Hepatocellular carcinoma chiwindi: Matendawa, Zizindikiro ndi Chithandizo

khansa chachikulu cha matenda chiwindi n'zochepa. Nthawi zambiri khansa ndi sekondale, kuti ndi metastatic. Chachikulu chiwindi zotupa anafotokoza holangio- ndi hepatocellular carcinoma. khansa awa akhoza kukhala amuna ndi akazi (kawirikawiri). Ana, zotupa izi pafupifupi sizidzachitikanso. Odwala achinyamata angathe khansa chiwindi, zichokera kwa minofu embryonic - hepatoblastoma. kudwala uyu ali osowa. Pafupifupi onse yaikulu zotupa chiwindi amaonedwa kukhala aukali. Iwo kutenga malo 5 cha imfa mu dongosolo khansa pathologies. Panopa tikufunafuna njira zatsopano pofuna kuthana ndi khansa chiwindi. Great patsogolo Zimapezeka chotulukira ndi akulimbana mankhwala m'thupi.

Kufotokozera za carcinoma hepatocellular

Hepatocellular carcinoma - khansara maselo chiwindi poyera atypia. Poyerekeza ndi zina chachikulu pathologies oncological za thupi, ndi ambiri ofala. chotupa umenewu umatchedwanso kwa chiwindi carcinoma selo. Mu pafupipafupi carcinoma hepatocellular pakati pa anthu 5 waukulu kwambiri padziko lonse. chotupa Izi ndi m'mayiko otukuka. Zimatanthauza khansa aakulu ndipo mofulumira kupata ndi zambiri amapha. Si chabe matenda mochedwa matenda, komanso ndewu ake ndi luso metastasize ziwalo zina. Ichi ndi chifukwa perfusion chiwindi.

mitundu yonse ya khansa zalembedwa mu gulu mayiko a Matenda (ICD). Monga khansa kudwala ena, ali yekha wapadera malamulo ake, ndipo carcinoma hepatocellular. ICD-10 ntchito m'mayiko onse a dziko. Mu gulu la matenda ali kachidindo S22.0, kutanthauza "carcinoma chiwindi foni." Nthawi zambiri, kudwala izi zimachitika ndi maziko a matenda aakulu, mchikakamizo cha zinthu chowawa.

Zimayambitsa carcinoma chiwindi

Monga amadziwika, ndi etiology a zotupa zilonda silinakwaniritsidwe kuphunzira. Komabe, asayansi akhala anafufuza Mfundo imautsa chitukuko cha chotupa. No mwapadera kwa chiwindi carcinoma selo. Kumubweretsa zotsatira izi:

1. onyamula yaitali mavairasi ena. Zikuoneka kuti pathologies monga aakulu chiwindi B ndi C, azitaya osauka carcinoma kwa chiwindi ndi nthawi zoposa 100. Komanso, matenda awa kawirikawiri asymptomatic. Choncho, kuchepetsa chiopsezo cha khansa ayenera nthawi amapereka magazi a chiwindi mavairasi.
2. Chiwindi matenda a etiology iliyonse. M'malo a hepatocytes mu minofu connective zambiri kumachitika chifukwa cha matenda aakulu tizilombo, madyedwe mowa ndi mankhwala.
3. Kudya chakudya wolemera aflatoxin.
4. Majini chingawapangitse kukhala zidakwa matenda.
5. Chikuonetseratu hepatotoxic mankhwala.

Ngati ife kukusalani ali precipitating zinthu, kusamala angathe kukhala hepatocellular carcinoma ndi kochepa. Komabe, palibe amene sangayesedwe kwa chotupa ichi. Monga khansa kudwala zina, zingathe kudzetsa mwangozi ionizing dzuwa, kusuta zakudya m'thupi, nkhawa, ndi zina zotero. D.

The pathogenesis wa carcinoma hepatocellular

Chifukwa, aakulu kutupa maselo chiwindi anayamba kusandutsa mu zinthu chotupa. Kodi kwenikweni kumabweretsa ndi losadziwika. Chifukwa zochita za HIV kwa minofu chiwindi ndi kuvutika, thupi limakhala edematous, ndiponso yopweteka kwambiri. mtima permeability ukuwonjezeka, iwo yodzala-blooded. Choncho, ntchito chiwindi ndi makutu. Kuwonjezera pa mfundo yakuti thupi kuwononga particles ndi tizilombo, zimakhudzira zinthu zina zoipa akubwera kuchokera chakudya. Zonsezi kumabweretsa kusintha selo. Ngale umakhala kukula, ndi cytoplasm ndi organelles ena ankatembenukira kwa periphery lapansi. Pambuyo pake, selo imayamba kugawanitsa unmotivated. Iwo amalandira kuchuluka kwa mtima, hepatocyte kagayidwe mu linaphwanya. Muchipindachi, chotupa chimayamba lithe mapulotini achuluke kwambiri kudzera m'magazi. Choncho cholukanalukana chiwindi C ndi Hepatocellular carcinoma.

