odwala amakhala ndi chotupa chapafupi chakumudzi chomwe chimakhudza ziwongola dzanja, ma cymph node, kapena chiwindi kapena mapapo.

Odwala ambiri amakhala ndi ululu wam'mimba kwambiri, womwe nthawi zambiri umakhazikika kumbuyo. Ululu umatha kuchepa thupi litakhazikika kutsogolo kapena m'malo a fetal. Kuchepetsa thupi ndi khalidwe. Pancreatic adenocarcinomas amachititsa jaundice wovuta (nthawi zambiri amayambitsa kuyabwa) mu 80-90% ya odwala. Khansa ya thupi ndi mchira wa tiziwalo timene timayambitsa kukokana kwa msana, komwe kumayambitsa splenomegaly, mitsempha ya varicose ya esophagus ndi m'mimba, komanso magazi am'mimba. Khansa ya pancreatic imayambitsa matenda a shuga mu 25-50% ya odwala, kuwonetsa zizindikiro za tsankho la glucose (mwachitsanzo, polyuria ndi polydipsia), malabsorption.

Cystadenocarcinoma

Cystoadenocarcinoma ndi khansa yachilendo ya adenomatous pancreatic yomwe imachitika chifukwa cha kupweteketsa koipa kwa cystadenoma mucosa ndikudziwonetsera ngati kupangika kwakukulu kwa chipinda chapamwamba cha m'mimba. Kuzindikira kumapangidwa ndi CT kapena MRI ya m'mimba, komwe ma cystic misa yomwe imakhala ndi zinthu zowola nthawi zambiri imawonedwa, kupangidwa kwa volumetric kumawoneka ngati necrotic adenocarcinoma kapena pancreatic pseudocyst. Mosiyana ndi ductal adenocarcinoma, cystoadenocarcinoma ili ndi chidziwitso chabwino. Odwala 20% okha ndi omwe ali ndi metastases pochita opaleshoni; Kuchotsa kwathunthu chotupa pa nthawi ya distal kapena proximal pancreatectomy kapena pa Whipple opaleshoni kumapangitsa 65% yopulumuka zaka 5.

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Intraductal papillary-mucinous chotupa

Intraductal papillary-mucinous tumor (VPMO) ndi mtundu wosowa wa khansa womwe umatsogolera mucus hypersecretion ndi kutsekeka kwa duct. Kufufuza kwakale kungawonetse kukula, malire ndi malire kapena kukula. Milandu yambiri (80%) imawonedwa mwa akazi ndipo njirayi imapangidwa kakang'ono kwambiri mumsempha wa kapamba (66%).

Zizindikiro za khansa ya pancreatic zimaphatikizapo kupweteka komanso kubwerezabwereza kwa kapamba. Kuzindikira kumapangidwa ndi CT pofanana ndi endoscopic ultrasound, MRCP kapena ERCP. Ndikotheka kusiyanitsa njira yoyipa ndi yoyipa pokhapokha pakuchotsa opaleshoni, yomwe ndi njira yosankhira. Ndi chithandizo cha opaleshoni, kupulumuka kwa zaka 5 ndi kukula kwa benign kapena malire ndi kupitirira 95% ndi 50-75% ndi njira yoyipa.

Zizindikiro

Njira zophunzitsira zodziwitsira khansa ya kapamba ndi spiral CT yam'mimba ndi MRI ya kapamba (MRTP). Ngati chotupa chosaoneka kapena matenda a metastatic apezeka pa nthawi ya CT kapena MRI ya kapamba, chotupa chopanda singano ya malo omwe akukhudzidwawa chimachitidwa poyang'anira mbiri ya zotupa ndi kutsimikizika kwa matendawo. Ngati ma Sc scan akuwonetsa kuyambiranso kwa chotupa kapena mapangidwe osatupa, pancreatic MRI ndi endoscopic ultrasound zimawonetsedwa kuti zikuwunikira siteji ya ndondomeko ndi mfundo zazing'ono zomwe sizimadziwika ndi CT. Odwala omwe ali ndi jaundice yolepheretsa amatha kuchita ERCP ngati kafukufuku woyamba wofufuza matenda.

