Rhabdomyosarcoma Embryonal: ukwelashwa, onalesi sifo

Rhabdomyosarcoma libhekisela uhlobo Sarcoma - soft umdlavuza izicubu, ithambo noma ezicutshini. Ithumba kuvame ukuvela nini bemisipha exhunywe amathambo. Rhabdomyosarcoma - umdlavuza ayedabuka imisipha lwamathambo. Bathoma kunoma iyiphi ingxenye eyodwa yomzimba noma ezindaweni eziningana.

Microscopically rhabdomyosarcoma e abadala ine uhlobo amaseli side noma imikiswe yinqaba. isici eziningi zalo isimila ebuntwaneni.

izinhlobo rhabdomyosarcoma

Rhabdomyosarcoma isakhiwo sangaphakathi zihlukaniswe izinhlobo:

1. rhabdomyosarcoma amaseli Embryonal siqukethe round futhi fusiform kabani uphenyo cytoplasm sikhombisa striations longitudinal noma transverse. Lolu hlobo rhabdomyosarcoma kanengi. Kubonakala rhabdomyosarcoma embryonal ezinganeni kuya enkathini yokuthomba. Itholakala entanyeni noma ikhanda, ezithweni zangasese, ku nasopharynx. Ukuzwela kwama ezimileni kuya ukwelashwa ngemisebe, kodwa ekuthanda babheme okusheshayo.

2. Alveolar rhabdomyosarcoma yakhiwa iqembu amaseli round futhi okusaqanda, okuyinto zizungezwe septa zezicubu zezinzwa. Ukuze lolu hlobo izimila libhekene ukubukeka on the imilenze noma izingalo, esiswini, webele, anal noma izitho zangasese. Ngokuvamile-ke ingatholakala intsha kanye nabantu abadala ku nasemilenzeni. Izibikezelo ayiyinhle.

3. Ukwakheka rhabdomyosarcoma pleomorphic - polymorphic, amaseli iribhoni-like othini lokuphotha emise star emise yesimila okuyinto zingavela izinyawo noma izandla zabantu. Njengomthetho, rhabdomyosarcoma kukhula kwenzeka ngokushesha futhi akakubangeli ubuhlungu nokuphazamiseka sokusebenza. Kwenzeka emithanjeni kuphela. Bavame ukhule ngokusebenzisa isikhumba futhi wambozwa izilonda, ukwakha exophytic, isimila ukopha.

engcupheni

Phakathi kwezici kwemvelo wathola enjalo, ukuthi ukwandisa amathuba okwenziwe ngaleli lwesimila. Loku kuyehluka kakhulu zomdlavuza rhabdomyosarcoma.

Ngenxa yokuthi akuyona ncamashi eyaziwa izimbangela ukuthuthukiswa isimila, asikwazi ukunikeza noma yimuphi iseluleko sokugwema lasungulwa. Nokho, kumelwe sikhumbule ukuthi nge ukwelashwa okufanele kweziguli rhabdomyosarcoma kwesinye isikhathi zelashwe ngokuphelele.

Izinto eziyingozi ezingabangela i ukubukeka rhabdomyosarcoma embryonic kukhona izifo zofuzo uzimisele ezifana:

1. Li-Fraumeni Syndrome iyisifo ezingavamile lapho njengefa isici, umonakalo isakhi sofuzo lapho ulahlekile omunye umzali imvamisa ophakeme wasukuma ahlukahlukene isimila izinhlobo. Ngefa kule zokugula ngocansi ngokucacile of isimila nezicubu ukusabela lapho kakhulu kukhulisa ematfuba ekuthuthukiseni izimila esemncane (iminyaka engu-30).

2. Neurofibromatosis Uhlobo lokuqala - ezivamile isifo ngofuzo esibangela ukubukeka nezici ezithile ukuze umdlavuza.

3. Syndrome Beckwith-Wiedemann - zokugula, esibonakala by macrosomia, macroglossia futhi omphalocele. Libuye ukukhubazeka obonakalayo izingane odongeni phambi esiswini, umbhunu, hypoglycaemia ezisanda kubelethwa, le kwehlukana kwemisipha rectus.

4. Costello syndrome - isifo ezingavamile, okuyinto libhekene kombungu esizalweni: ukukhula retardation, izici indawo ebusweni, izinguquko isikhumba.

5. Noonan Syndrome - eyasithola ngofuzo libhekene onesiqu esifushane okuyiwona lokuchezuka futhi ekuthuthukiseni ukuphathwa kwabathintwayo. Lesi simo singenzeka kunoma ekhaya noma akhona yini amalungu alo.

