Carcinoid chirwere: zviratidzo, kuongorora chirwere uye kurapwa

Medical nhamba dzinoratidza kuti uwandu kenza rave kuramba kumuka. Zvinouraya zvaitika kubva kuwedzera akanyorwa ose gore. Izvi zvinonyanya anotambudza uye anoita vanachiremba kuti kuitisa chokudzivirira basa pakati vanhu kuti varambe zvishoma hasha rwakakura kukura.

Carcinoid chirwere: chii?

Carcinoid - ichi ndicho bundu Masero ari neuroendocrine hurongwa. Masero aya anogona kuva chero nhengo uye munyama. chikuru basa ravo - kukura zvikuru vanoshingaira mapurotini. About makumi masere muzana carcinoids zvose dziri mune nemudumbu, panzvimbo yechipiri ndiwo mumapapu. Zvikuru kashoma, muzana shanu chete nyaya, namamota zvinowanikwa nedzimwe nhengo uye munyama.

Carcinoid chirwere uye carcinoid bundu haagoni kuparadzaniswa mumwe, sezvo chirwere - kuva zviratidzo kuti azviise pakanyorwa kukura uye basa malignancy. Pashure pezvose, muviri ikasakendenga achipinda mahormone ropa secreted nokuda bundu. bowel carcinoids kungava "mbeveve", kureva hakuiti unooneka kusvikira nguva yakadaro kusvikira pane metastases uye hosha asingadi kupinda inouraya pachikuva.

zvikonzero

Vaongorori asati ruzivo zvakakwana kunzwisisa nei kuva carcinoid chirwere uye carcinoid bundu. Masayendisiti anogona kuvaka hypotheses nezvechirwere etiology, asi zvose kubvumirana ndechokuti zvirwere dzimwe nguva haizorambi kuziva mutated masero APUD maitiro (ane Acronym tsamba mashoko okutanga "Ameni," "akazotsiviwa", "kuitwa", "decarboxylation" ).

A chete kenza sero kuti kunze kwayo noushamwari kwakakwana kukura itsva kuti ichabereka hormone kuchinja kuti zvienderane zvaunoda zvose nokukanganisika pezvakaitwa ari mumuviri womunhu.

pathogenesis

Sei kuva carcinoid chirwere? Chii uye sei kuzvidzivisa? Sezvo neuroendocrine masero iri yose muviri, uye kurapwa kuratidzwa bundu rinenge haagumiri muitiro, vanachiremba havana kukwanisa.

Pane imwe nguva ari muchitokisi iri "kukundikana" DNA riri akapora kana zvisiri anoramba kushanda pamwe wakakanganiswa chaenga. Izvi zvinotungamirira nokuvhiringidzirwa muchitokisi nerevane wayo kusingadzoreki kupesana. Kana muviri utano, masoja emuviri vanoita kuti mutation uye kubvisa ari kufungira chinhu. Kana izvi zvikasaitika, ipapo sero Ndichawanza, achasika mamiriyoni emaBhaibheri uye kutanga kuparadzira nomuviri muchetura uye mahormone.

vanachiremba kazhinji vanokundikana kuona nzvimbo bundu, pasinei symptomatic carcinoid syndrome.

Carcinoma of bapu

gumi muzana dzokushungurudzwa ari kufema ino chete anogona kuva kuzvimba, uye somugumisiro, carcinoid syndrome. Nezviratidzo zvemapapu vachava non-zvakananga, uye dzimwe nguva haana zvachose. Izvi nokuda duku kukura namamota uye kusavapo metastasis. Varwere kutsvaka rubatsiro kubva yepamusoro chirwere uye, sezvo mutemo, kwete oncologist, uye vokutanga kusvika chiremba. Aikwanisa akanga remuSamoa kurapa bronchiolitis, asima kana kufema kukundikana, kusvikira vakafunga pamberi kenza kwacho.

Zviratidzo hazvisi atypical:

• palpitations, palpitations;
• dyspepsia;
• kunzwa kupisa nenhokwe ropa rokumusoro hafu kwemuviri;
• kukosora, kupfupika mweya;
• bronchospasm.

With yakatarwa iyi zvirwere asingarambiki vanofungidzirwa carcinoid. No kuparadzwa, zvikuru uremu, zvinoderedza pamusoro kutapata, kurukutika uye zvimwe zviratidzo runozivisa kenza kwacho.

diki bowel mota

Muna ura duku zvishoma kakawanda kupfuura zvemapapu, bundu yakanyorwa uye zvichabatsira carcinoid syndrome. Zviratidzo nayo mashoma chaizvo. Kazhinji pane non-zvakananga abdominal marwadzo chete. Izvi imhaka duku kukura bundu. Dzimwe hazvibviri kuwana kunyange kushandiswa. Education Kazhinji netsaona munguva radiological kuzviongorora.

pamusoro chete gumi muzana namamota zvose duku ura pamusoro etiology ose mhaka carcinoid syndrome. Nokuti chiremba, ichi zvinoreva kuti kwacho ave akaipa uye kupararira chiropa. mapundu aya anogona kukonzera obturation pamusoro lumen ari ura uye somugumisiro, intestinal mhingaidzo. Murwere anouya kuchipatara nokutambura-kufanana nemarwadzo, kuda kurutsa, kurutsa uye kusagadzikana chair. Uye mhaka ichi vachaziva chete patafura uchishandisa.

