Kusukela ngoJulayi 2016, i-BAC (i-Bronchioloalveolar carcinoma) yigama elingasetshenziswanga kepha lisetshenziswe phakathi kuka-2004 no-2011 ukuchaza uhlobo oluthize lwe-lung adenocarcinoma. Lokho kusho ukuthi ezinye ze-oncologists zisasebenzisa leli gama, ngakho-ke umlando nezici zalokho okwake kwahlukaniswa njengeBAC kuzochazwa lapha.
I-BAC, lapho ihlelwe ngaphansi kwalesi sihloko, ngezinye izikhathi yayibizwa ngokuthi "imfihlakalo" umdlavuza wamaphaphu.
Ukubalwa kwama-akhawunti kwamaphesenti angu-2 ukuya kwangu-14 azo zonke izinhlobo zomdlavuza wamaphaphu, kancane kancane kwaziwa ngalolu hlobo lomdlavuza kunamanye amakhemikhali ephuzi lamaphaphu angewona amancane .
Sibutsetelo
Njengoba kuphawuliwe ngenhla, i-BAC manje isetshenziswe kabusha ngaphansi kwesihloko samaphaphu adenocarcinomas , kodwa kusukela leli gama ngezinye izikhathi lisasetshenziswa odokotela, kuzochazwa kuleso simo. Esikhathini esisha, i- BAC ingase ibhekiswe ngokuthi "i-adenocarcinoma ephezulu kakhulu" esekelwe iphethini evamile yokukhula kwesisu. I-BAC iqala ngamaseli eduze emasakeni amancane emoyeni ( alveoli ) ezindaweni ezingaphandle zamaphaphu. Lendlala noma izicubu ezihlukanisa i-alveoli noma nge-airways. Ngokungafani nezinye izinhlobo zomdlavuza wamaphaphu ovame ukusakazeka emgodini wamaphaphu ( pleura ) nakwezinye izifunda zomzimba, i-BAC isakazeka ngokuyinhloko emaphashini. Ingabonakala njengendawo eyodwa endaweni yomaphaphu, noma njengamabala ahlakazekile kuwo wonke amaphaphu.
Kunezinhlobo ezimbili eziyinhloko ze-BAC: i-non-mucinous BAC ivame kakhulu futhi itholakala kaningi kulabo ababhema, futhi i-mucinous BAC, engavamile futhi evame ukutholakala kwabangabhemi.
Ihluke Kanjani Kwelinye Cancers Lungula?
I-BAC ingathinta kakhulu abangewona abokubhema, abesifazane nabase-Asiya (ikakhulukazi abase-Asiya asempumalanga) kunezinye izinhlobo zomdlavuza wamaphaphu.
Isigameko saso sibonakala sanda, ikakhulukazi kwabesifazane abasha abangabhema.
Izimpawu
Izimpawu ze-BAC zifana nezimpawu ezibonwe namanye amakhansela emaphaphu , futhi zihlanganisa ukukhwehlela okuqhubekayo , ukukhwehlela igazi (i-hemoptysis), nobuhlungu besifuba. Kodwa futhi uye wabizwa ngokuthi "i-masquerader." Kuyinto engavamile ukuthi i-BAC iphoswe nge-pneumonia noma ezinye izifo zamaphaphu ngaphambi kokuthi zifunwe.
Ukuxilongwa
Ukuxilongwa kwe-BAC kubuye kufane nokuxilongwa kwamanye amagciwane kanaphaphu , ngezinye izinto ezimbalwa. Ukuxilongwa kwe-BAC kudinga isampula yamathambo, futhi ukuhleleka kwe-needle aspiration biopsy kunganikeza ukuxilongwa cishe ingxenye yesikhathi. Ngokungafani nezinye izifo zomdlavuza wamapayipi, lapho ukuhlolwa kwe-PET kuyasiza ngaphezu kokuhlola kwe-CT ekunqumeni ukuthi umdlavuza ukhona, ukukala kwe-PET akuthenjelwa kancane. Isiteji (izigaba 1 kuya ku-4 noma i-TNM isiteji) kufana nesiteji nezinye izinhlobo zomdlavuza wamaphaphu .
Ukwelapha
Ukwelapha ukwelashwa okukhethwa yi-BAC, futhi uma isisu esisodwa singasuswa, kuvame ukuba nethuba elihle lokuthi lizophulukiswa. Kubonakala kungacabangi kakhulu nge- chemotherapy yendabuko, futhi kukhona ukuphikisana ngokuthi ngabe i-adjuvant chemotherapy noma imithi (i-chemotherapy enikezwe kanye nokuhlinzeka) kufanele isetshenziswe ngokuhlinzwa.
