Ukuqina Okuncane Kusasebenza Esikhathini Sokunyathelisa Kwe-Melanoma, Izinga Lika Clark Lisebenza Ngokuvamile
Udokotela wakho uthi i- melanoma yakho isigaba se-IIA (T2bN0M0) no-Breslow ukujula kwe-2 mm.
Uyazibuza ukuthi ukhuluma ngani ulimi lwangaphandle-empeleni, i-melanoma jargon ingadida futhi idangele. Ukuze kukusize uqonde ukuthi kungani ukwelashwa okhethekile kukhethwe wena, nansi incazelo emfushane yokuthi la magama asho ukuthini.
I-Melanoma Diagnosis
Uma udokotela wakho ebona imvukuzane esolisayo phakathi nokuhlolwa kwesikhumba , isinyathelo esilandelayo yisisindo se- isikhumba .
Uma i-biopsy yembula i-melanoma, i-pathologist izohlola i-biopsy ukuthola isiteji (ubukhulu) besifo ukuze uhlele kahle ukwelashwa kwakho.
Ngaphandle kwenombolo ye-TNM , ungase uzwe udokotela asebenzise inombolo ye-Breslow noma inombolo ye-Clark ukuchaza ukubikezela kwakho (ukubuka). Lezi zindlela ezimbili zokugaya i-melanoma zisetshenziselwa kuphela uma i-melanoma ivinjiwe, okusho ukuthi ayizange isakaze kunoma iyiphi i-lymph nodes noma enye isitho emzimbeni. inombolo ye-Clark ukuchaza ukubikezela kwakho (ukubuka). Lezi zindlela ezimbili zokugaya i-melanoma zisetshenziselwa kuphela uma i-melanoma ivinjiwe, okusho ukuthi ayizange isakaze kunoma iyiphi i-lymph nodes noma enye isitho emzimbeni.
Nansi indlela yokuzihumusha:
Ukunyuka okuncane
Okokuqala kubikwa ngu-Alexander Breslow, MD, ngo-1970, ubukhulu be-Breslow buchazwa ngokuthi ukuphakama okuphelele kwe-melanoma, kusukela phezulu kakhulu (okuthiwa "uhlaka lwesigcawu") endaweni yokungena okujulile esikhumbeni.
Insimbi ebizwa ngokuthi "i-micrometer ye-ocular" isetshenziselwa ukukala ubukhulu be-tumor esisuswe (esususiwe).
Ngokuvamile, ukuphakama kwe-Breslow kuya phezulu, kubika ukubikezelwa-ngamanye amazwi, okwandisa i-melanoma, ithuba elikhulu lokusakaza. Nazi amazinga okusinda oneminyaka emihlanu esekelwe ubukhulu obuningi be-Breslow.
Khumbula ukuthi lezi zindleko zokusinda ziyizilinganiso futhi angeke zibonise icala lakho ngabanye:
- ngaphansi kuka-1 mm: ukusinda kweminyaka engu-5 kunamaphesenti angu-92 kuya kuma-97%-okusho ukuthi abantu abangu-92 kuya kwangu-97 kubantu abayikhulu bazobe besaphila eminyakeni emihlanu emva kokutholakala ukuthi bane-melanoma engaphansi kwe-1mm ubukhulu.
- 1.01 kuya ku-2 mm: ukusinda kweminyaka emihlanu kunamaphesenti angu-81 kuya kuma-92%
- 2.01 kuya ku-4 mm: ukusinda kweminyaka emihlanu kunamaphesenti angama-70 kuya kwamaphesenti angu-81
- ngaphezulu kuka-4 mm: ukusinda kweminyaka emihlanu kungama-53% kuya kuma-70%
Ngenxa yokunemba kwayo ekubikezelweni kwemiphumela, ubukhulu be-Breslow bufakwe ohlelweni olujwayelekile lwe-TNM lwesiteji se-melanoma. Eqinisweni, ubukhulu be-Breslow buyinto ebaluleke kakhulu yokubikezelwa kwe- melanoma, kanye ne-tumor (T) isigaba, nokuba khona kwesilonda (isikhumba esiphukile, ukuphuma kwegazi, ukuvuvukala).
I-Clark Level
Izinga likaClake libhekisela ekujuleni kwezinga lesi sifo esiye sangena emigqeni yesikhumba . Loluhlelo lwaluqale lwasungulwa yi-WH Clark, MD, emuva ngo-1966. Amazinga kaClake achazwe ngokomthetho kanje:
- I-Level I: Ihlanganiswe ku-epidermis (isikhumba esiphezulu sesikhumba) esibizwa nge-melanoma "in situ"
- Izinga II: Ukuhlasela kwe-papillary (phezulu)
- I-Level III: Ukugcwalisa imithi yamaphepha , kepha akukho okungeziwe emgqeni we-reticular (ephansi)
- Izinga IV: Ukuhlasela kwe-dermis
- Izinga V: Ukuhlasela kwezicubu ezijulile, ezingaphansi
Konke lokhu kushiwo, amazinga kaClark ajwayelekile ukuthi asebenzise ukubala ukubikezela manje. Lokhu kungenxa yokuthi ucwaningo luye lwaboniswa ukuthi luba nomphumela omncane womphumela, ukuphindaphinda kancane, nokuzithoba kunalokho ukujula okuBreslow. Okunye ukungalungi kwalesi simiso sesiteji ukuthi ngokuvamile kunzima ukuhlukanisa phakathi kukaClark Level II neNqanaba III , futhi angeke kusetshenziswe kuma-melanomas ezintendeni zezandla nasemagqumeni.
Kukhona isibonelo esisodwa lapho amazinga kaClark angasetshenziswa ukubikezela ukubikezela-ezigulini ezine-melanoma encane (engaphansi kwe-1.0 mm).
Ngisho noma kunjalo, isetshenziselwa kuphela ukuzenzakalela uma inani le-mitotic le-melanoma elincanyana lingenakulinganiswa. Inani le- mitotic libhekisela kwinani lamangqamuzana omdlavuza ahlukanisa. Izinga eliphakeme le-mitotic libonisa ukuthi umdlavuza cishe usakazeka.
Izwi elivela
Zama ukungaxhunyiwe kakhulu emininingwaneni yenqubo yokunyathelisa i-melanoma. Kunalokho, gxila ukuthi isigaba somdlavuza wakho sisho ukuthini ukwelashwa kanye nemibono yakho.
> Imithombo:
> I-American Cancer Society. (Meyi 2016). Izigaba zomdlavuza wesikhumba se-Melanoma.
> I-American Cancer Society. (Meyi 2016). Izinga lokusinda komdlavuza wesikhumba se-melanoma, ngesigaba.
> Balch CM et al. Version Final ye-2009 AJCC Ukumiswa kweMelanoma nokuHlelwa. J Clin Oncol . 2009 Dec 20; 27 (36): 6199-6206.
> Balch CM, et al. Ukuhlaziywa kwezici ze-prognostic zeziguli ezingu-17 600 ze-melanoma: ukuqinisekiswa kwe-American Joint Committee eKaranoma. J Clin Oncol . 2001 Aug 15; 19 (16): 3622-34.