I-biopsy ngokuvamile ayidingi
Umdlavuza wesibindi (obizwa nangokuthi i- hepatocellular carcinoma ) kwenzeka lapho amangqamuzana angavamile esibindi aqala ukukhula ngokungalawuleki. Ngokuvamile, ukuxilongwa kwesifo somdlavuza wesibindi kuhilela izinyathelo ezilandelayo-ukuhlolwa ngokomzimba, ukuhlolwa kwegazi, ukucabangela igazi futhi ngezinye izikhathi i-biopsy.
Kuncike ekutheni uke wahlolelwa yini ukuthi unesifo sesibindi esingapheli kanye / noma i- cirrhosis , noma ngabe isifo esingenasifo esibangelwa yisibindi esingenakubindi, udokotela wakho angase aqhubekele ngokuhlukile ngokuthola umdlavuza wesibindi.
Ukuhlolwa Kwemvelo
Ngemuva kokubukeza izingozi zakho zesifo somdlavuza wesibindi (isibonelo, kungakhathaliseki ukuthi unomlando we-cirrhosis noma umlando wokusebenzisa kabi utshwala), uma udokotela wakho esolwa ngomdlavuza, uzobheka kahle isisu sakho, ikakhulukazi ngakwesokudla lapho isibindi sitholakala. Ngokuqondile, udokotela wakho uzocindezela ngaphansi kwe-ribcage yakho efanele ukuze anqume ukuthi isibindi sakho sikhulisiwe.
Udokotela wakho uzophinde abheke ezinye izibonakaliso zesifo sesibindi eside (okwandisa ingozi yokuba nomdlavuza wesibindi) njengo:
- Ipeni elikhulisiwe, elisehlangothini eliphezulu elingakwesokunxele kwesisu sakho
- Imisipha ebonakalayo esiswini sakho
- Isisu esisigcwele amanzi, esivimba
- Ubufakazi be- jaundice (ngokwesibonelo, ukuphuziza kwesigungu esilungu sehlo
Amalebhu
Kunezibalo eziningi zokuhlolwa kwegazi udokotela wakho angase oda ukuze asize ukuxilonga umdlavuza wesibindi futhi anqume ukuthi yini engabangela umdlavuza.
I-Alpha-Fetoprotein (AFP) I-Marker ye-Tumor
I-AFP iyi-protein ephezulu kuma-fetus kodwa iwela emazingeni aphansi ngemva kokuzalwa.
Ukuchaza umphumela wakho wokuhlolwa kwegazi we-AFP kungaba yinkinga. Ngesinye, umuntu angaba nesifo somdlavuza wesibindi kanti izinga labo le-AFP lingase libe lendabuko (akuvele nje livuke). Ngaphezu kwalokho, amazinga aphakeme e-AFP angase aphakanyiswe ngenxa yezizathu ngaphandle kwesifo somdlavuza wesibindi (isibonelo, i-cirrhosis noma i-hepatitis esebenzayo engapheli).
Okubalulekile ukuthi ngenkathi kuhlolwa okuwusizo, izinga le-AFP akulona ukuhlolwa kwegazi okucacile ukuxilongwa komdlavuza wesibindi-kungumunye wechungechunge olulodwa.
Ukuhlolwa kwe-Cirrhosis
Uma ukuhlola ngokomzimba noma ukuhlolwa kwe-imaging kwembula ukuthi unesifo esingenasifo sesibindi kanye / noma isifo se-cirrhosis, kodwa imbangela engemva kwayo ayingakaqunyiwe, udokotela wakho uzoyala uchungechunge lwegazi lokuhlolwa. Isibonelo, uzokwenza ukuhlolwa kwegazi ukuhlola ukutheleleka nge-hepatitis B no-C. Angase futhi ahlele ama-ferritin namazinga ensimbi ukuhlola i- hemochromatosis , enye imbangela evamile ye-cirrhosis.
Izivivinyo Zezinsizakalo Ze-Liver (LFTs)
I-LFTs iqukethe uchungechunge lokuhlolwa kwegazi olunika odokotela bakho umbono wokuthi isibindi sakho sisebenza kahle kangakanani. Lezi zivivinyo zingasiza futhi udokotela wakho ukuba athole uhlelo oluhle kakhulu lokwelashwa kwesifo somdlavuza wesibindi sakho. Isibonelo, uma umdlavuza wakho wesibindi uncane futhi uqukethe futhi isibindi sakho sibonakala sisebenza kahle, bese ususa umdlavuza ngokuhlinzwa kungase kube ukukhetha okunengqondo.
Ezinye izivivinyo
Udokotela wakho angalaya ezinye izivivinyo zegazi ukuze anqume ukuthi ezinye izitho zomzimba wakho zisebenza kanjani. Isibonelo, angase alawule ukuhlolwa kwegazi okuhlola ukuthi izinso zakho zisebenza kanjani kahle. Ukwengeza, njengoba umdlavuza wesibindi ungathinta amazinga wegazi, i-calcium, nama- platelet , lezi zivivinyo zingabuye zenziwe.
Ukucabanga
Ukuhlola ukuhlolwa kubalulekile ekuhloleni umdlavuza wesibindi.
I-Ultrasound
Ukuhlolwa kokuqala umuntu angase abe nakho yi-ultrasound. Ngesikhathi se-ultrasound, i-probe izocindezelwa kahle ngesisu sakho ukubona ukuthi kukhona yini izixuku ezisebindi.
