Syndrome Carcinoid: iimpawu, isifo kwaye afumane unyango

izibalo Medical zibonisa ukuba inani somhlaza sele abaye besanda ngokwanda. iziphumo ebulalayo ukusuka kubhalwe ngakumbi qho ngonyaka. Le nto yonke okhathaza kwaye ubangela, amagqirha, ukuba aqhube umsebenzi othintelo phakathi kwabantu ukuze ugcine kancinci ukukhula ndlongo bandise.

syndrome Carcinoid: ntoni na?

Carcinoid - oku nethumba uqhelekileyo iiseli kwenkqubo neuroendocrine. Ezi seli lube naliphi na iziko kunye namalaphu. Owona msebenzi wabo - ukuphuhlisa iiproteni esebenzayo kakhulu. Malunga asibhozo ekhulwini zonke carcinoids ibekwe iphecana zesisu, indawo yesibini le emiphungeni. Kakhulu ngakumbi, babengafane amahlanu ekhulwini kuphela iimeko, nangezilonda zifumaneka kwezinye izigqeba kunye namalaphu.

syndrome Carcinoid kwethumba carcinoid ngeke yahlukanisiwe ukusuka kwenye nenye, njengokuba syndrome - iseti iimpawu ezivelayo kule yangasemva ukukhula kunye umsebenzi yobubi. Ngapha koko, umzimba uyiphendula ukungena hormone igazi secreted yi nethumba. carcinoids kwesisu inokuba "sisidenge", oko akuthethi ukuzibonakalisa de kube lelo xesha kude kukho metastases kwaye sifo ukuya kwi-terminal eqongeni.

izizathu

Abaphandi nangoku ulwazi ngokwaneleyo ukuqonda isizathu sokuba ukuphuhlisa syndrome carcinoid kwethumba carcinoid. Izazinzulu ukwakha nantoni na awayefike sele malunga umyalezo sifo, kodwa bonke ayavuma ukuba amajoni omzimba kwinqanaba elithile liyayeka ukuba baqaphele iiseli mutated inkqubo APUD (ungayiqondiyo of oonobumba bokuqala la magama, "Amen," "ezihlangwini", "ingxenye", "decarboxylation" ).

Iseli umhlaza enye ukuze uthatyathwe kuwo liphuhlise ukukhula entsha ngokupheleleyo ukuba uya kuvelisa hormone ongayiguqula ukuba sihambelane neemfuno zenu zonke iinkqubo kwemichiza emzimbeni womntu.

Pathogenesis

ingaqala njani carcinoid syndrome? Yintoni na nokuthintela njani? Njengoko iiseli neuroendocrine ibekwe wonke umzimba, kunye ezibonisa kwezonyango nethumba phantse akayeki inkqubo, oogqirha bengenako.

Ngesinye isihlandlo iseli "ukusilela" DNA leyo incamatheliswe mhlawumbi ngokungachanekanga iyaqhubeka ukusebenza Isiqwenga yonakele. Oku kukhokelela ukuphazamiseka komsebenzi iseli neyantlukwano yayo olungalawulwayo. Ukuba umzimba usempilweni, amajoni omzimba iza basabela njani ukuguquka kwaye ukuba balahle loo nto ekrokrisayo. Ukuba oku akwenzeki, ngoko ke iseli ndibandise, iza kudala izigidi iikopi ze uqale ukuba lwandile ngabona ubuthi omzimba kunye iihomoni.

oogqirha besilela ngokufuthi ukuchonga indawo ithumba, nangona lingaze carcinoid syndrome.

Carcinoma kwemiphunga

ishumi ekhulwini kwirejistara isixokelelwano sokuphefumla kuphela inokuphuhlisa ukudumba kwaye, ngenxa yoko, carcinoid syndrome. Imiqondiso kwemiphunga iya kuba non-ngqo, yaye maxa kwaphela. Oku kubangelwa ubukhulu elincinane ngokwentelekiso yamathumba kunye nokungabikho Ukudlulela. Izigulane zifuna uncedo ukususela isifo eliphezulu kwaye, njengoko umthetho, kungekhona somdlavuza, kwaye eyokuqala ukuya therapist. Yena waba azamile ukunyanga bronchiolitis, isifuba okanye ukusilela yokuphefumla, de ibe bubukho orhanelwa inkqubo somhlaza.