Tiyenera kukumbukira kuti ndi matenda enaake nthawi kuyambitsa matenda a chiwindi kapena khansa. Nthawi zambiri, izo kale matenda pamene mavuto uka. dzina lina la chiwindi C - "mtima wakupha". Izi ndi chifukwa anasiya mawonetseredwe matenda a matenda kwa zaka zambiri, ndi kufa kunatsala pang'ono chifukwa cha kuchotsa kugwira ntchito kwa chiwindi.

Gulu la Khansa hepatocellular

Hepatocellular carcinoma chiwindi lagawidwa njira zosiyanasiyana matenda ndi morphological. Komanso, chotupa ali m'magulu malinga siteji ya chitukuko ndi digiri ya mwamphamvu. Malinga macroscopic chithunzi olekanitsidwa mfundo, chachikulu ndi mitundu akakufunsani khansa chiwindi. Akuti mitundu osiyana fibrolamellar hepatocellular carcinoma. Malinga ndi chithunzi matenda ali 6 mitundu ya carcinoma chiwindi selo. Pakati pawo:

1. Gepatomegalichesky mwina.
2. Icteric mawonekedwe.
3. Febrile mwiniwake wa khansa chiwindi.
4. Ascites mawonekedwe.
5. Pachimake m'mimba mwina.
6. Metastatic khansa chiwindi.

Nthawi zambiri pali mitundu mitundu angapo matenda. Gawo khansa Chiwindi-selo zimadalira kukula chotupa ndi kuchuluka kwake mu mfundo pafupi lymph ndi ziwalo zina.

Hepatocellular carcinoma: zizindikiro

Zizindikiro zimadalira mtundu matenda a carcinoma. Nthawi zambiri, magawo oyambirira a khansa alibe zizindikiro. Komanso, matenda ndi zovuta chifukwa chakuti zizindikiro chotupa amafanana ndi chithunzi matenda ena chiwindi matenda (a chiwindi aakulu, matenda enaake). Ndi mawonetseredwe mochedwa khansa monga otsika kalasi kutentha thupi, kusowa chilakolako cha kufooka, lymphadenopathy, kuwonda. Pamene gepatomegalicheskoy mawonekedwe carcinoma ndinawona kuwonjezeka zikusintha chiwindi, kupweteka kwa hypochondrium bwino. Gawo limodzi la odwala ndi matenda a chikasu ndiyo mitundu ya kudwala. Iwo ali madokotala ananena zawo osauka. Matenda a chikasu ndiyo amapezeka mu gawo loyamba kapena wachiwiri chotupa.

Komanso, odwala amadandaula kuwawa ndi kuyabwa. Pamene mtundu febrile amalembedwa kuwonjezeka thupi kutentha zonse zosasangalatsa kupweteka zomverera pamimba chapamwamba. Ascites limapezeka magawo zapamwamba wa khansara, chotupa limodzi ndi zizindikiro zosonyeza kuledzera. Wofala pachimake m'mimba mawonekedwe. Iwo amakhala ndi ululu, minofu mavuto abdominals. Njira kwa metastatic hepatocellular carcinoma chogwidwa ndi zizindikiro za ziwalo zina. Pakati pawo - mafupa, mapapo, matumbo.

mitundu Morphological wa carcinoma chiwindi

Kafukufuku wakapangidwe kazachilengedwe mawonekedwe zotupa secrete zotsatirazi:

1. Chachikulu hepatocellular carcinoma. Zimatengera gawo lonse kapena Lobe chiwindi. Pamene odulidwa ali omveka bwino. Komanso yaing'ono foci (nthambi) akhoza kupezeka mwa chotupa malo. Mmodzi wa mitundu ya khansa chachikulu chiwindi akuti ndi mawonekedwe a m'mimba. Pa yachigawo wapezeka chotupa malo, mkati limene pali madzi bulauni. M'mimbamo khoma wakuda ndi yosalala.
2. Nodular hepatocellular carcinoma. Yodziwika ndi kuchuluka kwa foci chotupa ili yonse padziko parenchyma thupi.
3. Akakufunsani Chiwindi carcinoma. Nthawi zambiri akufotokozera pa maziko a matenda enaake. parenchyma zonse imakhala miyambo ya minofu connective ndi maselo nthenda.

carcinoma Fibrolamellar tichipeza chimodzi kapena malo ochepa lalikulu. Nthawi zambiri isanafalikire mu Lobe kumanzere kwa chiwindi. Mtundu chotupa - chikasu kapena wobiriwira. mawonekedwe ena osiyana imatengedwa kuti encapsulated (zing'onozing'ono), kwa chiwindi carcinoma selo. Iwo amakhala ndi madokotala ananena zawo yabwino ndi kukula pang'onopang'ono, chotupa kukula masentimita zosakwana 5 awiri.

