Syndrome Carcinoid: izimpawu, ukuxilongwa kanye nokwelashwa

izibalo kwezokwelapha kubonisa ukuthi isibalo umdlavuza iye kancane kancane liphuma. imiphumela Obulalayo kusukela ngokuya eqoshiwe minyaka yonke. Leli qiniso wonke okhathaza futhi kubangela odokotela ukuba baqhube umsebenzi izifo phakathi kwabantu ukuze ugcine kancane nolaka ukukhula Lubanzi.

syndrome Carcinoid: kuyini?

Carcinoid - lena isimila ezivamile kwamaseli kohlelo neuroendocrine. La mangqamuzana zingaba inoma isiphi isitho nezicubu. Umsebenzi wawo oyinhloko - ukuthuthukisa amaprotheni kakhulu asebenzayo. Mayelana ayisishiyagalombili amaphesenti zonke carcinoids zitholakala kule ipheshana emathunjini, endaweni yesibili kukhona emaphashini. Okuningi akuvamile, amaphesenti ayisihlanu kuphela izimo, izimila ezitholakala kwezinye kwezitho nezicubu.

syndrome Carcinoid futhi isimila carcinoid ayikwazi bahlukana, njengoba syndrome - iqoqo izimpawu evelayo ngemuva ukukhula umsebenzi umdlavuza. Phela, umzimba iphendula engene amahomoni igazi ethakwa ngu yesimila. wamathumbu carcinoids kungenzeka "eziyizimungulu", okusho akusho ukuzibonakalisa kuze kufike leso sikhathi kuze kube kukhona metastases kanye nesifo akungeni esigabeni esigungwini.

izizathu

Abacwaningi namanje hhayi ulwazi olwanele ukuze baqonde ukuthi kungani ukuthuthukisa syndrome carcinoid futhi isimila carcinoid. Ososayensi bakwazi ukwakha imibono eyayisinesikhathi mayelana isifo omsakazo, kodwa bonke bayavumelana yokuthi esimiso somzimba sokuzivikela ezifweni esithile iyeke ukuqaphela amaseli soguquko lwegciwane singalawuleka APUD uhlelo (emelela of izinhlamvu zokuqala amagama "Amen," "eyandulela", "nokwenziwa", "decarboxylation" ).

A umdlavuza kuseli eyodwa ukuze aphume bakhula ephelele ukukhula entsha ezokwenza ukukhiqiza ama-hormone nemithi ukushintsha ukuze ivumelane izidingo zakho zonke izinqubo kwamakhemikhali emzimbeni womuntu.

pathogenesis

ingaqala kanjani carcinoid syndrome? Kuyini futhi kanjani ukuze ngikuvimbele? Njengoba sazi ukuthi neuroendocrine amaseli asezindaweni ezikahle kulo lonke umzimba, futhi kubonakaliswa emitholampilo yesimila cishe akagcini inqubo, odokotela abakwazi.

Ngesinye isikhathi engqamuzaneni ungesinye DNA "ukwehluleka" okuyinto walulama noma ngokungalungile Sizoqhubeka nokusebenza nge isinqamu lilimele. Lokhu kuholela ukuphazamiseka cell umsebenzi nokuhlukanisa yayo engalawuliwe. Uma umzimba uphilile, amasosha omzimba nawo ngeke basabela kuguquka futhi ukuqeda into esolisayo. Uma lokhu kungenzeki, bese iseli ngizakwandisa, kuzodala kusakazwa izigidi zamakhophi bese uqale ukusakaza ngokusebenzisa ubuthi emzimbeni futhi hormone.

odokotela ababevame ukwehluleka ukukhomba indawo kwe-isimila, naphezu lingaze syndrome carcinoid.

Carcinoma yamaphaphu

Kuphela amaphesenti ayishumi of amacala e umgudu wokuphefumula angagcina zokuzikhukhumeza, futhi ngenxa yalokho, syndrome carcinoid. Izimpawu wamaphaphu kuyoba non-ethize, futhi ngezinye izikhathi neze. Lokhu kungenxa ubukhulu elincane izimila kanye ukungabikho Ukudlulela. Iziguli ukufuna usizo kusukela isifo oluseqophelweni, njengoba umthetho, hhayi oncologist, futhi ngowokuqala owelapha. Wayengase kwadingeka ehluleka aphathe bronchiolitis, isifuba somoya noma nokuvaleka kwemigudu yokuphefumula, kuze kube ukuba khona esolwa inqubo umdlavuza.

