Akuru a ɛyɛ nwonwa a ɛwɔ dwensɔtwaa mu? Momma yensua (Intraductal Papillary Mucinous Neoplasm - IPMN) ho ade wɔ ɔkwan a ɛnyɛ den so!

Dɛn ne yare a ɛwɔ din tenten yi? Ebia woresusuw nea `Intraductal Papillary Mucinous Neoplasm` anaa `(IPMN)` yɛ ho. Ebia edin no bɛyɛ te sɛ nea ɛyɛ hu kakra na ɛyɛ den sɛ yɛbɛte ase, nanso momma yɛmma ɛnyɛ mmerɛw. Ebia wo anaa obi a wunim no ate tebea yi ho asɛm. Enti, mommma yɛnnsuro na yɛnhwehwɛ nea ɛyɛ ankasa.

Dɛn ankasa ne `IPMN`?

Sɛ yɛbɛka no tiawa a, IPMN yɛ akisikuru anaa akisikuru a nsu ahyɛ mu ma a ɛba wo dwensɔtwaa no ntini mu. Eyinom nyɛ kokoram ankasa, nanso nnuruyɛfo bu no sɛ “nea edi kokoram anim.” Wei kyerɛ sɛ wɔnyɛ kokoram mprempren, nanso wobetumi abɛyɛ kokoram daakye.

Susuw ho hwɛ, ɛtɔ da bi a ɛte sɛ afifide ketewaa bi. Ebia ɛbɛyɛ dua kɛse anaasɛ ɛnyɛ saa. Saa na saa `(IPMN)` tumor yi te. Nhwehwɛmufoɔ gye di sɛ wɔ nnipa a wɔnya dwensɔtwaa mu kokoram, anaa nnipa du biara mu mmienu anaa mmiɛnsa mu no, kokoram no hyɛɛ aseɛ sɛ `(IPMN)`. Nnipa binom tumi nya saa akisikuru yi mfe pii a wɔrenkyerɛ yare no ho sɛnkyerɛnne biara. `(IPMN)` no, wɔde oprehyɛn, anaasɛ wɔde ahwɛyiye hwɛ bere tenten.

So `IPMN` yɛ kokoram bere nyinaa?

Dabi, ɛnyɛ IPMN nyinaa na ɛbɛyɛ kokoram . Ɛno ne ade a edi kan a ɛsɛ sɛ yɛte ase. Nanso, awiei koraa no, ebinom betumi abɛyɛ pancreatic ductal adenocarcinoma (PDAC). PDAC ne kokoram a abu so sen biara wɔ dwensɔtwaa mu. Kokoram a ɛwɔ dwensɔtwaa mu yɛ kokoram a ɛntaa nsi koraa. Ɛyɛ kokoram a ɛwɔ United States nyinaa mu bɛyɛ 3%. Nanso, kokoram a ɛwɔ dwensɔtwaa mu na ɛma kokoram a wowuwu nyinaa mu 7%. Nea ɛyɛ awerɛhow no, mpɛn pii no wonhu no ntɛm, bere a ayaresa no betumi atu mpɔn kɛse no.

Hena na tebea yi ka no kɛse?

Ɛyɛ den ma nnuruyɛfo sɛ wɔbɛka nnipa dodow pɔtee a wɔwɔ saa akisikuru yi, efisɛ mpɛn pii no ɛmma yare no ho sɛnkyerɛnne mma na wonhu. Nanso nhwehwɛmu ahorow ada no adi sɛ ɛtaa ba mmarima a wɔadi fi mfe 50 kosi 70 so .

Dɛn na ɛba nipadua a ɛwɔ saa `(IPMN)` yi so?

