Indlela I-Ovarian Cancer Ithola Ngayo

Kukhona izivivinyo eziningi nezinqubo ezingasetshenziselwa ukuxilonga umdlavuza we-ovarian, kubandakanya ukuhlolwa kwe-pelvic; ukuhlola izithombe, njenge-ultrasound yangaphandle, i-CT, i-MRI, noma i-PET scan; nokuhlolwa kwegazi, njenge-CA-125. Ukuze kutholakale ukuxilongwa, i-biopsy ivame ukudingeka ukuthi bobabili baqinisekise ukuthi inqwaba iyingozi (umdlavuza) futhi ihloniphe uhlobo nesigcawu sesifo.

Uma kutholakala ukuxilongwa, le miphumela kanye nokuhlolwa okuqhubekayo kusetshenziselwa ukucacisa isigaba sesifo, esizosiza ekutholeni inkambo yokwelashwa engcono kakhulu.

Ukuhlola Ukuhlola / Ukuhlolwa Kwekhaya

Ngeshwa, azikho ukuzihlola komdlavuza we-ovarian. Ngaphezu kwalokho, ukuhlolwa kwe-genetic at home akukwazi nakanjani ukubeka ingozi yakho yokuthuthukisa lesi sifo. Kubalulekile ukuba bonke abesifazane bajwayelane nezibonakaliso nezimpawu futhi bakhulume nodokotela babo uma banezinkinga zokugula.

Ukuhlolwa Kwemvelo

Ayikho imihlahlandlela yokuhlola yomdlavuza we-ovarian. Kodwa-ke, ukuhlolwa kwesivikelo somzimba esenziwe ngumhlengikazi wakho (noma okuqhutshwa ngenxa yobuningi bezimpawu) kungase kutholakale isisindo esifundeni se-ovary yakho, okuthiwa yi-adnexal mass. Noma kunjalo, lesi sheke sinemikhawulo.

Ukuhlolwa kwenziwa nge-bimanually ngesandla esisodwa esiswini sakho futhi esisodwa esiswini sakho. Njengoba udokotela ezwa nge-ovary yakho ngaphansi kwezicubu ezinamafutha, ukuhlolwa akunembile kakhulu ekuboneni ubukhulu kubantu abakhuluphele kakhulu noma abakhuluphele kakhulu.

Ngisho nabesifazane abancanyana, ukuhlolwa kwe-pelvic kungabikho kalula izicubu ezincane zama-ovarian.

Kubalulekile ukuphawula ukuthi i-Pap smear yedwa (ngaphandle kokuhlolwa kwe-bimanual), kuyilapho kuyasiza ekutholeni umdlavuza wesibeletho, akusizi kakhulu ekutholeni umdlavuza we-ovarian.

Ukucabanga

Ukuhlola ukuhlolwa kuyadingeka kokubili ukuthola amantombazane amancane ama-ovarian nokuqhubeka nokuqonda izixuku ezingazizwa ekuhlolweni.

Izinketho zihlanganisa:

I-Ultrasound e-Transvaginal

I-ultrasound ye-pelvic wuhlolo olusebenzisa amagagasi omsindo ukudala isithombe sezitho zomzimba. Ngokuvamile uhlolo lokuqala olwenzelwe ukuhlola ubuningi bama-ovarian futhi abuvezi abantu emisebeni. Inqubo ingenziwa noma isisu (i-probe ifakwe ngaphezulu kwesikhumba sakho) noma i-transvaginally (i-probe ifakwa ngaphakathi kwesiswini ukuze usondele eduze kwe-ovary). Kodwa-ke, okwakunjalo akuyona into efana neyokugcina ekuchazeni izixuku ze-ovari, ikakhulukazi lezo ezincane.

I-ultrasound inganikeza ukulinganisa ubukhulu besisindo, futhi sinqume ukuthi i-cyst elula, i-cyst eyinkimbinkimbi, noma iqinile. Ama-cysts ajwayelekile ajwayelekile. I-cyst eyinkimbinkimbi ingaba yinhlonipho, kodwa iphakamisa ukukhathazeka ngokuba nomdlavuza uma iqukethe ama-nodules noma ama-excrescences (ukukhula okungavamile). I-ultrasound ingabuye ibheke uketshezi kwamahhala ekhanda, into evame ukubonwa ngezicubu eziphambili kakhulu.