I-BAC ibonakala igxile kakhulu ezithandweni ezithintekayo ezisha, izindlela zokwelapha ezihloswe ukukhomba ukuguqulwa kwezakhi zofuzo ngaphakathi kwesisu. Abantu abanalo hlobo lomdlavuza wamaphaphu kufanele babe nokuhlolwa kofuzo (ukuprofiliswa kwamangqamuzana) okwenziwe ngesisu sabo . Kukhona manje ukwelashwa okuvunyelwe kulezi zomshukela zamaphaphu ezinezinguquko ze- EGFR , i- ALK rearrangements , kanye nokulungiswa kabusha kwe-ROS1 , nemithi isetshenziselwa ukuvivinywa kokwelashwa kulabo abanezinye izinguquko zofuzo emathunjini abo kanye.
Ukuguqulwa kwamangwenya kubhekwa njengokwelashwa okwengeziwe, futhi uma umdlavuza ungabuyeli emaphashini ahlwanyelwe, unikeza elinye ithuba lokuphila isikhathi eside.
Isibikezelo
Ngokuvamile, isilinganiso sokusinda singcono kangcono ku-BAC kunezinye izinhlobo ze-non-small cell cell lung cancer, ikakhulukazi lapho ibanjwa ekuseni futhi isifo esisodwa kuphela. Kwesinye isifundo, labo abatholakala bephethe i-BAC futhi banezicubu ezingaphansi kwamamentimitha amathathu ububanzi, benesilinganiso seminyaka engu-5 sokusinda samaphesenti angu-100 ngokuhlinzwa. Ngezigaba kamuva zezilinganiso zokusinda kwesifo zihluka kakhulu, kuye ngokuthi izici ezifana nezicubu ezihlukile ku-lobe efanayo, ukubandakanyeka kwe-lymph node, nokusakazeka okude kwesikhumba.
Imithombo:
Arenberg, D., i-American College of Chest Physicians. Umdlavuza we-Bronchioalveolar wamaphaphu: I-ACCP ubufakazi-based based clinic practice practice (edition 2nd). Isifuba . 2008. 132 (3 Suppl): 306S-13S.
Butt, U., no-T. Allen. I-Demise ye-Term Bronchioloalveolar Carcinoma. Archives of Pathology and Laboratory Medicine . 2015. 139 (8): 981-13.
Ebright, M. et al. Iphethini yemitholampilo kanye nesigaba se-pathologic kodwa hhayi izici ze-histologic zibikezela imiphumela yomphumela we-bronchioloalveolar carcinoma. The Annals of Thoracic Surgery . 2002. 74 (15): 1640-6.
UGarfield, D. et al. I-carronoma ye-Bronchioalveolar: icala lezifo ezimbili. Cancer Cancer Clinic . 2008. 9 (2): 24-9.
U-Liu, Y. et al. Ukubikezela kanye namaphesenti aphindaphindiwe ku-Bronchioloalveolar Carcinoma. Isifuba . 2000. 118: 940-947.
MacDonald, uL. noHazdi. I-sweet-needle aspiration biopsy ye-bronchioloalveolar carcinoma. I-Cancer . 2001. 93 (1): 29-34.
Raz, D. et al. I-carronoma ye-Bronchioalveolar: ukubuyekezwa. Cancer Cancer Clinic . 2006. 7 (5): 313-22.
Funda, W. et al. I-epidemiology ye-bronchioloalveolar carcinoma kule minyaka engamashumi amabili edlule: ukuhlaziywa kwedatha ye-SEER. I-Cancer Lung . 2004. 45 (2): 137-42.
Sakurai, H. et al. I-carronoma ye-Bronchioloalveolar yamapentimitha angu-3 noma ngaphansi ububanzi: ukuhlolwa kokubikezela. The Annals of Thoracic Surgery . 2004. 78 (5): 1728-33.
I-West, H. Bronchioloalveolar carcinoma, kuhlanganise ne-adenocarcinoma in situ. Kusesikhathini. Ifinyelele ngo-01/16/16. http://www.uptodate.com/contents/bronchioloalveolar-carcinoma-including-adenocarcinoma-in-situ
UZell, J. et al. Ukungafani kokuhlala isikhathi eside kwezilwane ze-bronchiolo-alveolar carcinoma ene-intrastateral intra pulmary metatstasis ekuxilongweni. Amanothi we-Oncology . 2006. 17 (8): 1255-1262.