Izimpawu kulokhu atypical:

• palpitations, palpitations;
• dyspepsia;
• uzizwa yokushisa hawu igazi engxenyeni engenhla umzimba;
• ukukhwehlela, iphika;
• bronchospasm.

Nale iqoqo iziyaluyalu ungakwazi neze esolwa carcinoid. Ayikho Ukuwohloka, ezinqala kwesisindo, ukuncishiswa amasosha omzimba, ukukhathala kanye nezinye izimpawu nobuntu inqubo umdlavuza.

wamathumbu isimila encane

Emathunjini amancane kancane kanengi ukudlula e-lung, isimila kulotshwe emvume carcinoid syndrome. Izimpawu ke iyivela kancane kakhulu. Ngokuvamile kukhona ubuhlungu non-ethize besisu kuphela. Lokhu kungenxa ubukhulu encane yesimila. Ngezinye izikhathi akunakwenzeka ukuba uthole ngisho imisebenzi. Ezemfundo sivame ukubona ngengozi ngesikhathi luhlolo radiology.

ezingaba yishumi kuphela amaphesenti zonke izimila emathunjini amancane etiology imbangela yalesi sifo carcinoid. Ukuze udokotela, lokhu kusho ukuthi inqubo isibe abulalayo ezigcwala isibindi. Lezi izimila kungabangela obturation we Isikhala sayo esingaphakathi emathunjini futhi ngenxa yalokho, isimiso emathunjini. Isiguli kuziwa esibhedlela ngemihelo-like, isicanucanu, ukuhlanza neziyaluyalu kwesitulo. Futhi imbangela yalesi simo bazi kuphela etafuleni yokusebenza.

Isimiso kungahle kubangelwe ngqo usayizi unesimila torsion amathumbu ngenxa izenzakalo of cystic zivuvukale ulwelwesi lwamafinyila. Ngezinye izikhathi AMANXEBA ukuphazamisa igazi ligeleze endaweni wamathumbu, okuholela necrosis futhi peritonitis. Noma imiphi yale mibandela kuyinto esongela ukuphila futhi kungaholela ekufeni isiguli.

Isimila ka isithasiselo

Izimila isithasiselo - okuyinto eyivelakancane uqobo. Phakathi kwabo carcinoids hlala unendawo ehloniphekile lokuqala, kodwa neze kubangele carcinoid syndrome. Izimpawu zazo eziyindlala kakhulu. Njengomthetho, kuba okwatholakala pathologists ngemva appendectomy. Ukuvuvukala ngobukhulu ingaphansi koyedwa isentimitha futhi siziphathe kakhulu 'sokuthula'. Kungenzeka ukuthi ngemva ukususwa isimila ka isithasiselo livela kwenye indawo, ongabalulekile.

Kodwa uma isimila kubonakele ku ngamasentimitha amabili ubukhulu, nokuningi, kufanele uqaphele Ukudlulela e-lymph wendawo kanye nokusabalalisa isimila cells e nezinye izitho. appendectomy Ordinary Kulezo zimo akakwazi ukubhekana yonke ukuhlola futhi kuyodingeka ukuheha oncologists azokuqhubela ukwelashwa olunzulu.

izimila Rectal carcinoid

Enye kwasendaweni, lapho cishe neze carcinoid syndrome. Ayikho izimpawu yesimila futhi ngephutha kutholakele phakathi izindlela zokuxilonga ezifana colonoscopy noma sigmoidoscopy.

Amathuba umdlavuza (umdlavuza), futhi ukubonakala metastases ezikude incike ubukhulu yesimila. Uma-ke mkhulu ububanzi ngamasentimitha amabili, ingozi yezinkinga imayelana ayisishiyagalombili amaphesenti. Uma isimila akaphinde asibalele elilodwa sentimutha ububanzi, ungaqiniseka ukuthi amaphesenti ayisishiyagalolunye nesishiyagalombili, akukho Ukudlulela.