Kuyesa kwa labotale kuyenera kuchitidwa. Kuwonjezeka kwa zamchere phosphatase ndi bilirubin kumawonetsa kusungunuka kwa bile duct kapena metastasis pachiwindi. Kudziwitsa kwa antigen a CA19-9 komwe kumayenderana ndi kapamba kungagwiritsidwe ntchito kuwunika odwala omwe ali ndi pancreatic carcinoma komanso kuwunika pachiwopsezo cha khansa. Komabe, kuyesaku sikukuzindikira mokwanira kapena mwachindunji kuti agwiritse ntchito posanthula anthu ambiri. Miyezo yakukwera ya antigen iyenera kuchepa pambuyo pa chithandizo chopambana, kuwonjezereka kwotsatira kukuwonetsa kupita patsogolo kwa njira yotupa. Miyezo ya Amylase ndi lipase nthawi zambiri imakhalabe yochepa.

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Chithandizo cha Khansa ya Pancreatic

Pafupifupi 80-90% ya odwala, chotupacho sichigwira ntchito chifukwa cha kuwunika kwa metastases pakuzindikira kapena kumera m'matumbo akulu. Kutengera komwe kuli chotupa, opaleshoni yosankha ndiyo, nthawi zambiri, opaleshoni ya Whipple (pancreatoduodenectomy). Mankhwala owonjezera omwe ali ndi 5-fluorouracil (5-FU) ndi mankhwala a radiation akunja nthawi zambiri amalembedwa, omwe amalola kupulumuka pafupifupi 40% ya odwala pazaka 2 ndi 25% yoposa zaka 5. Chithandizo chophatikizika ichi cha khansa ya kapamba chimagwiritsidwanso ntchito kwa odwala omwe ali ndi zotupa zochepa koma zosagwira ntchito ndipo zimapangitsa kupulumuka pafupifupi chaka chimodzi. Mankhwala amakono ambiri (mwachitsanzo gemcitabine) atha kukhala othandiza kwambiri kuposa 5-FU ngati chemotherapy yoyambira, koma palibe mankhwala okha kapena osakanikirana omwe ndi othandiza kwambiri. Chemotherapy ikhoza kuperekedwa kwa odwala omwe ali ndi metastases ya chiwindi kapena metastases yakutali ngati gawo la pulogalamu yofufuzira, koma chiyembekezo chamankhwala kapena popanda chithandizo chimakhalabe chosavomerezeka ndipo odwala ena amatha kusankha kusakhazikika.

Ngati chotupa chosagwiritsidwa ntchito chikupezeka pakuchita opaleshoni yomwe imayambitsa kuvulala kwamtundu wa gastroduodenal kapena biliary, kapena ngati chitukuko chikuyembekezeka, matumbo awiri ndi mabilire amachitika pofuna kuthana ndi zovuta. Odwala omwe ali ndi zotupa zogwiritsa ntchito ndi jaundice, kukomoka kwa mapangidwe amtundu wa biliary kungathetse kapena kuchepetsa jaundice. Komabe, mwa odwala omwe sangathe kugwira ntchito omwe akuyembekezeka kukhala ndi moyo wopitilira miyezi 6-7, ndikofunika kukhazikitsa anastomosis chifukwa cha zovuta zomwe zimakhudzana ndi kubinya.

Zizindikiro mankhwala a khansa ya kapamba

Mapeto ake, odwala ambiri amakumana ndi zowawa komanso amafa. Pankhaniyi, chithandizo chamankhwala a khansa ya pancreatic ndikofunikira monga kwakukulu. Kusamalidwa koyenera kwa odwala omwe ali ndi matenda opha ziwonetsero ayenera kuganizira.

