Koj puas khaus thiab muaj ib qho chaw txawv txawv ntawm koj daim tawv nqaij? Tej zaum nws yog tus kab mob Extramammary Paget's Disease (EMPD)!

Koj puas tau pom ib daim tawv nqaij liab, tawv nqaij tawv, thiab qee zaum tawv nqaij tawv, tshwj xeeb tshaj yog nyob rau hauv qhov chaw mos, qhov chaw mos, lossis qhov chaw mos? Nws zoo li maj mam loj hlob, thiab qee zaum khaus, puas yog? Zoo, yog li hnub no peb yuav tham txog ib qho mob tshwj xeeb ntawm daim tawv nqaij zoo li ntawd. Cov kws kho mob hu nws ua Extramammary Paget's Disease , lossis luv luv EMPD . Nws tsis tshua muaj, tab sis nws yog ib qho tseem ceeb uas yuav tsum paub txog.

Kab mob Paget sab nraud ntawm lub mis (EMPD) yog dab tsi?

Hais yooj yim xwb, EMPD yog ib yam mob tawv nqaij uas tsis tshua muaj. Qee zaum nws tuaj yeem cuam tshuam nrog lwm hom mob qog noj ntshav. Tab sis qhov ntawd tsis yog txhua lub sijhawm. Nws yog ib yam mob uas koj daim tawv nqaij liab, tawv nqaij tawv, lossis tawv nqaij tawv thiab loj zuj zus. Qee zaum nws tuaj yeem tsis kuaj pom tau ntau xyoo tom qab tus kab mob pib.

Nws lub npe hu ua "Paget's Disease" tom qab Sir James Paget, tus kws kho mob Askiv zoo heev hauv xyoo pua 19th. Nws lub npe tau raug siv rau ntau hom mob qog noj ntshav vim nws txoj kev koom tes rau hauv kev kho mob. Lo lus "extramammary" txhais tau tias "sab nraum lub mis." Qhov no tsis yog yuav tsum tsis meej pem nrog Paget's disease ntawm lub mis.

Kwv yees li ntawm 7% thiab 40% ntawm cov neeg uas muaj Kab Mob Extramammary Paget's yuav muaj mob qog noj ntshav hauv qab . Txawm li cas los xij, raws li kuv tau hais ua ntej, EMPD tsis yog ib txwm yog ib qho cim ntawm lwm yam kab mob. Kev kho mob thaum ntxov tuaj yeem pab txo koj cov tsos mob thiab pab nrhiav pom mob qog noj ntshav hauv qab.

Cov hom EMPD tseem ceeb yog dab tsi?

Muaj ob hom EMPD tseem ceeb:

1. Mob EMPD thawj zaug: Qhov no yog ib qho mob ntawm daim tawv nqaij uas tshwm sim yam tsis tau npaj tseg. Nws pib ntawm daim tawv nqaij yam tsis muaj lwm yam ua rau.

2. EMPD theem ob: Qhov no yog tshwm sim los ntawm ib qho mob qog nqaij hlav hauv qab lwm qhov hauv lub cev.

Leej twg yuav muaj feem mob EMPD ntau dua?

Txhua tus neeg tuaj yeem mob EMPD, tab sis nws feem ntau tshwm sim rau cov pab pawg hauv qab no:

• Cov neeg muaj hnub nyoog ntawm 50 thiab 80 xyoo .
• Feem ntau ntawm cov poj niam .
• Nws kuj tseem pom tau ntawm cov txiv neej Esxias .
• Cov neeg dawb .

Tab sis nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qhov no yog ib qho mob tsis tshua muaj.

Vim li cas qhov EMPD no thiaj tshwm sim?

Dab tsi ua rau muaj tus mob EMPD thawj zaug?

Yog hais qhov tseeb, cov kws kho mob tseem tsis tau paub meej tias yog dab tsi ua rau muaj tus kab mob EMPD thawj zaug. Lawv xav tias nws yuav pib tshwm sim hauv qee hom hlwb hauv peb lub cev. Cov hlwb no suav nrog:

• Cov qe ntshav Apocrine gland duct: Cov no yog cov qog hws thiab nyob ze ntawm cov plaub hau follicles.
• Cov hlwb keratinocyte: Cov no yog cov hlwb uas pab kho cov tawv nqaij.
• Cov hlwb Toker: Cov no yog cov hlwb pom nyob rau hauv daim tawv nqaij ('cov ntaub so ntswg vulvar') nyob ib ncig ntawm lub txiv mis thiab qhov qhib ntawm qhov chaw mos.

