Koj puas tau qhia koj tus menyuam txog High-Grade Glioma? Cia peb tham txog nws.

Nws nyuaj rau piav qhia ua lus tias nws zoo li cas ua niam txiv thaum hnov ​​​​tias koj tus menyuam muaj mob qog noj ntshav hauv hlwb. Muaj ntau cov lus nug uas los rau hauv siab thaum lub sijhawm zoo li no. Yog li, hnub no peb yuav tham txog High-Grade Glioma, ib hom qog noj ntshav hauv hlwb loj heev, kis tau sai. Peb vam tias cov ntaub ntawv no yuav muab qee qhov kev nkag siab thiab lub zog rau koj thaum lub sijhawm nyuaj no.

Kab mob Glioma Qib Siab yog dab tsi? Cia peb nkag siab yooj yim heev.

Hais yooj yim xwb, mob glioma qib siab yog ib hom mob qog noj ntshav uas loj hlob sai heev hauv koj tus menyuam lub hlwb lossis tus txha caj qaum. "Glioma" txhais tau tias yog ib qho qog. Cov qog no tshwm sim thaum ib hom cell hu ua "glial cells" pib faib thiab loj hlob sai yam tsis muaj kev tswj hwm. Cov glial cells no yog ib hom cell uas txhawb nqa thiab pub cov neurons, lossis cov hlab ntsha, hauv peb lub paj hlwb nruab nrab.

"Qib siab" txhais tau hais tias hom glioma no loj hlob sai heev thiab nruj heev . Qhov tseeb, cov gliomas qib siab yuav tsis kho tau tag nrho. Qhov no yog vim lawv nyuaj kho dua. Qhov no yog vim cov hlwb qog noj ntshav no kis tau sai heev rau hauv lub hlwb lossis tus txha caj qaum. Lawv kuj loj hlob los ntawm kev nkag mus thiab sib txuas nrog cov hlwb noj qab haus huv. Xav txog seb nws nyuaj npaum li cas los tshem tawm cov qog noj ntshav yam tsis ua rau cov nqaij noj qab haus huv puas tsuaj thaum cov hlwb noj qab haus huv thiab cov hlwb qog noj ntshav sib txuas. Yog vim li cas qee zaum nws nyuaj rau tshem tawm lawv tag nrho nrog kev phais.

"Qib" ntawm cov gliomas qib siab yog dab tsi?

Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) faib cov qog ntshav gliomas raws li lawv qhov kev loj hlob thiab qhov hnyav. Yog li ntawd, muaj ob hom: "qib qis" (tsis hnyav heev, qib 1 thiab 2) thiab "qib siab" (hnyav dua, qib 3 thiab 4). Cov qog ntshav gliomas qib siab yog cov qog loj hlob sai uas yog qib 3 lossis 4.

Qee cov gliomas hauv cov neeg laus yuav pib ua qib qis thiab tom qab ntawd dhau los ua qib siab. Txawm li cas los xij, qhov xav tsis thoob, gliomas qib siab hauv cov menyuam yaus feem ntau pib ua qib siab. Txawm li cas los xij, gliomas qib qis hauv cov menyuam yaus feem ntau kho tau thiab tsis tshua muaj qib siab.

Cov gliomas qib siab feem ntau tshwm sim qhov twg hauv lub hlwb?

Cov gliomas qib siab feem ntau tshwm sim hauv "supratentorial compartment" ntawm lub hlwb, lossis lub brainstem.

• Supratentorial compartment: Qhov no yog thaj chaw ntawm lub hlwb uas muaj lub cerebrum, thalamus, thiab hypothalamus. Cov qog no tuaj yeem tsim los ntawm cov hlwb glial nyob ntawm no.
• Lub hlwb:Cov gliomas qib siab no kuj tseem tuaj yeem tsim nyob rau hauv qhov ntawm lub hlwb hu ua "pons." Qhov no hu ua ib hom tshwj xeeb ntawm "Diffuse Intrinsic Pontine Gliomas" (DIPG). Hom DIPG no yog qhov ua rau mob hnyav heev thiab nyuaj kho.

Qhov chaw ntawm lub qog yog qhov tseem ceeb heev, vim nws yuav txiav txim siab seb koj tus menyuam muaj kev kho mob li cas. Piv txwv li, cov qog hauv lub hlwb feem ntau tsis tuaj yeem raug phais tshem tawm kom muaj kev nyab xeeb.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm qhov xwm txheej no?