Mhingaidzo anogona kukonzerwa zvakananga bundu saizi uye torsion ura nokuda mananara fibrosis uye kuzvimba mucous membrane. Dzimwe mavanga kunokanganisa ropa riyerere kuti bowel nharaunda, iyo inotungamira necrosis uye peritonitis. Chero ava ezvinhu chinouraya uye zvingaita kuti rufu nomurwere.

Bundu of okuwedzera

Namamota of okuwedzera - isingawanzowanikwi kuwanika pachako. Pakati pavo carcinoids kugara nzvimbo yairemekedzwa pakutanga, asi zvakaoma kukonzera carcinoid syndrome. Zviratidzo zvavo zvikuru zvishoma. Kazhinji, ndiwo zvakawanwa pathologists pashure appendectomy. Kuzvimba kukura idukusa chimwe sendimita uye achiita chaizvo "kunyarara". Mikana yokuti pashure kubviswa bundu iri okuwedzera rinowanika mune imwe nzvimbo, vasingakoshi.

Asi kana bundu rakanga dzakaonekwa mune masendimita maviri kukura, uye zvakawanda, unofanira kuva vasingafariri metastasis vari munharaunda node nodes uye kufambiswa bundu masero mune dzimwe nhengo. Munhuwo appendectomy pakadai haagoni kurarama zvose screenings uye vachafanira kukwezva oncologists kuitisa izere kurapwa.

Rectal carcinoid anomera

Mumwe localization, umo anenge asina akaratidza carcinoid syndrome. No nezviratidzo bundu uye netsaona panguva chirwere maitirwo ezvinhu akadai colonoscopy kana sigmoidoscopy.

The ndingangokuvara malignancy (malignancy), uye chitarisiko metastases kure kunoenderana kukura bundu. Kana mukuru kupfuura dhayamita pamusoro masendimita maviri, mukana yematambudziko anenge makumi masere muzana. Kana bundu harimiri mumwe sendimita mu dhayamita, unogona kuva nechokwadi kuti makumi mapfumbamwe namasere muzana, hapana metastasis.

Naizvozvo, nzira kurapwa mune izvi nyaya mbiri yakasiyana. Bundu duku chinobviswa kazhinji mari resection pamusoro muura, uye kana pane zviratidzo malignancy, izvozvo zvingada kubviswa yose muura, uyewo mishonga.

gastric carcinoid

Kune mhando nhatu carcinoid mapundu mudumbu, zvichikonzera carcinoid syndrome. Zvaidiwa wokutanga mhando anomera:

• miganhu diki (kusvika 1 cm);
• benign kosi.

Possible kuparadzirwa bundu zvakaoma kana kwacho rinoburitsa yose dumbu. Vari chokuita pertsinoznoy kupererwa neropa kana chirwere gastritis mune murwere. Treatment anomera akadaro kugamuchira somatostatin chinovhiringidza kuti kugadzirwa gastrin kana gastrectomy.

The mhando bundu wechipiri inokura zvishoma nezvishoma, kashoma kuva kenza. Ndivo dzakakurumbira varwere vane majini chirwere akadai vakawanda kwemakemikari anobudiswa neoplasia. Musashamisika chete mudumbu, asi pineal shwanu, thyroid shwanu, rwatata.

Chechitatu mhando bundu - hombe mapundu kukura mune mudumbu utano. Vane nyanyisa, pinda vanyura muviri kumadziro uye zvinopa vakawanda metastases. Zvingakonzera perforation uye ropa.

Namamota of muura

The guru ura - ndiyo nzvimbo inonyanyoshandiswa chirwere carcinoid chirwere uye carcinoid bundu. Photo mucosa munguva Kuongorora bowel chidimbu rinoratidza kuvapo guru (masendimita mashanu kana kupfuura) anomera. Ivo metastasize kune kwematunhu node nodes uye inenge nguva nyanyisa.

Oncologists Muzviitiko vakadaro akanyeverwa yakakura kuvhiyiwa pamwe adjuvant uye neoadjuvant mishonga kuti vabudirire nani kushanda. Asi Kupona fungidziro varwere izvi richiri zvisingafadzi..