Odwala omwe ali ndi ululu wambiri kapena wowawa kwambiri ayenera kupatsidwa opiates mkamwa mu Mlingo wokwanira kupumula kwa ululu. Kudera nkhawa za kusuta fodya sikuyenera kukhala cholepheretsa chiwongolero chopweteka. Mukupweteka kwambiri, mankhwala opatsirana otulutsidwa (mwachitsanzo makonda a fentanyl, oxycodone, oxymorphone) ndi othandiza kwambiri. Percutaneous kapena intraoperative visceral (celiac) block imakupatsani mwayi wowongolera ululu kwa odwala ambiri. Pankhani ya ululu wosapilira, opiate amawathandizira mosazindikira kapena kudzera m'mitsempha, makonzedwe a epidural kapena intrathecal amapereka zina zowonjezera.

Ngati opaleshoni ya palliative kapena endicopic biliary stenting sikuchepetsa kuyabwa chifukwa chodwala jaundice, wodwala amayenera kupatsidwa cholestyramine (4 g pakamwa kamodzi mpaka kanayi patsiku). Phenobarbital 30-60 mg pakamwa katatu pa tsiku akhoza kukhala othandiza.

Ndi kuchepa kwa kapangidwe ka pancreatic pancreatic, pancrelipase ikhoza kutumikiridwa. Wodwala ayenera kutenga magawo 16,000-20,000 a lipase asanadye chilichonse. Ngati zakudya zimakhalitsidwa nthawi yayitali (mwachitsanzo mu lesitilanti), mapiritsi ayenera kumwedwa panthawi ya chakudya. PH yoyenera kwambiri ya ma enzymes mkati mwa matumbo ndi 8, mogwirizana ndi izi, madokotala ena amapereka mankhwala a proton pump inhibitors kapena H₂-Blockers. Kuyang'anira chitukuko cha matenda ashuga komanso chithandizo chake ndikofunikira.

Tanthauzo la matendawa. Zomwe zimayambitsa matendawa

Khansa yapakansa Ndi chotupa chowopsa chomwe chimatuluka m'maselo osinthika a pancreatic.

Khansa yapakansa ili m'malo achitetezo am'modzi mwa mafupa ena pafupipafupi. Kuyambira 1987, kuchuluka kwa khansa ya kapamba mdziko lathu kwakula ndi 30%, kuchuluka kwa azimayi ndi 7.6, mwa amuna - 9.5 pa anthu zana. Akatswiri akuti kuchuluka kwa matendawa padziko lonse lapansi kudzachuluka. Malinga ndi kudziwikiratu, kuchuluka kwa odwala khansa ya kapamba mu 2020 poyerekeza ndi zaka twente zapitazi, 32% azikhala apamwamba mmaiko otukuka, komanso m'maiko omwe akutukuka kumene - ndi 83%, kufikira 168,453 ndi milandu 162,401, motsatana. Mu 75% ya milandu, matendawa amakhudza mutu wa kapamba.

Zowopsa zazikuluzikulu za khansa ya kapamba:

1. kusuta (mu 1-2% ya omwe amasuta khansa ya pancreatic amayamba),
2. shuga mellitus (chiopsezo chokhala ndi matenda ashuga ndi 60% kuposa),
3. aakulu kapamba (khansa ya kapamba imayamba kuchuluka ka 20),
4. zaka (chiopsezo chokhala ndi khansa ya kapamba chimawonjezeka ndi zaka. Kuposa 80% ya milandu imakhalapo zaka zapakati pa 60 ndi 80)
5. liwiro (Kafukufuku waku US awonetsa kuti khansa ya kapamba imakhala yofala kwambiri ku anthu aku Africa kuno kuposa azungu. Mwina izi zili choncho chifukwa chazachuma komanso kusuta ndudu),
6. jenda (matendawa ndi ofala kwambiri mwa amuna kuposa akazi),
7. kunenepa kwambiri (kumawonjezera mwayi wokhala ndi khansa ya kapamba: 8% ya milandu imalumikizidwa ndi izi),
8. Zakudya (Zakudya zokhala ndi nyama yambiri, cholesterol yambiri, zakudya yokazinga zimatha kuwonjezera ngozi yotenga matendawa),
9. genetics (angapo obadwa nawo oncological syndromes amathandizira kutenga matenda, mwachitsanzo, khansa ya m'mawere, mabanja atypical syndrome ya melanoma yambiri, cholowa cholowa khansa.

