Incazelo kanye nesiprofetho kusukela kwesigaba 0 kuya kwesigaba IV
I-melanoma yindlela ehlukumeza kakhulu yomdlavuza wesikhumba . Ukumiswa kwe-Melanoma yinkqubo esetshenziselwa ukunquma ubukhulu besifo se-melanoma nokuthi kuphi nokuthi kusakazeke kangakanani. I-Melanoma ihlukaniswe ngezigaba ezivela ku-0, okuyindawo ephansi kunazo zonke, kuya ku-IV, okuyisigaba esiphezulu. Ukugxila kubalulekile ngoba kusiza ithimba lakho lokunakekelwa kwezempilo lihlele ukwelashwa okufanele.
Legalari yesithombe se-melanoma ibonisa ezinye zezigaba ezithombeni. Thola kabanzi mayelana nokuthi kusho ukuthini ukuba nesigaba esithile se-melanoma.
I-TNM Yokumiswa kwe-Melanoma
Ochwepheshe bezempilo baye bavela ngezindlela ezihlukahlukene zokugaya amagciwane. Lesi sihloko sisebenzisa uhlelo lwe-TNM luka-2009 oluphakanyiswa yi-American Joint Commission e-Cancer. Yisistimu yesiteji esetshenziswa kakhulu kunazo zonke emhlabeni.
Esikhathini sohlelo lwe-TNM, izinhlamvu T, N, ne-M zibhekisela ku:
- T = i-tumor: T ilandelwa inombolo ehambelana nobukhulu be-tumor.
- I = node: N ilandelwa inombolo ehambelana nokubandakanyeka kwe-lymph node .
- M = metastasis (ukusakazeka okude): M ilandelwa inombolo ehambelana nobukhulu bemetastasis.
Udokotela wakho angabela futhi i- Clark ne-Breslow inombolo- ukusimama kokungena kwe-tumor nobukhulu, ngokulandelana-ukuqhubekela phambili kwe-melanoma yakho futhi unqume ukuthi ukuchaza kwakho kuyini.
Ngaphezu kwalokho, i- "T" ingalandelwa "a" engabonakali isilonda, noma "b" esibonisa isilonda.
Ukujula, okubonisa izifo ezimbi kakhulu futhi kubonakala ngaphansi kwe-microscope, kwenzeka lapho i-melanoma ihlasela isikhumba esiphezulu.
Ngokuvamile, isisindo esiqhamukayo futhi esingaphezu kwalokho umdlavuza usakaze, isigaba esiphezulu esinikeziwe. Ukuphakama kwesiteji, kubi kakhulu isimo sengqondo eside.
Funda kabanzi mayelana nazo zonke izigaba ezahlukene ze- melanoma nokuthi yini ebonisa, ngezansi.
Isigaba 0
Uma i-melanoma ibanjwe esiteji sokuqala futhi ingazange ingena ngaphansi kwesikhumba, ibizwa ngokuthi i-melanoma in situ. Iyakwazi ukuphulukiswa kakhulu futhi ibizwa ngokuthi isiteji 0 noma ayinikezwa isiteji.
Isigaba I
Amazinga okuguqulwa aphezulu kakhulu ngokususwa kokuhlinzwa kusukela la ma-melanomas kungenzeka ukuthi asakazeke.
- Isigaba 1A (T1aN0M0): Isifo asizange sisakaze kulezi zindawo. Ingaphansi kwe-1 mm futhi ayilonda. Ukusinda kweminyaka emihlanu ngamaphesenti angu-95.
- Isiteji IB (T1bN0M0 noma i-T2aN0M0): I-tumor ayizange isakaze kuma-nodes. Ingaphansi kwe-1 mm, kodwa isilonda noma iphakathi kuka-1.01 no-2 mm kodwa ayilonda. Ukusinda kweminyaka emihlanu kungamaphesenti angu-89 kuya kwamaphesenti angu-91.