Dab tsi ua rau muaj EMPD theem ob?

EMPD theem ob yog tshwm sim los ntawm mob qog noj ntshav nyob rau lwm qhov chaw hauv lub cev. Mob qog noj ntshav ntawm lub qhov quav yog qhov ua rau kwv yees li ib feem peb ntawm cov neeg mob EMPD. Tsis tas li ntawd, muaj lwm hom mob qog noj ntshav uas tuaj yeem ua rau EMPD theem ob:

• Mob qog nqaij hlav ntawm qhov quav
• Mob qog nqaij hlav
• Mob qog nqaij hlav ntawm lub tsev menyuam
• Mob qog nqaij hlav zes qe menyuam
• Mob qog nqaij hlav prostate
• Mob qog nqaij hlav hauv tsev menyuam

Cov tsos mob ntawm EMPD yog dab tsi?

Cov tsos mob tseem ceeb ntawm EMPD yog pob khaus tawv nqaij uas zoo li eczema . Kev tshawb fawb tau qhia tias kwv yees li 65% ntawm cov neeg mob EMPD, nws tshwm sim nyob ib puag ncig lub qhov quav , thiab kwv yees li 20%, nws tshwm sim nyob ib puag ncig lub qhov quav .

Tej zaum koj yuav pom cov cheeb tsam ntawm koj daim tawv nqaij uas muaj cov yam ntxwv no:

• Zoo li ib lub crust ('Crusty')
• Liab ('Liab')
• Qias neeg

Cov pob me me maj mam loj zuj zus, thiab tej zaum yuav muaj cov npoo tsis sib luag. Thaum EMPD loj zuj zus, cov qhov txhab tob lossis cov pob me me yuav tshwm sim. Lwm cov tsos mob suav nrog:

• Kev xav kub hnyiab
• Daim tawv nqaij liab thiab khaus .
• Khaus khaus
• Mob los yog mob nqaij
• Tawv nqaij o (edema)

Feem ntau EMPD tshwm sim rau thaj chaw uas koj cov qog hws (tshwj xeeb tshaj yog cov qog tawv nqaij apocrine). Nws feem ntau pom nyob ib puag ncig qhov chaw mos. Nws kuj tseem tuaj yeem tshwm sim rau cov chaw no:

• Nyob ib ncig ntawm lub qhov quav (`Anus`)
• qau
• Perineum
• Lub noob qes

Tsis tshua muaj, EMPD kuj tuaj yeem pom nyob rau lwm qhov ntawm lub cev, xws li:

• Lub plab
• Qhov chaw mos
• Lub pob tw
• Pob tw
• Pob ntseg, qhov muag, lub ntsej muag lossis lub taub hau
• Lub hauv siab qis dua
• Lub hauv caug los yog lub duav

Nws yog ib qho tseem ceeb kom paub tias kwv yees li 10% ntawm cov neeg uas muaj tus kab mob Paget sab nraud ntawm lub mis tsis muaj tsos mob dab tsi .

Yuav kuaj mob EMPD no li cas?

Ua ntej, tus kws kho mob yuav nug koj txog koj cov tsos mob thiab kuaj koj lub cev. Yog tias lawv xav tias koj muaj EMPD, lawv yuav:Yuav ua ib qho kev kuaj tawv nqaij. Kev kuaj tawv nqaij yog kev coj me me ntawm koj daim tawv nqaij thiab kuaj nws hauv qab lub tshuab microscope.

Thaum saib hauv qab lub tshuab tsom iav, tus kws kho mob yuav nrhiav cov hlwb tshwj xeeb, loj, thiab tsis zoo uas hu ua "Paget cells." Lawv kuj txheeb xyuas cov hlwb no los ntawm kev saib seb lawv teb li cas rau ntau yam tshuaj (immunohistochemistry).

