Zizindikiro za khansa ya pancreatic - zolembedwa za mayeso ku Oncoforum

Khansa ya antigen CA19-9 ndiyo chizindikiro choyambirira kuchokera ku gulu la ma antigen omwe amalumikizana ndi nembanemba yama cell a chotupa (CA125, CA15-3, MCA, PSA) yomwe idapezeka ndikuwonetsa chifukwa chogwiritsa ntchito ukadaulo wosakanizidwa.

CA19-9 ndi mucin-sialo-glycolipid wokhala ndi kulemera pafupifupi pafupifupi kDa 1,000.

Mtengo woyeserera wa cholembera mu seramu ya munthu wamkulu, wathanzi ndi 40 Units / ml. Patsiku la 15 ntchito yaposachedwa, kuchepa kwa anthu olembetsedwa kudalembedwa 50% ya milandu. Kwa odwala 100% omwe poyamba sanali olemera kwambiri (64-690 U / ml) CA19-9, zotsatira zakupha zinalembedweratu kuposa miyezi 17, m'malo mwa 4 - motsutsana ndi kumbuyo kwa zizindikiro (75-24 000 U / ml), momveka bwino Kupitilira zomwe zafotokozedwazi.

Kupanda kutsimikiza kwathunthu kwa mayeso a CA19-9 kumachitika chifukwa cha kupezeka kwamatenda osiyanasiyana komanso matenda, zomwe zimayendera limodzi ndi kuchuluka kwa antigen awa:

• zotupa zoyipa za kusagwira pancreatic - hepato native and cholangiogenic carcinoma, khansa yam'minyewa yam'mimba, m'mimba, mapapu, chiberekero, m'mawere, matumbo akulu, mazira (makamaka khansa yamtundu wakhungu),
• matenda a chiwindi ndi biliary thirakiti,
• kapamba (pachimake komanso matenda),
• yotupa matenda am`mimba thirakiti.

Zizindikiro pakuphunzira kuchuluka kwa CA19-9 makamaka zimabukandi zotupa zoyipa za malo otsatirawa:

• m'mimba
• mapapu
• chiwindi
• kapamba,
• m'mimba
• endometrium,
• thumba losunga mazira (makamaka khansa yamtundu wa mucous).

Kuwonjezeka kwa CA19-9, poyerekeza ndi mtundu wamafotokozedwe, kumakhala kwenikweni ndi khansa ya kapamba pomwe chotupa chikufika pamtunda wa> 3 cm.Pompo, kuyesaku sikukwaniritsa zofunikira zomwe zimagwiritsa ntchito njira zomwe zili ndi chiyembekezo chogwiritsa ntchito ngati zowunika.

Kuphatikiza kwa Antigen> 1,000 U / ml, monga lamulo, kukuwonetsa kupita patsogolo kwa neoplasm - mpaka kukula> 5. cm.

Mlingo wa CA-19 umawonetsa kuphatikiza koonekera bwino ndi chikhalidwe chamatenda a matenda, chifukwa chake, kuyesedwa kogwirizana kumayesedwa, monga lamulo, pakukonzekera kowonekera kwa wodwalayo.

Kukula kwa kuyambiranso kwamatenda obwera chifukwa cha matendawa komanso / kapena kukhalapo kwa metastases ya chotupa choyambirira kumakhala koyenda limodzi ndi kuwonjezeka kwa gawo la antigen lomwe limafunsidwa.

Ma antigen ena angapo adazindikiritsidwa mu minyewa yoyipitsa ya pancreatic: CA50, CA242, CA494, DU-PAN-2, SPAN-1.

Kuphatikiza apo, kutsimikizika kwa izi kumapeto, ndipo chizindikiritso chake ndi chotsika kuposa chikhalidwe cha CA19-9. Mu 50% ya odwala, kuyesedwa kwa CA-125, komwe pamakhala makamaka khansa yamchiberekero, kungakhale kwabwino.

Tsoka ilo, kuwonjezeka kwa izi zolembedwazi kumangolembedwa pokhapokha matendawo sangayambitse matenda.

Pali kudzikundikira kwa data m'malo mozindikira kuwunika kwa kuwerengera kwa seramu testosterone ndi kutsikira kwa dehydrotestosterone mu khansa ya kapamba.

Miyezo yamilandu yofanana

95% ya zotupa zonse zoyipa zam'mimba ndi adenocarcinomas. Ichi ndichifukwa chake madokotala
Ngati angalankhule za "khansa yam'mimba," amatanthauza adenocarcinoma, ndipo zina zonse za morphological subtypes zimawonetsedwa mosiyana. Izi zimachitika chifukwa cha maphunziro azachipatala, metastasis.

Zochizira khansa ya m'mimba, njira zitatu zazikulu zimagwiritsidwa ntchito: opareshoni, ma radiation ndi chemotherapeutic - onse payokha komanso m'njira zosiyanasiyana. Njira yamankhwala imasankhidwa potengera momwe matendawa alili komanso momwe wodwalayo alili. Njira ya opaleshoni idakali "muyeso wagolide" wambiri.