Kumele uqaphele ukuthi isisu singaba ngaphansi kwe-1 mm futhi singabi nesilonda kodwa singacatshangwa njengeSigaba IA-uma sinesilinganiso esiphezulu se-Clark sokuhlasela. Ngokufanayo, i-tumor ingaba yi-T1b futhi ingaphansi kuka-1 mm ngaphandle kwesilonda uma i-Clark iphezulu.
Isigaba II
I-Melanomas ingaphulukiswa, kepha izinga lokuphumelela lihlehliswa ngemuva kweSigaba I ngoba inani elincane lamaseli omdlavuza lingase lisakaze kumasayithi akude. Ngaphezu kokuhlinzwa, ezinye izinhlobo zokwelapha zinganconywa.
- I-Stage IIA (T2bN0M0 noma i-T3aN0M0): Isisu asizange sisakaze kulezi zindawo. Iphakathi kuka-1.01 no-2 mm futhi isilonda, noma i-2.01 kuya ku-4 mm ngaphandle kokulonda. Ukusinda kweminyaka emihlanu kungamaphesenti angu-77 kuya kuma-79%.
- Isiteji IIB (T3bN0M0 noma i-T4aN0M0): Isisu asizange sisakaze kulezi zindawo. Iphakathi kuka-2.01 no-4 mm futhi isilonda noma ngaphezulu kuka-4 mm ngaphandle kwesilonda. Ukusinda kweminyaka emihlanu kungamaphesenti angu-63 kuya kuma-67%.
- I-Stage IIC (T4bN0M0): Isisu asizange sisakaze kulezi zindawo. Ikhulu kune-4 mm futhi isilonda. Ukusinda kweminyaka emihlanu kungamaphesenti angu-45.
Isigaba III
Njengoba lesi sifo sesifinyelele ekusebenzisaneni, izinga lokusinda lalezi zigaba liphansi kunalokuqala.
- Isigaba IIIA (T1a-4a, N1a-N2a, M0): I-tumor ayilona izilonda. Liye lasakazeka kwaze kwafika ama-nodes amathathu, kodwa awakhulisiwe. Ukusabalala kwe-nodal kubonakala kuphela ekuhlolweni okuncane kakhulu, hhayi ekuhlolweni kwezempilo. Ukusinda kweminyaka emihlanu kungamaphesenti angu-63 kuya kwamaphesenti angu-69.
- Isigaba IIIB: Lesi sigaba esiyinkimbinkimbi ngezimo eziningi ezingenzeka:
- I-T1b-T4b, i-N1a-N2a: I-tumor isilonda. Liye lasakazeka kwaze kwafika ama-nodes amathathu, kodwa awakhulisiwe. Ukusabalala kwe-nodal kubonakala kuphela ekuhlolweni okuncane kakhulu, hhayi ekuhlolweni kwezempilo.
- I-T1a-T4a, i-N1b-N2b: I-tumor ayilona isilonda. Liye lasakazeka kwaze kwafika ama-nodes amathathu, futhi ama-node akhuliswa ngenxa ye-melanoma.
- I-T1a / b-T4a / b, i-N2c: I-tumor ingaba nesilonda noma cha. I-tumor isakazeke esikhumba esiseduze ne-melanoma (i-metastasis yesathelayithi) noma emigwaqweni ye-lymph eseduze ( ekuhambeni kwemithambo ye-metastasis ), kodwa ama-lymph nodes aziqukethe i-melanoma.
Ukuphila okwedlule iminyaka emihlanu kwalesi sigaba ngamaphesenti angu-30 kuya kuma-59%.
- Isigaba IIIC:
- I-T1b-T4b, i-N1b noma i-N2b: I-tumor isilonda. I-melanoma isakaze kwaze kwafika izilonda ezintathu, ezikhuliswa ngenxa yomdlavuza.
- Noma yimuphi u-T, N3: I-tumor ingaba yimuphi ubukhulu futhi ingaba nesilonda noma cha. I-melanoma isakaze emagqumeni amane aseduze noma ngaphezulu, noma kukhona ama-node ahlanganisiwe (ama-matted) ane-melanoma kuwo, noma kune-metastase yesatellite noma ye-transit kanye nomdlavuza usakaze emaphethini omzimba oseduze.
