Glucagonoma yog dab tsi? Cia peb tham txog qhov mob tsis tshua muaj no!

Lub qog pancreas yog ib lub cev me me tab sis tseem ceeb heev hauv koj lub cev. Nws tsim ntau yam tshuaj hormones uas peb lub cev xav tau. Yog li, qee zaum, ib hom mob qog noj ntshav tsawg tsawg uas tshwm sim hauv lub qog pancreas tuaj yeem ua rau muaj teeb meem. Qhov ntawd yog qhov mob no hu ua Glucagonoma . Tej zaum koj tau mob ntshav qab zib tam sim ntawd, lossis koj tau mob ib yam dab tsi zoo li pob khaus txawv txawv ntawm koj daim tawv nqaij, nws yog ib qho tseem ceeb heev uas yuav tsum paub txog qhov no.

Glucagonoma yog dab tsi? Hais yooj yim xwb...

Glucagonoma yog ib hom mob qog nqaij hlav uas tsis tshua muaj tshwm sim hauv koj lub pancreas. Cov qog no tsim cov tshuaj hormones hu ua glucagon ntau dhau. Tam sim no koj yuav xav paub tias glucagon no yog dab tsi.

Glucagon yog ib yam tshuaj hormones tseem ceeb heev uas pab tswj peb lub cev cov piam thaj, uas yog, cov piam thaj hauv cov ntshav . Nws yog tsim los ntawm cov hlwb alpha, ib hom hlwb tshwj xeeb hauv koj lub txiav. Xav txog yog tias koj tsis tau noj mov ib ntus, yog tias koj tawm dag zog hnyav heev, lossis yog tias koj noj zaub mov uas muaj protein ntau, koj cov piam thaj hauv cov ntshav yuav poob qis, puas yog? Thaum ntawd glucagon no nkag los, tso cov piam thaj uas khaws cia rau hauv koj lub siab, uas yog, glycogen , thiab coj cov piam thaj hauv cov ntshav rov qab los. Nws zoo li ib tug neeg uas pab tswj cov piam thaj hauv peb lub cev.

Txawm li cas los xij, thaum muaj glucagonoma, cov tshuaj hormones glucagon no raug tsim tawm ntau dhau. Ces peb lub cev tsis tuaj yeem tswj tau nws. Kev sib xyaw ua ke ntawm cov tsos mob uas tshwm sim vim qhov no hu ua Glucagonoma Syndrome . Qhov no tuaj yeem ua rau muaj ntau yam teeb meem xws li teeb meem ntawm daim tawv nqaij thiab ntshav qab zib.

Hom mob qog noj ntshav no, hu ua glucagonoma, yog ib hom mob qog noj ntshav hauv pancreatic neuroendocrine , lossis islet cell tumors . Feem ntau, cov no tshwm sim hauv tus tw lossis nruab nrab ntawm lub pancreas.

Qhov no puas yog mob qog noj ntshav tiag?

Yog lawm, feem ntau, glucagonoma yog mob qog noj ntshav . Qhov tu siab yog, txawm tias thaum kuaj pom tias muaj mob qog noj ntshav, kwv yees li 50% ntawm cov neeg mob, uas yog, kwv yees li ib ntawm ob, mob qog noj ntshav no tej zaum yuav kis tau (metastasized) mus rau lwm qhov ntawm lub cev, tshwj xeeb tshaj yog lub siab .

Tus mob no feem ntau tshwm sim li cas?

Glucagonoma yog ib qho mob tsis tshua muaj . Muaj tsawg dua ib ntawm ib lab tus neeg mob tshiab uas tau kuaj pom txhua xyoo. Feem ntau nws cuam tshuam rau cov neeg hnub nyoog ntawm 50 thiab 70 xyoo .

Cov tsos mob ntawm qhov no yog dab tsi?

Glucagonomas feem ntau loj hlob qeeb qeeb . Yog li, tshwj tsis yog tias koj lub cev tsim cov glucagon txaus los ua teeb meem, koj yuav tsis muaj tsos mob dab tsi.

Txawm li cas los xij, thaum glucagonoma tsim glucagon ntau dhau thiab lub cev tsis tuaj yeem tswj nws, glucagonoma syndrome uas tau hais ua ntej tshwm sim.Nws tshwm sim. Tom qab ntawd, koj yuav pom cov tsos mob meej. Yog tias koj muaj cov tsos mob no, nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib kws kho mob sai li sai tau.

