Ukuxilongwa, ukuHlanganisa, nokuHlelwa kweziMastastase ze-Lymph Node
Umdlavuza we-Lung uvame ukusabalala kuma- lymph nodes ngaphambi kokusakaza kwezinye izifunda zomzimba. Yiziphi izitho zamakhansela ezenza umdlavuza wamaphaphu usakazeke, udokotela wakho wazi kanjani ukuthi umdlavuza wakho wamaphaphu usakaze kumakhansela akho, futhi lokho kusho ukuthini ukwelashwa kwakho nokubikezela?
Sibutsetelo
Umdlavuza we-Lung ungasakazeka ( ukumisa umzimba ) ngezindlela ezintathu eziyinhloko. Ingase isakaze nge:
- uhlelo lymphatic
- igazi
- endaweni esiseduze ne-tumor
(Manje sekucatshangwa ukuthi umdlavuza wamaphaphu, ngokungafani namanye amanyevuza, ungase usakaze nasemoyeni).
Lapho amangqamuzana omdlavuza wamaphaphu ehamba ngesistimu ye-lymphatic ayiswa ema-lymph nodes lapho angafaka khona futhi akhule. Umdlavuza we-Lung ngokuvamile uvame ukusabalalisa izitho zamakhemikhali eduze kwe-tumor, eyaziwa ngokuthi i-lymph node zesifunda, kodwa ingase isakaze nakwe-lymph nodes ezifundeni ezikude. Amanye amagama ongawazwayo achaza umdlavuza wamaphaphu osakazeke kuma-lymph nodes eduze kwe-tumor kufaka phakathi "izifo zesifunda," "ukusabalalisa kwendawo," noma "isifo esiphambili sendawo."
Yimaphi ama-Lymph Nodes angase abe nethonya
Ama-lymph node ukuthi umdlavuza wamaphaphu usakazeka kuqala okokuxhomeke endaweni yesikhumba. Uma ufunda nganoma yimiphi imibiko yakho ye-radiology, amagama achaza ukubandakanyeka kwe-lymph node kungaba yinto edideka kakhulu. Indlela elula yokucabanga ngomdlavuza wamaphaphu esakazeka kuma-lymph nodes ukuhlukanisa ama-nodes zibe izifunda ezintathu:
- I-lymph nodes: Ithemu libhekisela kuma-lymph nodes ephakathi kwamaphaphu. Lezi zingase zenze i-lymph nodes-okungukuthi, i-lymph nodes etholakala ezindaweni zangaphandle zamaphaphu-noma ama-lymph nodes, ekhona esifundeni esifubeni lapho ubuchopho obukhulu be-bronchi nemisindo engena emaphashini (i- hilum ).
- Ama-lymph nodes eziphakathi komzimba : Lawa angama-lymph nodes asekhona endaweni yesifuba phakathi kwamaphaphu (i- mediastinum ).
- Ama-lymph nodes ase-Extrathoracic: Leli gama libhekisela kuma-lymph nodes atholakala ngaphandle kwe-thorax (isifuba). Lezi zihlanganisa ama-lymph nodes angama-supraclavicular, asezindaweni ezingaphezu kwe-collarbone; kanye ne-scalene lymph nodes, esezintanyeni, eduze nombundu omkhulu.
Enye indlela ama-lymph nodes ahlukaniswa ngayo asekelwe eceleni komzimba lapho atholakala khona:
- Ama-lymph nodes amancane: Lokhu kubhekisela kuma-lymph nodes ohlangothini olufanayo lomzimba njenge-tumor.
- Ama-lymph nodes angama-contralateral : I- lralph nodes engama-contraralateral ngakolunye uhlangothi ("contra") yesifuba esivela kulesi sifo.
Izimpawu
Ngeke ube nezimpawu ezihlobene ngqo nomdlavuza wakho osakazeka kuma-lymph nodes akho. Uma unayo izimpawu, lezi zingabandakanya:
- Ukuvuvukala entanyeni yakho noma endaweni ngaphandle kwe-collarbone yakho.
- Ukuphefumula okubangelwa ukucindezela okuvela ku-lymph nodes ezivuvukile.
- Ukwesaba ngenxa yecindezelo emisipha eyenziwa yi-lymph nodes evuvukazayo noma eduze namaphaphu akho.
Ukuxilongwa
Ngemuva komdlavuza wemaphaphu kutholakala ukuthi, udokotela wakho uzongincoma ukuhlolwa ukuze abone ukuthi isisu sakho sesakazeke kuma-lymph nodes noma kumasayithi akude. Ukunquma ukuthi, futhi yini, i-lymph nodes umdlavuza wakho isakaze kuye kubalulekile ekukhetheni ukwelashwa okungcono kakhulu.