Kab mob glioma theem siab tuaj yeem tshwm sim rau cov menyuam mos, cov menyuam loj dua, cov hluas, thiab cov neeg laus. Txawm li cas los xij, kab mob glioma theem siab rau cov menyuam mos thiab cov menyuam yaus txawv ntawm kab mob glioma theem siab rau cov hluas thiab cov neeg laus. Vim yog qhov sib txawv no, kev kho mob rau cov menyuam mos thiab cov menyuam yaus yuav txawv.

Cov kab mob glioma theem siab feem ntau tshwm sim li cas?

Cov qog ntshav siab (high-grade gliomas) yog hom qog ntshav hauv hlwb thib ob uas pom ntau tshaj plaws rau cov menyuam yaus. Lawv suav txog li ntawm 10% thiab 20% ntawm tag nrho cov qog ntshav uas cuam tshuam rau lub paj hlwb hauv cov menyuam yaus.

Cov tsos mob ntawm cov kab mob glioma theem siab yog dab tsi?

Cov tsos mob yuav txawv ntawm ib tug me nyuam mus rau ib tug me nyuam. Lawv nyob ntawm seb qhov qog tau cuam tshuam rau qhov twg ntawm lub hlwb (lossis tus txha caj qaum), tus me nyuam lub hnub nyoog, thiab qhov qog loj hlob sai npaum li cas. Cov tsos mob no feem ntau yog tshwm sim los ntawm qhov qog muab kev nyuaj rau lub hlwb thiab ua rau o.

Cov tsos mob feem ntau yog mob taub hau. Qhov no yog qhov tseeb tshwj xeeb yog tias mob taub hau nrog rau xeev siab lossis ntuav. Mob taub hau no hnyav tshaj plaws thaum sawv ntxov. Qee zaum, nws tuaj yeem hnyav heev uas nws tsa koj sawv thaum hmo ntuj. Xav txog ib tug menyuam yaus uas muaj lub sijhawm nyuaj heev.

Lwm cov tsos mob uas yuav pom muaj xws li:

• Pom kev tsis meej, hnov ​​lus tsis meej, lossis hais lus tsis meej (pom kev tsis meej, hnov ​​tsis tau lus, hais lus tsis meej).
• Tsis muaj zog sib npaug lossis cov leeg nqaij tsis muaj zog (ataxia), xws li nyuaj rau taug kev lossis tuav cov khoom.
• Tsis meej pem lossis tsis nco qab.
• qaug zog tas li, xav tias tsis muaj zog.
• Kev qaug dab peg (zoo li kev mob taub hau) .

Cov menyuam mos uas tseem me me (cov menyuam mos) yuav pom tias lawv quaj txawv txawv, chim siab, thiab hloov pauv lawv tus cwj pwm noj mov (xws li tsis haus mis nyuj). Tej zaum lawv kuj yuav pom tias lawv lub taub hau loj me ntsis, thiab cov chaw mos mos (fontanelles) lossis "swamps" saum lawv lub taub hau yuav pom tseeb dua.

Vim li cas cov gliomas theem siab no thiaj li tshwm sim? Dab tsi yog cov ua rau?

Yuav kom ncaj ncees, cov kws tshawb nrhiav tseem tsis paub qhov laj thawj tseeb rau qhov no.Rau cov neeg laus, kev kho mob hluav taws xob yav dhau los tau pom tias yog ib qho ua rau muaj kev pheej hmoo rau kev tsim cov qog no. Nws muaj peev xwm hais tias cov menyuam yaus kuj yuav raug cuam tshuam los ntawm cov yam ntxwv sab nraud lossis ib puag ncig zoo sib xws, tab sis xav tau kev tshawb fawb ntxiv.

Txawm li cas los xij, qee cov kab mob caj ces uas tsis tshua muaj neeg paub txog tuaj yeem ua rau muaj kev pheej hmoo ntawm cov menyuam yaus uas muaj mob glioma ntau. Ib qho mob caj ces yog qhov tsis zoo lossis qhov tsis zoo ntawm cov noob caj ces, uas yog "code" uas qhia cov cell yuav ua haujlwm li cas .