Nsu bi a ɛyɛ den a ɛte sɛ jelly wɔ IPMN ahorow mu. Nnuruyɛfo frɛ no mucin. Sɛ saa akisikuru a ɛteɛ a ɛnyɛ kokoram yi fi ase dan kokoram a, efi ase yɛ nsu a wɔfrɛ no mucin yi pii. Fa no sɛ ɛte sɛ balloon ketewaa bi a nsu ahyɛ mu ma. Sɛ saa mucin yi boaboa ano a, ebetumi asiw dwensɔtwaa mu ntini a ɛwɔ wo dwensɔtwaa mu no ano. Saa ntini ahorow yi yɛ nsukorade nketenkete a ɛboa ma wɔyam aduan. Sɛ wɔsiw a, ebetumi ama dwensɔtwaa no ayɛ hyew (pancreatitis) .Eyi betumi ayɛ tebea a ɛyɛ yaw paa. Ɛtɔ mmere bi a, saa dwensɔtwaa mu ɔfe yi ne IPMN ho sɛnkyerɛnne a edi kan.

Dɛn ne IPMN ho sɛnkyerɛnne ahorow?

Nnipa pii a wɔwɔ saa tebea yi nte nka sɛ wɔyare anaasɛ wonni sɛnkyerɛnne pɔtee biara. Ɛno ne ɔhaw a ɛwɔ eyi mu. Mpɛn pii no, wohu saa akisikuru yi ara kwa bere a wɔreyɛ wɔn nhwehwɛmu ahwɛ sɛ wɔwɔ tebea foforo bi no. Nanso, nnipa binom betumi anya yare no ho sɛnkyerɛnne te sɛ:

• Yafunu mu yaw a ɛba bere ne bere mu: Ebia nnipa binom bɛte yafunu mu yaw bere a wɔadi awie no. Eyi nso betumi ama aduan ho akɔnnɔ asɛe.
• Wo mu duru a woanhyɛ da: Sɛ wo mu duru so tew a wommɔ mmɔden a, ɛno nso yɛ sɛnkyerɛnne.
• Akisikuru ne ɔfe.
• Akyi yaw.
• Oily poop/stool: Sɛ ɛte sɛ nea nsu a ɛwɔ nsu mu no yɛ srade a.

Ɛtɔ da bi a, saa akisikuru yi tumi de sɛnkyerɛnne a ɛte sɛ nyarewa afoforo ba. Nhwɛsoɔ:

• Jaundice: Wora a ɛyɛ kɔkɔɔ esiane bile ntini a esiw nti.
• Asikreyare a efi ase foforo: Asikre dodow a ɛkɔ soro wɔ mogya mu esiane dwensɔtwaa no ankasa a ɛsɛe nti.
• Pancreatitis: Tebea a efi dwensɔtwaa mu ntini a esiw mu ba.

Dɛn na ɛde IPMN ba?

Nhwehwɛmufo gye di sɛ IPMN ahorow no ba bere a nsakrae (nsakrae) ba awosu mu nkwaadɔm a ɛhwɛ yɛn nkwammoaa nyin so anaasɛ esiw akisikuru ano no mu. Eyi kyerɛ sɛ yɛn nipadua no ahobammɔ nhyehyɛe no bi yɛ mmerɛw. Sɛ obi a ɔwɔ abusua no mu anya dwensɔtwaa mu kokoram (PDAC) , a, saa abusua no mufo afoforo wɔ asiane kɛse mu sɛ wobenya IPMN ahorow.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Nnuruyɛfo titiriw de `(imaging)` nhwehwɛmu ahorow di dwuma de hu `(IPMN)`. Eyinom mu no, sɔhwɛ titiriw bi a wɔfrɛ no `Magnetic Resonance Cholangiopancreatography (MRCP)` ho hia yiye. Eyi yɛ sɔhwɛ a wɔde `(MRI)` afiri di dwuma. Eyi betumi atwa wo mmerɛbo, mogya ntini, akisikuru, dwensɔtwaa, ne dwensɔtwaa ntini ho mfonini a emu da hɔ yiye. Nnuruyɛfo de nhwehwɛmu yi di dwuma de hwɛ sɛ nsakrae bi aba dwensɔtwaa no mu anaa.