Zolemba zotupa za pancreatic

Chizindikiro cha khansa ya pancreatic CA 19-9 mwa akulu chimasungidwa ndi ma cell a bronchi ndi m'mimba dongosolo ziwalo. Mlingo wake umatha kuchuluka ndi khansa ya kapamba, rectum, matumbo akulu ndi ang'ono komanso chikhodzodzo. Kuwonjezeka pang'ono pamlingo wa chotupa cholembera CA 19-9 amadziwika mu pancreatitis yovuta kwambiri komanso ya hepatitis, cirrhosis, cholecystitis, matenda a ndulu.

An oncologist nthawi zonse adzafuna kuwona zotsatira za kusanthula pamlingo wa oncomarker CA 125. Zimapangidwa mu fetus ndi eprylium ya embryonic yam'magawo am'mimba komanso kupuma. Akuluakulu, amapangika pokhapokha ndi kupuma komwe. Kuphatikizika kwake kumachulukitsidwa nthawi zonse m'matumbo oyipa a kapamba. Chotupa ichi chitha kuphunziridwanso ndikuwunika odwala omwe akuwonetsetsa kuti ali ndi khansa ya chiwindi, m'mimba, ndi rectum. Kuphatikizika kwa chikhazikitso cha maselo otupa CA 125 kumatha kuchuluka mpaka kuchepa, hepatitis, cirrhosis, kapamba.

Kafukufuku wokhudzana ndi kuchuluka kwa chotupa cholembera CA 72-4 kumachitika ndi khansa ya kapamba. Chotupa ichi chimapangidwa ndi ma epithelial cell. The kuchuluka kwa chotupa chikhomo CA 72-4 akhoza kuchuluka mu nkhani ya kapamba, ena chosaopsa pancreatic zotupa ndi pa mimba.

Chizindikiro china, chomwe chikukula ndi khansa ya kapamba, ndi cholembera cha AFP kapena alpha-fetoprotein. Amapangidwa ndi yolk sac ya mwana wosabadwayo, ndipo akuluakulu ndi ana ndi chiwindi. Kuchulukitsa kwa chizindikiro cha oncological cha ACE kumatha kuwonetsa kukhalapo kwa khansa ya kapamba, colon kapena chiwindi. Mu khansa ya pancreatic, kuchuluka kwa zolemba zingapo kumatsimikizika nthawi yomweyo.

Chizindikiro choyambirira cha kuyezetsa khansa ya kapamba ndi chotupa cha Tu M2-PK, kapena chotupa cha mtundu wa chotupa cha pyruvate kinase M2.This metabolic tumor marker ikuwonetsa kusintha kwa kagayidwe kachakudya ka maselo a chotupa choyipa. Tumor M2-RK ndi puloteni yodziwika bwino yokhudza khansa, yomwe imawerengedwa ngati mtundu wa "chosankha" chodziwitsa njira zoyipa ziwalo zosiyanasiyana, kuphatikizapo kapamba.

Chizindikiro chodziyimira papancreas ndi chizindikiro cha CA 50 (Tumor marke). Uwu ndi sialoglycoprotein, womwe uli pamtunda wa epithelium komanso muzinthu zakudwala. Chimakhala chizindikiritso cha khansa ya kapamba. Chotupa ichi chimazindikira kwambiri kapamba kuposa CA 199.

Zisonyezero za pancreatic khansa chotupa kuwunika

Masautso a pancreatic chotupa amatsimikiza mu milandu:

pamaso pa cysts, pseudotumor pancreatitis ndi zina chosaopsa pancreatic neoplasms,

ngati mukukayikira khansa yapamba,

kuyang'ana kuzungulira kwa chotupa pakuchotsa,

kuwunika momwe ntchito yothana ndi khansa imayendera,

kuti mudziwe za khansa,

kuzindikira gawo loyambirira la metastases kapena kuyambiranso khansa ya kapamba.

Kuwona zotsatira za kusanthula kwa zolembera za khansa ya pancreatic ndi muyezo wazisonyezo

Kuunikira zotsatira za kafukufuku wama cholembera pancreatic kumafunikira maluso ena. Kutanthauzira kuwunikiraku kuyenera kuchitidwa ndi dokotala wa zasayansi komwe kafukufukuyu adachitidwira. Zotsatira za maphunziro a zokhala ndi zotupa mwina sizingafanane m'malo osiyanasiyana. Zimatengera njira yoyesera magazi kwa odwala khansa.

Ma labotale omwe adachitapo kafukufukuyu akuwonetsa zisonyezo zakusokonekera zomwe zalandiridwa kumalo opatsirira matenda. Chiwerengero chapakati cha zotupa za khansa ya kapamba chimawonetsedwa patebulo.

