Uma uzama ukubona isiteleka somdlavuza wakho wamaphaphu ungase uzizwe udidekile kakhulu. Kusho ukuthini uma i-oncologist yakho ikhuluma nge "TNM" nokuthi lokhu kuhambisana kanjani nezigaba? Ake sibheke incazelo yale nhlamvu ngayinye, ukuthi odokotela basebenzisa kanjani lokhu ukuze basungulwe umdlavuza, nokuthi yini ekugcineni ekushoyo ngokwemithi yokwelapha.
Uhlelo lwe-TNM
Ukuhlelwa kwe-TNM yomdlavuza wamaphaphu kungaphazamisa noma ubani ukuba aqonde, akeke wedwa umuntu osanda kushaywa nezindaba zomdlavuza we-lung wamaphaphu. I-TNM isiteji ihambisana kanjani nezigaba zomdlavuza wamaphaphu , njengesigaba 2 nesigaba 4?
Lokho Okushiwo Izincwadi
Incwadi ngayinye ye-TNM imelela ubukhulu noma ukusakaza komdlavuza kanje:
- I-T - Isekela ngobukhulu besisu. Usayizi wesisu uvame ukunikezwa ngamasentimitha (cm). Ukuze uqonde lokhu ngamasentimitha, u-5 cm ufana no-2 amayintshi.
- I-N- N imele i- lymph nodes futhi iveza ukuthi i-tumor isakazeke kuma-lymph nodes, futhi uma kunjalo, ikude kangakanani ne-tumor.
- I-M - M imelela imetastasis , okungukuthi, ukusabalala kwe-tumor kwezinye izingxenye zomzimba.
Okwenza isiteji sibalulekile
Izibalo ze-TNM zisiza odokotela ukuba baqonde ukuthi kunomdlavuza kangakanani, ngakho-ke, yiziphi izindlela zokwelapha ezingcono kakhulu kulowo mdlavuza. Kungasiza futhi ukubikezela ukuthi ukubikezelwa okuvamile kumuntu onomdlavuza wamaphaphu.
I-TNM isiteji isekelwe emininingwaneni yomhlaba wonke ngomdlavuza wamaphaphu ezinkulungwaneni zabantu futhi uqhathanisa ubukhulu bomdlavuza wamaphaphu nezimpendulo zokwelapha nokubikezelwa.
Lokho kusho ukuthi kubalulekile ukuqonda ukuthi kunezici eziningi ezithinta ukuchazwa komdlavuza wamaphaphu ohamba ngaphezu kwesigaba.
Impilo yakho ejwayelekile, uhlobo oluthile lomdlavuza wamaphaphu onayo, noma ngabe unayo "ukuhloswe" kwezakhi zofuzo ekuhloseni kwakho noma cha, ngisho nobulili bakho bungaba nendima ekutheni imithi yokwelapha izokusebenza kangcono kuwe nokuthi yini okumele uyibeke ngayo .
Ukuhlukunyezwa kwe-TNM yokuHlala
Uzobona ukuthi izincwadi zakho ze-TNM zizoba nezinombolo ezizilandela. Ake sibheke ukuthi izinombolo ezahlukene zisho ukuthini:
I-T - Ukuphakama komzimba
- I-Tx - Ubukhulu besisu abukwazi, noma amangqamuzana omdlavuza atholakala kuphela ku- sputum .
- T0 - Awukho ubufakazi bokudla okuyisisekelo.
- I-Tis - I- Carcinoma in situ - I-tumor ikhona kuphela kumaseli ahlanganisa umoya womoya futhi engakafiki emathisini aseduze.
- I-T1 - I-Tumors engaphansi noma elingana no-3 cm (1½ amasentimitha).
- T1a - Ngaphansi kokulingana no-2 cm.
- I-T1b - Inkulu kune-2 cm kepha ingaphansi kwelingana no-3 cm.
