Uma umdlavuza uphazamisa amathambo, lokhu kuvame kakhulu ngenxa yomdlavuza ongewona wesifuba oye waqala kwenye indawo emzimbeni futhi wasakazeka, noma wahlelwa emathanjeni. Ngokuphambene nalokho, ukugxila lapha kulawo makhankaso aqala emathanjeni, awaziwa nangokuthi amathrekhi asemathambo ayisisekelo.
Umdlavuza wamathambo oyinhloko empeleni uyisigaba esibanzi, esinezinhlobo eziningi ezihlukene zokuhlukunyezwa, ezinye zazo ezingavamile kakhulu; Kodwa-ke, lawa, i-osteosarcoma, i-chondrosarcoma, ne-Ewing sarcoma yizona ezivamile kakhulu.
Izizathu eziziwa
Nakuba izimbangela zomdlavuza wethambo aziwa ngokuqondile, izinguquko ku-DNA yamangqamuzana anomdlavuza ziyaziwa zibalulekile. Ezimweni eziningi, lezi zinguquko zenzeka ngengozi futhi azidluliswanga kusuka kubazali kuya ezinganeni.
Ososayensi baye bafunda amaphethini okuthuthukiswa ukuze bazame ukuqonda izici ezingozi ezihilelekile. I-osteosarcoma yilona uhlobo lwesithathu oluvame kakhulu lokulimala oluthinta amathambo kubantu abasha, kuqala kuphela i-leukemia ne-lymphoma. I-Chondrosarcoma iphinde ibe ngumdlavuza we-bone oyinhloko, kodwa ivame kakhulu kubantu abadala kunabantwana nasebancane, abaneminyaka yobudala ekutholeni iminyaka engu-51. Ukukhipha i-sarcoma kuvame ukutholakala ukuthi intsha, futhi isilinganiso seminyaka yokuxilongwa singama-15.
Amaphrofayli Okungcupheni Osteosarcoma
I-osteosarcoma iyinhloko yomdlavuza wethambo elivamile kakhulu. Kunemibandela embalwa eyaziwayo yokwandisa izinkinga zokuthuthukisa. Abantu abanesifo esingavamile saso esaziwa ngokuthi i-retinoblastoma yefa liba nengozi eyengeziwe yokuthuthukisa i-osteosarcoma.
Ukwengeza, labo abaye baphathwa ngomsakazo ngokusebenzisa i-radiotherapy kanye ne-chemotherapy banomngcipheko wokwanda kwe-osteosarcoma kamuva ekuphileni.
Ngokusobala, odokotela abaningi bayavuma ukuthi amathambo aphukile nalamelekile nemidlalo ayibangeli i-osteosarcoma. Kodwa-ke, ukulimala okunjalo kungaletha i-osteosarcoma noma i-tumor ekhona kakade ekunakekelweni kwezokwelapha, ngakho-ke kukhona ukuxhumana phakathi kwalaba ababili-kungukuthi ukulimala komshini akubonakali kubangela i-osteosarcoma.
Ubudala, Ubulili, Nezizwe Ezihlobene Nengozi
I-osteosarcoma ngokuyinhloko ithinta amaqembu amabili asezingeni eliphakeme-ukuphakama kokuqala kusekuqaleni kweminyaka eyishumi kanti eyesibili iphakathi kwabantu abadala.
- Kuziguli ezindala, i-osteosarcoma ngokuvamile ivela ethambo elingavamile, njengalabo abathinteka isifo sesifuba eside (isibonelo, isifo sikaPaget ).
- Phakathi kwabantu abasha, i-osteosarcoma iyingqayizivele kakhulu ngaphambi kokuba ineminyaka emihlanu, kanti lesi sigameko siphumelele ngesikhathi sokukhula kwentsha. Ngokwesilinganiso, ummeli "osezingeni elijwayelekile" le-osteosarcoma ebantwini abancane uneminyaka engu-16 ngamantombazane kanye neminyaka engu-18 ubudala yabafana.