Iimpawu kule meko Nedlac:

• iyangongoza, iyangongoza;
• ukuqunjelwa;
• bavakalelwe nobushushu hawu igazi isiqingatha ongentla umzimba;
• isikhohlela, uphelelwa umoya;
• bronchospasm.

Nale isethi ukuphazamiseka kunganzima ukuba eko carcinoid. Akukho ngokuncipha, okukhulu ukwehla kobunzima, ukuncitshiswa sifo, ukudinwa kunye nezinye iimpawu uphawu yenkqubo somhlaza.

ithumba yesisu amancinci

In emathunjini amancinci kancinci qho ngaphezu kwi kwemiphunga, nethumba kubhaliwe kunye nephepha layo carcinoid syndrome. Iimpawu kulo inqabile kakhulu. Kudla kukho non-ngqo iintlungu esiswini kuphela. Oku kubangelwa ubukhulu encinane nethumba. Ngamanye amaxesha akukho akukwazeki ukuba ndafumana kwimisebenzi. Imfundo kaninzi kubonwa ngengozi ngethuba loviwo radiology.

malunga kuphela ishumi ekhulwini zonke yamathumba yethumbu encinane umyalezo we unobangela onaso carcinoid. Kuba ugqirha, oku kuthetha ukuba inkqubo iye okubulalayo kwalutyhutyha esibindini. Ezi yamathumba kunokubangela obturation le mithambo yethumbu kwaye ngenxa yoko, emathunjini. Isigulane uza ukuya esibhedlele kunye zabasebenzi-kwanjengenimba, isicaphucaphu, ukugabha kunye ukuphazamiseka kwesitulo. Kwaye unobangela wale meko bazi kuphela phezu kwetafile yokusebenza.

Uphazamiseko ukuze kunokubangelwa ubungakanani ithumba ngqo kunye torsion emathunjini ngenxa izenzakalo abanesigulo kunye ukudumba inwebu yangaphakathi. Ngamanye amaxesha umonakalo ziphazamisa igazi kwemali ukuya kwindawo kwamathumbu, nto leyo ekhokelela necrosis kunye peritonitis. Nayiphi na yezi meko kukuba ubomi emngciphekweni yaye kungakhokelela ukufa isigulane.

A Ithumba ye isihlomelo

Yamathumba ze isihlomelo - kwisehlo ezinqabileyo ngokwayo. Phakathi kwabo carcinoids abahlala kwindawo ebekekileyo yokuqala, kodwa ngenkankulu ukuba carcinoid syndrome. Iimpawu yabo ezinqabileyo kakhulu. Ngokuqhelekileyo, oko iziphumo pathologists emva appendectomy. Ukudumba ngobukhulu yi sentimitha ngaphantsi kwesinye kwaye uziphatha kakhulu "cwaka". Amathuba okokuba emva kokuba ukususwa ithumba ye isihlomelo uvela kwenye indawo ethile, zingabalulekanga.

Kodwa ukuba ithumba kubonakele ku ngeesentimitha ezimbini ubukhulu, yaye ngaphezulu, kufuneka uqaphele Ukudlulela kwiindawo nkovu zasekuhlaleni kunye nokusasazwa kweeseli ithumba kwamanye amalungu. appendectomy eziqhelekileyo meko azikwazi ukumelana zonke luhlola kwaye kuya kufuneka ukuba nomtsalane oncologists ukuqhuba unyango ebanzi.

ngamathumba efakwa carcinoid

Enye lizwe, apho phantse ingachazwayo carcinoid syndrome. Akukho zimpawu nethumba yaye ngempazamo ezifumaneka ngexesha iinkqubo zokuxilonga ezifana colonoscopy okanye sigmoidoscopy.