Pancreatic khansa chotupa cholozera mfundo

Kodi zotupa ndizizindikiro

Mthupi la munthu aliyense pali chiwerengero cha zotupa. Amatulutsa mapuloteni enaake omwe amalowa m'magazi. Ndi kukula kwa chotupa, kuchuluka kwa maselo otere kumawonjezeka nthawi zambiri, zomwe zimapangitsa kuti chiwonetsero chachikulu cha zomwe zimakhala ndi chotupa m'magazi zithe.

Zosiyanasiyana zam'mimba zotupa zokhala ndi ziwalo zosiyanasiyana Glycoprotein CA 19-9 ndizapulogalamu yofunikira ya khansa ya kapamba. Chizindikirochi chimapangidwa ndi ma epithelial cell a m'mimba. Ndi kukula kwa oncological matenda, kuchuluka kwake m'thupi kumachulukanso. Chifukwa chake, kuwonjezeka kwa CA19-9 kumatha kuonedwa ngati chizindikiro cha chotupa cha kapamba.

Oposa 45% odwala carcinoma a chiwalochi amapitilira muyeso wabwinowo wa chizindikiro. Kutengera ndi kuzunzidwa, munthu akhoza kuweruza kuchuluka kwa zotupa maselo:

• pamene CA 19-9 ikuwonjezeka kuposa magawo 1000 pa ml, ndiye kuti metastasis yamitsempha imaganiziridwa,
• mulingo woposa 10,000 U / ml umawonetsera kufalikira kwa hemato native, komwe ndi kofanana ndi gawo lachinayi la matendawa.

Komanso, monga chonchi, tingaganizire kuti njira yochizira:

• pamlingo woposa 1,000 Units / ml, ndi magawo asanu okha a odwala omwe angathe kugwira ntchito,
• mwa odwala omwe ali ndi chizindikiro mpaka chikwi cha ma Units / ml, oposa theka amatha kugwira ntchito bwino.

Zofunika! Ngakhale kuti kuwonjezeka kwa chizindikiritso kuli ndi mitundu ya mitundu ya oncological, zizindikiro za ma labotale sizikunena zenizeni. Chifukwa chake, kuzindikiritsa kuyenera kukhala kokwanira nthawi zonse komanso kuphatikiza njira zofufuzira.

Zizindikiro zoyeserera pa zotupa

Kuwunikira kwa kuchuluka kwa zolembera zam'mimba za pancreatic tikulimbikitsidwa pazotsatirazi:

• kuzindikira mawonekedwe a cystic,
• zotupa
• kukhalapo kwa chizindikiro chokhala ndi matenda a khansa,
• pseudotumor mawonekedwe a kapamba.

Nthawi yomweyo, kuwunikiraku nthawi zambiri kumawonetsedwa ngati kuwunika, ndiko kuti, kuzindikira odwala omwe ali ndi khansa ya gland pakati pa anthu ambiri.

Kuyesa kwa magazi kwa zotupa kumachitika kuchokera m'mitsempha

Pambuyo pochizira zovuta za chotupacho, kuchuluka kwa CA 19-9 kumatsimikiziridwa kwa odwala. Izi ndizofunikira kuti muzindikire kuchuluka kwa mankhwalawa ndikuwonetseratu kukula kwodwalayo. Komanso, odwala oterowo amayesedwa nthawi zonse kuti adziwe kutayanso kapena kuchepa kwa chotupa.

Zosiyanasiyana zotupa LCD

Pali mitundu ingapo ya zolemba za oncological zomwe zimatha kuwonetsa kukhalapo kwa chotupa cha kapamba ndi ziwalo zina za m'mimba. Pambuyo pochita maphunziro angapo, zitha kuganiziridwa kuti ndi chiwalo chiti chomwe chingapangitse matendawa.

Zotupa zam'mimba

Ngati kuchuluka kwa zilizonse zomwe zalembedwa pamwambazi zitha kupitilira muyeso womwe ungachitike, izi zikuwonetsa kukhalapo kwa matenda otsatirawa:

• khansa ya m'mimba
• zotupa za m'mimba.
• kutupa kwa chiwindi, kapamba, matenda enaake,
• matenda a ndulu.

Kutumiza kugonjera

Kuti mudziwe kuchuluka kwa zofunikira, ndikofunikira kutenga magazi a venous. Izi zisanachitike, wodwalayo ayenera kumakonzekera masiku atatu. Ndikulimbikitsidwa kuti pakhale maphunziro angapo - chifukwa cha izi, mutha kuwonjezera kudalirika kwa zotsatira.

Magazi a venous ayenera kugwiritsidwa ntchito kuti azindikiritsa chotupa

Kuyamwa magazi kumachitika m'mawa, wodwalayo sayenera kudya ndi kumwa kwa maola 8 musanachitike njirayi. Kwa maola 72, simungathe kumwa mowa kapena kumwa mankhwala okhala ndi ethyl mowa. Muyenera kusiyanso mbale zonona, zokazinga komanso zosuta. Patsiku la mayeso, simungasute komanso kumwa mankhwala, masewera olimbitsa thupi ndi otsutsana.