Isisu kanye / noma i-Pelvic CT Scan

I-CT scan isebenzisa uchungechunge lwe-X-ray ukudala isithombe sesisu noma isikhumba. Kungasetshenziselwa ukusiza ekuxilongweni, kodwa kuvame ukusetshenziselwa umdlavuza wesiteji. Kuyinto evivinyayo ukuhlola ama-lymph nodes, amathumbu, isibindi namaphaphu (esifubeni CT scan) kunoma yibuphi ubufakazi bokuthi umdlavuza usakazekile.

Imigomo ongayibona embikweni wakho ihlanganisa ascites (ukwakhiwa kwamanzi emzimbeni); izidakamizwa (izindawo zokusabalala); i-carcinomatosis (izindawo ezisakazeke ze-tumor); ikhekhe le-omental (ukuqina kwe-omentum, umchamo ocolekileyo ophezu kwezitho zangasese); amafutha okugcoba (ukuvuvukala emathisini amathumbu omzimba); kanye ne-effusion (ukwakhiwa kwamanzi). Futhi, ama- lymph nodes angachazwa njengenwetshiwe. I-lymph nodes ekhulisiwe ivame ukukhudlwana kune-2 cm (ubude obuyi-1 intshi) ububanzi futhi ingaba nezindawo ze-necrosis ephakathi (ukufa kweseli) uma umdlavuza ukhona.

I-MRI

I- MRI (imaging magnontic resonance) ingasetshenziswa ngendlela efana ne-CT scan kodwa ayibandakanyi imisebe, okwenza kube ukuhlolwa okuphephile ngesikhathi sokukhulelwa.

I-MRI ivame ukuba ngcono kune-CT ekuchazeni okungajwayelekile kwezicubu futhi ingasetshenziselwa ukucacisa ukutholakala kwezinye izivivinyo.

I-PET Scan

Ngenkathi i-CT, i-MRI, ne-ultrasound kuyi-test imaging (imaging for physical anomensities), ukuhlolwa kwe- PET kuyinto test function, okuyinto isilinganiso umsebenzi. Lokhu kuhlolwa okubucayi kubheka ubufakazi bokuthola amandla okusabalalisa (noma ukusabalalisa) noma kuphi emzimbeni futhi kuyasiza ekubandlululeni phakathi kwezicubu ezincane kanye nomdlavuza.

Ngesisindo se-PET, inani elincane le-ushukela omsakazo lujojowe egazini. Ukuskena kwenziwa emva kokuba ushukela ube nesikhathi sokubanjwa ngamaseli. Amaseli amaningi akhulayo, njengamaseli omdlavuza, azokhanyisa kulo mfanekiso, ngokuvamile ohlangene no-CT.

Ama-Labs nezivivinyo

Ngaphandle kokucwaninga okucabangela nokuhlolwa, umsebenzi wegazi usuqedile ukufuna ubufakazi bokuthi okungavamile okutholakala ekuhlolweni kanye / noma ekucabangeni kungumdlavuza noma cha. Uvivinyo lungabandakanya:

Igazi Lisebenzela Ukutholwa Kwezimpawu Zokumnyama

Ukuhlolwa kwegazi okunye kungathola amaprotheni awaziwa njengama-tumor markers. Ezinye zazo zikhiqizwa ngamaseli avamile futhi anomdlavuza we-ovarian, ngakho-ke umdlavuza we-ovarian uboniswa uma inani elikhona egazini liphakeme kunalesivamile. Ezinye izimpawu ze-tumor zikhiqizwa kuphela ngamangqamuzana e-ovarian abe nomdlavuza futhi awabonakali kubantu abangenayo umdlavuza we-ovarian, ngakho ukuba khona kwabo yedwa kuyisibonakaliso sesi sifo.

Ukubona lezi zimpawu ze-tumor kusampula yegazi akusona indlela ephumelelayo yokuhlola umdlavuza we-ovarian, kodwa kungasiza ekutholeni ukuxilongwa nokulandela impendulo yalezi zomshukela ekwelapheni.

Ezinye izivivinyo zegazi

Ezinye izivivinyo zegazi ezingasiza ekwenzeni ukuxilongwa zihlanganisa inani eliphelele legazi (CBC), i-LDH, i-alkaline phosphatase, nesilinganiso sed noma i-C-reactive protein test (ebheka ukuvuvukala).