Mob pob khaus ntawm daim tawv nqaij (Necrolytic Migratory Erythema - NME)

Qhov no yog cov tsos mob tseem ceeb thiab feem ntau ntawm glucagonoma syndrome. Kwv yees li 90% ntawm cov neeg uas muaj tus kab mob no muaj teeb meem ntawm daim tawv nqaij no. Nws hu ua necrolytic migratory erythema (NME) .

Xav txog seb, koj daim tawv nqaij, tshwj xeeb tshaj yog nyob rau hauv qhov chaw mos, pob tw, thiab ceg qis, pib muaj cov pob liab, khaus, thiab qee zaum mob. Cov no tom qab ntawd hloov mus ua cov pob liab, tawg, thiab ua tawv tawv. Txawm tias tom qab lawv kho lawm los xij, tseem yuav muaj cov pob xim av nyob. Qhov no tuaj yeem tsim nyob rau hauv ib qho chaw, kho, thiab tom qab ntawd rov tshwm sim rau lwm qhov chaw. Nws zoo li pob khaus uas txav mus los ntawm qhov chaw mus rau qhov chaw.

Lwm yam ntxwv ntawm NME:

• Qhov no tuaj yeem tuaj thiab mus, thiab nws tuaj yeem txav mus los thoob plaws lub cev .
• Thaum xub thawj nws yuav khaus thiab mob heev .
• Cov pob khaus ntawd yuav liab thiab tom qab ntawd ua pob ua hlwv thiab ua ib daim tawv. Tom qab kho tas lawm, tej zaum yuav tseem muaj ib qho xim av nyob.
• Qhov no tuaj yeem ua rau muaj tej yam xws li mob nplaig (glossitis ), mob qhov ncauj, daim di ncauj tawg, thiab mob angular cheilitis .
• Kuj tseem yuav muaj teeb meem ntawm daim tawv muag o ( blepharitis ), plaub hau poob, thiab rau tes.

Cov tsos mob ntawm tus kab mob ntshav qab zib

Tus mob no ua rau muaj cov ntshav qab zib ntau ( hyperglycemia ), uas tuaj yeem ua rau muaj ntshav qab zib. Cov tsos mob ntawm tus mob ntshav qab zib muaj xws li:

• Ua nyias nyias tsis muaj laj thawj.
• Nqhis dej ntau dhau (Polydipsia) .
• Tso zis ntau zaus ( polyuria ), tshwj xeeb tshaj yog thaum hmo ntuj.
• Kev tshaib plab ntau dhau ( Polyphagia ).

Lwm cov tsos mob ntawm (glucagonoma syndrome)

Muaj ntau lwm cov tsos mob:

• Mob raws plab ntev .
• Cov ntshav hemoglobin qis (anemia ). Qhov no ua rau qaug zog thiab kiv taub hau.
• Cov ntshav txhaws, tshwj xeeb tshaj yog nyob rau hauv cov leeg ntshav tob ntawm ob txhais ceg ( Deep Vein Thrombosis (DVT) ).

Cov tsos mob ntsig txog lub hlwb thiab lub paj hlwb

Qee zaum, koj kuj tseem yuav pom cov tsos mob ntsig txog lub hlwb thiab lub paj hlwb, xws li:

• Kev Nyuaj Siab
• Kev puas hlwb
• Kev ntxhov siab
• Hyperreflexia (ua kom lub cev teb sai dua)
• Kev taug kev tsis ruaj khov (ataxia )
• Kev puas siab puas ntsws ( Kev puas siab puas ntsws))
• Kev ntshai thiab kev ua xyem xyav tsis muaj laj thawj ( Paranoid Delusions )

Dab tsi ua rau muaj glucagonoma?

Feem ntau, cov kws kho mob tsis paub qhov ua rau muaj glucagonoma. Txawm li cas los xij, kwv yees li 10% ntawm cov neeg mob, tus mob qog noj ntshav no muaj feem cuam tshuam nrog tus mob caj ces hu ua Multiple Endocrine Neoplasia type 1 (MEN type 1) .

Txawm li cas los xij, tsis yog txhua tus neeg uas muaj MEN hom 1 yuav muaj glucagonoma. Qhov ntawd kuj yog ib feem pua ​​me me xwb.

Koj paub qhov no li cas?

