Neuroblastoma kubantwana, 4 yeqonga. Oonobangela, iimpawu, iimpawu, abantu abane. unyango neuroblastoma komntwana

Neuroblastoma - a umhlaza inkqubo novelwano luvo. Kwiimeko ezininzi, esi sifo ibanjiwe kubantwana abaselula. Ngexesha ubhaqo lwalo kwandisa amathuba bachache ngokupheleleyo. Ukususela mathiriyeli kweli nqaku uza kufunda oonobangela ezingundoqo zesi sifo, yintoni mpawu oko kukhatshwa, apho kufuneka unyango.

uhlobo ezimangalisayo yineuroblastoma emntwaneni

Neuroblastoma - kakhulu eqhelekileyo Ithumba abulalayo umlinganiswa. Okubangela ukuba malunga ne-15% yazo zonke iimeko ingxelo yamathumba kwethuba lweentsana kunye kwabaNtwana abasaKhulayo. Iingcali ibonisa Ithumba ngabantwana ukuya kwiminyaka emihlanu ngokubanzi, kodwa ke kukho iimeko zesi sifo olufikisayo 11 kunye neminyaka eli-15. Ngenxa ukukhula kunye nophuhliso umntwana kusenokwenzeka ukuba kujamelana sifo singanyangekiyo lifinyele ngonyaka ngamnye.

Ekweneni neuroblasts, ngokutsho oogqirha, oko sinikezwe amangalisayo. Kuyinto nolaka ingakumbi futhi bewenza Ukudlulela kuyo nayiphi na ilungu lomzimba indlebe. Amaninzi ubunzima ngenxa umsebenzi wayo ngethambo kunye nenkqubo emithanjeni. ukukhula neuroblast Ngamanye amaxesha oogqirha esisigxina nakujoliso olutsha kwisahlulo babo ukuyilwa olulandelayo yamathumba. Yena kuqala metastasizes, ngoko gxotha uphuhliso yayo aze aqalise umva. Ezinezigulo lolunye uhlobo zimpawu iimpawu ezinjalo.

Brain neuroblastoma kubantwana wancinwa kuqala zizazinzulu evela eJamani, Rudolfom Virhovym ngo-1865. Ugqirha ebizwa ithumba "glioma." A engamashumi ezimbalwa kamva sisazinzulu American Dzheyms Rayt luphononongwa ngokweenkcukacha neoplasm yaye wachaza ngokweenkcukacha inkqubo nokubunjwa kwayo.

Izigaba zophuhliso neuroblastoma

Njengazo naziphi na ezinye nangezilonda umhlaza, neuroblastoma ebantwaneni uhamba kwizigaba ezininzi zophuhliso lecondzile, njengoko kuchaziwe ikuvumela ukuba abele an unyango olusebenzayo:

• Isigaba 1 luphawulwa bubukho yamathumba resectable lobungakanani esiqela lingayifumenanga ngaphezu kwe-5 cm, kunye nokungabikho metastases nkovu node.
• Step 2A. Ubungqina yamathumba localized, uninzi lwazo isuswe.
• Inyathelo 2B. Nkovu node metastases kwenzeka unilaterally.
• Inyathelo 3. Sibe ukubonakala yamathumba abambiseneyo.
• Inyathelo 4 (A-B). Neoplasm likhula, kukho Ukudlulela ukuba umongo, isibindi kunye zamanzi.

Kwakhona simele sicinge indlela nqanaba lokugqibela zokuphuhlisa neuroblastoma ebantwaneni. Inyathelo 4 iyahluka nto iyinqaba neoplasias neempawu zebhayoloji kuphumla, abe ALS elungileyo, ukuba unyango ngexesha elililo unika izinga basinde.

Eyona eziphambili ezibangela wophuhliso ithumba

Neuroblastoma, kwakunye nezinye iintlobo zomhlaza, ukuvela kwimvelaphi kwiDNA kwi eziphilayo. Okwangoku, ochwepheshe bathi kuphakamisa le tshintsho. Kuthathwa ukuba indima edlalwe yi izinto ekuthiwa umhlaza, oko kukuthi, iikhemikhali kunye nemitha. Iiseli fuzo kubangele aqale ukwanda, bakha ithumba. neoplasm elinobuhlungu luphawulwa ikhono ukwabelana eyahlula ukusuka ebubonisayo.