Wɔakyekyɛ saa ``(IPMN)`` akisikuru yi mu ayɛ no ahorow abiɛsa titiriw:

• Main duct type (MD-IPMN): Eyinom yɛ akisikuru a esiw wo dwensɔtwaa mu ntini titiriw no kwan. Eyi betumi ama ntini titiriw no ayɛ kɛse, anaasɛ atrɛw. Mpɛn pii no, nsu kwan kɛse bi ntwemu yɛ bɛyɛ milimita 3.5. Sɛ ɛsõ sen milimita 5 a, ebetumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ ɛda adi sɛ ɛyɛ kokoram.
• Branch duct type (BD-IPMN): Eyinom yɛ akisikuru a ɛba wɔ ntini nketewa a ɛte sɛ nkorabata mu a efi ntini kɛse no mu fi nkorabata mu. Saa akisikuru yi taa yɛ nea ɛnyɛ hu .
• Mixed type (MT-IPMN): Eyinom yɛ akisikuru a ɛba wɔ dwensɔtwaa no ntini atitiriw ne nkorabata nyinaa mu.

So sɔhwɛ afoforo wɔ hɔ a wɔde hu `IPMN`?

Yiw, sɔhwɛ afoforo wɔ hɔ. Nnuruyɛfo nso betumi ayɛ nhwehwɛmu bi a wɔfrɛ no Endoscopic Ultrasound (EUS). Eyi betumi atwa dwensɔtwaa ne akisikuru no ho mfonini a emu da hɔ yiye. Wɔ sɔhwɛ yi mu no, wobetumi afa akisikuru no ketewaa bi a wɔfrɛ no Fine-Needle Aspiration (FNA) (biopsy). Afei wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ nhwɛsode no mu de hu nkwammoaa ko (dysplasia) (sɛ ebia nkwammoaa no te sɛ nea ɛnteɛ) na wɔyɛ awosu mu nhwehwɛmu de hu asiane a ɛwɔ hɔ sɛ ɛbɛyɛ kokoram.

Dɛn ne `Dysplasia`? Dɛn nti na ɛho hia?

``Dysplasia'' kyerɛ ara ne sɛ wo nkwammoaa no hwɛ sɛnea ɛnteɛ bere a wɔde microscope hwɛ no.

• ``High-grade dysplasia'' kyerɛ sɛ wo nkwammoaa te sɛ kokoram nkwammoaa sen nkwammoaa a ɛwɔ apɔwmuden. Ɛno kyerɛ sɛ asiane no dɔɔso.
• Dysplasia a ɛba fam kyerɛ sɛ nkwammoaa bi te sɛ kokoram nkwammoaa, nanso wogye di sɛ asiane a ɛwɔ hɔ sɛ wobenya kokoram no sua.

Nnuruyɛfo de tebea no ho nsɛm (dysplasia) ne akisikuru no awosu mu nsɛm di dwuma de kyekyɛ IPMN ahorow mu ayɛ no ahorow atitiriw anan. Eyi yɛ asɛm a emu dɔ kakra, nanso mɛma ayɛ mmerɛw:

1. Gastric-type IPMNs: Eyinom taa nyin wɔ dwensɔtwaa no nkorabata ntini mu. Mpɛn pii no, wɔwɔ dysplasia a ɛba fam. Nnipa a wɔwɔ saa akisikuru yi mu bɛboro 90% te ase wɔ mfeɛ 10 akyi wɔ berɛ a wɔahu sɛ wɔanya bi no.

2. IPMN ahorow a ɛte sɛ dwensɔtwaa: Wobetumi ahu eyinom wɔ dwensɔtwaa no ntini atitiriw ne nkorabata nyinaa mu. Ebia wɔwɔ dysplasia a ɛkorɔn na awiei koraa no wobetumi abɛyɛ dwensɔtwaa mu kokoram. Nnipa a wɔwɔ saa akisikuru yi mu bɛyɛ 70% te ase wɔ mfeɛ 5 akyi wɔ berɛ a wɔahu sɛ wɔanya bi no. Saa ɔha biara mu nkyem yi so tew kɔ 50% wɔ mfe 10 mu.

3. Pancreatobiliary-type IPMNs: Wobetumi ahu eyinom nso wɔ ntini titiriw ne nkorabata no mu, na ɛwɔ dysplasia a ɛkorɔn nso. Nnipa a wɔwɔ saa akisikuru yi mu bɛyɛ 80% betumi anya dwensɔtwaa mu kokoram a ɛkɔ nipadua no mu.