Matenda a chiwindi hepatocellular carcinoma

M'pofunika kuchita zosiyanasiyana mayeso pamaso kudziwa matenda monga hepatocellular carcinoma. Kudwala Matendawa tichipeza magawo angapo. Choyamba, dokotala amamva madandaulo onse wodwala ndipo anayendera. chidwi linaperekedwa kwa khungu (mtundu, pamaso raschosov, kukha mwazi), lymph mfundo, palpation chiwindi. Khansa ya thupi lili pamwamba pa vuto limeneli, wandiweyani kapangidwe, amalembedwa mwachikondi. Kenako, chiwerengero cha Kafukufuku. Pakati pawo:

1. KLA, umagwirira magazi.
2. Kuona mlingo wa zolembera wapadera - alpha-fetoprotein.
3. Ultrasonography wa pamimba.
4. Yopangidwa tomography.
5. Studies kwa chiwindi ziwiya. Zikuphatikizapo angio ndi portogepatografiyu.

Matendawa ali Atafufuza cytological ndi histological. Kuchititsa maphunziro awa, anachita limba biopsy.

Hepatocellular carcinoma chiwindi: zochizira matenda

Kusankha chithandizo strategy zimadalira mtundu morphological ndi kukula chotupa, ndi gawo la ndondomeko ya khansa. Mu masiteji koyamba opaleshoni khansa imagwiridwa, chiyembekezo cha tinatake tozungulira chithokomiro, mankhwala amphamvu. Mu zotupa akakufunsani anachita embolization a mtsempha wamagazi kwa chiwindi. Izi zimathandiza kuti m'mbuyo kukula kwa zotupa ndi kuchepetsa ndondomeko. Hepatocellular carcinoma chiwindi sachita chidwi mankhwala radiotherapy. Komanso, ndiye kawirikawiri amenable kuti mankhwala amphamvu,% 15-20 kokha odwala ndi osakhalitsa zotsatira zabwino. Njira imodzi ndi chiwindi kupatsidwa zina. M'mayiko otukuka, njira imeneyi ambiri. Kupatsidwa zina za chiwalo mwiniwake wochititsidwa yekha mu magawo oyambirira a khansa. Pamaso pa metastases lakutali imatengedwa njira yokhayo kuchitira mankhwala symptomatic. Pamafunikanso chisamaliro palliative (kusamalira wodwala, misala) ndi mankhwala ochititsa dzanzi.

Opaleshoni mankhwala a khansa chiwindi

Opaleshoni alowererepo ikuchitika pafupifupi odwala onse amene anapezeka ndi "hepatocellular carcinoma". Mankhwalawa zikuphatikizapo chiwindi resection mu dera anatomical (gawo gawo theka thupi). Ngati yaing'ono-kakulidwe wagawo anachita enucleation ake aspirator wapadera. Njira ina ndi opaleshoni - ndi percutaneous embolization a mtsempha wamagazi kwa chiwindi.

Njira yabwino kwambiri ndi kumuika chiwalo kapena gawo zace. Minofu chiwindi amatha buluzi. Zimenezi zingadzetse kuchira bwino wodwalayo.

mankhwala ndi carcinoma hepatocellular

Kuwonjezera mankhwala chemotherapeutic mwachangu ntchito yatsopano pharmacological gulu la mankhwala - zoletsa wa kinases mapuloteni. mmene ndi kuchepetsa kuchuluka kwa maselo chotupa. Ngakhale zotsatira ambiri mbali, mankhwala awa ali imathandiza. Chitsanzo cha mankhwala gulu ili mankhwala "Nexavar".

Kuti madokotala ananena zawo za carcinoma hepatocellular

Mmodzi wa anthu ankhanza zotupa zilonda thirakiti m'mimba imatengedwa hepatocellular carcinoma chiwindi. Kuti madokotala ananena zawo kwa chotupa ichi nthawi zambiri zovuta. Mkulu mlingo kupulumuka 5-chaka ndi kokha pa zamitundu yaing'ono mapangidwe pambuyo opaleshoni kapena chiwindi kupatsidwa zina. Nthawi zambiri pali zisadzachitikenso a chotupa ndi metastasis mofulumira. Kuchotsa ntchito thupi amapha.

Kupewa carcinoma hepatocellular

zodzitetezera monga kafukufuku wa pachaka wa pa chiwindi mavairasi, kukana mankhwala ndi mowa. M'pofunikanso kukumbukira kuti kutupa chiwindi akhoza analandira chifukwa cha mwai monga mankhwala mano ndi kukongola, magazi.