I-CT Scans nama-MRIs
Uma ubukhulu bubonakala kwi-ultrasound, ukuhlolwa okunamandla okufana ne-computed tomography (CT scan) kanye / noma i-imagery magnontic resonance (MRI) yesibindi inqunyelwe ukunikeza ulwazi oluthe xaxa ngobuningi, njenge:
- Usayizi
- Indawo esesibindi
- Sakaza emifuleni yegazi eseduze noma kwezinye izingxenye zesisu
Lezi zivivinyo ze-imaging zingase zinikeze ulwazi mayelana nokuthi luhlobo luni lwesisindo olukhona, okusho ukuthi ubukhulu bungobuningi (okungewona umdlavuza) noma obubi (umdlavuza).
Angiography
Okokugcina, i-CT angiography noma i-MRI angiography ingenziwa ukuze inikeze isithombe se-arteries ehambisa igazi esibindi. Kuloluvivinyo, uzodinga i-IV efakwe engalweni yakho ukuze idayisi ehlukile ingaqondiswa ngesikhathi se- CT scan noma i- MRI.
I-Biopsy
Phakathi nesibindi se-foopsy, inaliti ibekwa esikhunjeni sesisu sakho ebunzini besibindi. Ukuze unciphise noma yikuphi ukungahambi kahle, indawo yesikhumba lapho inaliti iya khona isinganiselwe kusengaphambili. Amaseli avela kulesisindo asuswa futhi ahlolwe udokotela (obizwa ngokuthi i-pathologist) ukubona ukuthi umdlavuza ukhona yini.
Ngezinye izikhathi i-biopsy yesisindo sebindi isenziwa ngesikhathi sokuhlinzwa (okuthiwa i-biopsy yokuhlinzwa). Ngalolu hlobo lwe-biopsy, ucezu lobuningi noma lonke ubukhulu lususwe futhi luhlolwe umdlavuza.
Kubalulekile ukuqaphela ukuthi izikhathi eziningi i-biopsy ayidingi ukulawula (noma ukuphuma) ukuxilongwa kwesifo somdlavuza wesibindi. Lokhu kungenxa yokuthi i-CT scan kanye / noma i-MRI inganikeza ubufakazi obanele bokuthi isisindo sinomdlavuza noma cha.
Kulesi sibonelo, ukugwema i-biopsy kuyinto enhle, njengoba kukhona ukukhathazeka ukuthi ukususa amangqamuzana anomdlavuza osuka emzimbeni kungase kube "imbewu" eduze nezindawo zomdlavuza. Uma kunjalo, ukusakazeka komdlavuza kungenza umuntu angafaneleki ukufakelwa kwesibindi (okukhethwa kukho okungenzeka ukwelashwa).
Kungakhathaliseki ukuthi, ngezinye izikhathi i-biopsy iyadingeka ukuze kutholakale ukuthi ukucabangela ukuthi ukucabanga akusho yini.
Ukuhlonza okuhlukile
Kubalulekile ukukhuluma ukuthi lesi sifo somdlavuza esibindi singase singabi ngumdlavuza oyinhloko wesibindi kodwa kunesifo se- metastatic esivela kwenye umdlavuza. Isibonelo, umdlavuza wekoloni osazela esibindi ubizwa ngokuthi umdlavuza we-colon metastatic noma umdlavuza wesibili wesibindi. Kulesi simo, udokotela wakho uzodinga ukuphenya ukuthi umdlavuza oyinhloko uyini, uma ungaziwa.
Ngaphezu kwalokho, yazi ukuthi kunezinhlobo eziningi zokuxilonga ezingase zibe khona zesibindi sesibindi, okusho ukuthi akuwona umdlavuza.
Izibonelo ezimbili zezimbangela zesibindi (ezingezona umdlavuza) zihlanganisa:
Hemangioma Hepatic
I-hematic hemangioma iyinqwaba yemithwalo yegazi eyilona uhlobo oluvame kakhulu lwe-benign kwesibindi. Akuvami ukudala izimpawu, kodwa kungabangela ukuhlukunyezwa kwesisu, ukubhubhisa, noma ukuphumula kokuqala uma kuba sikhulu ngokwanele. Ngenkathi i-hemangioma e-hepatic ingadingi ukwelashwa, kungase kudingeke isuswe udokotela ohlinzayo uma ephula futhi evula, nakuba lokhu kungavamile.
I-Adenoma yeHepatic
I-adenoma ene-hepatic iyinhlamba yesibindi esinesibindi esivame ukungabikho izimpawu ngaphandle kokuthi igeze noma ikhule ngokwanele. Ngamaphesenti amancane amacala, i-adenoma ye-hepatic ingaba isifo somdlavuza wesibindi, yingakho ngokuvamile isuswe.
> Imithombo:
> I-American Cancer Society (2018). Uvivinyo lwe-Cancer Cancer.
> Bruix J, uSherman M, i-American Association ye-Study of Liver Illness. I-Hepatology . 2011 Mar; 53 (3): 1020-2. dx.doi.org/10.1002/hep.24199
> Schwartz JM, i-Carithers RL. (2017). Izici zomtholampilo nokuxilongwa kwe-primary hepatocellular carcinoma. I-Chopra S, ed. Kusesikhathini. Waltham, MA: UpToDate Inc.