Odwala omwe amathandizidwa ndi khansa amayenera kuyesedwa kangapo pachaka. Pankhaniyi, kuyankhulana pafupipafupi ndi adokotala amafunikira, komwe, ngati kuli koyenera, adzapereka mayeso ena.

Ogulitsa osakanikirana ndi njira zina zodziwonera amalola ngakhale magawo oyambirira kuti awone kukhalapo kwa chotupa pakukula kwa wodwala. Komabe, kuwonjezera kuchuluka kwa mapuloteniwa sikutsimikizira kuti ali ndi khansa. Kungowunika kokwanira komwe kumakupatsani mwayi wokhazikitsa matendawa.

Mukayezetsa zotupa

Chizindikiro cha khansa ya pancreatic chimalembedwa kuti chiziwongolera matendawa. Njira yayikulu yothandizira mankhwalawa m'magazi amatchedwa njira yakuchita opareshoni. Chifukwa chake, chifukwa cha kuchuluka kwa nthawi, njirayi ndiyabwino kudziwa kuyambiranso kwamatenda a khansa ya kapamba. Kuphatikiza apo, antigen imagwiritsidwa ntchito kuyesa kukhalapo kwa metastases isanachitike opaleshoni, kuchititsa kafukufuku wosiyana ndi khansa ndi matenda a chosaopsa.

Ndi chitukuko cha khansa ya kapamba, mayeso a chotupa amayenera kutengedwa pazotsatirazi:

• madandaulo opweteka kwambiri kumtunda kwa peritoneum, kupita patsogolo kwa jaundice, kuchepa thupi kwambiri,
• kuwunika komwe khansa ikuwonekera komanso kupezeka kwa mitundu yachiwiri ya kapamba,
• chotupa chotsimikizika chimatsimikiziridwa pakupangika kwa chotupa pamimba ndi matumbo.

Ayesanso zotupa:

• ngati mitundu yama cystic ikukayikiridwa,
• tsatirani luso la mankhwala odana ndi khansa,
• ndikuwunika mozama za kuchotsedwa kwamaphunziro.

Mitundu ya zotupa zolemba m'mimba

Kafukufuku wokhudzana ndi khansa ya khansa ya pancreatic amadziwika ndi chizindikiro cha zotupa zosiyanasiyana, ACE ndi ma antigen ena, omwe amagawidwa mu:

Komanso zotupa ndi:

• Zizindikiro - zikusonyeza kukhalapo kwa khansa yapadera
• Zizindikiro zosadziwika - kuwonjezeka kwa kutekeseka kumachitika ndi mitundu yonse ya khansa.

Mitundu ya zotupa pa kapamba:

1. Tu M2-PK ndi chizindikiritso cha mzere woyamba kuti mudziwe njira yopanda pake m'matumbo a chamba. Kusanthula kumawonetsera kuphwanya kwa metabolic zochitika zomwe zimawonedwa mu maselo osapangika bwino. Chizindikirochi chimadziwika kuti ndi mapuloteni enaake a khansa. M2-PK ndiye chisonyezo cha chisankho chomwe chimagwiritsidwa ntchito pofufuza njira zowonongeka, zomwe zimapangidwa paziwalo zosiyanasiyana, kuphatikizapo kapamba.
2. CA 125 - ndi cholembera cha khansa yamchiberekero yopangidwa ndi ziwalo zopumira. Changu chake chimakhala chokwera nthawi zonse pakakhala khansa m'matumbo a chamba. Ndi kuwonjezeka pang'ono kwa ndende, izi zikuwonetsa mapangidwe a hepatitis, cirrhosis, kapamba, nthawi ya bere.
3. CA 242 - imalowa m'magazi kuchokera ku ziwalo zoyipa. Chifukwa cha kupezeka kwake, zochitika zopanda pake m'mimba zokhala ndi matumbo zimapezeka, komanso khansa ya kapamba. Mimbayo imachulukanso ndi kapamba, ma cysts ndi kapangidwe kake m'mimba. Dziwitsani chizindikiro pamodzi ndi 19-9.
4. CA 19-9 - amadutsa kuchokera ku ma cell a bronchi. Kukula kwake kumakhala ndi zotupa zam'minyewa ya chiwindi, kapamba, chikhodzodzo, matumbo am'mimba, mafupa a mafupa. Kuwonjezeka pang'ono kwa chisonyezo kumachitika ndi matenda a gland, cirrhosis, pakakhala miyala mu ndulu.
5. CA 72-4 - imapangidwa ndi ma cell a epithelial ndipo imapangitsa kuti zitha kulankhula za kukhalapo kwa njira yoyipa ya mapangidwe a gland. Kuwonjezeka pang'ono mu mgululi kumazindikiridwa ndi milandu yofananira ndi chisonyezo cha 125. Kuchulukitsa kwa zizindikiro za khansa kumatha kuwonjezeka ngati pali kapamba, kapangidwe kake kovomerezeka, pakubala kwa mwana.
6. AFP - imapangidwa m'maselo a chiwindi. Kukula kwake kumawonetsa khansa ya kapamba, maselo a chiwindi ndi minofu ya m'mimba. Mtengo wake umawunikidwa limodzi ndi zolembera zina.
7. CA 50 ndi phindu lakumaso lomwe limapangidwa ndi minyewa ya mucosal. Chokwaniracho chimakhala chovuta kwambiri kupangitsa ziwalo kuti zizindikire khansa.
8. PSA - chikhomo cha Prostate, antigen wapadera, chikuwonetsa kupezeka kwa khansa ya prostate.
9. CEA ndi khansa yokhala ndi khansa yomwe imapangidwa ndi ma cell a fetal. Chizindikirocho chimawonedwa ndikuwonjezereka kwa antigen ndi matenda omwe angathe kutuluka m'mimba, thirakiti ya ziwalo za akazi. Kupatuka kochepa kukuwonetsa kuchepa kwa impso, kupezeka kwa chifuwa chachikulu, matenda olumikizana, pali kapamba, chiwindi, ndi matenda a chiwindi.

