Uhlelo lungakwazi ukubikezela amathuba akho okuvuselela umdlavuza wesifo sofuba
I-D'amico classification system ingenye yezindlela ezisetshenziselwa kakhulu ukuhlola ingozi yomdlavuza wesibeletho. Ngokwakhiwa ngo-1998 ngumcwaningi wezokwelapha ogama lakhe lingu-D'amico, lolu hlelo luhlelwe ukuthi luhlolisise ingozi yokuphindaphinda ngemuva kokwelashwa kwendawo yomdlavuza wesifo sofuba. Ihlukanisa iziguli zibe amaqembu amathathu aphindaphindiwe-engozini: okuphansi, okuphakathi, kanye nengozi enkulu, besebenzisa izinyathelo ezinjengezinga legazi le-PSA , amamaki e-Gleason, nezigaba ze-tumor nge-T-scores
Umsebenzi nokubaluleka kohlelo lwe-D'amico lokuhlukanisa
Uhlelo lwe-D'amico group classification system lusetshenziselwa ukulinganisela amathuba okuphindaphinda noma yisiphi isiguli usebenzisa isethi yemingcele ebekiwe futhi isetshenziswe kabanzi njengenye yamathuluzi wokuhlola engozini. Lokhu kuhlaziywa kungasiza labo abanomdlavuza wesibeletho ukuba benze isinqumo esinolwazi mayelana nokuphathwa kwabo.
Ngokuchaza umdlavuza wakho we-prostate njengengxenye yenye yalezi zigaba ezintathu, lolu hlelo lungakusiza wena nodokotela wakho ukuba wenze izinqumo zokwelapha ezengeziwe. Kunezici eziningi okufanele uzicabangele uma wenza isinqumo mayelana nokuphathwa komdlavuza we-prostate , kufaka phakathi izinga elide lokuphila kanye nezinye izimo ezingozini noma izimo zempilo ezingapheli ongase ube nazo. Zonke izindlela zokwelapha umdlavuza we-prostate zithatha ingozi enkulu yezinkinga noma imiphumela emibi. Yeka ukuthi lezi zinkinga zingathí sina kangakanani zizohlukahluka komunye umuntu, kodwa kubalulekile ukukhumbula engqondweni lapho ukhetha uhlelo lokulashwa.
Indlela uhlelo lokusebenza olusebenza ngayo
Okokuqala, kubalulekile ukuqoqa izinombolo zakho:
- I-PSA: Uzodinga imiphumela yokuhlola kwakho kwe-PSA , ukuhlola kwegazi okuthola i-anti-protein-antigen - iprotein ekhiqizwa ngamaseli ku-prostate yakho.
- I-Gleason score: Imiphumela ye-Gleason score yakho , enikezwe ngokubukeka okukhulu kwamangqamuzana omdlavuza wakho.
- Isigaba sesitholampilo T score: Futhi isiteji sakho T , ubukhulu besisu sakho njengoba kuboniswe ultrasound noma ngesikhathi ukuhlolwa rectal.
Ukusebenzisa lezi zinombolo, ingozi yakho ingabalwa njengalokhu:
- Ingozi ephansi: Labo abane-PSA ngaphansi noma abalingana no-10, isiqephu se-Gleason esingaphansi noma esilingana no-6, noma esesiteji sesitholampilo T1-2a
- Ingozi ephakathi: Amadoda anePSA phakathi kuka-10 no-20, isiqephu se-Gleason se-7, noma esesiteji se-T2b
- Inengozi enkulu: Labo abane-PSA abangaphezu kuka-20, isilinganiso se-Gleason silingana noma sikhulu kunezingu-8, noma sisendaweni yesitholampilo T2c-3a.
Okushiwo Ucwaningo Mayelana Nesimiso
Ucwaningo olubili oluhlanganisa amacala omdlavuza we-prostate angaphezu kuka-14 000 abuke amandla okubikezela amanani okuphila komdlavuza kanye nendawo jikelele yokuphila kanye nokusebenza komtholampilo wesistimu yokuhlukanisa izifo ezinjalo esikhathini esizayo.
Lezi zinsuku zalinganiselwa ukuthi izinga lokusinda ngemuva kokuhlinzwa libizwa nge-Kaplan-Meier. Lokhu kuhlaziywa kubalwa ukusinda okungahambi kahle kwe-biochemical (BRFS), okusho ukusinda komdlavuza wesi-prostate ngaphandle kwezinga eliphezulu le-PSA ukulibiza ngokuthi ukuphindaphinda umdlavuza, amanani ezigulini ezigaba ezihlukahlukene zomdlavuza. Labo ababebikezela izinga lokusinda babese beqhathaniswa namacala abonakalayo ukuze babone uma ukusebenzisa uhlelo lwe-D'amico esekelwe ekuhlaleni isisusa kusiza isiguli ukuba senze isinqumo sokwelashwa esinolwazi futhi ngaleyo ndlela sikhule amathuba okuphila.
Ucwaningo lwathola ukuthi amadoda abenolwazi olwengeziwe lokuthola ulwazi (njengaloluhlelo lwe-D'amico-based classification system) ayenamazinga aphezulu okusinda ngokulandela ukwelashwa komdlavuza wabo we-prostate, ikakhulukazi lawo madoda anengozi enkulu yokuphindaphindiwe.
Noma kunjalo, uhlelo alukwazi ukuhlola ngokunembile ingozi yokuphindaphinda kulabo abanezici eziningi eziyingozi. Njengoba amacala omdlavuza we-prostate anezici eziningi eziyingozi, ama-D'amico classification system angeke afaneleke emadodeni anomdlavuza we-prostate kanye nodokotela bawo njengamanye amasu okuhlola.
> Imithombo
- IBoorjian SA, uKarnes RJ, uRangel LJ. Ukuqinisekiswa kwe-Mayo Clinic yezinhlelo ze-D'amico zezinhlekelele zokubikezela ukusinda ngemuva kwesifo se-prostatectomy esiqine. J Urol. 2008 Apr; 179 (4): 1354-60; ingxoxo 1360-1. Epub 2008 Mar 4.
- Gabriele, D., Jereczek-Fossa, B., Krengli, M. et al. I-Beyond D'Amico amakilasi okulimala ukubikezela ukuphindaphinda ngemuva kwe-radiotherapy yangaphandle ye-prostate yomdlavuza wesi-prostate: i-Candiolo classifier, i- Radiation Oncology . 2016. 11 (1): 23.
- UHernandez DJ, uNielsen ME, Han M. Ukuhlolwa okwenziwe ngengozi ye-D'amico isifo somdlavuza we-prostate. Urology. 2007 Nov; 70 (5): 931-5.
- Yuh, B., Artibani, W., Heidenreich, A. et al. Indima ye-prostatectomy yama-radical prostatectomy kanye ne-lymph node dissection ekulawulweni komdlavuza omkhulu wesifo sofuba: ukubuyekezwa okuhlelekile. Urology yaseYurophu . 2014. 65 (5): 918-27.