4. Oncocytic-type IPMNs: Eyinom yɛ akisikuru a ɛntaa nsi koraa. Wɔyɛ kɛse wɔ dwensɔtwaa mu ntini titiriw no mu na wɔwɔ dysplasia a ɛkorɔn. Nnipa a wɔwɔ akisikuru a ɛte sɛɛ no ​​mu bɛyɛ fã benya dwensɔtwaa mu kokoram a ɛyɛ hu.

Nea ɛho hia: Mma saa nkyekyɛmu ne akontaabu yi nnyɛ wo hu. Eyinom yɛ nsɛm a ɛfa nneɛma nyinaa ho ara kwa. Wo duruyɛfo nkutoo na obetumi akyerɛ wo nea wo tebea no te ankasa.

Ɔkwan bɛn so na wɔsa IPMN ahorow?

Sɛ wobu IPMN sɛ asiane nnim a , nnuruyɛfo taa kamfo kyerɛ sɛ wɔnkɔ so nhwɛ akisikuru no yiye.Eyi te saa efisɛ akisikuru a ɛnyɛ hu (IPMN) dodow no ara nyɛ kokoram. Nanso, sɛ wowɔ akisikuru wɔ wo dwensɔtwaa no mu ntini titiriw no mu, a ɛkyerɛ sɛ wowɔ asiane mu kakra a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn nyi akisikuru no. Nhwɛso ahorow bi ni:

• Distal pancreatectomy: Eyi hwehwɛ sɛ woyi dwensɔtwaa no dua ne/anaasɛ nipadua no fi hɔ. Sɛ akisikuru wɔ ntini atitiriw a ɛwɔ saa beae no mu a, wɔyɛ oprehyɛn yi.
• Total pancreatectomy: Eyi hwehwɛ sɛ woyi dwensɔtwaa nyinaa, akisikuru, akisikuru a ɛtaa ba, yafunu ne dwensɔtwaa ketewaa no afã horow, ne mpɛn pii no akyi berɛmo no. Eyi yɛ oprehyɛn kɛse.
• Whipple procedure (pancreaticoduodenectomy): Wobetumi akamfo oprehyɛn yi akyerɛ wɔ akisikuru a ɛwɔ dwensɔtwaa ti no ntini atitiriw mu (ɔfã a ɛtrɛw sen biara a dwensɔtwaa no ne dwensɔtwaa ketewa no di nkitaho) no ho. Nea ɛka ho ne sɛ wobeyi dwensɔtwaa no ti, dwensɔtwaa ketewaa no fã a edi kan (duodenum), akisikuru, akisikuru no fã, ne ntini a ɛbɛn hɔ no afi hɔ.

Dɛn ne nsɛnnennen a ebetumi afi oprehyɛn yi mu aba?

Sɛnea ɛte wɔ oprehyɛn kɛse biara ho no, nsɛnnennen bi wɔ hɔ a ebetumi de aba. Ɛnyɛ obiara tebea na ɛyɛ pɛ. Enti, ɛbɛyɛ papa sɛ wubebisa wo duruyɛfo no nsɛnnennen pɔtee a ebia wubehyia no ho asɛm.

Bere tenten ahe na egye ansa na obi ho atɔ no wɔ oprehyɛn a ɛte sɛɛ akyi?

Eyi gu ahorow wɔ onipa biara mu. Nanso, ɛsɛ sɛ nnipa dodow no ara tra ayaresabea hɔ nna kakraa bi wɔ dwensɔtwaa mu oprehyɛn akyi. Ebetumi agye adapɛn anaa asram pii ansa na ne ho atɔ no koraa.

So ɛsɛ sɛ meyɛ nnuru anaa mframa a wɔde sa yare bere a wɔayɛ me oprehyɛn awie no?

Nhwehwɛmu ahorow bi ada no adi sɛ nnuru a wɔde sa yare ne/anaasɛ mframa a wɔde sa yare betumi aboa wɔ oprehyɛn akyi. Nanso, ɛsɛ sɛ wususuw ayaresa ahorow no mu nsunsuanso bɔne nso ho. Ɛtɔ mmere bi a, nsunsuanso bɔne a efi mu ba no betumi ayɛ kɛse asen mfaso a ɛwɔ ayaresa ahorow no so. Bisa wo duruyɛfo ma ɔmma no eyi ho nsɛm pii.