Ndikofunikira kumvetsetsa kuti mfundo za chikhomo china zimatha kukula chifukwa cha matenda osiyanasiyana. Chifukwa chake, pakuwonetsetsa matendawa, mitundu ingapo ya ma antigen imagwiritsidwa ntchito.

1. Mu pancreatic oncology - CA 242, CA 19-9.
2. Khansa m'mimba - CA 242, CEA.
3. Mafunde akuthyoka mu ma testicles - AFP.
4. Metastases ya chiwindi - CA 19-9, CEA, AFP.

Njira yowunikira

Kudziwa chizindikiro cha chotupa cha khansa ya pancreatic ndikutenga magazi kuchokera mu mtsempha. Kuyesa kumachitika ndi mayeso a labotale atatha masiku atatu akukonzekera.

Ndikulimbikitsidwa kuyezetsa mayeso kuchipatala chimodzi, izi zithandizira kuzindikira zotsatira zoyenera.

Kukonzekera

Kuti muwonjezere kudalirika kwa phunziroli, malamulo angapo ayenera kusamalidwa:

1. Magazi amatengedwa m'mawa, pomwe m'mimba mulibe kanthu.
2. Kudya ndizovomerezeka maola 8 mpaka 12 musanatenge magazi.
3. Tsiku lisanafike phunziroli, chotsani yokazinga, kusuta, mafuta kuchokera ku chakudya, ndipo phatikizani ndi zonunkhira.
4. Kwa masiku atatu amaletsedwa kumwa mowa.
5. Patsiku la phunziroli, kusuta fodya komanso kumwa mankhwala ndikosavomerezeka.
6. Tsiku la mayeso lisanafike, tikulimbikitsidwa kuti mupumule, osadzaza thupi.
7. Pewani kupsinjika tsiku latha.

Mankhwalawa apezeka ndi khansa ya kapamba, kuyezetsa magazi kumafunika katatu pachaka. Kuti muzindikire zotsatira zoyenera za chikhansa cha pancreatic mu khansa ya pancreatic, muyenera kufunsa dokotala.

Norm ndi matenda mu zotsatira

Kuzindikira kwa chizindikiro kumasonyezedwa ndi kukhalapo kwa mapangidwe a oncological, omwe amawonetsa kuti ndi chizindikiro chiti chomwe chimapambana.

Pankhani ya chizolowezi, kuwunika kwa zotupa zokhala ndi vuto losayenera kudzakhala zero mwa munthu wathanzi kapena pafupi ndi mtengo wake. Mukuyimira kwa digito, chizolowezi chake ndi 0-34 magawo / ml.

Kuzindikira kukusonyeza izi:

• munthu amakhala wathanzi kwathunthu
• zotsatira zabwino zamankhwala polimbana ndi khansa,
• kukhalapo kwa chotupa pa siteji ya mapangidwe.

Pankhaniyi, kuchuluka kwa antigen m'maphunziro amodzi payekha sikuwonetsa kukhalapo kwa kusintha kwa masinthidwe. Zimachitikanso kuti CA 19-9 ndi chizindikiro cha khansa ya chiwindi, m'mimba.

Pakakhala kuchuluka kwa chidwi, izi zikuwonetsa kukhalapo kwa oncology. Kukwera kwake kumakhala kofunika. Malinga ndi chizindikiro cha kuphatika kotero, oncology imakamba za kukhalapo kwa metastases yomwe imapezeka kutali.

Chotupa chizindikiritso choposa 35-40 mayunitsi / ml amawonedwa matenda otsatirawa:

• zotupa za khansa m'matumbo,
• chotupa pa chikhodzodzo, thumba losunga mazira,
• chodabwitsa chachilengedwe cha chiwindi, matenda enaake,
• kupezeka kwa miyala mu bile.