Yog tias koj muaj mob tawv nqaij hu ua necrolytic migratory erythema (NME) uas tau hais ua ntej lawm, tus kws kho mob yuav xav tias muaj glucagonoma. Tom qab ntawd lawv yuav ua cov kev kuaj xws li:

• Kev Kuaj Ntshav Qab Zib Thaum Noj Mov: Yog tias cov piam thaj siab, tej zaum yuav muaj glucagonoma thiab tej zaum yuav paub tseeb tias muaj tus kab mob ntshav qab zib.
• Kev Ntsuas Ntshav Glucagon Thaum Noj Mov: Cov qib Glucagon siab dhau heev hauv glucagonoma - feem ntau ntau dua 500 picograms ib milliliter (pg/mL). Cov qib glucagon thaum noj mov ib txwm yog tsawg dua 150 pg/mL.
• Kev Kuaj Ntshav Amino Acid: Glucagonoma feem ntau ua rau cov amino acids qis hauv cov ntshav ( hypoaminoacidemia ).
• Kev suav cov ntshav tag nrho (CBC): Qhov no kuaj xyuas seb puas muaj ntshav tsis txaus , vim tias ntshav tsis txaus tuaj yeem tshwm sim nrog glucagonoma.

Kev kuaj duab zoo li no tuaj yeem pab paub tseeb tias puas muaj pob:

• Kev Ntsuas CT
• Kev Ntsuas MRI
• Kev Siv Ultrasound Endoscopic

Yuav kho li cas?

Kev kho mob ntawm glucagonoma feem ntau nyob ntawm seb tus mob qog noj ntshav puas txwv rau ntawm lub txiav (hauv zos) lossis tau kis mus rau lwm qhov ntawm lub cev (metastasized) .

Yuav ua li cas tswj cov tsos mob ua ntej

Kauj ruam thawj zaug yog tswj cov tsos mob thiab teeb meem uas tshwm sim los ntawm kev tso glucagon ntau dhau. Qhov no raug kho raws li nram no:

• Cov tshuaj los tswj cov glucagon ntau dhau: Cov tshuaj txhaj hu ua Octreotide thiab Lanreotide pab txo cov teebmeem ntawm glucagon ntau dhau thiab tiv thaiv kev tsim glucagon. Cov tshuaj no tuaj yeem ua rau qeeb qeeb ntawm kev loj hlob ntawm cov qog nqaij hlav. Lawv kuj muab kev pab los ntawm cov tsos mob ntawm NME, ntshav qab zib, raws plab, thiab cov kab mob ntawm lub paj hlwb.
• Kev tswj tus kab mob ntshav qab zib: Tej zaum koj yuav xav tau tshuaj kho tus kab mob ntshav qab zib los yog txhaj tshuaj insulin kom koj cov ntshav qab zib nyob rau hauv qhov ntau thiab tsawg.
• Kev txhawb nqa kev noj haus:Kev noj haus kom tag nrho (TPN) , cov amino acid thiab cov tshuaj zinc pab tau kom txo tau cov teeb meem ntawm kev tsis noj qab haus huv.
• Kev kho mob ntawm daim tawv nqaij NME: Cov tshuaj tua kab mob thiab corticosteroids tuaj yeem txhim kho NME.
• Kev Kho Mob Tiv Thaiv Kev Ntshav: Cov tshuaj ua kom cov ntshav nyias xws li heparin pab tiv thaiv kev txhaws ntawm cov hlab ntsha tob (DVT) .

Yog tias nws tsuas yog txwv rau lub pancreas xwb...

Yog tias tus mob qog nqaij hlav tsuas yog nyob hauv lub qog pancreas xwb, kev phais yog txoj kev kho mob tseem ceeb . Yog tias tus kws phais mob tuaj yeem tshem tawm cov qog nqaij hlav tag nrho, feem ntau tus kab mob yuav kho tau . Tom qab tshem tawm glucagonoma, koj cov qib glucagon yuav tsum rov qab mus rau qhov qub. Koj cov tsos mob kuj yuav tsum ploj mus.

Yog tias nws tau kis mus rau lwm qhov chaw (metastasized) ...

Thaum twg ua tau, cov kws kho mob pom zoo kom phais tshem cov qog nqaij hlav. Qhov no yuav suav nrog kev tshem tawm cov qog nqaij hlav hauv lub txiav, cov qog ntshav ze, thiab lub siab.

