Khansa ya chiwindi - hepatocellular carcinoma

Hepatocellular carcinoma ndi khansa yomwe imayamba m'chiwindi.

Hepatocellular carcinoma imayambitsa khansa yambiri ya chiwindi. Khansa yamtunduwu imachitika nthawi zambiri mwa amuna kuposa akazi. Nthawi zambiri amapezeka mwa anthu azaka 50 kapena kupitilira apo.

Hepatocellular carcinoma siyofanana ndi khansa ya chiwindi ya metastatic, yomwe imayamba m'chiwalo china (monga bere kapena koloni) ndikufalikira chiwindi.

Nthawi zambiri, chifukwa cha khansa ya chiwindi chimakhala chowonongeka kwakanthawi komanso kufooka kwa chiwindi (cirrhosis). Matenda a chiwindi angayambidwe ndi:

• Kumwa mowa kwambiri
• Matenda osokoneza bongo a chiwindi
• Matenda a hepatitis B kapena hepatitis C
• Kutupa kwa chiwindi komwe kumatenga nthawi yayitali (kwanthawi yayitali)
• Iron imadzaza m'thupi (hemochromatosis)

Anthu omwe ali ndi matenda a hepatitis B kapena C ali pachiwopsezo chachikulu cha khansa ya chiwindi, ngakhale sangakhale ndi matenda enaake.

Zizindikiro za khansa ya chiwindi zimatha kuphatikizira izi:

• Kupweteka m'mimba kapena kufatsa, makamaka kumtunda kwakumanja
• Kuvulaza kosavuta kapena kutuluka magazi
• Kukula kwa mimba (ascites)
• Khungu lachikaso kapena maso (jaundice)
• Kuchepetsa thupi kosadziwika

Wothandizira zaumoyo adzakuyesani ndikufunsani za matenda anu. Kuyezetsa thupi kumatha kuwonetsa chiwindi chokulirapo, chofewa kapena zina za matenda enaake.

Ngati wothandizirayo akukayikira khansa ya chiwindi, mayeso omwe atha kuyitanidwa ndi awa:

• M'mimba mwa CT scan
• Mimba ya m'mimba ya MRI
• M'mimba ultrasound
• Chiwindi
• Kuyesa kwa chiwindi
• Seramu alpha fetoprotein

Anthu ena omwe ali ndi mwayi waukulu wokhala ndi khansa ya chiwindi amatha kupita kukayezetsa magazi pafupipafupi kuti awone ngati zotupa zikukula.

Kuti muzindikire bwino hepatocellular carcinoma, chiwonetsero cha chotupacho chiyenera kuchitidwa.

Chithandizo chimadalira momwe khansa yapitira patsogolo.

Opaleshoni imatha kuchitidwa ngati chotupacho sichinafalikire. Asanachite opaleshoni, chotupacho chitha kuthandizidwa ndi chemotherapy kuti ichepetse kukula kwake. Izi zimachitika popereka mankhwala molunjika m'chiwindi ndi chubu (catheter) kapena mwa kuwapatsa kudzera m'mitsempha (mwa IV).

Chithandizo cha radiation m'dera la khansa chingathandizenso.

Ablation ndi njira ina yomwe ingagwiritsidwe ntchito. Ablate amatanthauza kuwononga. Mitundu yochotsa zinthu imaphatikizapo kugwiritsa ntchito:

• Mafunde a wailesi kapena ma microwave
• Ethanol (mowa) kapena acetic acid (viniga)
• Kuzizira kwambiri (cryoablation)

Angalimbikitsidwe kumuika chiwindi.

Ngati khansayo singathe kuchotsedwa opaleshoni kapena kufalikira kunja kwa chiwindi, nthawi zambiri pamakhala mwayi woti muchiritsidwe kwa nthawi yayitali. Chithandizo m'malo mwake chimangoyang'ana pakukonza ndikuwonjezera moyo wamunthuyo. Chithandizo pankhaniyi chitha kugwiritsa ntchito mankhwala omwe akuwatsata omwe amatha kumwa ngati mapiritsi. Mankhwala atsopano a immunotherapy angagwiritsidwenso ntchito.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Ngati khansayo singathe kuchiritsidwa kwathunthu, matendawa nthawi zambiri amapha. Koma kupulumuka kumatha kusiyanasiyana, kutengera momwe khansa yapita patsogolo ikapezeka komanso momwe mankhwala aliri opambana.

Itanani omwe akukuthandizani ngati mukumva kupweteka m'mimba, makamaka ngati muli ndi mbiri ya matenda a chiwindi.

Njira zodzitetezera zikuphatikiza:

• Kupewa ndi kuchiza matenda a chiwindi kungathandize kuchepetsa chiopsezo. Katemera wa ana motsutsana ndi hepatitis B akhoza kuchepetsa chiopsezo cha khansa ya chiwindi mtsogolo.
• Musamamwe mowa wambiri.
• Anthu omwe ali ndi mitundu ina ya hemochromatosis (iron overload) angafunikire kuyang'aniridwa ndi khansa ya chiwindi.
• Anthu omwe ali ndi hepatitis B kapena C kapena cirrhosis akhoza kulimbikitsidwa kuti awonetse khansa ya chiwindi.

Pulayimale chiwindi cell carcinoma; Chotupa - chiwindi; Khansa - chiwindi; Matenda a hepatoma

• Dongosolo m'mimba
• Chiwindi
• Khansa ya hepatocellular - CT scan

Pezani nkhaniyi pa intaneti Abou-Alfa GK, Jarnagin W, Dika IE, et al. Khansa ya chiwindi ndi ya ndulu. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 77.

Di Bisceglie AM, Befeler AS. Zotupa zamatenda ndi zotupa. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 96.

Tsamba la National Cancer Institute. Chithandizo chachikulu cha khansa yayikulu ya chiwindi (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/liver/hp/adult-liver-kuchiritsa-pdq. Idasinthidwa pa Marichi 24, 2019. Idapezeka pa Ogasiti 27, 2019.

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala a NCCN mu oncology: khansa ya hepatobiliary. Mtundu 3.2019. www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Idasinthidwa pa Ogasiti 1, 2019. Idapezeka pa Ogasiti 27, 2019.