- I-T2 - I-tumor ingaphezu kuka-3 cm kepha ingaphansi kuka-7 cm. Izicubu ze-T2 zingavimba ingxenye yomoya, kepha azizange ziholele ekuphefumuleni noma zibangele amaphaphu ( atelectasis ). Kungenzeka ukuthi basakaze egumbini elizungeze amaphaphu. Kungenzeka futhi ukuthi baseduze ne- bronchus eyinhloko kodwa okungenani ngu-2 cm (cishe ngamasentimitha) kude nendawo lapho i-bronchus ihlukanisa ukuya emaphashini ngayinye.
- I-T2a - Inkulu kunezingu-3 cm kepha ingaphansi kwelingana no-5 cm.
- I-T2b - Inkulu kunama-5 cm kepha ingaphansi kunani noma ilingana no-7 cm.
- I-T3 - I-Tumors ingaphezu kuka-7 cm, noma ingaphansi kwe-7 cm kodwa nge-nodule ehlukile ku-lobe efanayo. Izitholampilo ze-T3 zihlanganisa nezicubu ezingaphansi kuka-7 cm kodwa zihlasela emgodini wamaphaphu (i- pleura ), udonga lwesifuba, i- diaphragm , i-bronchus eyinhloko, noma ilele ngaphakathi kwe-2 cm endaweni lapho i-bronchus ihlukana ukuya emaphashini . I-tumor ihlukaniswa njenge-T3 uma ingaphansi kwe-7 cm kepha ihlotshaniswa ne-pneumonia noma ukuwa kwephasi lonke.
- I-T4 - I-tumor yanoma yisiphi isayizi, kodwa ngesinye isicucu e-lobe ehlukene ohlangothini olufanayo lomzimba, noma isisu esihlasela izakhiwo esifubeni njengenhliziyo, imithwalo yegazi emikhulu eduze kwenhliziyo, i- trachea , ephindaphindiwe i-laryngeal nerve (i-nerve eduze ne-trachea), i- mediastinum (isikhala esiphakathi kwamapayipi), isifo , noma indawo lapho i-bronchus eyinhloko ihlukanisa khona ukuya emaphashini amabili.
N - Ukubandakanya kwama-Lymph Nodes
- N0 - Azikho amathrekhi ahilelekile.
- I-N1 - I-tumor isakaze emaqenjini aseduze ohlangothini olufanayo lomzimba.
- I-N2 - I-tumor isakazekile ukuze idlulisele kude kodwana ngakwesinye isifuba esifubeni.
- I-N3 - I-tumor iye yasakazeka kuma-lymph nodes ngakolunye uhlangothi lwesifuba esivela ku-tumor yangempela, noma isakaze kuma-node eduze kwe-collarbone noma imisipha yentamo.
M - Metastasis (Spread) kwezinye izindawo
- M0 - I-tumor ayizange isakaze ezindaweni ezikude.
- I-M1
- I-M1a - I-tumor iye yasakazeka emaphakeni ahlukile, kuya emapayipi amancane (ama-pleusion ama- pleural amahloni ) noma yakha ama-nodules ku-pleura.
- I-M1b - I-tumor isakaze ezindaweni ezikude zomzimba, ezifana nobuchopho noma amathambo.