Ucwaningo lwathola ukuthi inhlanganisela ye- red cells cell indices , eyaziwa ngokuthi ububanzi be-distribution cell cell (RDW), futhi umthamo weplatelet (MPV) ungase ube usizo ekubikezelweni ukuthi iziphi izicubu zomzimba zinesifo somdlavuza futhi ezingekho. (I-RDW ivame ukuphakama futhi i-MPV iphinde ibe nomdlavuza we-ovarian.)

I-Ovarian Risk Index

Izingozi eziningana zokuhlukumezeka kwezimboni zibheke ekuhlanganyeleni kokuthola okuhlolwayo nokucabangela ukubikezela ukuthi ingabe inkinga ingaba ngumdlavuza we-ovari futhi uma kudingeka i-biopsy. Yize lezi zingase zibe usizo, izinyathelo zomgomo zokulinganisa ingozi ziyiqiniso kakhulu uma zisetshenziselwa ukuhlola okuzithobayo kochwepheshe, oncologist onjalo wegazi.

I-Biopsy Yokuhlinza

I-biopsy ye-lesion esolisayo ivame ukwenza ngokuhlinzwa. Ngezinye izikhathi, i-biopsy yenaliti (lapho inaliti ifakwa khona esikhumbeni) ingacatshangwa, kodwa kucatshangwa ukuthi uma umdlavuza we-ovariya ukhona, lokhu kungabangela ukuthi yini eyaziwa njenge-seeding (ukusakazwa kwesisu).

I-biopsy yokuhlinzwa ingenziwa noma i-laparoscopy, ukuhlinzekwa okuncane lapho kwenziwa khona izimbalwa ezincane esiswini kanye nesiphakamiso esinekhamera nezinsimbi ezifakiwe, noma i-laparotomy, lapho ukukhishwa kwendabuko kwenziwe khona esiswini. I-biopsy (isampula) ithathwe futhi ithunyelwe kumuntu wezokwelapha ukuthola ukuthi ingumdlavuza, futhi uma kunjalo, uhlobo.

Uma unesifo se-biopsy, udokotela wezokwelapha uzobheka isampula njengemikhakha ebuyisiwe futhi efriziwe ukuze aphinde aveze lesi sifo. Embikweni wakho, isampula izochazwa ngokuthi iyinhlamba (engeyona umdlavuza) noma iyingozi (engeyona umdlavuza). Bheka ngezansi ukuthola ulwazi oluthe xaxa ekuhloleni imibiko ye-pathology emva kokuhlinzwa komdlavuza we-ovarian.

Ukuhlonza okuhlukile

Isisindo esivela esifundeni se-ovary ne-fallopian tube ekuhlolweni noma ekuhlolweni kwe-imaging kubhekiswa njengobuningi be- adnexal . Izimbalwa ezimbalwa ezikhona (kuneziningi) zingabandakanya lokhu okulandelayo, okungase kubhekwe konke ngokungeziwe kumdlavuza we-ovarian:

Izivivinyo zokuhlaziya

Uma ukuxilongwa komdlavuza we-ovarian kwenziwa, isinyathelo esilandelayo sibeka isisu. Olunye ulwazi oludingekayo ukuze kusetshenziswe isiteji lungabuthwa kusuka ekuhlolweni kwe-imaging kanye ne-biopsy, kodwa ngokuvamile ukuhlinzeka (ukukhipha ama-ovari kanye nezicubu eziningi ezengeziwe) kuyadingeka ukuze kulungiswe kahle umdlavuza. Ukuqaphela isiteleka somdlavuza kubalulekile ekukhetheni izinketho zokwelashwa ezingcono kakhulu.

Ngemuva kokuhlinzwa, udokotela wakho ohlinzayo uzothumela noma yiziphi izicubu ezasuswe kumuntu wezokwelapha. Lokhu kungabandakanya ama-ovari, ama-tubespian tubes, isisu, nezicubu nama-biopsies athathwa kwezinye izifunda zesisu sakho. Ngaphansi kwe-microscope, uzoqinisekisa ukuthi uyatholakala yini umdlavuza we-ovari futhi uphinde ubone ukuthi yiziphi amasampula aqukethe amangqamuzana omdlavuza.