Zizindikiro za Cancer Pancreatic

Nthawi zambiri, magawo oyamba, matendawa amakhala asymptomatic, ndipo zotengeka zake zimalolera kukayikira kukhalapo kwake:

• kuwonda kapena kusasangalala pamimba,
• kuwoneka kwa zizindikiro za matenda ashuga (ludzu, shuga wowonjezera wamagazi, ndi zina zambiri),
• pafupipafupi, zimbudzi zotayirira.

Ndi kukula kwa matendawa, zizindikiro zina zitha kuoneka:

• kupweteka pamimba kumtunda kumbuyo,
• jaundice pakhungu ndi mapuloteni amaso (chifukwa cha kutuluka kwa chiwindi kuchokera ku chiwindi mpaka matumbo),
• mseru ndi kusanza (chifukwa chofinya chotupa cha duodenum),
• kuwonda.

Komabe, Zizindikiro zonsezi sizakudziwika, ndipo zikachitika, njira zodziwitsira ndikofunikira.

Kugawa ndi kukula magawo a khansa ya kapamba

Kutengera komwe kuli chotupacho:

1. mutu wachikondwerero
2. nkhani ya kapamba,
3. thupi kapamba
4. mchira wa kapamba,
5. kuwonongeka kwathunthu kwa kapamba.

Kutengera ndi mbiri yakale ya matendawa (omwe atsimikiza ndi zotsatira za mbiri yakale chotupa):

1. ductal adenocarcinoma (wopezeka mu 80-90% ya milandu),
2. neuroendocrine zotupa (insulinoma, gastrinoma, glucagonoma, etc.),
3. zotupa zoyipa (zotupa, ma serous),
4. mitundu ina yachilendo ya mbiri.

Pancreatic neuroendocrine chotupa

Kutengera ndi gawo la matenda:

Ndayamba. Chotupa ndichaching'ono, osapitirira kapamba. Palibe metastases.

Gawo lachiwiri. Kufalikira kwa chotupa kunja kwa thupi, koma osakhudzana ndi ziwiya zazikulu zakukonzekera mkati. Pali metastases pamitsempha yamagazi, palibe metastases ku ziwalo zina.

III gawo. Kumera kwa chotupa mu ziwonetsero zazikulu zotsogola pakakhala kuti palibe metastases ku ziwalo zina.

Gawo la IV. Pali metastases ku ziwalo zina.

Mavuto a Cancer a Cancreatic

Ngati mapangidwewo ali mthupi kapena mchira wa kapamba, ndiye kuti kupangika kwa zovuta kumachitika kawiri pa nambala 4 yamatenda, ndipo amayanjana ndi khansa kuledzera.

Ngati chotupa chili m'mutu wa kapamba, zovuta zotsatirazi zimayamba:

• Chovala chowopsa

Mawonekedwe: chikasu cha azungu amaso, khungu, kuda kwamkodzo, ndowe zimayamba kuwala. Chizindikiro choyamba chodwala matenda owononga khansa chingakhale khungu lanu. Kukula kwa vutoli kumalumikizidwa ndi kumera kwa chotupa mu ducts, kuonetsetsa kutumiza kwa bile kuchokera ku chiwindi kupita ku duodenum. Nthawi zambiri, musanayambe ndi opaleshoni yamankhwala yolimbitsa thupi, ndikofunikira kuyimitsa zizindikiro za jaundice (njira yovomerezeka kwambiri ndiyotulutsira madzi a bile ducts pansi pa scan ya ultrasound).

• Kuletsa duodenal

Mawonekedwe: kusanza, kusanza, kumva kupsinjika ndi chidzalo cha m'mimba. Vutoli limayamba chifukwa chakuti chotupa chochokera kumutu wachikondacho chimafalikira ku duodenum, chifukwa chomwe chimbudzi cha m'mimba chimatsekedwa, ndipo chakudya sichingasiye m'mimba m'matumbo aang'ono.

• Kutuluka kwamkati

Kuwonetsedwa kusanza kwamdima ("malo a khofi") kapena mawonekedwe a ndowe zakuda. Izi zikuchitika chifukwa cha kuvunda kwa chotupa, ndipo, monga chotulukapo chake, kupezeka kwa magazi.