Ukuqhathaniswa kwezinyathelo zomdlavuza we-Lung kanye ne-TNM Staging
Iningi labantu liyazi kangcono izigaba zomdlavuza wamaphaphu kunezibalo ze-TNM. Nasi ukuqhathaniswa kwesigaba somdlavuza wamaphaphu kanye nesiteji se-TNM:
- TisN0M0
- Isigaba 1A I-Cancer Lung
- T1aN0M0
- I-T1bN0M0
- Isigaba 1B I-Cancer Lung
- T2aN0M0
- Isigaba 2A I-Cancer Lung
- T1aN1M0
- I-T1bN0M0
- T2aN1M0
- Isigaba 2B I-Cancer Lung
- I-T2bN0M0
- I-T2bN1M0
- T3N0M0
- Isigaba 3A I-Cancer Lung
- T3N1M0
- T4N0M0
- I-T4N1M0
- I-T1N2M0
- I-T2N2M0
- I-T3N2M0
- Isigaba 3B I-Cancer Lung
- T1N3M0
- I-T2N3M0
- T3N3M0
- I-T4N2M0
- T4N3M0
- Noma yikuphi u-T, Noma yikuphi N, M1a
- Noma yikuphi u-T, Noma yikuphi N, M1b
I-Newly Diagnosed With Cancer Lung
Uma usanda kuthiwa unomdlavuza wamaphaphu , mhlawumbe uzizwa ukwesaba futhi ukhathazekile. Kungenzeka ukuthi uzwile ukuthi ukwazi okuningi mayelana nomdlavuza wakho kungathuthukisa imiphumela, kodwa ungakwenza kanjani lokho uma konke kubonakala kubhalwe ngolunye ulimi?
Thatha isikhathi sokuzifundisa. Khuluma nodokotela wakho bese ubuza imibuzo eminingi. Funda ukuthi ungathola kanjani ulwazi lomdlavuza omuhle ku-intanethi . Abantu abaningi abanomdlavuza wamaphaphu bacabangela ukuthola umbono wesibili, futhi lokhu kubaluleke kakhulu. Ngokuvamile kunconywa ukuthi wenze lo mbono wesibili kwelinye leNational Cancer Institute-izikhungo zomdlavuza ezikhethiwe lapho kungenzeka khona ukuthi ube ne-oncologists ekhethekile ngohlobo oluthile lomdlavuza wamaphaphu. Futhi, uma unomdlavuza wesifo samangqamuzana ongewona omncane, qiniseka ukuthi udokotela wakho ucele ukuprofetha kwegene (ukuprofetha kwe-molecular) kwesisu sakho .
Qinisekisa ukuba ngummeli wakho siqu ukunakekelwa komdlavuza wakho. Ukuze wenze lokhu, kungasiza ukuxhumeka emphakathini womdlavuza wamaphaphu online (i-hashtag yi-#LCSM). Le miphakathi ingakusizi nje kuphela ukusekela kodwa ingakusiza ufunde futhi uhambe ngendlela yakho ngokuzikhethela okuningi okuzobhekana nakho.
Okungaphezu kwakho konke, hlala ethembeni. Izindlela zokwelapha umdlavuza wamaphaphu ziyathuthuka, futhi izinga lokuphila liyakhula futhi. Kube nemithi emisha eminingi evunyelwe umdlavuza wamaphaphu eminyakeni embalwa edlule kunasekupheleni kwamashumi eminyaka ngaphambili.
> Imithombo:
> Edge, S. et al (Eds.). I-AJCC Incwadi Yokusakaza Ngomdlavuza. I-7th Edition. Springer. ENew York, NY. 2010.
> National Cancer Institute. Ukunakekelwa Kwemdlavuza Yamangqamuzana Angewona Amancane (PDQ) - I-Health Professional Version. Kubuyekezwe 03/31/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all
> Nicholson, A., Chansky, K., Crowley, J. et al. I-International Association ye-Study of the Lung Cancer Stage Cancer Staging Project: Iziphakamiso Zokubukeza Ukwelashwa Kwemitholampilo Kanye Nezokwelapha Kwe-Cell Small Lung Cancer Kwingqikithi Ezayo Eyesishiyagalolunye Yokwehlukaniswa Kwe-TNM ye-Cancer Lung. I-Journal ye-Thoracic Oncology . 2016. 11 (3): 300-11.
> Rami-Porta, R., Crowley, J., no-PP. I-Goldstraw. I-Revised TNM Yokuguqula Isifo se-Lung Cancer . Ama-Annal of Thoracic and Surgery Cardiovascular . 2009. Vol 12, Cha 1.