Ukusinda kweminyaka emihlanu kungamaphesenti angu-24 kuya kuma-29%.
Isigaba IV
Lesi sigaba se-melanoma sihlotshaniswa ne- metastasis ngaphesheya kwezingqimba zendawo zesifunda ezindaweni ezikude emzimbeni njengamaphaphu, isibindi, noma ubuchopho, noma ezindaweni ezikude zesikhumba. Ayikho isimo se-lymph node noma ubukhulu obucatshangelwayo. Iminyaka emihlanu yokusinda emaphesenti angu-7 kuya kuma-19.
Isifinyezo sezinyathelo
| Isiteji | Izici |
| IA | I-tumor ≤ 1.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; ayikho imitha eseduze |
| IB | I-tumor ≤ 1.0 mm ngesilonda noma i-Clark level IV noma iV; isisu 1.01-2.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; ayikho imitha eseduze |
| IIA | I-Tumor 1.01-2.0 mm ngesilonda; isisu 2.01-4.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; ayikho imitha eseduze |
| IIB | I-tumor 2.01-4.0 mm nesilonda |
| IIB | I-tumor> 4.0 mm ngaphandle kwesilonda; akukho ukubandakanyeka kwe-lymph node; ayikho imitha eseduze |
| IIC | I-tumor> 4.0 mm nesilonda; akukho ukubandakanyeka kwama-nodal; ayikho imitha eseduze |
| IIIA | Ukudumala kwanoma yikuphi ukuqina ngaphandle kwesilonda ngesinye se-lymph node esilungile |
| IIIB | I-tumor yanoma yikuphi ukuqina ngaphandle kwesilonda nge-lymph nodes emibili kuya kweyesithathu |
| IIIC | I-tumor yanoma yikuphi ukuqina kwamakhansela amancane noma ngaphezulu noma ngaphezulu noma ama-node abathintekayo noma ama-s / satellite (ama) angenawo ama-transit ngaphandle kwama-lymph nodes emasethini noma inhlanganisela ye-transit (s) / satellite (s), noma i- melceroma yesilonda kanye ne- lymph node (s) ye- metastatic |
| IV | Ukuthutha kwanoma yikuphi ubukhulu nganoma yiziphi izigcawu kanye nanoma yimiphi imitha eseduze |
Izwi Mayelana Nokusinda Amanani Ngezinga
Ungase ukwesabeke yizinga lokusinda elibalwe ngenhla, kodwa gcina okulandelayo engqondweni. Izibalo ziyizinombolo, hhayi abantu. Babikezela ukuthi umphumela wesilinganiso ungaba yini, kodwa basho kancane ukuthi wena, njengomuntu oyedwa, uzosabela kanjani ekwelapheni . Ngaphezu kwalokho, ukwelashwa kuyaqhubeka. Izindlela zokwelapha ezintsha zivunyiwe, futhi okuningi okwamanje zivivinywa ekuvivinyweni kwemitholampilo. Izibalo zivame ukuthi zineminyaka eminingana ubudala, futhi zingase zingabonakali ukuthi umuntu uzosabela kanjani empilweni namuhla.
Izinhlelo Zokwelapha
Njengoba kuphawuliwe ekuqaleni, ukwelashwa kwe-melanoma kuxhomeke kakhulu esigabeni esithile. Izihloko ezilandelayo zikhuluma ngokukhetha ukwelashwa okusekelwe esiteji:
- Ukwelashwa Kwe-Melanoma Ekuqaleni (Isigaba I no-Stage II)
- Izinketho zokwelashwa kwe-Melanoma (Isigaba III nesigaba IV)
> Imithombo:
> Balch, C., Gershenwald, J., Soong, S. et al. I-Final Version ye-2009 AJCC Ukusabalalisa i-Melanoma nokuHlelwa. I-Journal ye-Clinical Oncology . 2009. 27 (36): 6199-6206.
> Mahar, A., Compton, C., Halabi, S. et al. I-CriticalAssessment yamathuluzi wokuProvinst Clinic ku-Melanoma. Ama-Annal of Oncology Yokuhlinza . 2016. 23 (9): 2753-61.