Carcinoid Syndrome: Zviratidzo, mapikicha

The zvinoratidza carcinoid chirwere kunobva chii zvinhu zviri zvikaramba bundu. Izvi zvinogona kuva kweserotonin, bradykinin, histamine kana chromogranin A. The kupfuura mifananidzo zviratidzo chirwere vari:

• Akatsvuka kumeso uye yokumusoro muviri. It kunoitika Varwere anenge zvose. Achiperekedzwa yomunzvimbo kuwedzera tembiricha. Kurwisa zvaitika, vanogona kuva kukonzerwa doro, kushushikana kana muviri. Muchiitiko chino, pane tachycardia, kumanikidza anodonhedza.
• Kushungurudzwa nechigaro. ¾ chipo pavarwere. Kazhinji, izvi kunoitika nokuda kutsamwa ari mucous Kamudzira ari zvomudumbu turakiti, kusagadzikana bowel mhingaidzo.
• Kuvhiringidza komoyo kuri mumashoko hafu varwere. Carcinoid chirwere inosimudzira paumbwe mwoyo vharafu stenosis uye kunokonzera cardiac kukundikana.
• Wheezing mumapapu inokonzerwa spasm yacho principales.
• Abdominal marwadzo Rinobatanidzwa ne kwaita metastases vari chiropa, intestinal mhingaidzo kana bundu kupindirwa kupinda dzimwe nhengo.

Carcinoid dambudziko - chirwere kuti kunoratidzwa unopinza ichidonhedzera kumanikidzwa pakuvhiya. Naizvozvo, varwere dzakabatwa somatostatin kuti zvakafanana manipulations.

Diagnostics

Zvinoita here kuziva carcinoid chirwere? Signs, mapikicha, zvakasiyana kurapwa zviratidzo haripi pachena kunotoda mufananidzo, pasina mhinduro yaionekwa. Kakawanda bundu - kwetsaona kuwana chiremba kana radiologist. Kuti asimbise pamberi namamota, zvakafanira kuita biopsy pakati njodzi nzvimbo uye vaongorore tishu.

achiri Unogona kushandisa bvunzo kuziva rakakwirira kwevari mahormone, asi mashoko aya angava anoratidza zvimwe zvirwere, uye chiremba ane kufunga pakati pavo zvaanazvo kuita. Chinonyanya chaicho bvunzo inhamba 5-hydroxyindoleacetic acid. Kana zvayo pamwero rwuchiwanzwa, kuti ndingangokuvara carcinoid - anenge 90%.

mishonga

Zvine musoro kuti kurapa mishonga-carcinoid chirwere? Signs, Photo mucosa pana EGD biopsy remunharaunda node nodes uye kuchinja kwemakemikari omuviri vanogona kupa chiremba nzwisisei kuti matambudziko kuti zvinokonzerwa murwere pamberi bundu. Kana kushurudzira iri vanoshorwa murwere kunyange kana kubviswa bundu, penyanzvi angarayira kushandisa mishonga.

Kakawanda, vanachiremba vanoshandisa cytotoxic yomuchipatara kutitadzise kukura anomera. Asi nekuda vakawandisa divi migumisiro nzira iyi inokurudzirwa chete kana zvashata. Kunze kugona kwaro - 40 chete%.

symptomatic kurapwa

Pane zvakanaka kunzwa kuchengetwa pamusoro pakanyorwa pathologies akadai carcinoid urwere, carcinoid bundu. Zviratidzo sevanonyanya raikonzerwa mhando kemikari kuti anosunungura bundu. Kana ichi chiri kweserotonin, murwere Mushonga Nachiremba antidepressants. Kana mukuru "kurwisa" ndiko histamine, chiuyai yakatsviriridza blockers histamine receptors vari kurapa.

chakaita zvokugadzirwa analogues ose somatostatin akawanikwa, nokuderedza zviratidzo nokuda anenge 90%. Ivo tunodzivisa kugadzirwa mahormone akawanda kuti vane basa nzvimbo yavo yakasimba pakurapa chirwere ichi.

kushanda kurapa

Danho rinokosha mushonga ndiko kubvisa bundu kubva pamuviri, munobvunzisisa resected metastases, chiropa tsinga ligation.

On bhuku kuvhiyiwa rinokanganisa nzvimbo uye ukuru namamota, kuvapo kana kusavapo metastases. Kakawanda, vanachiremba vanovhiya kubvisa hosha chikamu muviri, uye Mabhokisi pakati remunharaunda node nodes. Kazhinji, zviri zvakakwana kuponesa vanhu kubva carcinoid nokusingaperi. In yepamusoro nguva apo hunorapa kurapwa hazvibviri, murwere anokokwa kupedza embolization ari hepatic tsinga kubvisa zviratidzo chirwere.

mataridzikiro

Chii kutarisira varwere nechirwere carcinoid chirwere uye carcinoid mota? Flushing, palpitations uye tichibatwa breathlessness, kungangova kuramba navo kusvikira pakuguma kwoupenyu, asi achava zvishoma raidudzwa pashure kurapwa.

Medicine, pane zviitiko apo varwere akararama pashure pokuvhiyiwa makore anopfuura gumi, uye symptomatic kurapa. Asi avo avhareji upenyu hupfupi makore anenge 5-10. Kuipa fungidziro vari bundu riri yemapapu, uye yakanaka - iri okuwedzera.