Ngokuguqula imizila ye ukumqumbisa ukuyilwa yineuroblastoma kuvela kwixesha lophuhliso ezingekazalwa okanye ngokukhawuleza emva kokuzalwa komntwana. Ngoko ke, inkoliso izigulane - grudnichki. Imvelaphi nethumba iqala ngo neuroblasts. Oku iiseli zemithambo-luvo ubuntwana, ezo eqalisiweyo olungekazalwa ngexesha kuphuhliso lwayo intrauterine. Xa zesiqhelo neuroblasts ukukhulelwa bacinga ukuba umsebenzi luvo okanye iiseli banoxanduva lokusekwa adrenal.

uninzi lwabo sele kwasekwa ngexesha lokuzalwa komntwana. iiseli ubuntwana ngokuqhelekileyo shwaka. Xa inkqubo zophendlo lwezifo ze neuroblasts ngeli ithuba ibe ithumba. Ubungqina kuphela komhlaza factor - yofuzo. Nangona kunjalo, ubungozi sisifo zamafa engaphenduli ngaphezu-2%.

Amaninzi, oogqirha ukuxilonga yineuroblastoma retroperitoneal, indawo oyithandayo apho eyendawo - amadlala adrenal. Enyanisweni, lo ithumba ezinokuvela naphi na emzimbeni. neuroblastoma Retroperitoneal kubantwana kwenzeka-50% amatyala, 30% ezigulane eziphuhliswe maqhuqhuva ithumba ye-luvo ummandla empontshwa, i-20% abakhetha ukuba kwasendaweni of wesibeleko kunye thoracic.

wenza njani ithumba?

Xa lokuqala nqanaba lenkqubo zophendlo lwezifo kwizigulo ezithile hayi zikhona. Ngoko ke, ngoku nethumba kaninzi kubonwa ezinye izifo ezithile kweli qela lobudala.

Iimpawu neuroblastoma ebantwaneni zenzeka kuxhomekeka kwindawo yamathumba emzimbeni, iindawo kuwenza kunye neqondo kwezinto vasoactive. Ngokwesiqhelo, esiludumbo ithumba iphambili kwisithuba retroperitoneal, ngakumbi ngqo kwi adrenal. Kwiimeko ezinqabe kakhulu, oko yenzelwe entanyeni okanye mediastinum.

wenza njani neuroblastoma ebantwaneni? Iimpawu zesi sifo zibangelwa nokukhululwa hormone ngokuthi iiseli umhlaza okanye yamathumba njalo kwenye okanye kwelinye iqumrhu. Maxa wambi ekukhuleni kwayo kuchaphazela ukusebenza amathumbu kunye isinye. Ngenxa ucinezelo kwemithambo yegazi kubaguli kwenzeka isingxobo samatyhalarha naso kunye esiphelweni nokudumba asezantsi.

amabala ukuba yingqombela, nokuba bamantshontsho kwi isikhumba nayo iimpawu yineuroblastoma ebantwaneni. ukubonakala kwazo libonisa ukubandakanyeka kwinkqubo zophendlo lwezifo weeseli epidermal. Ngenxa kwii-nethumba ngqo ngumongo ithambo umntwana iba buthathaka, ngokufuthi uyagula. Kulo mzekelo, nkqu inxeba encinane kunokukhokelela ukopha kakhulu.

Ukuqaphela iimpawu yineuroblastoma, abazali kufuneka udibane nogqirha. efumanise lomhlaza kusekwangoko unako ukusindisa ubomi bomntwana.

neuroblastoma Retroperitoneal

Neoplasm imvelaphi neurogenic kwithishyu okwenzeka kwisithuba retroperitoneal, ebonakala kukukhula ngokukhawuleza. Ngexesha elifutshane, lihlaba kungena emjelweni spinal, ekusekeni efanayo engqindilili nethumba, leyo ukubonwa Ngokucofa.

Neuroblastoma le ingaba adrenal ebantwaneni ekuqaleni ngakubanampawu ezithile de ifikelela ubungakanani enomtsalane kwaye iqala kukwayamanisa kwizihlunu ezikufutshane. Ziintoni iimpawu ithumba kubonakala?

1. Ubukho nokusekwa ezishinyeneyo kwi kwisisu.
2. Ekweneni umzimba uphela.
3. Ubuhlungu kunye neentlungu kummandla empontshwa.
4. umzimba.
5. Ukunyuka kwamaqondo.
6. Utshintsho Iimpawu igazi waqononondisa kwegazi.
7. Ndindisholo, ukushwabana nemilenze.
8. Akonwabanga iziphiwo olusebenzayo iphecana zesisu kunye nenkqubo womchamo.

Okunye kwasendaweni yamathumba imvelaphi neurogenic

Neuroblastoma ngomva mediastinum kubantwana sikhatshwa ilahleko ubunzima elibukhali, ubunzima igwinya, kukho ukuphazamiseka umsebenzi sokuphefumla. Kwezinye iimeko, esi sifo kukhokelela notshintsho imilo esifubeni.