Ngakho-ke, indlela eyinhloko yokwelashwa kulezi zimo ezimbili lihlukile. Isimila encane isuswe resection ngokuvamile ukonga nopopopo, uma kukhona izimpawu umdlavuza, uma kudinga ukususwa lonke ikholoni, nokwelashwa ngamakhemikhali.

carcinoid esiswini

Kunezinhlobo ezintathu carcinoid izimila esiswini, okubangela carcinoid syndrome. I izici Uhlobo lokuqala izimila:

• Ubukhulu encane (kufika ku-1 cm);
• Yiqiniso kungavamile ukuba ingozi.

ukusabalala olungenzeka isimila kunzima uma inqubo ithumba lonke esiswini. Zihlotshaniswa anaemia pertsinoznoy noma kolwelwesi okungalapheki isiguli. Ukwelashwa izimila ezifana ukuthola okusithiyayo somatostatin ukukhiqizwa gastrin noma gastrectomy.

Uhlobo isimila yesibili sikhula kancane kancane, azivamile anomdlavuza. Ziyakwazi luvame iziguli nge kofuzo ezifana amaningi endocrine neoplasia. Marvel hhayi kuphela esiswini, kodwa indlala pineal, yegilo indlala, amanyikwe.

Uhlobo lwesithathu isimila - a izimila ezinkulu ezikhulayo usuthi enempilo. Ziyakwazi abulalayo, engena ijule odongeni umzimba futhi ahlinzeke metastases amaningi. Kungadala perforation ukopha.

Izimila ikholoni

Ithumbu elikhulu - iyindawo lapho ezivamile kutholakala ukuthi uphethwe yini syndrome carcinoid futhi isimila carcinoid. Photo mucosa ngesikhathi Ukuhlola ingxenye wamathumbu ikhombisa khona ezinkulu (amasentimitha amahlanu noma ngaphezulu) izimila. Bona iyakhula ukuze lesifunda lymph node kanye cishe njalo ebulalayo.

Oncologists ezimweni ezinjalo belulekwa ukuba ukuhlinzwa olukhulu nge adjuvant, ngelashwa nangemithi neoadjuvant kuzuzwe nomphumela ongcono. Kodwa sokusinda Izibikezelo lezi iziguli namanje okungekuhle.

Syndrome Carcinoid: Izimpawu, izithombe

Izenzo sifo carcinoid kuxhomeke kulokho izinto ziya ekhishwe lwesimila. Lokhu kungaba serotonin, bradykinin, histamine noma chromogranin A. izimpawu ejwayelekile iningi isifo yilezi:

• Ububomvu ebusweni nomzimba engenhla. Senzeka cishe zonke iziguli. Ehamba ukukhuphuka sendawo lokushisa. Ukuhlaselwa zenzeka angesabi, zingase senziwa utshwala, ukucindezeleka noma umsebenzi. Kulokhu, kukhona tachycardia, ingcindezi lehla.
• Ukukhungatheka ngezinsimbi zesihlalo. ¾ ekhona iziguli. Ngokuvamile, lokhu kwenzeka ngenxa yokucasuka we ulwelwesi lwamafinyila yaleli pheshana wokugaya ukudla, iziyaluyalu wamathumbu isimiso.
• Ukuphazamiseka inhliziyo esivela e kwesigamu iziguli. Carcinoid syndrome ikhuthaza kumiswa inhliziyo valve stenosis futhi kubangela ukuhluleka inhliziyo.
• Kwesifuba emaphashini kubangelwa spasm ze- bronchi.
• Ubuhlungu besisu lihlotshaniswa ukuvela metastases esibindini, isimiso emathunjini noma isimila ayehlasela ku nezinye izitho.

