Umdlavuza we-ovariya kwenzeka cishe ku-1 ku-18,000 ukukhulelwa. Izimpawu nezibonakaliso zifana nalabo abangabikho ukukhulelwa. Ngokuvamile isisindo se-ovarian sitholakala ngesikhathi sokuqala kokuvakashela ukuzalwa kokuzalwa. Uma ibuyela emuva evamile emva kokuhlolwa okunezinhlobonhlobo kanye nama-ultrasound, ukuxilongwa ngokuvamile kuyisisindo esisebenza kahle ngenxa yezinkinga ze-hormonal ngesikhathi ukhulelwe.
Izifo ze-germ cell ovarian yizona ezivame ukutholakala zifinyelele eminyakeni engama-30 ubudala, futhi izicubu ezinama-gonadal stromal zitholakala kuyo yonke iminyaka ethwele abantwana. Zombili lezi zinhlobo zivame ukubandakanya i-ovary eyodwa kuphela uma kuqhathaniswa ne-common epithelial ovarian cancers. Ngenxa yalokho, uma i-tumor itholakale ku-ovary eyodwa kuphela, ukususwa kwe-ovary kuphela kungase kube ukwelashwa okwanelisayo ngesikhathi sokukhulelwa.
Izimpawu ezivamile zingafana nezixuku ezinobungozi noma ezimbi kakhulu. Lokhu kufaka phakathi ukuguqula i-ovary ekuhlinzekeni kwegazi (i-torsion), ukuvuza, ukuphuka, ukuphuma noma ukutheleleka. Kuncike ekutheni lapho ukhulelwe isisindo se-ovarian sitholakala, kungenzeka noma singenakuzwa ngeso lengqondo ngudokotela wezilonda noma ngesisu. Uma kungase kuvezwe, lokho okutholakele kungasiza esinqumweni sokuthi kufanele usebenze noma uqaphele ngokucophelela ngokuhlolwa ngezikhathi kanye ne-ultrasound. Isisindo se-ovarian esisodwa esisodwa esihamba ngokukhululekile futhi sincane kunamamitha ayisentimitha angu-4 (angaba ngu-4 amasentimitha), singabonwa ngokuhlolwa kwesikhashana kuze kube sekupheleni kwesibili sokukhulelwa.
Ngalesi sikhathi, uma ubukhulu buyancipha ngosayizi, ngokuzenzekelayo kungase kube yinkinga yokusebenza. Ngakolunye uhlangothi, uma ikhula, uzodinga ukuhlinzwa ngokushesha. Futhi, uma uhlolo lokuqala luzizwa lungavamile, aluhambisani (lunamathele kwezinye izitho zomzimba), kubonakala sengathi lubandakanya kokubili ama-ovari noma uketshezi kulesiswini nesifuba ku-ultrasound, kungase kube yisikhathi sokuhlinzwa kungakhathaliseki ukuthi i-trimester yokukhulelwa.
Ngenhlanhla, umdlavuza ngesikhathi sokukhulelwa uvame ukutholakala esiteji sokuqala (isiteji I), ikakhulukazi ngoba isiguli ngokuvamile sifuna ukunakekelwa kwezokwelapha ekuseni ngenxa yokukhulelwa, ngaphambi kokuqala kwezimpawu zokuthuthukisa umdlavuza we-ovarian. Isibikezelo sifana nalokhu ngaphandle kokukhulelwa, ngokuyinhloko kuye ngokuthi uhlobo lwesisu nesigaba nobani.
Ukuhlola nokuhlola
I-Ultrasound iphephile ngesikhathi sokukhulelwa, kepha ukuhlolwa kwe- CT noma i-CAT kuveza imisebe futhi akuphephile, ikakhulukazi ngesikhathi sokukhulelwa kokuqala. I-MRI noma i-Magnetic Resonance Imaging ngokuvamile ibhekwa njengokuphephile ngesikhathi sokukhulelwa futhi ingasetshenziswa uma i-ultrasound inganikeli ulwazi olwanele.