Amathuba yobubi (yobubi), kunye ukubonakala metastases ezikude kuxhomekeke kubungakanani thumba. Ukuba mkhulu netoti iisentimitha ezimbini, umngcipheko iingxaki imalunga asibhozo ekhulwini. Ukuba Ithumba akuthethi kuthi ukuya ku sentimitha enye ububanzi, unokuqiniseka ukuya kumashumi asithoba anesibhozo ekhulwini, akukho Ukudlulela.

Ngoko ke, indlela kunyango kwezi meko ezimbini ezahlukeneyo. A Ithumba encinane lisusiwe resection ngokuqhelekileyo enoqoqosho ikholoni, yaye ukuba kukho iimpawu yobubi, oko kwakuya kufuna ukususwa lonke ikholoni, ngokunjalo ichemotherapy.

carcinoid esiswini

Kukho iindidi ezintathu carcinoid yamathumba esiswini, ebangela carcinoid syndrome. Iimpawu zohlobo yokuqala yamathumba:

• Ubukhulu amancinci (ukuya kwi-1 cm);
• ikhondo elihle.

ukwanda kunokwenzeka kunzima nethumba xa inkqubo nokhupho isisu. Bona ezinxulumene igazi pertsinoznoy okanye gastritis engapheliyo umguli. Unyango yamathumba enjalo ukufumana inhibition somatostatin zokukhokhela gastrin okanye gastrectomy.

Uhlobo lwesibini ithumba ekhula kancinci, akufane zibe ngumhlaza. Bona zimandla izigulane yokugula ezifana neoplasia ezidalwe ezininzi. Musani ukumangaliswa kuphela isisu, kodwa ingaba pineal, lengqula nobubovu, injeke.

Uhlobo lwesithathu ithumba - a nangezilonda enkulu bekhula esiswini esempilweni. Ba yingozi, zingene nzulu eludongeni umzimba nokunika metastases ezininzi. Kungabangela perforation kwegazi.

Yamathumba le colon

Amathumbu amakhulu - yindawo apho sesona ngoxilongo syndrome carcinoid kwethumba carcinoid. Photo isifo ngethuba loviwo yabantu abangakwaziyo kwamathumbu ibonisa ubukho ezinkulu (iisentimitha ezintlanu okanye ngaphezulu) ngamathumba. Baya iyakhula ukuba ezalathelwe nkovu lwengingqi kwaye phantse ngamaxesha amabi.

Oncologists kwiimeko ezinjalo bacetyiswa ukuba utyando olukhulu kunye adjuvant kunye ichemotherapy neoadjuvant ukuphumeza ukusebenza ngcono. Kodwa ukusinda abane kwezi zigulane isekhona nezinzima.

Syndrome Carcinoid: Iimpawu, iifoto

Ke iziphiwo syndrome carcinoid kuxhomekeke koko izinto kumbiwa ithumba. Oku serotonin, bradykinin, histamine okanye chromogranin A. Imiqondiso ezininzi lifana sifo zezi:

• Anozizi ubuso nomzimba ongasentla. Senzeka phantse zonke izigulane. Ehamba ekwenyukeni lobushushu. Ukuhlaselwa kwenzeka ngokuzenzekelayo, ukuba kuxhokonxwa utywala, uxinezeleko okanye ukuzilolonga. Kulo mzekelo, kukho tachycardia, xi tsakisi.
• USatyo esitulweni. ¾ isipho kwizigulane. Ngokuqhelekileyo, oku kwenzeka ngenxa kwinwebu ukuba inwebu kwiinwebu phecana wokudla, ukuphazamiseka of namathumbu kokuphazanyiswa.
• Ukuphazamiseka Zezomntu izicwangciso zentliziyo obekwayo isiqingatha kwizigulane. Carcinoid syndrome ikhuthaza ukubunjwa yentliziyo nokufakelwa stenosis kwaye ebangela ukungaphumeleli intliziyo.
• Ukutswina emiphungeni ngenxa spasm le bronchi.
• neentlungu esiswini linxulunyaniswa ukuvela metastases esibindini, emathunjini okanye ithumba ukuwubona kwezinye izigqeba.

nengxaki Carcinoid - isimo iphawulwa nokwehla okukhulu koxinzelelo xa kusenziwa utyando. Ngenxa yoko, izigulane elawulwa somatostatin ukuya zazo efanayo.

ekuxilongweni

Ngaba kunokwenzeka ukuba ukufumanisa carcinoid syndrome? Gns, iifoto, unyango saa kwizigulo akuthethi unika umfanekiso ocacileyo lwezonyango, akukho iziphumo ezibonakalayo. Isikakhulu ithumba - ngengozi ufumane ugqirha okanye ray. Ukuze ukuqinisekisa ubukho yamathumba, kuyimfuneko ukwenza biopsy le ndawo abachaphazelekayo sihlolisise kwithishyu.