Ezinye izivivinyo ezingenziwa kungenzeka zihlanganisa:
- CT scan noma i-MRI yesifuba sakho nesisu
- I-PET Scan - Ikakhulukazi uma unomdlavuza wamaphaphu ongewona omncane
- I-Endobronchial Ultrasound
- Mediastinoscopy
- I-lymph node biopsy - Uma i-lymph nodes ingafinyelelwa yinqubo efana ne- endobronchial ultrasound noma i- mediastinoscopy , udokotela wakho angathatha isampula ye-lymph node ukuyihlola ngamangqamuzana omdlavuza
Isiteji
I-TNM yokudlavuza komdlavuza wamaphaphu kuyindlela yokwenza isiteji esicabanga ngobukhulu besisu sakho, ukutholakala kwama-lymph nodes abathintekayo umdlavuza, nanoma yibuphi ubufakazi bokusabalalisa kwesisu sakho ezindaweni ezikude zomzimba wakho.
Esigabeni se-TNM, i-N imele ukubandakanyeka kwe-lymph node:
- N0 - Akukho ukusabalala kwesifo se-lymph nodes
- I-N1 - I-tumor isakaze emaqenjini aseduze ohlangothini olufanayo lomzimba
- I-N2 - I-tumor iye yasakazeka kumagqabha ahamba phambili ngaphandle kohlangothi olufanayo lomzimba
- I-N3 - Amangqamuzana omdlavuza asetshenziselwa izilonda zelulini ngakolunye uhlangothi lwesifuba esivela ku-tumor, noma kuya emagqumeni angama-lymph nodes eduze kwe-collarbone noma imisipha yentamo
Ukwelapha
Ukwelashwa komdlavuza wamaphaphu osakazekile kuma-lymph nodes kuncike esigabeni somdlavuza wakho kanye nempilo yakho jikelele. Uma umdlavuza wamaphaphu usakaze emaphethelweni ambalwa kuphela e-lymph nodes, ukwelapha ukwelashwa kungacatshangwa. Uma i-tumor isakaze ezindaweni ezikude noma ezindaweni ezikude, izinketho zokwelapha ngokuvamile zibandakanya i- chemotherapy , ukwelapha imishanguzo , imithi yokwelapha, kanye ne-immunotherapy.
Isibikezelo
Ukuchazwa komdlavuza wamaphaphu osakazekile kumagciwane amancane kuncike ezintweni eziningana, okubandakanya ukuthi yiziphi i-lymph nodes ezithintekile, uhlobo lomdlavuza wamaphaphu onalo, ubukhulu besisu sakho, noma ngabe isisu sakho sesakaze kwezinye izindawo zomzimba wakho, kanye nempilo yakho jikelele. Izilingo eziningi zokwelashwa zifuna izindlela ezingcono zokwelapha umdlavuza wamaphaphu futhi zinikeza ithemba lokuthi ukuchazwa kwesibindi kuzokwenza ngcono esikhathini esizayo.
Izwi elivela ku-Lymph Node Ukubandakanya ne-Cancer Lung
Ukunquma ukuthi, uma kukhona amantombazane lymph emzimbeni wakho anempilo yamangqamuzana omdlavuza wamaphaphu kubaluleke kakhulu ekukhetheni ukhetho olungcono kakhulu lwezokwelapha zesisu sakho. Ukuqaphela ukuthi yiziphi izitho zamakhansela kanye nobuhlobo bawo nesisu sakho esiyinhloko esibamba iqhaza elikhulu emigqeni.
Kungaba nzima kakhulu ukwazi ukuthi i-lymph nodes iyathinteka yini ngumdlavuza, futhi ngokuvamile akunakwenzeka ukwenza izinhlayiya kuzo zonke izindawo ezingenzeka. Ngenxa yalesi sizathu, ukuhlolwa kokuhlolwa nokuhlolwa kwe-imaging kuncike kakhulu. Ukuba khona kwama-lymph nodes ku-mediastinum (isifunda esifubeni esiphakathi kwamaphaphu) kubaluleke kakhulu kokubili ukuhlukanisa izinketho zokwelapha (isibonelo, ukuhlinzwa nezinye izifo) kodwa kuye kwaba nzima ukutadisha. Esikhathini esidlule, inqubo ebizwa ngokuthi i-mediastinoscopy yayivame ukuqhutshwa ukuze odokotela abahlinzayo babone ngeso lengqondo lezi nodes. Ngesikhathi samanje, izibalo ze-PET ezihlangene ne-CT zivame ukunikeza lolu lwazi ngendlela engavamile kakhulu.
> Imithombo:
> Almeida, F. et al. Ukuhlolwa kokuqala kwesiguli esingenasifo somdlavuza wesifo samaphaphu: ukuxilongwa kanye nesiteji. Ama-Opinions amanje ku-Pulmonary Medicine . 2010. 16 (4): 307-14.
> Riquet, M. et al. Ukuhlukaniswa kwesibalo se-lymph node ukubandakanyeka emdlalweni wamaphaphu kanye neNhlangano Yomhlaba Yomhlaba Yonyaka we-Study of Cancer Lung Cancer echazayo ezindaweni. I-Interactive Cardiovascular and Thoracic Surgery . 2010. 11: 260-264.
> Xia, Y., Zhang, B., Zhang, J., Li, W., Wang, K, no H. Shen. Ukuhlolwa kwe-metastasis ye-lymph node emdlavuza wamaphaphu: ngubani oyisikhulu sezomthetho ?. I-Journal ye-Thoracic Disease . 2015. 7 (Suppl 4): S231-7.