Koj yuav paub li cas yog tias koj muaj mob qog noj ntshav nrog EMPD?

Tom qab koj tau kuaj pom tias muaj EMPD, koj tus kws kho mob yuav ua ntau yam kev kuaj ntxiv los xyuas seb puas muaj mob qog nqaij hlav hauv qab. Cov kev kuaj no yuav suav nrog:

• Kev kuaj mob ultrasound ('Ultrasound')
• Kev kuaj mob mis (mammogram)
• Kev kuaj mob Pap smear
• Kev kuaj mob plab hnyuv los yog proctoscopy
• Kev kuaj CT
• Kev kuaj lub zais zis (cystoscopy)
• Kev kuaj mob prostate
• Retrograde pyelogram (kev kuaj mob ntawm lub raum thiab txoj hlab zis)
• Kev kuaj mob ultrasound los yog koob biopsy ntawm cov lymph nodes
• Kev kuaj mob sab saud (kev kuaj mob ntawm caj pas, txoj hlab pas, thiab lub plab)

Cov kev kho mob rau EMPD yog dab tsi?

Feem ntau cov kws kho mob kho tus kab mob Paget sab nraud ntawm lub mis los ntawm kev phais.

• Kev phais mob Mohs: Hauv txoj kev kho mob no, tus kws phais tshem tawm cov tawv nqaij uas raug mob los ntawm ib txheej, khaws cov tawv nqaij noj qab nyob zoo.
• Kev txiav tawm dav hauv zos: Hauv cov txheej txheem no, tus kws phais tshem tawm thaj chaw ntawm EMPD nrog rau qee cov nqaij noj qab haus huv nyob ib puag ncig nws. Cov npoo ntawm qhov txhab ces raug xaws.

Qee zaum cov kws phais yuav tsum tshem tawm ib thaj chaw loj ntawm daim tawv nqaij thiab lwm cov nqaij. Ib txhia neeg uas muaj EMPD nyob ib puag ncig lub qhov chaw mos yuav tsum tau tshem tawm ib feem lossis tag nrho lub qhov chaw mos (ib qho 'vulvectomy').

Xav txog qhov no: Yog tias koj tsis tuaj yeem phais vim muaj lwm yam mob lossis kev noj qab haus huv tsis zoo, koj tus kws kho mob yuav qhia lwm yam kev kho mob xws li:

• Kev kho mob tiv thaiv kab mob
• Kev kho dua daim tawv nqaij laser
• Kev kho mob photodynamic (PDT)
• Kev kho mob hluav taws xob
• Cov tshuaj siv rau kev kho mob qog noj ntshav (tshuaj cytotoxic)

Qhov tseem ceeb tshaj plaws yog tias yog muaj mob qog noj ntshav hauv qab, nws kuj yuav tsum tau kho cais.

Puas muaj ib txoj hauv kev los txo qhov kev pheej hmoo ntawm kev mob EMPD?

Tu siab kawg li, tsis muaj dab tsi uas peb ua tau los txo qhov kev pheej hmoo ntawm kev mob EMPD.

Ib tug neeg uas muaj EMPD yuav xav tau lub neej yav tom ntej zoo li cas?

Tom qab kho mob EMPD tas, koj yuav tsum mus ntsib kws kho mob ntxiv. Qhov no yuav nyob ntawm seb qhov mob EMPD nyob qhov twg. Feem ntau EMPD rov tshwm sim dua hauv lossis nyob ib puag ncig thaj chaw uas tau kho mob yav dhau los. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia.

Kab mob Paget sab nraud ntawm lub mis tsis tshua muaj uas nws kis mus rau lwm qhov ntawm lub cev. Txawm li cas los xij, qee zaum nws tuaj yeem kis mus rau cov qog ntshav lossis lwm yam kabmob. Koj tus kws kho mob tuaj yeem piav qhia tau zoo tshaj plaws txog yam uas ua tau rau koj.

Puas yog EMPD rov qab los tom qab nws kho tau zoo lawm?