Yamathumba zaglazno isithuba zinqabile kakhulu, kodwa bazi kabanzi ngazo. Oku kungenxa yokuba zonke iimpawu senkqubo zophendlo lwezifo alibonakali ngeliso lenyama. Neoplasm luphawulwa imbonakalo amabala ezimnyama kwi iliso, elijongeka ukutyumka eqhelekileyo. Olunye uphawu uvikivwa neuroblastoma ijwabu. Oku kuthatha lweliso lakho ngokuchasene nemvelo equmbile.

Iifomu neuroblastomas

Xa iingcali Okwangoku ukwahlula yineuroblastoma iintlobo ezine, nganye eneyazo indawo ethile kunye nokwenza kube neempawu ezikhethekileyo.

• Medulloblastoma. Neoplasm asuka nzulu kwiCerebellum, nto ke leyo ebangele ayisuseki yi uqhaqho. Le ngezifo luphawulwa Ukudlulela ngokukhawuleza. Iimpawu zokuqala umhlaza kuvela incoordination.
• Retinoblastoma. Le Ithumba yobubi ochaphazela retina iliso kwizigulane abaselula. Ukungabikho unyango kukhokelela iyonke kubumfama nobuchopho metastases.
• Neyrofibrosarkoma. Le Ithumba yenzelwe kwisisu.
• Simpatoblastoma. Le Ithumba olubulalayo, ethi "ekhaya" lakhe ukhetha inkqubo onovelwano Wayesoyika adrenal. Neoplasm eqalisiweyo olungekazalwa ngexesha kuphuhliso lwayo intrauterine. Ngenxa yokwanda ngokukhawuleza apha emqolo ukuze bahlukunyezwe ubungakanani simpatoblastomy oko kuthetha ukukhubazeka.

Indlela ukuqaphela neuroblastoma?

Ekuqaleni, lo ugqirha ubeka sifo okukrokrelwayo igazi nomchamo iimvavanyo 'neuroblastoma'. Ebantwaneni, iimpawu zesi sifo ziyafana nezinye izifo, kunye nokuvavanywa kweelebhu izinto eziphilayo ishenxisa ezinye izinto kunokwenzeka. amazinga aphezulu hormone catecholamine kwi umchamo ibonisa ubukho bomhlaza.

Ukuze ubone ubungakanani ithumba, kwasendaweni izigulane alo emiselweyo CT, ultrasound kunye MRI. Enye indlela ebalulekileyo biopsy diagnostic. Ngethuba le nkqubo, ingcaphephe yenza iiseli umhlaza ucingo iimviwo kwilebhu elandelayo, uhlalutyo histological.

Ngokusekelwe kwiziphumo zeemvavanyo ugqirha iphuhlisa Amaqhinga unyango, inika isikhokelo malunga unyango kunye nendlela yobomi malunga nesigulane eso.

ongakhetha therapy

Unyango lwe neuroblastoma kwi umntwana idla inxaxheba kwisebe lwengcali Oncology ezininzi (himioterapevt, ugqirha, ray). Emva kokufunda iimpawu ithumba, oogqirha nokuphuhlisa amaqhinga ngentshabalalo. Kuxhomekeka kwindlela nethumba iphendula imisebenzi eyenziwa ngaphandle, kwaye uqikelelo ngexesha loxilongo lokugqibela.

Ngokubanzi, ukunyanga yineuroblastoma ebantwaneni ibandakanya ezi ndlela zilandelayo:

1. Amachiza. Le nkqubo iquka ukuqaliswa amachiza-umhlaza kwi izikimu eyenzelwe ngokukhethekileyo. Amalungiselelo nempembelelo embi kubume iiseli umhlaza, ukuthintela ukwanda kwabo. Nabo yosulela namanye amalungu omzimba, nto leyo ekhokelela ukuba iziphumo ebezingalindelekanga eqhelekileyo (ilahleko iinwele, isicaphucaphu, isisu esihambisayo). Ukusebenza uthomalaliso linyuke izihlandlo eziliqela kunye abohlukeneyo ezinomongo.
2. unyango Surgical kubandakanya ukususwa yamathumba. Phambi kokuba nokusebenza isicelo ichemotherapy. It ikuvumela ukuba isantya sokukhula thumba netyala Isemantiki of metastases. Admissibility ugcwalise ukususwa yayo ixhomekeke indawo nobukhulu. A Ithumba encinane ekufuphi umnqonqo, ukwenza ungenelelo kuyingozi kakhulu.
3. Radiation therapy in yezonyango mihla isetyenziswa enqabile. Kuyinto ngokuya kwiminyaka yakutshanje indawo uqhaqho ngokunjalo radiation akukhuselekanga kwaye ithwala isoyikiso esithile ukuya ubomi bomntwana. therapy Imitha kucetyiswa ngqongqo bungqina, xa kukho ukusebenza phantsi kwezinye iindlela zonyango, kwimeko yineuroblastoma unresectable ebantwaneni.