Inkinga Carcinoid - isimo elinesimo iconsi elibukhali ingcindezi phakathi nokuhlinzwa. Ngakho-ke, iziguli iqondiswa somatostatin ukuze manipulations efanayo.

ukuhlola

Kungenzeka yini ukuthola carcinoid syndrome? Izimpawu, izithombe, impatho disparate izimpawu akukuniki isithombe emtholampilo ecacile, ayikho imiphumela ebonakalayo. Ngokuvamile isimila - i ngephutha ukuthola udokotela ohlinzayo noma radiologist. Ukuze uqinisekise khona izimila, kubalulekile ukwenza biopsy ukusuka endaweni yenhlekelele eliphelele bese ibheka nezicubu.

Usengasebenzisa isivivinyo ukuthola amazinga aphakeme ama-hormone, kodwa lezi idatha zingase zibe Indlela ezinye izifo, futhi lo dokotela has ukuthola ngumuphi kubo ongathiwa kumelwe senze. Ukuhlolwa esithize kakhulu inombolo 5-hydroxyindoleacetic acid. Uma amazinga ayo luyanda, ematfuba carcinoid - cishe u-90%.

ngelashwa nangemithi

Ingabe kunengqondo ukuba aphathe nokwelashwa ngamakhemikhali-carcinoid syndrome? Izimpawu, isithombe mucosa at EGD biopsy lymph lesifunda ISIZINDA kanye ukushintsha kwama-hormone anganikeza udokotela umqondo yezinkinga ezidalwa Isiguli khona lwesimila. Uma umhlahlo okungekuhle isiguli noma ngabe ukukhishwa kwe-isimila, ochwepheshe ukweluleka iphendukele ngamakhemikhali.

Ngokuvamile, odokotela asebenzise amanxusa cytotoxic kuthiye ukukhula nokuthuthuka izimila. Kodwa ngenxa inani elikhulu imiphumela engemihle le ndlela Kunconywa kuphela uma eziphuthumayo. Ngaphandle ukusebenza yayo - 40%.

ukwelashwa okunezimpawu

Kukhona imizwa ungakhululekile ukuthi kuyagcinwa ku isizinda pathologies ezifana syndrome carcinoid, isimila carcinoid. Izimpawu zivame ukuba eduze ahlobene nohlobo hormone kudedela lwesimila. Uma lokhu serotonin, isiguli antidepressant enqunyiwe. Uma "umqali" main kuyinto histamine ke ziqokonyiswe blocker histamine zemizwa yokwelapha.

zokwenziwa analogue of somatostatin eziye zatholakala, ekunciphiseni izimpawu cishe 90%. Bona zivimbela ekukhiqizweni kwama-hormone eziningana ukuthi banesibopho endaweni yabo niqinile ekwelapheni lesi sifo.

ukwelashwa op

Isinyathelo esibalulekile uphathwa ukususa isimila emzimbeni, futhi useshe metastases resected, isibindi Umthambo Ligation.

Ngevolumu ukuhlinzwa kuthinta indawo kanye nosayizi izimila, khona noma ukungabi khona metastases. Ngokuvamile, odokotela abahlinzayo ukususa ingxenye onesifo yomzimba, futhi amaphakheji of lesifunda zamanzi. Njengomthetho, kungcono ngokwanele ukuze asindise abantu kusukela carcinoid phakade. Ezimweni eziphambili, lapho ukwelashwa ekwelapheni akunakwenzeka, isiguli mema chitha embolization we Umthambo hepatic ukususa izimpawu zesifo.

ukuba nombono ongafani ngeke

Yini okumele uyilindele iziguli ukuthi nginesifo syndrome carcinoid futhi isimila carcinoid? Flushing, palpitations kanye neziqubu Ukuphelelwa, kungenzeka ukuba sihlale nabo kuze kube sekupheleni kokuphila, kodwa azoba ngaphansi evelele ngemva kokwelashwa.

Medicine, zikhona izimo lapho iziguli aphila iminyaka engaphezu kwengu eziyishumi emva kokuhlinzwa, futhi ukwelashwa lingaze. Kodwa kwesilinganiso sobude beminyaka yokuphila kwabo eminyakeni engaba ngu-5-10. Onalesi sifo seziphelile isimila ise wamaphaphu okungcono - esithasiselweni.