Nov yog qee qhov xwm txheej zoo li no:

• Kab mob Neurofibromatosis hom-1 (`Neurofibromatosis hom-1 - NF1`)
• Kab mob Turcot
• Li-Fraumeni syndrome

Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ntau tus menyuam uas muaj tus kab mob glioma qib siab tsis muaj keeb kwm tsev neeg ntawm tus mob no.

Yuav kuaj mob glioma qib siab li cas?

Koj tus menyuam tus kws kho mob yuav xub saib xyuas koj tus menyuam cov tsos mob thiab keeb kwm kev kho mob kom zoo zoo. Tom qab ntawd, yuav ua tau ib qho kev luam theej duab lub hlwb, lossis 'imaging', kom pom seb puas muaj qog thiab seb nws puas ua rau muaj cov tsos mob. Yog tias muaj qog, yuav ua 'biopsy' kom paub tseeb tias nws yog qog nqaij hlav (malignant) lossis benign (benign).

• Kev Thaij Duab: Kev thaij duab MRI (Magnetic Resonance Imaging) thiab kev thaij duab CT (Computed Tomography scan) tuaj yeem pab cov kws kho mob pom cov qog nqaij hlav hauv koj tus menyuam lub hlwb lossis tus txha caj qaum. Kev thaij duab MRI, tshwj xeeb tshaj yog kev thaij duab MRI uas muaj qhov sib txawv, tuaj yeem tsim cov duab meej dua thiab ntxaws dua li kev thaij duab CT. Kev thaij duab MRI siv cov hlau nplaum thiab cov nthwv dej xov tooj cua los tsim cov duab ntawm cov khoom hauv lub cev ntawm lub vijtsam computer. Hauv kev thaij duab MRI uas muaj qhov sib txawv, cov xim tsis muaj teeb meem raug txhaj rau hauv koj tus menyuam txhais tes. Qhov no ua rau cov cheeb tsam uas muaj cov qog nqaij hlav pom tseeb dua ntawm lub vijtsam.

• Kev kuaj mob qog nqaij hlav: Ib txoj kev kho mob tshwj xeeb hu ua "stereotactic biopsy" tuaj yeem qhia qhov chaw tseeb ntawm lub qog nqaij hlav thiab coj ib daim ntaub me me los ntawm qhov ntawd thiab xa mus rau chav kuaj mob. Tom qab ntawd, tus kws tshwj xeeb hu ua "pathologist" yuav tshuaj xyuas cov cell kom pom tias lawv puas yog cov cell glioma qib siab. Cov kev kuaj no kuj tseem tuaj yeem txheeb xyuas qee yam ntxwv ntawm cov cell qog nqaij hlav. Cov yam ntxwv no qee zaum siv los txiav txim siab txog kev kho mob. Piv txwv li, qee qhov kev kho mob qog nqaij hlav tshiab yog tsim los ua haujlwm rau qee hom cell qog nqaij hlav xwb. Yog li, cov kev kuaj no kuj tseem tuaj yeem pab txiav txim siab seb koj tus menyuam puas yog tus neeg sib tw zoo rau kev kho mob ntawd.

Qee zaum, yog tias ua tau, cov kws kho mob yuav tshem tag nrho cov qog nqaij hlav tawm es tsis txhob tsuas yog noj ib daim me me mus kuaj xwb.Tom qab ntawd, nrog rau kev kuaj mob, kev kho mob (phais mob) kuj tshwm sim.

Txawm li cas los xij, kev kuaj mob tej zaum yuav tsis ua tau txhua lub sijhawm rau cov gliomas qib siab. Nyob ntawm seb qhov mob qog nyob qhov twg (piv txwv li, hauv lub hlwb), kev rho ib daim nqaij tuaj yeem ua rau cov feem tseem ceeb ntawm lub hlwb puas tsuaj. Hauv cov xwm txheej zoo li no, cov kws kho mob vam khom kev kuaj duab los ua qhov kev kuaj mob.

Puas kho tau cov mob glioma theem siab kom zoo tag nrho?

Qhov no yog lo lus nug loj tshaj plaws uas txhua tus neeg xav txog. Nws nyuaj rau muab cov lus teb ncaj qha. Muaj ntau yam uas cuam tshuam rau qhov no, xws li tus menyuam hnub nyoog, cov kev hloov pauv caj ces twg muaj nyob rau hauv cov hlwb qog noj ntshav, thiab muaj pes tsawg tus qog tau raug tshem tawm thaum lub sijhawm phais.