Kokubili ukuhlola nokuhlola okucubungulayo kungasiza ekunqumeni ukuthi umdlavuza usakaze yini kuma-lymph nodes noma kwezinye izifunda zomzimba. Ukuze uthole amakhemikhali e-ovarian asezingeni eliphakeme, ama-biopsies ngokuvamile athathwa ema-lymph nodes, i-omentum (i-fatty, i-carpet efana nesakhiwo esiphezulu kwamathumbu), futhi ngokuvamile izindawo eziningana ze-peritoneum (i-membrane eqondisa isisu somzimba). Udokotela ohlinzayo uzosusa noma enze inothi kwanoma yimaphi ama-nodules abukeka asolisayo noma ezinye izixuku. Uma umdlavuza wawuyi-mucinous, isithasiselo sizosuswa.

Ukuhlanza kungenziwa futhi, lapho udokotela ohlinzayo ejoza u-saline esiswini bese ehoxisa umkhuhlane ukuze afune ubufakazi bamangqamuzana omdlavuza.

Okutholakele okusiza ukuthola isiteji kufaka:

Thayipha kanye ne-subtype: Ukwazi uhlobo kanye ne-subtype yomdlavuza we-ovari anganikeza ulwazi ngokuhlukumezeka okulindelekile kwe-tumor nokuthi ngabe iyashesha noma ikhula kancane.

Ibanga le-Tumor: Lesi yisilinganiso sokuhlukunyezwa kwesisu. Ngomdlavuza we-endometrioid ovarian, amagciwane anganikwa ibanga eliphakathi kwe-1 no-3:

Ama-tumorous serous anikezwa kokubili kokulinganisa esikhundleni: ibanga eliphansi noma ibanga eliphezulu.

Izigaba

Umdlavuza we-ovariya uhlelwe ngokusebenzisa izindlela ezilula noma ezigcwele ze-FIGO. Ukuthola kungabuye kuchazwe njengomdlavuza we-ovarian umngcele. Yize ngezansi ikakhulukazi zikhathaza udokotela wakho, kungase kube usizo njengoba usebenza ukuqonda ukuthi yiziphi izinketho zokwelapha ezingakulungele wena.

I-Borderline i-Ovarian Cancer

Amagciwane e-ovarian e-Borderline yilawo angase abe namandla aphansi kakhulu. Lezi zivunguvungu zivame ukuqala emuva kokuhlinzwa. Lezi zinambuzane zinganikezwa isiteji uma udokotela wakho ohlinzayo engaqiniseki ngesikhathi sokuhlinzwa noma umdlavuza wezinga eliphezulu uphakathi, noma uma kubonakala sengathi kwasabalalisa isisu.

Isitatimende esilula

Ukuze uthole isithombe esibanzi sokwehluka phakathi kwezinyathelo, lezi zingahle ziphulwe zibe yi:

Ukulinganisa okugcwele kwe-FIGO

I-FIGO egcwele, ebizwa ngokuthi i-International Federation of Gynecology and Obstetrics, isistimu yokuphawula okusebenzisa izibalo zamaRoma ngezigaba (ukulinganisa ukubikezela) kanye nezinhlamvu zezigaba (yiziphi izinketho zokwelapha zokusiza).

> Imithombo:

> Society of American of Clinical Oncology. I-Ovarian, i-Fallopian, ne-Peritoneal Cancer: Izigaba namaBanga. I-Cancer.Net. Kubuyekeziwe ngo-08/16. https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/stages-and-grades

> Henderson, J., Webber, E., noG. Sawaya. Ukuhlolwa kwe-Cancer ka-Ovarian: Umbiko Wokufakaza Obufakazi Nokubuyekeza Okuhlelekile kwe-US Preventive Services Task Force. I-JAMA . 2018. 319 (6): 595-606.

> National Cancer Institute. I-Ovarian Epithelial, I-Tube yama-Fallopian, ne-Primary Peritoneal Cancer Treatment (PDQ) -Health Professional Version. Kubuyekezwe 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq

> Qin, Y., Wu, Y., Xian, X. et al. Ukusetshenziswa okukodwa kanye okuhlanganisiwe kwe-Red Cell Distribution Width, ivolumu yePlatelet ephakathi, ne-Cancer Antigen 125 yokuthola ukuhlukana okuhlukile kwe-Ovarian Cancer kanye ne-Benign Ovarian Tumors. I-Journal ye-Ovarian Research . 2018. 11 (1): 10.

> Soletormos, G., Duffy, M., Othman, S. et al. Ukusetshenziswa Kwemithi Yomdlavuza Emdlalweni We-Cancer Epithelial: Imihlahlandlela Ebuyekezwayo Evela Eqembu LaseYurophu Lama-Markor Tumor. I-International Journal ye-Gynecological Cancer . 2016. 26 (1): 43-51.