Ndi zikwangwani zokwezeka, khansa sichimawonedwa nthawi zonse. Chifukwa chake, limodzi ndi kuyezetsa magazi a biochemical, njira zina zodziwira matenda zimagwiritsidwa ntchito.

1. Ultrasound
2. Kusanthula kwa X-ray.
3. CT
4. MRI
5. Njira yofufuzira yopezeka ndi electrochemiluminescent.

Njira zochizira ndizosiyana. Chilichonse chimadalira pamlingo womwe matenda awonekera. Mukazindikira matenda pamlingo wokhazikitsa mapangidwe ndi kuchita kafukufuku wokwanira, zotsatirapo zake zidzakhala zabwino, ndiye kuti dokotala amakupatsani mankhwala.

Wovutitsidwayo ayenera kutsatira malangizowo kuti akwaniritse zochizira.

Opaleshoni imafunidwa pamene CA 19-9 ili yochepera kuposa 950 unit / ml. Ngati mtengo upitilira mayunitsi 1000 / ml, ichi ndi chizindikiro choopsa chomwe chikuwonetsa kuphwanyidwa kwambiri ziwalo zina, ndiye kuti opareshoni sitingapewe. Ma membala owunika amaunika tsiku lililonse amakhala ndi opaleshoni ya khansa ya VMP.

Kodi ndingafunike liti kukhala ndi cholembera cha khansa ya kapamba?

Kuwona zolemba za khansa ya pancreatic kumayikidwa pazisonyezo zotsatirazi:

• kudandaula kwa odwala kupweteka kwam'mimba, zizindikiro za dyspeptic, kuchepa thupi msanga, jaundice (wokhala ndi chotupa m'dera la mutu wa pancreatic) ndi zizindikiro zina zomwe zimawoneka ndi kusintha koopsa m'matumbo,
• zinthu zomwe zitha kukhala pachiwopsezo cha matenda a khansa ya m'matumbo (cholowa, kusuta, uchidakwa, matenda ashuga, kunenepa kwambiri, chifuwa cham'mimba, chosaopsa cha zotupa ndi zina),
• kupezeka kwa mawonekedwe ngati chotupa m'mutu, thupi kapena mchira m'mbali mwa gland nthawi ya ultrasound pazifukwa zina zilizonse,
• kuwunika bwino kwa opareshoni kapena chithandizo china,
• amaganiza kuti khansa metastases kapena chotupa mobwerezabwereza mankhwala,
• zovuta pakusankha njira zamankhwala.

Kukonzekera kusanthula zotupa mufunika kutsatira malamulo ochepa osavuta:

Pambuyo pa opareshoni ndi njira zina zochizira (radiation, chemotherapy), wodwalayo amawonedwa ndi oncologist. Njira yotsatirira imaphatikizaponso kuyesa kwa magazi kwa chotupa. Kusanthula koyamba kumachitika pakatha milungu iwiri kuchokera pa opaleshoni kapena kutha kwa njira yothandizira. Kenako, kwa zaka ziwiri, phunziroli limachitika kamodzi pamiyezi itatu iliyonse, pambuyo pake - kamodzi pa miyezi isanu ndi umodzi kwa zaka 6.

Mtengo wakufufuzira m'malo osiyanasiyana azachipatala ndi omwe amathandizira odwala amatha kusiyanasiyana. Nthawi zambiri mtengo wa kusanthula chikhomo chimodzi umasonyezedwa, umatha kusiyanasiyana kuchoka pa 800 mpaka 1,500 ma ruble, kutengera chipatala komanso mtundu wa chotupa.

Vuto loyipa la kapamba (kachidindo kake malinga ndi ICD-10 ndi C25) ndi matenda oopsa, omwe nthawi zambiri amapezeka kumapeto, pomwe chithandizo sichikugwira ntchito. Chofunikira kwambiri pakuwonjezera nthawi yodwala ndikuwonetsetsa koyambira kwa matenda ndi kuyamba kwa chithandizo. Njira yosasokoneza - kuwunika kwa zotupa - imaphatikizidwa mu ndondomeko ya matenda a pancreatic oncology.

Pali mitundu ingapo ya ma antijeni a khansa (choyambirira komanso chachiwiri), kuchuluka kwa magazi komwe kumawonetsa kukhalapo kwa chotupa chodera, kukula kwake, komanso mawonekedwe a metastases. Kutsimikiza kwa kuchuluka kwa olemba khansa kumachitidwanso kusankha njira zochiritsira ndikuwunika momwe mankhwalawo alili.

Kuti mudziwe zoyambirira zamankhwala oncopathology, ndikofunikira kuti mupeze nthawi yoonana ndi a oncologist ku malo apadera azachipatala komanso kukayezetsa. Chimodzi mwazachipatala zamakono zomwe zili ndi ndemanga zambiri zabwino kuchokera kwa odwala ndi Kashirka Oncology Center (Blokhin Cancer Center ku Moscow ku station ya Kashirskaya metro).