Ziwonetsero Kupewa

Kukula kwa khansa ya mutu wa kapamba kumadalira mtundu wa matendawa:

• At kapamba wa adenocarcinoma atatha opaleshoni yayikulu kwambiri ndi maphunziro a chemotherapy ,oposa zaka 5 amakhala 20-40% ya odwala. Tsoka ilo, ili ndi chotupa chambiri chamkaka komanso chankhanza kwambiri, chokonda kubwereranso pafupipafupi komanso metastasis yoyambirira.
• At neuroendocrine zotupa matendawa ndi bwino, ngakhale ndi nthenda ya IV. Mpaka 60-70% ya odwala amakhala ndi zaka zopitilira 5, ngakhale pakalibe chithandizo chamankhwala chopangira opaleshoni. Zambiri zotupa izi zimakula pang'onopang'ono, ndipo motsutsana ndi maziko a chithandizo chosankhidwa bwino, kuchira kwathunthu kumatha kuchitika.

Kupewetsa matendawa kumakhalabe ndi moyo wathanzi: kukana kusuta ngati chiopsezo, kupatula mowa, chomwe ndichomwe chimapangitsa kuti pakhale matenda a kapamba. Kukhala ndi moyo wokangalika komanso kudya zakudya zoyenera kumachepetsa chiopsezo chotenga matenda a shuga motero kutha kwa khansa ya kapamba.

Zambiri

Lingaliro la "khansa ya pancreatic" limaphatikizapo gulu la zilonda zam'mimba zopezeka pancreatic parenchyma: mutu, thupi ndi mchira wake. Zowonekera zazikulu zamatenda izi ndi kupweteka kwam'mimba, kukomoka, kuchepa thupi, kufooka, jaundice. Chaka chilichonse, anthu 8-10 pa anthu masauzande ambiri padziko lapansi amapezeka ndi khansa ya kapamba. Kuposa theka la milandu, imapezeka mwa okalamba (63% ya odwala omwe amapezeka ndi khansa ya pancreatic aposa zaka 70). Amuna amakonda chizolowezi chamtunduwu, amakhala ndi khansa ya pancreatic imayamba kamodzi ndi theka pafupipafupi.

Khansa ya pancreatic imakonda kukhala metastasis ku ma lymph node, mapapu ndi chiwindi. Kuchulukana mwachindunji kwa chotupa kumatha kubweretsa kulowa kwake mu duodenum, m'mimba, magawo oyandikira kwa matumbo akulu.

Zoyambitsa Khansa Yapancreatic

The etiology yeniyeni ya khansa ya pancreatic sichikudziwikiratu, koma zomwe zimapangitsa kuti zimveke zimadziwika. Komabe, mu 40% ya milandu, khansa ya kapamba imachitika popanda chifukwa. Chiwopsezo chotenga khansa chikuwoneka mosavuta mu anthu omwe amasuta paketi kapena zochulukirapo za ndudu tsiku lililonse, omwe amadya zakudya zambiri zokhala ndi zopatsa mphamvu zomwe zimachitidwa opaleshoni pamimba.

Matenda omwe amathandizira khansa ya pancreatic ndi awa:

• shuga mellitus (woyamba ndi wachiwiri)
• chifuwa chachikulu (kuphatikizapo chibadwa)
• hereditary pathologies (cholowa osati polypous colorectal carcinoma, mabanja adenomatous polyposis, Gardner syndrome, matenda a Hippel-Lindau, ataxia-telangiectasia)

Kuchepa kwa khansa kumawonjezeka ndi ukalamba.

Gulu la Khansa ya Pancreatic

Khansa ya pancreatic imayang'aniridwa malinga ndi dongosolo lapadziko lonse lapansi loyipa la neoplasms TNM, pomwe T ndi kukula kwa chotupa, N ndiye kupezeka kwa metastases mu zigawo za lymph node, ndipo M ndi metastases mu ziwalo zina.