Cov kev kho mob rau cov kab mob glioma qib siab yog dab tsi?

Lub hom phiaj tseem ceeb ntawm kev kho mob yog tshem tawm cov qog, nres lossis tswj kev loj hlob ntawm cov qog, thiab muab kev pab rau tus menyuam los ntawm kev txo cov tsos mob.

Nyob ntawm seb hom qog nqaij hlav, nws qhov chaw nyob, thiab lwm yam, tej zaum yuav muaj ntau tus kws tshwj xeeb koom nrog kev saib xyuas koj tus menyuam. Pawg neeg no yuav muaj xws li tus kws phais hlwb, tus kws kho mob qog nqaij hlav hlwb, tus kws kho mob hluav taws xob, tus kws kho mob endocrinologist, tus kws saib xyuas neeg mob, thiab tus neeg ua haujlwm pabcuam zej zog.

Ib lossis ntau yam hauv qab no yuav siv tau los kho:

• Kev Phais Mob: Kev phais mob yog kev kho mob tseem ceeb rau cov gliomas qib siab uas tuaj yeem tshem tawm tau yam tsis muaj kev phom sij. Hauv qhov no, tus kws kho mob sim tshem tawm ntau npaum li ntau tau ntawm cov qog nqaij hlav yam tsis ua rau cov nqaij mos noj qab haus huv nyob ib puag ncig puas tsuaj.
• Kev Kho Mob Hluav Taws Xob: Kev kho mob hluav taws xob tsom mus rau qhov chaw yog ib qho kev kho mob rau cov menyuam yaus hnub nyoog tshaj 3 xyoos. Feem ntau cov menyuam yaus me me tsis tau txais kev kho mob hluav taws xob vim tias nws tuaj yeem cuam tshuam rau lawv txoj kev loj hlob ntawm lub hlwb. Kev kho mob no suav nrog lub tshuab uas siv cov duab X-rays ntau los tsom rau qhov mob qog, ceev faj kom tsis txhob ua puas rau cov nqaij noj qab haus huv ib puag ncig. Kev kho mob hluav taws xob ua rau cov qog me me, tua cov hlwb qog, thiab txo cov tsos mob.
• Kev Kho Mob Siv Tshuaj Kho Mob: Vim tias cov menyuam yaus me me heev tsis tuaj yeem tau txais kev kho mob hluav taws xob, kev siv tshuaj kho mob siv los tswj kev loj hlob ntawm qog. Kev kho mob siv cov tshuaj los tua cov hlwb qog. Txawm li cas los xij, tseem muaj kev sib cav txog seb kev siv tshuaj kho mob siv tau zoo npaum li cas rau cov qog gliomas qib siab. Txawm hais tias qee cov tshuaj kho mob siv tshuaj kho mob, xws li temozolomide, ua haujlwm zoo rau qee hom qog gliomas hauv cov neeg laus, cov tshuaj zoo ib yam tsis zoo rau cov menyuam yaus.
• Kev kho mob rau cov neeg mob uas mob hnyav:Cov kws kho mob Palliative tuaj yeem pab koj txiav txim siab uas yuav pab tswj koj tus menyuam lub neej zoo thaum lub sijhawm kho mob. Lawv kuj tseem tuaj yeem qhia cov hau kev los pab koj tus menyuam daws qhov teeb meem thiab kom tau txais kev pab los ntawm cov tsos mob.

Mob glioma theem siab yuav rov tshwm sim dua tom qab kho mob. Yog tias qhov no tshwm sim, koj tus kws kho mob yuav hais kom "tshuaj kho mob uas tsom mus rau." Cov no yog cov kev kho mob uas tsom mus rau cov molecules tsis zoo (ua los ntawm kev hloov pauv caj ces) hauv koj tus menyuam lub qog. Cov "kev kho mob uas tsom mus rau molecular" no yuav muaj los ntawm "kev sim tshuaj." Cov kev sim tshuaj yog cov kev tshawb fawb uas sim kev nyab xeeb thiab kev ua haujlwm zoo ntawm cov kev kho mob tshiab.

Qee zaum, yog tias cov tshuaj kho mob tsom mus rau cov neeg mob no muaj nyob rau hauv kev ua lag luam, lossis yog tias cov kev tshawb fawb yav dhau los tau qhia tias lawv muaj txiaj ntsig zoo rau koj tus menyuam hom glioma, koj tus kws kho mob yuav muaj peev xwm muab rau koj sab nraum kev sim tshuaj.