Tiam sis yog tus kws phais tsis muaj peev xwm tshem tawm ib qho lossis tag nrho cov pob, koj pab neeg kho mob yuav pom zoo ib lossis ntau qhov kev kho mob no:

• Kev kho mob qog noj ntshav: Kev kho mob no ua haujlwm los ntawm kev rhuav tshem cov hlwb qog noj ntshav thiab tiv thaiv lawv kom tsis txhob loj hlob.
• Kev Tshem Tawm Radiofrequency: Qhov no siv cua sov los ntawm cov nthwv dej xov tooj cua los tua cov hlwb qog noj ntshav.
• Cryosurgical Ablation: Qhov no siv cov tshuaj txias heev, xws li cov kua nitrogen, los rhuav tshem cov hlwb qog noj ntshav.
• Chemoembolization: Kev kho mob no thaiv cov ntshav mus rau mob qog noj ntshav.

Yuav ua li cas thiaj li yuav kho tau tus mob no?

Qhov kev xav ntawm ib tus neeg uas muaj glucagonoma nyob ntawm ntau yam:

• Koj lub hnub nyoog thiab kev noj qab haus huv tag nrho .
• Qhov loj ntawm lub qog mob qog noj ntshav .
• Txawm tias tus mob qog noj ntshav tau kis mus rau lwm qhov lawm los tsis tau .

Yog tias tus mob qog nqaij hlav tsuas yog nyob rau hauv lub qog pancreas xwb, feem ntau qhov kev cia siab yuav zoo . Kev phais kom tshem tawm cov qog nqaij hlav feem ntau kho tau, tab sis qhov no tsuas yog rau kwv yees li 20% ntawm cov neeg mob glucagonoma.

Vim tias glucagonoma tsis tshua muaj, tsis muaj cov ntaub ntawv txaus los hais tias koj tuaj yeem nyob ntev npaum li cas lossis qhov tshwm sim yuav yog dab tsi yog tias mob qog noj ntshav kis mus. Koj pab neeg kho mob yuav muab tau cov ntaub ntawv ntxiv raws li koj qhov xwm txheej tshwj xeeb.

Qhov no puas tiv thaiv tau?

Vim tias cov kws tshawb fawb tsis paub qhov ua rau feem ntau ntawm cov neeg mob glucagonoma, tsis muaj dab tsi koj tuaj yeem ua los tiv thaiv nws .

Txawm li cas los xij, yog tias ib tug ntawm koj cov txheeb ze thawj zaug (niam txiv thiab cov kwv tij neej tsa) tau raug kuaj pom tias muaj MEN (Multiple Endocrine Neoplasia) , tham nrog koj tus kws kho mob txog kev kuaj noob caj noob ces. Yog tias koj kuj muaj MEN, kev kuaj noob caj noob ces tuaj yeem pab nrhiav pom cov qog nqaij hlav thaum ntxov.

Kev kuaj pom tias muaj mob qog noj ntshav yog ib qho kev paub tsis zoo heev. Thaum nws yog ib yam dab tsi tsis tshua muaj xws li glucagonoma, nws nyuaj dua. Tab sis nco ntsoov, koj pab neeg kho mob nyob ntawd los teb koj cov lus nug thiab txhawb nqa koj. Yog tias koj xav tias koj lub siab thiab lub siab nyob ib leeg nrog glucagonoma, nug koj tus kws kho mob txog cov kev pab cuam thiab cov kev pabcuam uas tuaj yeem pab koj.

Thaum kawg, tej yam yuav tsum nco ntsoov (Cov Lus Coj Mus Tsev)

Yog li, txawm hais tias glucagonoma yog ib qho mob tsis tshua muaj, nws yog ib qho tseem ceeb uas yuav tsum paub txog nws. Tshwj xeeb tshaj yog tias koj tam sim ntawd muaj cov tsos mob zoo li ntshav qab zib nrog rau cov tawv nqaij txawv txawv (NME), raws li tau hais, mus ntsib kws kho mob yam tsis muaj kev ncua. Yog tias nws raug lees paub thaum ntxov, nws tuaj yeem kho tau. Txawm hais tias qhov no tsis tshua muaj, muaj kev kho mob.

Tsis txhob txhawj, koj tsis nyob ib leeg. Koj tus kws kho mob thiab pab neeg kho mob yuav pab koj hla txoj kev no. Ua kom koj lub zog khov kho thiab ua raws li cov lus qhia uas lawv muab rau koj.

Glucagonoma , mob qog nqaij hlav pancreatic, glucagon, ntshav qab zib, cov tsos mob ntawm daim tawv nqaij, cov tshuaj hormones, cov mob qog nqaij hlav tsis tshua muaj