Uyakwazi futhi ukusebenzisa uvavanyo ukuze ukubona imigangatho ephakamileyo emzimbeni, kodwa ezi data kusenokuba kubonisa ezinye izifo, kwaye ugqirha kufuneka uku bana phandle nguwuphi na kubo anayo ukuyenza. Uvavanyo kakhulu ezithile linani-5-hydroxyindoleacetic acid. Ukuba inqanaba layo siyandiswa, amathuba carcinoid - phantse 90%.

chemotherapy

Ngaba kusengqiqweni ukunyanga ichemotherapy-carcinoid syndrome? Gns, photo isifo kwi EGD biopsy ezalathelwe nkovu zengingqi kunye notshintsho hormone anganika ugqirha ufifi iingxaki ukuba kwabangelwa isigulane phambi ithumba. Ukuba lentelekelelo elingamncediyo kumguli nokuba kususwe nethumba, iingcali ukucebisa bangabheneli ichemotherapy.

Amaninzi, oogqirha basebenzisa arhente cytotoxic ukuba zinqanda ukukhula kunye nophuhliso yamathumba. Kodwa ngenxa yenani elikhulu yeziphumo ebezingalindelekanga yale ndlela kucetyiswa kuphela kwiimeko ezingxamisekileyo. Ngaphandle ukusebenza kwayo - 40% nje kuphela.

unyango lingaze

Kukho iimvakalelo ntofontofo ukuba kuvandlakanywa kwi imvelaphi ezimbi ezifana syndrome carcinoid, ithumba carcinoid. Iimpawu zidla ukuba izalana ngokusondeleyo uhlobo hormone ikhupha thumba. Ukuba oku serotonin, isigulana yokunciphisa emiselweyo. Ukuba 'umhlaseli "eziphambili histamine, ngoko kuza kucaca blocker receptors histamine in kunyango.

nucleoside zokwenziwa of somatostatin zifunyenwe, ukunciphisa iimpawu ngama 90%. Bona zinqanda imveliso emzimbeni emininzi zinoxanduva indawo yabo iqinile ukunyanga esi sifo.

therapy operative

Inyathelo elibalulekileyo uphathwa ukususa ithumba emzimbeni, Usingxoke metastases resected, isibindi kwemithambo tubal.

Ngomhla umthamo kotyando echaphazela indawo kunye nobungakanani nangezilonda, ubukho okanye ukungabikho metastases. Amaninzi, oogqirha ukususa inxalenye enesifo lomzimba, kunye neephakheji nodes nkovu lwengingqi. Ngokuqhelekileyo, kuba ngokwaneleyo ukuze asindise abantu carcinoid ngonaphakade. Kwiimeko phambili, xa unyango ephilisayo akunakwenzeka, isigulane kumenywa ukuba bachithe embolization kwemithambo hepatic ukususa iimpawu zesi sifo.

Outlook

Yintoni ukulindela izigulane ukuba unesifo syndrome carcinoid kwethumba carcinoid? Siwasebenzise, iyangongoza kunye ezikwenza Ukuphelelwa, kungenzeka ukuba ahlale nabo de kwasekupheleni kobomi, kodwa kuya kuba ngaphantsi ngokukhawuleza emva konyango.

Medicine, kukho iimeko apho izigulane wahlala iminyaka engaphezu kweshumi emva kotyando, kunye nonyango nomqondiso. Kodwa avareji ubomi babo malunga 5-10 iminyaka. I-ALS zinkulu ithumba ise kwemiphunga, neyona - kwisihlomelo.