Cov kev kho mob no muaj cov kev mob tshwm sim li cas?

Tham nrog koj tus kws kho mob txog tej yam tshwm sim ntawm kev kho mob sib txawv. Txawm hais tias cov kws kho mob sim ua qhov zoo tshaj plaws kom tsis txhob ua rau cov nqaij noj qab haus huv puas tsuaj thaum lub sijhawm kho mob hluav taws xob, qee cov nqaij noj qab haus huv tseem tuaj yeem raug cuam tshuam. Nyob ntawm seb qhov twg ntawm lub hlwb raug cuam tshuam, kev kho mob hluav taws xob tuaj yeem cuam tshuam rau kev ua haujlwm ntawm lub hlwb, kev loj hlob ntawm tus menyuam, thiab cuam tshuam kev tsim cov tshuaj hormones.

Nws yog ib qho tseem ceeb heev uas yuav tsum tau sib tham thiab ntsuas qhov zoo thiab qhov tsis zoo ntawm kev kho mob nrog pab neeg kho mob uas kho tus menyuam.

Yog tias kuv tus menyuam muaj mob glioma theem siab, kuv yuav tsum xav li cas?

Koj tus menyuam txoj kev mob nkeeg nyob ntawm ntau yam, uas koj tus kws kho mob tuaj yeem tham nrog koj. Hom cell uas raug mob, cov yam ntxwv ntawm cov cell, thiab pes tsawg tus qog tau raug tshem tawm thaum lub sijhawm phais mob txhua yam txiav txim siab qhov tshwm sim.

Nug koj tus kws kho mob seb yuav xav li cas raws li qhov mob tshwj xeeb ntawm koj tus menyuam.

Tus nqi ntawm kev ciaj sia rau cov glioma qib siab yog dab tsi?

Hom qog no yuav rov qab los tom qab kho mob. Tus nqi ciaj sia tsib xyoos rau cov gliomas qib siab hauv cov menyuam yaus yog tsawg dua 20%. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov qog no txawv ntawm ib leeg. Lawv loj hlob nyob rau ntau qhov chaw sib txawv, thiab cov yam ntxwv ntawm cov hlwb hauv lawv txawv. Cov kev sib txawv no tuaj yeem cuam tshuam rau koj tus menyuam lub neej yav tom ntej.

Kuv yuav tsum nug tus kws kho mob li cas?

Muaj ntau lo lus nug uas koj xav txog thaum lub sijhawm zoo li no. Tab sis tsis txhob hnov ​​qab nug koj tus kws kho mob cov lus nug no:

• Muaj kev kho mob dab tsi rau kuv tus menyuam?
• Qhov chaw ntawm lub qog cuam tshuam li cas rau cov kev kho mob?
• Cov kev pheej hmoo cuam tshuam nrog kev kho mob yog dab tsi?
• Peb yuav tsum xav tau cov txiaj ntsig dab tsi los ntawm kev kho mob?
• Kuv yuav tsum saib xyuas kuv tus menyuam li cas thaum lub sijhawm kho mob?
• Kuv tus menyuam yuav tsum tuaj kho mob thiab saib xyuas ntau npaum li cas?

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Kev kuaj pom tias muaj mob glioma theem siab yog ib qho nyuaj heev ua. Mob qog no kis tau sai heev, thiab cov qog tuaj yeem rov qab los txawm tias tom qab kho tas lawm los xij. Koj yuav tsum xav txog cov txiaj ntsig ntawm kev kho mob piv rau cov kev mob tshwm sim uas koj tsis xav kom koj tus menyuam raug.

Siv tag nrho cov peev txheej uas muaj los pab koj, koj tus menyuam, thiab koj tsev neeg thaum lub sijhawm no. Tham nrog koj tus kws kho mob txog cov kev xaiv kho mob thiab kev sim tshuaj kho mob. Yog tias muaj cov kev pabcuam saib xyuas kev mob nkeeg, hu rau lawv. Qhia rau koj tus menyuam tias koj yuav txhawb nqa lawv thaum lawv ntsib qhov kev kuaj mob no ua ke. Qhov no yuav yog lub hauv paus zoo rau lawv.

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