Izingane kwadingeka ezizalwa zinesisindo esiphansi nokukhula, banokuningi kunabanye, ingozi rhabdomyosarcoma embryonal. Nokho, Njengomthetho, izimbangela zezinkumbulo rhabdomyosarcoma embryonal alwaziwa. A uphawu lesi sifo ukubonakala isimila beba more and.

izimpawu

Symptomatology lesi sifo yomdlavuza kunqunywa. Kuyadingeka ngokushesha kudokotela uma izingane ohlwini izimpawu umdlavuza:

• edema noma ukuvuvukala, okwandisa ubukhulu noma cha odlulayo, ngezinye izikhathi ubuhlungu;
• amehlo ezinkulu;
• ubuhlungu bekhanda;
• nobunzima nge sokuzikhulula futhi ukuchama;
• igazi e umchamo;
• ukopha ingemuva, ikhala nomphimbo.

ukuhlola

Kuze kube manje, nezindlela sokunquma rhabdomyosarcoma kuze izimpawu zayo zokuqala nezisobala.

Izimpawu zokuqala umdlavuza - ukuvuvukala wendawo noma induration, akakubangeli izinkinga ekuqaleni noma ubuhlungu. Lokhu uphawu kuyisici sobuntu rhabdomyosarcoma, izingalo, imilenze, esifubeni.

Uma isimila itholakala esiswini noma okhalo endaweni kungadala Ubuhlungu obukhulu besisu, ukuhlanza noma ukuqunjelwa. It rhabdomyosarcoma embryonal isikhala retroperitoneal. Okuningi akuvamile, ukuthuthukisa esiqeshini biliary, rhabdomyosarcoma kubangela i-jaundice.

Uma kukhona izinsolo lokhu isimila, kubalulekile ukuqhuba biopsy, okuzokwenza ucacise onjani rhabdomyosarcoma eqale.

Ezimweni eziningi, kuba khona rhabdomyosarcoma ezindaweni lapho Kutholwe kalula, isibonelo, ingaphakathi acinene noma ngaphandle inhlamvu yeso. Uma avele emehlweni bulging, noma uketshezi acinene, kufanele ngokushesha kudokotela ukuthi unesimila esolwa lapho ethola ukuthi unesifo ngendlela efanele usaqala yentuthuko yayo. Esimweni lapho rhabdomyosarcoma livela phezu umzimba, it is kalula Kutholwe ngaphandle kokuhlolisisa. Lokhu okuthiwa rhabdomyosarcoma embryonal izicubu zomzimba ezithambile.

Ngo-30% eziguli nge rhabdomyosarcoma embryonal kukhona ngendlela efanele usaqala uma kungenziwa lususwe. Kodwa iningi lama-iziguli ezinemininingwane, lokho kuhlolisisa kwembula metastases encane, ekwelapheni edinga khona imiphumela emibi yokwelashwa ngamakhemikhali.

rhabdomyosarcoma Embryonal, okuyinto zitholakala kule ndawo isende ngokuvamile sakha ezinganeni ezincane futhi wathola abazali bengane uma ukugeza. Uma izimila zenzeka ngomgudu womchamo, babangela nobunzima ukuchama noma olunegazi osenyameni - izimpawu ukuthi akunakugwenywa.

isimila esiteji

1. Isinyathelo sokuqala. Ithumba kungenzeka imuphi usayizi, kodwa ingakamiswa lasakazekela-lymph kohlelo futhi itholakala yezindawo prognostically evumayo zomzimba:

- amehlo noma endaweni periocular;

- ikhanda nentamo (ngaphandle izicubu asebuchosheni nomgogodla intambo endaweni);

- the Bile Amapayipi kanye nenyongo sesinye;

- esibelethweni noma amasende.

Izindawo ngaphandle ohlwini, ezibhekwa ezindaweni ezingezinhle.

2. yesibili esiteji. Ukuvuvukala ingenye esishintshashintshayo okungekuhle (esishintshashintshayo angekho ku evumayo). usayizi isimila lingaphansi kuka 5 cm futhi singazange sande ukuze-lymph livelile.

3. Isinyathelo sesithathu. Ithumba itholakala endaweni enobutha negcwele ukukhonza futhi ukuhlangabezana omunye kwale mibandela elandelayo:

- ubukhulu yesimila esingaphansi 5 cm, futhi yahlakazeka-lymph olandelayo;

- isimila kukhulu kunenani 5 cm, futhi kukhona ingozi ukuthi uyokwendlala eseduze lymph node.