I-osteosarcoma ayiqabuki uma iqhathaniswa namanye amagciwane; Kulinganiselwa ukuthi abantu abangaba ngu-400 abangaphansi kweminyaka engama-20 ubudala batholakala ukuthi bane-osteosarcoma minyaka yonke e-United States. Abafana bathinteka kakhulu ezikoleni eziningi, kanti ukukhula kwentsha yase-Afrika kuphakeme kunabamhlophe.
Izingozi Zengozi Okusebenzayo Kubantu Abancane
- Ubukhona bezinkinga ezithile zomdlavuza we-genetic ezingavamile
- Ubudala phakathi kweminyaka engu-10 no-30
- Ukuphakama okude
- Ubulili besilisa
- Umncintiswano wase-Afrika-waseMelika
- Ukutholakala kwezifo ezithile zethambo
Izingozi Zengozi Ezidingekayo Kubantu Abadala
Izifo ezithile zethambo ezifana nesifo sikaPaget , ikakhulukazi ngokuhamba kwesikhathi, zihlobene nengozi eyengeziwe ye-osteosarcoma.
Noma kunjalo, ingozi enkulu iphansi, ngephesenti elilodwa kuphela lalabo abanesifo sikaPaget abake besakha i-osteosarcoma.
Ukuvezwa kweminye imilayezo yinkinga engozini, futhi ngoba isikhathi esivela phakathi kwe-irradiation yomdlavuza kanye nokubonakala kwe-osteosarcoma ngokuvamile kuyisikhathi eside (isibonelo, iminyaka engu-10 noma ngaphezulu), lokhu kuvame kakhulu kunamaqembu asebekhulile.
I-Genetic Predispositions
Ukudalula ama-genetic syndromes we-osteosarcoma kufaka:
- I-Bloom syndrome
- I-Diamond-Blackfan i-anemia
- I-Li-Fraumeni syndrome
- Isifo sikaPaget
- I-Retinoblastoma
- I-Rothmund-Thomson syndrome (ebizwa ngokuthi i-poikiloderma congenitale)
- Werner syndrome
- Ukulahlekelwa komsebenzi we-p53 ne-retinoblastoma i-tumor suppressor geni kukholelwa ukuthi kunendima ebalulekile ekuthuthukiseni i-osteosarcoma.
Nakuba ukuguqulwa kwamagciwane amaqanda (i-egg kanye ne-sperm) we-p53 ne-retinoblastoma izakhi ezingavamile, lezi zakhi zofuzo ziguqulwa eziningi zesampula ze-osteosarcoma, ngakho kukhona ukuxhuma ekuthuthukiseni i-osteosarcoma. Ukuguqulwa kwegciwane emkhakheni we-p53 kungaholela engozini enkulu yokuthuthukisa izifo ezimbi ezihlanganisa i-osteosarcoma echazwe ngokuthi yi- Li-Fraumeni syndrome .
Nakuba ukuguqulwa kwezakhi zofuzo nezifo ze-oncogenes kuyadingeka ukukhiqiza ama-osteosarcomas, akucaci ukuthi yiziphi lezi zenzakalo ezenzeka kuqala nokuthi kungani kwenzeka noma kwenzeka kanjani.
Ama-osteosarcomas kulabo abanesifo se-Paget
Kukhona i-subset engavamile ye-osteosarcomas enesifo esibi kakhulu. Izifo zivame ukuvela kubantu abaneminyaka engaphezu kwengu-60. Izidumbu zikhulu ngesikhathi sokubukeka kwazo futhi zivame ukulimaza kakhulu, okwenze kube nzima ukuthola ukuthengiswa okuphelele (ukukhishwa), kanye namaphasastase wamaphaphu ngokuvamile abekhona ekuqaleni.
Iphrofayli engozini yileliqembu elidala. Bahlakulela cishe ngamaphesenti ayisishiyagalombili abantu abanesifo sikaPaget, ngokuvamile lapho amathambo amaningi ethinteka. Izikhumba zivame ukuvela esikhwameni, isikhwameni esiseduze nasezinkalweni, nasesitheni lesandla eduze kwesigxobo sehlombe; kunzima ukwelapha ngokuhlinzwa, ikakhulukazi ngenxa yobudala besiguli kanye nobukhulu besisu.