Yog, EMPD yog ib yam mob uas tuaj yeem rov tshwm sim dua txawm tias tom qab kho thiab rov zoo los xij, txawm tias tom qab ntau xyoo los xij. Qee zaum nws tuaj yeem rov qab los tom qab ntau tshaj 15 xyoo. Yog vim li ntawd cov kws kho mob thiaj li pom zoo kom saib xyuas mus ntev thiab kuaj xyuas tsis tu ncua.

Yog tias kuv muaj EMPD, kuv yuav saib xyuas kuv tus kheej li cas?

Qhov zoo tshaj plaws uas koj ua tau yog mus ntsib koj tus kws kho mob kom tau teem caij mus ntsib kws kho mob tas li. Yog tias koj tus kws kho mob pom cov cim qhia tias EMPD rov qab los, lawv tuaj yeem pib kho tam sim ntawd.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj pom muaj cov cim tshiab ntawm EMPD, lossis yog koj muaj cov tsos mob tshiab, mus ntsib kws kho mob tam sim ntawd.

Nws yog ib qho ib txwm muaj uas yuav ntshai, txaj muag, thiab chim siab thaum koj pom daim tawv nqaij liab lossis pob nyob rau hauv ib qho chaw rhiab heev ntawm koj lub cev, xws li koj lub noob qes. Tus mob no, hu ua Extramammary Paget's Disease (EMPD), qee zaum tuaj yeem tsis meej pem nrog lwm yam mob ntawm daim tawv nqaij, yog li nws tuaj yeem siv sijhawm ntev kom tau txais kev kuaj mob tseeb. Yog tias muaj mob qog noj ntshav hauv qab, EMPD tuaj yeem ua rau mob hnyav dua.

Txawm li cas los xij, cov xov xwm zoo yog tias feem ntau cov neeg uas muaj EMPD nyob tau lub neej zoo li qub, puv npo tom qab kev kho mob. EMPD feem ntau yog phais kho. Yog tias muaj mob qog noj ntshav hauv qab, qhov ntawd kuj yuav tsum tau kho. Vim tias Extramammary Paget's Disease tuaj yeem rov tshwm sim dua, kev kuaj mob tsis tu ncua nrog koj tus kws kho mob tuaj yeem pab kuaj pom nws thaum ntxov yog tias nws rov qab los.

Cov lus tseem ceeb tshaj plaws rau koj yuav tsum nco ntsoov (Cov Lus Coj Mus Tsev)

• EMPD yog ib qho mob tawv nqaij tsis tshua muaj uas tej zaum yuav txuas nrog mob qog noj ntshav.
• Ua tib zoo saib xyuas tej daim tawv nqaij liab, tawv nqaij tawv, tawv tawv, lossis tawv nqaij nce, tshwj xeeb tshaj yog nyob ib ncig ntawm lub qhov chaw mos, qhov tso, lossis qhov quav. Cov tsos mob yuav muaj xws li khaus, kub hnyiab, thiab mob.
• Yog koj pom ib lub cim zoo li no , tsis txhob txaj muag lossis ntshai, tab sis mus ntsib kws kho mob tam sim ntawd.
• Kev kuaj mob EMPD yog ua los ntawm kev kuaj daim tawv nqaij.
• Kev phais yog kev kho mob uas siv ntau tshaj plaws.
• Nws yog ib qho tseem ceeb uas yuav tsum tau mus kuaj mob ntxiv, vim tias EMPD tuaj yeem rov tshwm sim dua.
• Tsis txhob txhawj, feem ntau cov neeg uas muaj EMPD nyob zoo tom qab kho mob. Qhov tseem ceeb yog kom kuaj pom thaum ntxov thiab tau txais kev kho mob zoo.

Yog koj muaj lus nug ntxiv txog qhov no, nrog koj tus kws kho mob tham. Nws tuaj yeem muab cov lus qhia uas haum rau koj.

Kab mob Paget sab nraud ntawm lub mis, EMPD, kab mob ntawm daim tawv nqaij, mob qog nqaij hlav ntawm daim tawv nqaij, cov qe ntshav Paget, cov pob ntawm daim tawv nqaij, khaus, qhov chaw mos ntawm lub qhov ncauj tsev menyuam, thaj chaw perianal, kab mob ntawm daim tawv nqaij, phais Mohs