4. Isigaba sesine. usayizi isimila kungaba yini, futhi bekubonakala lasakazekela-lymph esilandelayo. Sekube nezigameko eziningi ukusabalala komdlavuza ezindaweni ezikude zomzimba.

amaqembu ingozi

Inikezwe nesineke ingozi iqembu inquma amathuba yokuphindela rhabdomyosarcoma. Noma yimuphi ngane iphiwa ukwelashwa rhabdomyosarcoma embryonal, kumele zithole imiphumela emibi yokwelashwa ngamakhemikhali ezengeziwe ukuba abe amathuba kancane isimila Ukuphinda. Buka anticancer izidakamizwa, umthamo kanye nenombolo lesitigamu - konke lokhu kunqunywa ingozi kunoma izingane okukhulunywa - ongaphakeme, liletha okusezingeni eliphezulu.

zokwelapha

Iziguli rhabdomyosarcoma embryonal ungelashwa ngezindlela ezahlukene.
Ukwelashwa kuhilela izimila abulalayo izindlela ehlukile okuyinto ubhekwa bendabuko. Okunye amasu bangaphansi zokwelapha. Isiyazanywa aye ayisebenzisa kaningi ngcono izindlela ezikhona kokuphatha noma ukukhulisa inani idatha yezindlela entsha ye ukwelapha iziguli nge rhabdomyosarcoma. Uma ngenxa zokwelapha, kubonakala sengathi izindlela ezintsha zokwelapha aphakeme bendabuko, ukuphathwa entsha engena isigaba bendabuko.

Njengoba izimila abulalayo bavame ukuvela ezindaweni ezihlukahlukene zomzimba, osebenza inqwaba ukwelashwa. Ukwelashwa nokuvikelwa rhabdomyosarcoma ezinganeni wawuqondiswa oncologist ezingane.

Phakathi izindlela zokwelashwa, kukhona ezinye ukuthi kungabangela side effects, ngisho nalapho ukuphathwa kudlule isikhathi eside.

ukuhlinzwa

indlela Steel, noma ukukhishwa kwe-isimila, kabanzi lisetshenziswe ekwelapheni rhabdomyosarcoma. Lo msebenzi ibizwa ngokuthi "ububanzi excision wendawo". Lokhu kuphazamisa ukususa ingxenye isimila nendlala okuthiwa i nezicubu eziseduze kanye lymph node ukuthi sithinta rhabdomyosarcoma. Ukwelashwa ngezinye izikhathi kuba ukwenza imisebenzi eminingana. Isinqumo Yokuqashwa ukusebenza kanye nohlobo kuncike ezicini ezilandelayo:

- beka endaweni yokuqala yesimila;

- imisebenzi ingane yomzimba ehlaselwe isimila;

- isimila ekuphenduleni radiotherapy noma amakhemikhali angasetshenziswa nsuku kuqala.

Iningi ukususwa nezinga lezingane wawuqeda wonke lo mqulu yesimila ngu ukuhlinzwa akunakwenzeka.

Embryonal rhabdomyosarcoma izicubu zomzimba ezithambile ivame ukuba zimiswe ezindaweni ezihlukahlukene zomzimba, ngamunye edinga ukusebenza yayo. kokungenela Steel kuboniswa uma rhabdomyosarcoma umthondo noma amehlo, uma biopsy waqinisekisa uphethwe. Ngaphambi ukusebenza singasetshenziswa eyabelwe nokwelashwa ngamakhemikhali noma ngemisebe ukunciphisa izimila ezinkulu, esingenakubalwa wahlinzwa ukuze senze lula umsebenzi wokususa umdlavuza.

Ngisho noma udokotela Awukwazi ukususa yonke isimila, iziguli ekupheleni ukusebenza kufanele ngaphansi nokwelashwa ngamakhemikhali ukucindezela amangqamuzana omdlavuza ukuze bahlale bephila. Kanye nokwelashwa ngamakhemikhali, ukwelashwa ngemisebe isetshenziswa. Ukwelashwa okuhloswe ngazo ukunciphisa ubungozi yokuphindela sifo kuthiwa ukwelashwa adjuvant.

ukwelashwa ngemisebe

Nge lolu hlobo ukwelashwa esetshenziswa-X-ray noma ezinye ngemisebe. ukwelashwa ngemisebe sibhekiswe okuthile, ukubulala isimila cells noma ukumisa ekukhuleni kwayo. isicelo sayo kwezokwelapha bathole izindlela ezimbili radiotherapy - zangaphakathi nezangaphandle.