Komabe, pankhaniyi, gululi silikhala lothandiza kwenikweni pakukhudzana ndi khansa komanso kudziwikiratu mphamvu ya mankhwalawa, popeza momwe thunthu limakhalira limagwira ntchito yofunika pakuyembekeza kuchiritsidwa.

Laboratory matenda

• Kuyesedwa kwa magazi kumaonetsa zizindikiro za kuchepa kwa magazi, kuwonjezeka kwa maselo othandiza magazi kuundana komanso kuthamanga kwa ESR. Kuyesa kwa biochemical magazi kumawonetsa bilirubinemia, kuchuluka kwa zamchere phosphatase, michere ya chiwindi pakuwonongeka kwa bile ducts kapena metastasis chiwindi. Komanso, zizindikiro za mtundu wa malabsorption syndrome zitha kuzindikirika m'magazi.
• Tanthauziro wamamakalonda a chotupa. Marker CA-19-9 atsimikiza mtima kuthana ndi vuto la chotupa cha ntchito. Mu magawo oyambilira, chizindikirochi sichikupezeka mu khansa ya pancreatic. Khansa ya embryonic antigen imapezeka mu theka la odwala omwe ali ndi khansa ya kapamba. Komabe, ndikofunikira kudziwa kuti kusanthula kwa chizindikirochi kungakhalenso koyipa pancreatitis (5% ya milandu), ulcerative colitis. CA-125 imadziwikiranso theka la odwala. M'matendawa kumapeto kwa matendawa, ma antigen a chotupa amatha kupezeka: CF-50, CA-242, CA-494, etc.

Chida chozindikira

1. Endoscopic kapena transabdominal ultrasonography. Ultrasound yamimba yam'mimba yopatula matenda a ndulu ndi chiwindi, imakupatsani mwayi kuti mupeze chotupa cham'mimba. Kufufuza kwa endoscopic kumapangitsa kuti zitheke kutulutsa zitsanzo za biopsy.
2. Dongosolo la tomography ndi MRI imatha kuwona minyewa yapancreatic ndikuwona mawonekedwe a chotupa kuchokera 1 masentimita (CT) ndi 2 cm (MRI), komanso kuwunika momwe matumbo am'mimba alili, kupezeka kwa metastases, komanso kukulitsidwa kwa ma lymph node.
3. Positron emission tomography (PET) imatha kuzindikira maselo owopsa, amatha zotupa ndi ma metastases.
4. ERCP imawulula zotupa za kapamba aliyense kuchokera kukula mpaka masentimita awiri. Komabe, njirayi ndi yachilendo ndipo imathandizira kuti pakhale zovuta.

Kuti mupeze metastases yaying'ono m'chiwindi, pa mesentery yamatumbo kapena peritoneum, diagnostic laparoscopy imachitika.

Kupewa kwa Khansa ya Pancreatic

Kupewa khansa ya pancreatic kumaphatikizapo zinthu zotsatirazi: kusiya kusuta fodya komanso kumwa mowa mwauchidakwa, chithandizo chokwanira komanso chokwanira cha matenda a kapamba ndi matenda amwano, kukonza koyenera kagayidwe kachakudya ka shuga, kutsatira chakudya, kudya mokwanira popanda kudya mopatsa chidwi komanso chizolowezi chodya mafuta ambiri komanso zonunkhira. Kusamala kwambiri ndi zizindikiro za pancreatitis ndikofunikira kwa odwala omwe akuchitidwa opaleshoni pamimba.

Matenda a Khansa ya Pancreatic

Anthu omwe ali ndi khansa ya pancreatic amayang'aniridwa ndi akatswiri mu gastroenterology, oncology, dokotala wochita opaleshoni komanso radiologist.

Khansa ya kapamba ikapezeka, nthawi zambiri matendawa amakhala osavomerezeka, pafupifupi miyezi 6 ya moyo. 3% yokha ya odwala ndi yomwe imakwanitsa zaka zisanu. Izi zimachitika chifukwa chakuti nthawi zambiri khansa ya kapamba imapezeka mu magawo amtsogolo komanso mwa odwala omwe ali ndi zaka za senile, zomwe sizimalola kuchotsedwa kwa chotupa.