Ngezinye izikhathi ukuxoshwa kudingekile, ikakhulukazi uma ithambo liphuka ngenxa yomdlavuza, okuyinto eyenzeka njalo.
I-Parosteal ne-Periosteal Osteosarcomas
Lezi yi-subset ebizwa kanjalo ngokuthi indawo yawo ngaphakathi kwethambo; ngokuvamile i-osteosarcomas enobudlova obonakalayo ebusweni bethambo ehlangene nengqimba yezicubu ezungeze ithambo, noma i-periosteum. Ngokungavamile bangena ezingxenyeni zangaphakathi zethambo futhi abavamile ukuba ama-osteosarcomas amahle kakhulu.
Iphrofayli engozini ye-osteosarcoma yama-parosteal ihluke kuleyo ye-osteosarcoma yakudala: ivame kakhulu kwabesifazane kunamadoda, ivame kakhulu emkhakheni weminyaka engu-20 kuya kwengu-40 ubudala, futhi ivela ngemuva kwethanga, eduze kwamadolo , nakuba noma iyiphi ithambo emasendeni lingathinteka.
I-Osteosarcoma Prognosis ephakeme kakhulu
Izimo eziyingozi ziye zaxhunyaniswa nama-prognoses angcono nakakhulu, kodwa ngeshwa, lezi zici ezifanayo azizange ziwusizo ekuboneni iziguli ezingase zizuze emiphakathini yezokwelapha ezikhudlwana noma ezincane ngenkathi igcina imiphumela emihle kakhulu. Izinto eziyaziwa ukuthi zithonya imiphumela zifaka okulandelayo.
Isitifiketi Esiyisisekelo Sokuhlupha
Ezingxenyeni ezitholakala ezingalweni nasemilenzeni, lezo ezikude kakhulu nomgogodla womzimba, noma i-torso, zine-pregnosis engcono.
Izicubu eziyinhloko ezakha ku-skull kanye nomgogodla zihlobene nengozi enkulu yokuqhubeka nokufa, ikakhulukazi ngoba kunzima ukuthola ukukhishwa okuphelele komdlavuza kulezi zindawo. I-head and neck i-osteosarcomas emaseni nasemlonyeni kunendawo yokuhlonza okungcono kunamanye amasayithi asemqoka ekhanda nangentanyeni, mhlawumbe ngenxa yokuthi iya kuqala.
Ama-osteosarcomas ama-Hipbone akha amaphesenti ayisikhombisa kuya kwangu-9 azo zonke i-osteosarcomas; Izinga lokusindisa iziguli ziyizingxenye ezingu-20 kuya kwangu-47.
Iziguli ezine-osteosarcoma ye-multifocal (echazwe njengezilonda zamathambo amaningi ngaphandle kwesisu esiyisisekelo esicacile) sinokuhlushwa okubi kakhulu.
I-localized vs. Matastatic Disease
Iziguli ezinezifo zendawo (akukho ukusakazeka ezindaweni ezikude) zinezibikezelo ezingcono kakhulu kuneziguli ezinezifo zemetastatic. Iziguli eziningi ezingamaphesenti angu-20 zizoba nemisasasa ebonakalayo ekucatshangweni, kanti iphaphu iyisayithi evamile kakhulu. Ukuchazwa kweziguli ezinezifo ze-metastatic kubonakala kunqunywa ikakhulukazi ngamasayithi we-metastases, inani le-metastase, kanye nokwenyuka kokuhlinzwa kwesifo se-metastatic.
Kulabo abanesifo se-metastatic, i-prognosis ibonakala ingcono ngamaphesenti ayisithupha amaphaphu futhi uma isifo sesakazeke emaphaphu owodwa kuphela, kunokuba kokubili kumaphaphu.
I-Tumor Necrosis Ngemuva kwe-Chemotherapy
I-tumor necrosis lapha ibhekiselwa emathisheni omdlavuza "aphelile" ngenxa yokwelapha.
Ngemuva kwe-chemotherapy nokuhlinzwa, i-pathologist ihlola i-necrosis ye-tumor esithombeni esisusiwe. Iziguli ezine-necrosis ezingamaphesenti angama-90 ezithombeni eziyinhloko ngemva kwe-chemotherapy zinokubikezela kangcono kuneziguli ezine-necrosis encane.