Me duruyɛfoɔ kaa sɛ ɔnhwɛ `IPMN` no so. Dɛn na ɛno kyerɛ?

Eyi kyerɛ sɛ wo nhwehwɛmu ahorow no ada no adi sɛ wo IPMN no nyɛ hu na ɛnyɛ nea ɛbɛyɛ yiye sɛ ɛbɛyɛ kokoram. Nnuruyɛfo bɛkɔ so de mfoninitwa nhwehwɛmu (te sɛ MRCP) ahwɛ saa akisikuru a ɛnyɛ hu yi so. Wei kyerɛ sɛ, "Momma yɛnhwɛ eyi so na yɛnhwɛ sɛ biribi sesa anaa."

Dɛn na metumi ayɛ de atew asiane a ɛwɔ hɔ sɛ menya IPMN no so?

Nhwehwɛmufo gye di sɛ nsakrae a ɛba awosu mu nkwaadɔm mu na ɛde saa akisikuru yi ba. Enti, biribiara nni hɔ a wubetumi ayɛ pɔtee de asiw IPMN kwan sɛ ɛrennya nkɔso. Nanso, nea edidi so yi betumi aboa ma asiane a ɛwɔ hɔ sɛ wubenya dwensɔtwaa mu kokoram no so atew na aboa wo ma woasusuw asiane a ɛwɔ hɔ sɛ wubenya IPMN ho:

• Sua w’abusua aduruyɛ ho abakɔsɛm.Sɛ obi a ɔwɔ w’abusua mu anya dwensɔtwaa mu kokoram (PDAC) a, asiane kɛse wom sɛ wubenya IPMN.
• Kokoram a ɛwɔ dwensɔtwaa mu ne sigaretnom wɔ abusuabɔ. Sɛ wode tawa (sigaret, beedis, sigaret) di dwuma a, bɔ mmɔden sɛ wubegyae.
• To nsa a wonom ano hye, anaa gyae koraa.
• Bɔ mmɔden sɛ wobɛkɔ so ayɛ wo mu duru a ɛfata.
• Bɔ mmɔden sɛ wode aduan pa ne apɔw-mu-teɛteɛ besiw asikreyare a ɛto so abien ano. Sɛ wowɔ asikreyare a, wo ne wo duruyɛfo nyɛ adwuma na ama asikre dodow a ɛwɔ wo mogya mu no so.

Bere tenten ahe na wubetumi ne IPMN atra ase?

Sɛnea ɛte wɔ kokoram biara ho no, ntɛm a wobehu ne ayaresa ne nneɛma a ɛho hia sen biara a ɛbɛma wɔahu nkwa. Sɛ yɛka ne nyinaa bom a, nnipa bɛyɛ 95% a wohu na wɔsa wɔn yare ansa na IPMN ayɛ dwensɔtwaa mu kokoram no da so ara te ase mfe anum wɔ bere a wɔahu no akyi. Sɛ wowɔ nsɛmmisa bi fa wo tebea no ho a, wo duruyɛfo na obenya nsɛm a eye sen biara.

Mewɔ IPMN a ɛnyɛ den. Mɛyɛ dɛn ahwɛ me ho?

Mpɛn pii no, saa akisikuru yi nyɛ kokoram. Nanso, ɛyɛ ade a ɛfata sɛ wobɛte adwennwen ne dadwen nka esiane adwene a ɛne sɛ, “Ebia ebetumi aba saa” nti. Sɛ wote nka saa a, wo ne wo duruyɛfo nka ho asɛm. Ɔbɛkyerɛkyerɛ nea enti a asiane kakraa bi na ɛwɔ hɔ sɛ wubenya kokoram wɔ dwensɔtwaa mu no mu. Ɔbɛtu wo fo nso wɔ nneɛma a wobɛtumi ayɛ de atew asiane a ɛwɔ hɔ sɛ wobɛnya dwensɔtwaa mu kokoram nyinaa so.