1. 
   Dubrovskaya, S.V. Momwe mungatetezere mwana ku matenda ashuga / S.V. Dubrovskaya. - M: AST, VKT, 2009. - 128 p.
2. 
   Tsyb, A.F. Radioiodine mankhwala a thyrotoxicosis / A.F. Tsyb, A.V. Dreval, P.I. Garbuzov. - M: GEOTAR-Media, 2009. - 160 p.
3. 
   Laboratory matenda a bakiteriya vaginosis. Malangizo oyenera. - M: N-L, 2011 .-- 859 p.
4. Kunenepa kwambiri kwa Morbid, Medical News Agency - M., 2014. - 608 c.
5. Odinak M. M., Baranov V. L., Litvinenko I. V., Naumov K. M. Kuwonongeka kwa dongosolo lamanjenje mu matenda a shuga mellitus, Nordmedizdat - M., 2012. - 216 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Zizindikiro za khansa yapakansa

Talingalirani zomwe zikwangwani zimatulutsa m'matumbo.

• CA 125. Ndi antigen yapadera yomwe imapangidwa ndi kupuma kwamphamvu. Kuwonjezeka kwake kumadziwika m'matumbo oyipa a kapamba, chifuwa, chiberekero, panthawi yapakati komanso endometriosis. Pothana ndi chizolowezi chambiri, CA 125 imatha kuwonetsa pancreatitis ndi cirrhosis.
• CA 19-9. Zimapangidwa ndi bronchi. Kukula kwa chotupa ichi kumachitika chifukwa cha khansa ya kapamba, m'mimba, matumbo ndi chikhodzodzo, komanso pamaso pa metastases. Kupatuka kochepa pazachilendo kumawonekera ndi kapamba, matenda a ndulu ndi matenda amitsempha.
• CA-242. Amapangidwa ndi maselo apypical a kapamba, ndiye kuti, ndiye chizindikiro chake chotupa, ngati CA 19-9. Ndi chithandizo chake, kuunika kwa zotupa zoyipa zomwe zili m'mimba kumachitika. Kupatuka kwakung'ono ku chizolowezi kumachitika chifukwa cha kapamba, mapapo ndi chisa cham'mimba.
• CA 72-4. Chizindikiro china chapadera cha kapamba. Amapangidwa ndi epithelium ya chiwalo ndipo amawonetsa njira zoyipa ndi zoyipa. Ngati mfundo zake zidapitilira pang'ono, titha kulankhula za matenda omwewo omwe akuwonetseredwa ndi oncomarker CA 125 - kapamba ndi cirrhosis. Komanso, kuwonjezeka pang'ono kwa CA 72-4 ndi chikhalidwe cha pakati.
• AFP. Kupangidwa ndi maselo a chiwindi. Miyezi yambiri ya AFP m'magazi imadziwika ndi khansa ya kapamba, chiwindi ndi matumbo akulu.
• Tu M2-RK. Oncomarker wa kagayidwe kachakudya njira. Amadziwika m'matenda a metabolic omwe amagwirizana ndi zochitika za khansa.
• CA 50. Amapangidwa ndi ma epithelial cell a mucous membranes omwe ali ndi ziwalo zosiyanasiyana. Chotupa chija chimakonda kwambiri matenda aliwonse oopsa.
• CEA (khansa-embryonic antigen). Nthawi zambiri amapangidwa ndi maselo a mluza pa nthawi yapakati. Zizindikiro za CEA zimakwezedwa mu khansa ya ziwalo zoberekera za amayi, kupuma komanso kugaya chakudya. Kupatuka pang'ono pazomwe zimachitika kumawonetsa zovuta ndi kapamba, mafupa, kawirikawiri ndi chiwindi, chifuwa chachikulu komanso kusokonezeka kwa chiwindi.

Zizindikiro zodzipereka

Dokotala wazindikiritsa zotupa amalembedwa ndi dokotala pazinthu zotsatirazi:

• kuganiza kwa kakulidwe ka khansa mu kapamba kapena ziwalo zina zamkati,
• cholecystitis
• matenda opatsirana komanso otupa m'mimba thirakiti,
• kukayikira kupangika kwa matenda a chiwindi,
• matenda a ndulu
• chiwindi
• cystic fibrosis.

Chizindikiro cha chotupa

Talingalirani za mndandanda wamalingaliro a zolembera za khansa ya pancreatic.

M'mabungwe osiyanasiyana azachipatala, zotsatira zake zimatha kusiyana kwambiri mzake, kotero kuyesedwa mobwerezabwereza kumalimbikitsidwa kuti muzitenga malo amodzi.