Kodwa-ke, abacwaningi baqaphele ukuthi i-necrosis encane akufanele ihunyushwe ukuthi isho ukuthi i-chemotherapy ayizange iphumelele; ukwelapha amanani weziguli ezine-necrosis encane noma engekho ngemuva kokungeniswa kwe-chemotherapy eziphakeme kakhulu kunamazinga okuphulukisa iziguli ezingatholi i-chemotherapy.
Iphrofayli yengozi ye-Chondrosarcoma
Lesi yisisu esinonya samangqamuzana akhiqiza i-cartilage, futhi limele cishe amaphesenti angu-20 azo zonke izicubu zethambo eziyinhloko . I-Chondrosarcoma ingavela ngokwayo noma okwesibili, kulokho okubizwa ngokuthi "ukuwohloka okulimazayo" kwezicubu ezinobuthi (njenge-osteochondroma noma i-enchondroma enobungozi). Izici zengozi zihlanganisa:
- Ubudala: Ngokuvamile kwenzeka kubantu abaneminyaka engaphezu kwengu-40 ubudala; Kodwa-ke, kwenzeka nakancane eqenjini elidala, futhi lapho liyenzeka, livame ukuba nelinye lezinga eliphakeme elikwazi ukubhekana nezidakamizwa.
- Ubulili: Kubangelwa ukuvama okulinganayo kokubili kobulili.
- Indawo: Kungenzeka kunoma yisiphi isifuba, kodwa kukhona ukuthambekela kokuthuthukiswa ku-hipbone ne-thighbone. I-Chondrosarcoma ingase iphakame kwamanye amathambo aphansi, njenge-scapula, izimbambo, ne-skull.
- I-Genetics: Izifo eziningi ze-exostoses syndrome (ngezinye izikhathi ezibizwa ngokuthi i-multiple osteochondromas syndrome) yisimo esizuze njengefa esenza kubangele amanxeba amaningi emathanjeni omuntu, okwenziwe ikakhulukazi we-cartilage. I-Exostoses ingaba buhlungu futhi iholele ekutheni ama-bone deformities kanye / noma ama-fractures. Isiyaluyalu i-genetic (ebangelwa ukuguquguquka kunoma iyiphi yezinhlobo ezintathu zegciwane i-EXT1, EXT2, noma i-EXT3), futhi iziguli ezinalesi simo zinengozi enkulu ye-chondrosarcoma.
- Ezinye izicathulo ze-Benign: I- enchondroma yi-tumorous cartilage tumor ekhula ngaphakathi kwethambo. Abantu abathola eziningi zalezi zicubu banezimo ezibizwa nge-enchondromatosis eminingi. Futhi banengozi eyengeziwe yokuthuthukisa i-chondrosarcoma.
I-Ewing Sarcoma Risk Profile
Lokhu kuvame kakhulu kubantu abamhlophe (okungewona amaSpanishi noma amaSpanishi) futhi abavamile kakhulu phakathi kwabase-Asia baseMelika futhi abangavamile kakhulu phakathi kwabase-Afrika baseMelika. Ukukhipha izicubu kungenzeka kunoma yikuphi ubudala, kodwa kuvamile kakhulu kwentsha futhi akujwayelekile kubantu abadala kanye nezingane ezincane. Ayingavamile kubantu abadala asebekhulile.
Cishe wonke ama-tumor cell tumor anezinguquko ezibandakanya isakhi se-EWS, esitholakala kwi-chromosome 22. Ukusebenza kwegciwane le-EWS kuholela ekukhuleni kwamangqamuzana nokuthuthukiswa kwalomdlavuza, kodwa indlela eqondile okwenzeka ngayo okwamanje kucacile.
> Imithombo:
> I-American Cancer Society. Izivivinyo ze-Osteosarcoma. https://www.cancer.org/cancer/osteosarcoma/detection-diagnosis-staging/how-diagnosed.html.
> National Caner Institute. I-Osteosarcoma kanye ne-Histiocytoma e-Malignant Fibrous ye-Bone Treatment (PDQ®) -Health Professional Version. https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq.