Uma umdlavuza wakho webele usakaze kuma-lymph nodes akho ukhetho lwezokwelapha luvame ukuba lukhuni kakhulu. Ngesifo somdlavuza webele esifushane, asikwazi ukuthi yiziphi ukwelashwa okungase zisakaze (imitha). Njengoba ama-metastases aphethwe ngamaphesenti angama-90 okufa komdlavuza webele, ukwazi isikhathi sokuphatha kabi, futhi uma ukwelashwa kwe-adjuvant kufana ne-chemotherapy kungase kube ngaphezulu, kubalulekile.
Lapho umdlavuza webele usakazeka kuma-lymph nodes uye wabikezela "inhloso" yayo yokumisa. Lezi zomshukela, uma zishiya yedwa, cishe ziyosakazeka kuwo wonke umzimba futhi ekugcineni zibangele ukufa.
Yiziphi izindlela zokwelapha umdlavuza webele oye wasakazeka kuma-lymph nodes, futhi lokhu kusho ukuthini ukuphawula kwakho?
Kungani i-Lymph Nodes ibalulekile ku-Cancer yebele
Umdlavuza wesibeletho uqala ngamangqamuzana ambalwa, okuyinto ehlangene emathisini akho asebele. Bangase bahlale ematokisini lapho ubisi lwebele lukhishwa khona: ama-milk and ducts akho. Njengoba la maseli ekhula futhi ehlukana, angase ahlasele nezicubu eziseduze.
I-tumor ekhulayo ingase ichithe iseli noma i-clump yamaseli. Leli cell elimele lomdlavuza lingasebenzisa uhlelo lwakho lwegazi noma i-lymph njengenethiwekhi yemigwaqo ukuze ukwazi ukuhamba kuwo wonke umzimba wakho. Isistimu yakho ye-lymph isebenza ngegazi lakho elijikelezayo ukunikeza izakhi kuwo wonke amaseli wakho, kanye nokususa imikhiqizo yamasosha wamaselula.
I- lymph nodes yiyona "imisebe yokumisa" kule mgwaqo omkhulu, lapho i-lymphatic fluid ehlungwa khona, ixubene namaseli omzimba (lymphocytes), futhi idluliselwe emuva emzimbeni wakho we-lymph fluid.
Ngakho-ke, uma isifo somdlavuza ovulekile senza ukuba lymph nodes yakho, kungenzeka futhi ukuthi umdlavuza ungathunyelwa kwezinye izingxenye zomzimba wakho.
Uma uthola isifo, ama-lymph nodes akho eduze nendawo ethintekile angathula ngoba aqoqe amagciwane. Futhi uma uhlakulela umdlavuza webele, i-lymph nodes emlenzeni wakho (ama-lymph nodes) asezindaweni ezivame kakhulu ukuthi amangqamuzana omdlavuza angenela, okwenza lezo zinombolo zivule.
Ukuxilongwa Ukusebenzisa i-Sentinel Lymph Node Biopsy
Izicubu zomzimba ziqukethe ezinye zelph nodes, ezenza uketshezi lwama-lymphatic futhi zidlulise. Izifo zesisu zivame ukudlulela endaweni yakho ye-axilla noma indawo engaphansi kwe-underarm. Ukuhlola indawo ye-lymph node indawo engaphansi kwe-underarm kufanele ibe yingxenye yokuhlolwa kwesifuba samathumbu, kanye nesifuba sakho sokuzihlola . Ama-lymph nodes angavuvukala angase abe ubufakazi bokuthi umdlavuza usakaze ngaphesheya kwesifuba sakho, kodwa indlela kuphela yokukwazi ngokuqinisekile ukuthi isuswe futhi ihlolwe.
Kunezinqubo ezimbili ze-lymph node biopsy. Esikhathini se- sentinel lymph node biopsy , idayisi kanye nomakaki omsakazo bajojelwa emdlalweni wesibeletho sakho sebele. I-node yokuqala noma ama-node adayiswa ngombala abizwa ngokuthi ama-lymph node-a-first nodes lapho kulindeleke ukuthi umdlavuza uhambe khona.
Enye indlela ye-lymph node biopsy ye-sentinel ukwenza i-lysphry node dissection. Kule nqubo, zonke izitho zamalym ezitholakala emgqeni wakho zisusiwe.
Siye safunda ukuthi ukuthola amangqamuzana omdlavuza ema-lymph node wakho we-sentinel kuyinto enhle kakhulu yokwenza ukuthi umdlavuza uzotholakala kunoma iyiphi enye yezinyimba zakho ezisele.
Ama-lymph nodes ama-axillary ngokuvamile avame ukuqala lapho umdlavuza webele usakazeka kodwa kukhona okunye okuhlukile. Amagciwane okubeletha esiphakathi kwesifuba sakho angase adle ukuze afike emlenzeni we-lymph phakathi kwamabele akho. Uma izidakamizwa zisuswe zithunyelwa emnyangweni wezokwelapha ukuze zibukwe ngokubukeka nangaphansi kwe-microscope.
Isimo se-Lymph Node
Umbiko wokukhubazeka mayelana ne-lymph node yakho "isimo" sitshela ukuthi noma cha isiphi isibonakaliso somdlavuza sikhona ema-lymph nodes akho asusiwe.
Ungase uzwe amagama afana nama-macrometastases noma ama-micrometastases uma udokotela wakho ohlinzayo exoxa ngezinombolo zakho. Ama-macrometastase abhekisela ekusabalaleni komdlavuza kuma-lymph nodes obonakala emehlweni. Ama-Micrometastases esikhundleni salokho kubhekisela ebufakazini bomdlavuza ema-lymph nodes angabonakala kuphela ngaphansi kwe-microscope.
Uma i-lymph node yakho icacile ngomdlavuza, isimo sakho se-lymph node kuthiwa siyingozi futhi sibalwa nge-N0 ngokwemigomo ye-TNM yomdlavuza webele. Uma une-tumor encane namaconsi acacile, cishe akunakudinga ukuthi uzodinga imithi yokwelashwa.
Uma unomdlavuza we-lymph nodes, umdlavuza wakho uzocatshangwa ukuthi i- lymph node-positive . Ngokusekelwe kuhlelo lwe-TNM, i-tumor yakho izobizwa nge-N1, N2, noma i-N3 isekelwe ukuthi zingaki zelph nodes eziqukethe amangqamuzana omdlavuza nokuthi kude kangakanani ne-tumor ama-positive node atholakalayo.
Eminye imiphumela ebalulekile ekuPhileni nasePhumeleni
Isimo se-lymph node ingenye yezici ezibalulekile ekwenzeni izinqumo mayelana nokwelapha umdlavuza webele, kodwa kunezinye izivivinyo ezidlala indima kokubili ukwelashwa nokubikezelwa. Lokhu kufaka:
- Usayizi wesisu : Usayizi wesisu udlala indima emdlalweni wesifo somdlavuza webele .
- Isimo se-receptor yesifo se-hormone: Amaseli omdlavuza wakho azohlolwa ukuze anqume isimo sakho se-receptor yakho , okungukuthi, noma ngabe amangqamuzana omdlavuza wakho anemitholampilo ye-estrogen noma i-progesterone ebusweni, ngoba lokho kusiza ukukhetha ukhetho lwezokwelapha.
- Isimo se-HER2: Isici sokukhula komuntu isifo se-epidermal 2 , uma sikhona emangqamuzaneni omdlavuza wakho, sineqhaza ekuxilongweni nasekwelapha.
- Ibanga le-Tumor: Ibanga lokuhlukumeza liyisilinganiso sokuhlukunyezwa komdlavuza futhi lokhu kuhlolwa kungakhombisa izindlela zokwelashwa.
- Ukuba khona kwanoma yimiphi imithanguzo yegazi: Uma umdlavuza wakho usakaze kwezinye izifunda zomzimba, isibonelo, amathambo akho noma amaphaphu akho, lokhu kubalulekile ekukhetheni izinketho zokwelashwa.
Ukwelashwa Kwabantu Abanobuhle BamaNode
Uma une-nodeinel node biopsy futhi ayibi, cishe ngeke kudingeke ube ne-lysphry node dissection. Ngokuphambene nalokho, uma unomdlavuza wamangqamuzana avela ku-lymph node yakho ye-sentinel, i-axillary node dissection ingafakwa kanye nokuhlinzwa komdlavuza wakho webele. Uma i-lymph nodes yakho ihle, kuzodingeka uxoxe ngokukhetha okunye ukwelashwa nge-oncologist yakho emva kokuhlinzwa.
Ukubandakanyeka kwe-lymph nodes kusikisela ukuthi umdlavuza ubonise ikhono lokusabalalisa ngaphesheya kwesifuba sakho futhi uzokwaziswa ukuba ube nokwelashwa kwe-adjuvant systemic ezifana ne-chemotherapy ukubulala noma yimaphi amangqamuzana omdlavuza oqhubekayo emzimbeni wakho. Ukwelashwa kwe-Adjuvant kubhekisela kokwelashwa okunikezwayo hhayi ngoba noma yimuphi umdlavuza ubonakala, kodwa ngoba kusolakala ukuthi kungenzeka ukuthi kunezinye amangqamuzana omdlavuza akhona.
Kulabo abanesifo se-estrogen receptor positive, ukwelashwa kwama-hormone ngokuvamile kunconywa iminyaka emihlanu kuya kwengu-10 emva kokwelapha. Lokhu kungaba yi-tamoxifen kulabo abano-premenopausal kanye ne-aromatase inhibitor kulabo abangama-postmenopausal. Kwabesifazane be-postmenopausal abazosebenzisa i-aromatase inhibitor, i-Zometa imithi ye-bisphosphate iyanconywa futhi ibonakala inciphisa ingozi yokuthuthukisa amathisaseli we-bone. Amathambo yindawo ejwayelekile kunazo zonke ze-metastase nomdlavuza wesifuba.
Ukwelashwa kwezidakamizwa kungenzeka noma kunganconywa kuye ngokuthi inani lamantombazane angama-lymph aphilile, nezinye iziphumo zesisu sakho.
Isibikezelo
Ukubikezela, okubizwa ngokuthi i-outlook, yindlela eyodwa udokotela ekhuluma ngayo ukuthi izinkinga zokusinda ziyakunikela kanjani emva kokuqeda ukwelashwa. Khumbula, ukuba nomdlavuza owodwa nje emzimbeni wakho kuningi kakhulu. Ukwelashwa kuklanyelwe ukubulala abaningi, uma kungenjalo, amangqamuzana omdlavuza wakho ngangokunokwenzeka.
Uma unesifo se-lymph ecacile nesikhumba esincane, esincane, ukubikezela kwakho ngemuva kokwelashwa kuhle kakhulu. Ngakolunye uhlangothi lwesigubhu, uma unama-lymph nodes amaningana ahilelekile noma i-tumor enkulu, ukwelashwa kwakho kungase kubenze kakhudlwana, futhi umbono wakho uyoba nzima ukunquma kuze kube yilapho usuqede konke ukwelashwa. I-athikili eshicilelwe eNew England Journal of Medicine ibonisa ingozi enkulu yokuphindaphinda kweziguli ezinama-lymph nodes amane noma ngaphezulu. Futhi. usayizi we-tumor yisici sokuzimela esizimele.
Kungakhathaliseki ukuthi ukuxilongwa kwakho kufinyeleleka kuleso sikali, sicela wazi ukuthi izinga lokusinda liyathuthuka, ukwelashwa kusebenza kahle futhi kuphumelele, futhi ngisho nomdlavuza wesifuba we-metastatic ngezinye izikhathi ungaphethwe isikhathi eside.
I-Lymph Node Isilinganiso
| I-Lymph Node Isilinganiso | Okushiwo Isilinganiso |
| N0 | Okubi noma okucacile - akunawo umdlavuza futhi akukho micrometastasis |
| I-N1, 2, 3: I-lymph nodes enembile (ehilelekile) | |
| N1 | I-Cancer itholakala ku-1-3 lymph nodes ngaphansi kwengalo noma i-lymph nodes ngaphakathi kwebele |
| I-N2 | I-Cancer itholakala ku-4-9 lymph nodes ngaphansi kwengalo noma i-lymph nodes ngaphakathi kwebele |
| N3 | I-Cancer itholakala ku-lymph nodes ayishumi noma ngaphezulu ngaphansi kwengalo noma isakaze ngaphansi noma ngaphezu kwe-collarbone. Kungenzeka ukuthi itholakale ku-nodes engaphansi kwesidumbu kanye nama-lymph nodes ngaphakathi kwebele |
Okubalulekile
Uma une-lymph nodes enomdlavuza webele wesandulela-ngculaza, ukwelashwa cishe kuyoba nobudlova futhi kufaka phakathi i-chemotherapy, ukwelashwa kwe-hormonal, ukwelashwa okuhloswe nge-HER2 kulabo abano-HER2 obuhle, futhi mhlawumbe nemisebe. Lokhu kusho ukuthi abantu abaningi abanomdlavuza we-lymph node-positive bahlala bengenawo umdlavuza ngemuva kokwelapha, futhi isimo esihle se-lymph node asisho ukuthi umdlavuza wakho uzobuya.
Imithombo:
I-Laronga, C. Ulwazi Lomguli: Umhlahlandlela Webele Lomdlavuza Wokuxilongwa Nokunakekelwa (Ngaphandle Kwezingqalasizinda). Kusesikhathini.