Kuphunzira zamam'mimba zotupa

Ngati zotupa zikupitilira muyeso, sizitanthauza kuti khansa ya kapamba. Chifukwa chake, kuyezetsa magazi ndikofunikira kuyambitsa kuwunika mozama ndi njira zina zodziwira matenda:

• Ultrasound
• radiology
• compression tomography,
• MRI

Kuzindikira matendawa ndikumasulira moyenera matendawa ndikotheka mothandizidwa ndi njira yonse. Ngati zotsatira zoyesazi zili zabwino ndipo zikuwonetsa kuti pali zilonda zapakhosi, dokotala amupatseni chithandizo choyenera. Mwachitsanzo, opareshoni ikuwonetsedwa kuti CA 19-9 siyapamwamba kuposa 950 U / ml. Ngati chotupa chizindikirika kuposa mtengo uwu, tikukamba za njira yoyendera ndi ma metastases ku ziwalo zakutali, chifukwa chake opaleshoni singawonetsedwe.

Kudalirika kwa kusanthula, kaya ndikofunikira kuti muperekenso kachiwiri kuti mutsimikizire

Madokotala ambiri amalimbikitsa kuti zolemba zotupa ndi mayeso ena a labotale azichitika kumalo amodzi odziwitsa. Njira ndi matanthauzidwe abwinobwino m'makliniki osiyanasiyana amatha kukhala osiyanasiyana, ndipo ngakhale kusiyana pang'ono kumapangitsa chithunzi cha matendawa.

Ngati miyezo ya antijeni oyipa ikupitilira kwa nthawi yoyamba, ndikulimbikitsidwa kuyambiranso kuwunika pambuyo pa masabata 3-4. Ndikofunikira kupatula zina zomwe zingawakhudze, mwachitsanzo, kukonzekera molakwika mayeso omwe akubwera kapena kumwa mankhwala.

Mikhalidwe yapadera yokhudza magazi

Pali zinthu zambiri zomwe zimapangitsa kutsimikiza kwa zotupa. Kukula kwa maantivitamini oyipa kungakhudze kusamba kwa mkazi, kumwa mowa patsiku la kusanthula, kusuta, kupereka magazi m'mimba yonse. Kuti mupeze chidziwitso chodalirika, zinthu zonsezi siziyenera kuphatikizidwa.

Ndizodziwikanso kuti mfundo zomwe amalemba ndi khansa ya pancreatic zimasokoneza zifukwa izi:

• CA 125: ma pathologies a kubereka kwamkazi (polycystic ovary, endometriosis, fibroids), pakati, peritonitis, ascites ndi pericarditis.
• CA 19-9: matenda a ndulu, matenda am'mimba osatha.
• CA 72-4: mavuto am'mapapo.

Kodi ndingayesetse kuti mayeso?

Kafukufuku wa zolemba za khansa ya pancreatic (CA 125, CA 19-9, CA 72-4) amachitika m'makliniki ambiri m'mizinda yaku Russia. Mtengo ndi nthawi yodziwira matendawa itha kusiyanasiyana ndi dera. Tikukulimbikitsani kuti mupeze m'nkhani yathu momwe kafukufuku amachitidwira komanso mtengo wake wonse pazowunika izi.

Kupita ku Moscow?

• Chipatala "MedCenterService", st. 1 Tverskaya-Yamskaya, 29. Mtengo ndi ma ruble 2420.
• Medical Center "SM-Clinic", Volgogradsky Prospekt, 42. Mtengo 2570 rubles.
• Medical and Diagnostic Center, Central Clinical Hospital, Russian Academy of Science, Litovsky Boulevard, 1A. Mtengo 2440 rub.

Kodi anthu ozindikira khansa amayesedwa kuti ku St.

• Medical Center "Union Clinics", st. Marat, 69/71. Mtengo wa 1990 rub.
• Medical Center "University Clinic", ul. Tauride, 1. Mtengo 2880 rub.
• Chipatala "Andros", st. Lenin, 34. Mtengo wa ma ruble 2360.

M'madera a Russia muli ma network a diagnostic Laboratories "Invitro". Mpaka pano, tsamba lachipatala lidazindikira kuti kafukufuku wa enieni a pancreatic tumor markers (CA 125, CA 19-9, CA 72-4) amachitika kokha m'maofesi a dera la Ural. Mtengo wodziwitsa ndi ruble 1800. ndi ma ruble 150. kwa magazi a venous.

Kudikirira nthawi yayitali bwanji?

Zotsatira za kuwunika kwa zotupa ziyenera kudikirira masiku 5 - iyi ndi nthawi yanthawi yomwe zipatala zambiri ndi malo azachipatala amafunikira kuti aphunzire zomwe akuphunzira.

Pafupifupi 90% ya odwala amafa ndi khansa ya pancreatic m'chaka choyamba chodziwitsa. Chifukwa chachikulu ndi njira yotsatila yamatenda ndi kupita kwa dokotala pambuyo pake. Kudziwona kwakanthawi kachitidwe ka oncological pogwiritsa ntchito chotupa m'magazi kumapangitsa kusankha njira zoyenera zamankhwala ndikusinthira matendawo kuti apulumuke.

Tikuthokoza chifukwa chopatula nthawi kumaliza kafukufukuyu. Malingaliro a aliyense ndiofunika kwa ife.