Kwangaphandle isebenzisa umthombo emisebeni ngaphandle komzimba womuntu ngoba irradiating yesimila. Yangaphakathi ukwelashwa ngemisebe noma brachytherapy irradiates isimila kanye nokubekwa izinto radioactive e eduze ngokushesha ngaphakathi komzimba womuntu. Isetshenziselwa ukwelapha umdlavuza wesinye, ikhanda nentamo, wendlala, ngemomozi yakho.

Uhlobo ukwelashwa ngemisebe futhi umthamo kunqunywa ubudala somntwana uhlobo isimila, kwasendaweni saso ekuqaleni kodwa futhi khona isimila asalile nokuthi leso senzo senziwe isimila sokungena eliseduze lymph node ngemva kokuhlinzwa.

ngelashwa nangemithi

Lolu hlobo yokwelapha abantu abanomdlavuza osebenzisa imithi ukuze kufe zamangqamuzana omdlavuza. Chemotherapy kusiza ukubulala lezi amaseli noma ukugwema ukwahlukana yabo. A letindzala chemotherapy zithathwa ngomlomo noma ijovwe ngemithambo yegazi noma intramuscularly. Ukufika e igazi, izidakamizwa ezithinta amangqamuzana omdlavuza wonke umzimba. Lapho lesifunda chemotherapy kuthiwa ijovwe ngqo kwezitho zomzimba izimbobo emazinyweni, kanye i-cerebrospinal fluid. Inhlanganisela imiphumela emibi yokwelashwa ngamakhemikhali livame ukusetshenziswa, okuyinto kwelashwa isetshenziswa ezingaphezu kweyodwa izidakamizwa anti-umdlavuza. ngelashwa nangemithi indlela ekhethiwe kuye ngohlobo komqondo nezinga lokukhula kwengane we neoplasm.

Ukwelashwa ngamakhemikhali nokushiswa ukhonjiswa zonke ingane nothola ukwelashwa ngoba rhabdomyosarcoma. It ikuvumela ukunciphisa amathuba isifo Ukuphinda. Kukhethwa imithi, umthamo kanye nenombolo ye nezinqubo kuchazwe iqembu ingozi rhabdomyosarcoma.

ukwelashwa okusha

izinhlobo ezintsha ukwelashwa rhabdomyosarcoma, uvivinyo:

• Ukweqiwa ezinkulu ngamakhemikhali ngokuhlanganyela enifeza lwama-stem cell ukufakelwa. Indlela kwenza kube nokwenzeka ukuhlela esikhundleni lamaseli hematopoietic ukuthi ayafa ngesikhathi ukwelashwa komdlavuza. egazi beya ziyasuswa ngaphambi ekwelapheni umnkantsha noma igazi yesiguli futhi agcinwe. Ekupheleni ngamakhemikhali raskonserviruyut alondolozwe stem cells futhi libuyiselwa esigulini by ukumnika. Ngakho amaseli weengazi yokuvuselela.
• Immunotherapy. Lapho lolu hlobo of ukwelashwa ukulwa umdlavuza usebenzisa isimiso somzimba sokuzivikela sesiguli. izidakamizwa Iphathwe kukhona ukuthuthukisa noma buyisela nesivikelo semvelo yokulwa nomdlavuza. Lokhu kwelashwa libizwa biotherapy izimila.
• ukwelashwa Afunwayo. Lolu hlobo lwe-therapy sibhekiswe Ukudlulela. yokwelapha Afunwayo kusekelwe ukusetshenziswa omzimba athile ukuthi uxhumo nomsebenzisi amangqamuzana omdlavuza. La masosha omzimba afana amasosha omzimba ezivamile umzimba womuntu. Ngakho abakubonisayo umuthi zobuchwepheshe. Siyabonga yokwelapha okubhekiswe ekwelapheni "yokuthakwa kwamakhemikhali" zingatholakala ukuhlasela amangqamuzana omdlavuza kuphela ngaphandle ulimaza amaseli enempilo. Lapho rhabdomyosarcoma e angiogenesis inhibitor asetshenziswa yokwelapha target. Le mithi ukuvimbela ukwakheka imithambo yegazi izimila. Lokhu kuholela ekutheni ukuthi unciphise unesimila izitobhi ezikhulayo. Angiogenesis inhibitor futhi amasosha omzimba monoclonal - izinhlobo ejenti othola zokwelapha yokulawula rhabdomyosarcoma sombungu.