Intraductal Papillary Mucinous Neoplasm (IPMN) yɛ din tenten a ɛtɔ mmere bi a ɛma adwene tu fra ma akisikuru a ɛba wɔ dwensɔtwaa mu ntini mu na ebetumi abɛyɛ dwensɔtwaa mu kokoram. Mpɛn pii no, saa akisikuru yi mfa sɛnkyerɛnne biara mma na wɔtaa hu wɔ akwanhyia mu bere a wɔreyɛ nhwehwɛmu esiane nneɛma afoforo nti.

Sɛ wo duruyɛfo ka kyerɛ wo sɛ wowɔ IPMN a, ebia wo ho bedwiriw wo. Nanso kae sɛ, sɛ wowɔ saa tebea yi a, ɛnkyerɛ sɛ akyinnye biara nni ho sɛ wubenya kokoram. Mpɛn pii no, nhwehwɛmu foforo bɛkyerɛ sɛ akisikuru no nyɛ kokoram (ɛnyɛ bɔne). Sɛ wo kurukuruwa no nyɛ kokoram a, wo duruyɛfo bɛkɔ so ahwɛ so ahwɛ sɛ asiane kɛse wom anaasɛ ɛyɛ kokoram anaa. Na, nea ɛho hia no, sɛ wohu sɛ wo kurukuruwa no yɛ nea asiane kɛse wom mpo a, nnipa bɛyɛ 95% a wɔahu sɛ wɔwɔ IPMN na wɔasa wɔn yare ansa na abɛyɛ kokoram no da so ara te ase mfe anum wɔ bere a wɔahu no akyi.

Ɛmfa ho sɛnea wo tebea te biara no, nneɛma bi wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ sɛ wubenya dwensɔtwaa mu kokoram no so. Wo ne wo duruyɛfo nka eyi ho asɛm. N’ani begye sɛ ɔbɛboa wo.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti mewɔ anidaso sɛ seesei woanya ntease pa wɔ nea yɛaka ho asɛm no ho, ``(IPMN)``. Ɛwom sɛ eyi yɛ asɛmti a ɛyɛ den kakra de, nanso momma yɛmmɔ mmɔden sɛ yɛbɛte ase kɛkɛ.

• IPMN yɛ akisikuru a ɛba dwensɔtwaa no ntini mu na ebetumi abɛyɛ kokoram. Ɛnyɛ wɔn nyinaa na wɔbɛyɛ kokoram.
• Mpɛn pii no, ɛnkyerɛ sɛnkyerɛnne biara na wohu wɔ akwanhyia mu bere a wɔreyɛ nhwehwɛmu foforo.
• Wɔnam nhwehwɛmu te sɛ `(MRCP)` ne `(EUS)` so na ɛkyerɛ yare no.
• Ebia nea ɛka ayaresa ho ne sɛ wɔbɛhwɛ anaasɛ wɔbɛyɛ oprehyɛn , a egyina akisikuru no su ne asiane a ɛwɔ hɔ so.
• Sɛ wobehu no ntɛm na wɔasa no yare a, ɛho hia sen biara.
• Sɛ wɔka kyerɛ wo sɛ wowɔ IPMN a, mma wo ho nnyɛ wo hu. Wo ne wo duruyɛfo nkasa na si ayaresa nhyehyɛe a eye sen biara a wobɛfa so ama wo tebea no ho gyinae.
• Susuw asetra mu nsakrae (sigaretnom a wobegyae, mu duru a wobɛkɔ so akura mu, ne nea ɛkeka ho) a ebetumi atew asiane a ɛwɔ hɔ sɛ wobenya kokoram a ɛwɔ dwensɔtwaa mu no so nso ho.

Sɛ wowɔ nsɛmmisa foforo bi fa eyi ho a, ntwentwɛn wo nan ase sɛ wubebisa wo duruyɛfo. Kɔ so nya apɔwmuden!

` Pancreas, IPMN, Kokoram, Pancreatic Kokoram, Tumor, Nsɛnkyerɛnne, Ayaresa