Ukudla ekhethekileyo kunye uxilongo izigulane elincinane akayibonisanga. Abazali abaninzi bazama ukumelana nazo zonke iintlobo iindlela lobomi Chad, alungise ukutya kwakhe. Oku kubonakaliswa ukuba ezinye iimveliso okanye, ngaphezulu ncam, izinto ezifumaneka kuzo, ukwandisa zokuzikhusela zomzimba ephawulekayo zinqanda ukukhula yamathumba. izinto ezinjalo ziquka zinc, intsimbi, betaine, iivithamini ezahlukeneyo. Bazizityebi ungeniselo citrus, amabala abaselula, iminqathe, ithanga.

Impumelelo naluphi na unyango kuxhomekeka yineuroblastoma indlela enkulu abantwana. Izinto ezibangela izifo kunye nenqanaba izifo zibalulekile nazo. Ukusetyenziswa iindlela ezinkulu kwi nisaqala ithumba Ukwakheka inika ithemba bachache ngokupheleleyo. Noko ke, oku akuthethi akumkhululi isigulane encinane ukutyelela ugqirha kunye abapasa iimviwo ukwenzela ukuthintela ukwenzeka kunokwenzeka.

Kwenzeke recovery lokugqibela ngaphandle kwi inyathelo yesibini, ukuba umsebenzi ngempumelelo kunye nechemotherapy.

kuvela iingxaki ezithile zigaba bamva bale ngezifo njengoko neuroblastoma. Abantwana isigaba 4 nomhlaza kudla kunye kuqikelelo yedanisayo. Iphinde kunokwenzeka emva kususwa nethumba, kwisiqalo ezibonakala achache. Isizukulwana elandelayo yendalo angendawo ngokuqhelekileyo senziwa kwindawo enye apho ngaphambili. Sase- eli nyathelo yi-20% ukusinda iminyaka emihlanu. Kulo mzekelo, yonke into ixhomekeke uqeqesho eengcali, ukufumaneka izixhobo zonyango eziyimfuneko.

Outlook

Emva olunzulu therapy Oncology ALS kwizigulana kakhulu intle. Abantwana kunye nenkqubo lithumba lobulali, oogqirha bathi kusenokwenzeka ukuba kwakhona ngokukhawuleza kangangoko kunokwenzeka. Ngokumalunga kolu didi yezigulane, nethumba kungaphela ngaphandle kotyando, kodwa unyango zonyango kakhulu kule meko inyanzelekile. Xa abantwana abadala, lwakuba lwandile phandle ithumba, amathuba recovery epheleleyo asezantsi kakhulu. Ngaphezu koko, lo ithumba nga ziphinde zenzeke.

Le ngenxa unyango rhoqo kudlala uneneuroblastoma yesibini ebantwaneni. Kuqikelelo lwemozulu kulo mzekelo asiyiyo kuFeliks. Ithumba angavela kwakhona emva kweminyaka embalwa, kuquka emva unyango ngempumelelo. Olu hlobo kubachaphazela amayeza ekubhekiselwe yeziphumo ebezingalindelekanga kungu. Kungenxa yoko le nto zonke izigulane ngaphandle kokukhetha, emva kwikhondo unyango kuyacetyiswa ngoogqirha uhlala waphawula.

amanyathelo othintelo

Oogqirha musani ukunika naziphi na iingcebiso ezithile lokuthintela uphuhliso uhlobo esibulalayo ye nethumba kwakunye nezizathu yokwakhiwa yayo ayikaqondwa kakuhle, ngaphandle kwe ukuthambekela zamafa afanele. Xa izihlobo close wakha ukujongana mgibe bene ngexesha ucwangciso lokukhulelwa inqweneleka ukuya yokubonisana of zofuzo u doctor-. kusenokwenzeka ukuba siphephe ukuphazamiseka elizayo ezinxulumene nokuzalwa umntwana mpilweni.

Ngelishwa, umhlaza ngoku ngokuya olufunyanwa izigulane abaselula akukho uneneuroblastoma Ngaphandle ebantwaneni. Photo ngezifo inokufumaneka iincwadi reference zonyango ezikhethekileyo. Iindlela ezithile zokuthintela, oogqirha ningayisondezi ngenxa awukacaci umyalezo ngezifo. Xa iimpawu eziphambili lidiza kwesi sifo, kubalulekile ukuba ufune iingcebiso zobugqirha. Kuphela emva kokuba ngokusebenzisa uvavanyo olupheleleyo lokuqonda nga kugweba umlinganiswa nangezilonda nokuphuhlisa isicwangciso engumzekelo unyango. I ingcali ngaphambili aya kuqinisekisa uxilongo lokugqibela, ngcono amathuba sokubuyisela ngokupheleleyo. Hlala uphilile!