Ukuhlolwa kwegazi kwe -CA-125 kungenziwa kepha akusilo ngokunembile ngesikhathi sokukhulelwa. Ukukhulelwa ngokwayo kungabangela ukuphakama kule marker ye-tumor, okungenani kubangeni lamakhulu amaningana. Ngakho-ke, izinga elingaphezulu kuka-35IU / ml livame ukubhekwa njengelijwayelekile, kodwa ekukhulelwe, leli zinga lingaba ngu-200 noma 300 noma ngaphezulu nje ngenxa yokukhulelwa ngokwayo. Noma kunjalo, izinga ezingxenyeni cishe libangelwa umdlavuza.
Ukuphathwa
Ukwelashwa ngokuyisisekelo kufana nesimo esingakhulelwe. Isinyathelo sokuqala ukuhlinzwa, nombuzo kuphela lapho. I-trimester yesibili ngokuvamile ikhethwa kusukela ihlotshaniswa nethuba elingaphansi lokukhulelwa kokukhulelwa.
Uma izivivinyo ziphakamisa ukusola okuphansi komdlavuza, khona-ke lesi yisikhathi sokukhomba. Uma ukusola kuphakeme, khona-ke ukuhlinzwa kufanele kwenziwe ngokushesha ngangokunokwenzeka.
Ukuhlinzwa
Ngesikhathi sokuhlinzwa, uma udokotela we-pathologist eqinisekisa umdlavuza, khona-ke ukuhlinzwa kwesiteleka kuqediwe. Lokhu kusho okungenani ukususwa kwe-ovary ethintekayo, izidakamizwa zama-lymph nodes kanye ne-peritoneum ezindaweni ezihlukahlukene. Uma kubonakala sengathi umdlavuza usakaze ngaphesheya kwe-ovary, i- cytoreduction noma i-debulking yenziwa njengoba kungekho ekukhulelwe.
Kubalulekile ukuxoxa ngamathuba kanye nezinketho ngaphambi kokuhlinzwa. Isinqumo esibucayi, kuye ngokuthi yi-trimester, yilokho okufanele kwenziwe ngokukhulelwa.
Emdlavuza wokuqala, ukukhulelwa kungavame ukuqhutshwa futhi kuphela i-ovary isusiwe kanye nesiteji. Uma umdlavuza usakaze ngaphesheya kwe-ovary, kungcono kakhulu ukususa isibeletho ukuqeda umdlavuza omkhulu ngangokunokwenzeka. Uma ukukhulelwa kungaphansi kwamasonto angama-24, ukususa isibeletho ngokusobala kuzoqeda ukukhulelwa kanti ingane engenakuphila. Uma ukukhulelwa kungaphezu kwamasonto angu-24 kodwa kungakafiki esimweni esivuthiwe (ngokuvamile esingaphezu kwamasonto angu-36) isigaba saseCesarean singenziwa ngaphambi kokukhipha isibeletho nosana olunikeziwe. Kodwa-ke, kukhona umehluko omkhulu ekutheni umntwana osanda kuzalwa asinde eduze kwamasonto angu-24 ngokuphambene namasonto angama-36. Zonke lezi zindaba zibalulekile ukumboza ngaphambi kokuhlinzwa.
I-Chemotherapy
Ukwelashwa komdlavuza wama-ovari ngaphezu kokuhlinzeka kuyafana okufanayo, isigaba sesiteji njengokungathi akukho ukukhulelwa okungaphezu kwe-trimestre yokuqala. Zonke izitho zesisu seziqedile ukuthuthukiswa ekupheleni konyaka wokuqala. Ngaphandle kwalolu phuzu ikakhulukazi ukukhula, okungahle kuphelelwe yisikhathi ngamakhemikhali, kepha akukho nhlobo yokulimala okuzalwa.
Imithi ye-chemotherapy kanye nezinqumo zokuthi noma ngabe i-chemotherapy iyadingeka yini noma ayiyona into efana neyesizwe esingakhulelwe. Ngenhlanhla, njengoba ama-cancer amaningi amaningi e-ovarian athole ngesikhathi sokukhulelwa yi-stage I, i-chemotherapy ingavinjelwa. Uma kudingeka, kufanele kuqalwe ngokushesha ngangokunokwenzeka. Uma i-chemotherapy iyadingeka ngesikhathi se-trimester yokuqala, kungenzeka ukuthi kuyodingeka ukhethe ngokunqamula ukukhulelwa. Ukulinda izinyanga kungalimaza impilo kamama futhi kunciphise amathuba okuphulukiswa.