Koj tus me nyuam puas tau muaj ib lub pob me me nyob rau ntawm lawv lub cev? Los yog daim tawv nqaij khaus lossis khaus khaus uas tsis kho? Qee zaum cov no yog qhov ib txwm muaj, tab sis tsis tshua muaj lawv tuaj yeem yog cov cim ntawm tus mob tsis tshua muaj hu ua Langerhans Cell Histiocytosis (LCH). Nws yog ib qho ib txwm muaj uas yuav ntshai thaum koj hnov lub npe no, vim tias nws tsis yog ib yam dab tsi uas peb tau hnov. Tab sis tsis txhob txhawj, cia peb tham txog nws hauv cov lus yooj yim.
Hais yooj yim xwb, LCH yog dab tsi?
Xav txog peb lub cev zoo li lub teb chaws loj. Muaj ib pab tub rog los tiv thaiv lub teb chaws no, thiab qhov ntawd yog peb lub cev tiv thaiv kab mob . Ib hom tub rog tshwj xeeb hauv pab tub rog no hu ua Langerhans cells . Cov cell no yog ib hom cell ntshav dawb. Lawv txoj haujlwm tseem ceeb yog tawm tsam cov kab mob thiab cov kab mob uas nkag mus rau hauv peb lub cev thiab tiv thaiv peb ntawm kab mob. Cov tub rog no pom muaj thoob plaws hauv peb lub cev, tshwj xeeb tshaj yog nyob rau hauv daim tawv nqaij, lub ntsws, cov qog ntshav, pob txha, lub zais zis, thiab lub siab.
Tiam sis nyob rau hauv rooj plaub ntawm LCH, cov Langerhans hlwb no nce ntau yam tsis tuaj yeem tswj tau thiab sib sau ua ke rau ntau qhov chaw ntawm lub cev. Nws zoo li ib pab tub rog sawv ib puag ncig hauv ib qho chaw yam tsis muaj kev sib ntaus. Thaum lawv sib sau ua ke zoo li no, lawv pib ua puas rau cov nqaij noj qab haus huv hauv cov chaw ntawd. Cov qhov txhab tsim nyob rau hauv cov chaw ntawd.
Qhov xov xwm zoo txog tus mob no yog tias feem ntau cov menyuam yaus tuaj yeem rov zoo los ntawm tus kab mob nrog kev kho mob kom zoo. Qee zaum, tshwj xeeb tshaj yog tias nws tsuas yog cuam tshuam rau daim tawv nqaij xwb, nws yuav ploj mus nws tus kheej yam tsis muaj kev kho mob. Txawm li cas los xij, yog tias cov hlwb no cuam tshuam rau cov kabmob tseem ceeb xws li pob txha, tus po lossis lub siab, yuav tsum tau kho mob hnyav dua.
Puas yog LCH mob qog noj ntshav?
Qhov no yog ib lo lus nug uas ntau tus neeg muaj. Qhov tseeb, tseem muaj kev tsis pom zoo me ntsis ntawm cov kws kho mob txog qhov no. Ntau tus kws tshawb fawb xav tias LCH yog ib yam mob zoo ib yam li mob qog noj ntshav, uas yog, neoplasm . Uas yog, kev loj hlob tsis zoo ntawm cov hlwb. Tab sis lwm tus xav tias nws yog ib yam kab mob o ntawm lub cev tiv thaiv kab mob.
Txawm li cas los xij, LCH raug kho los ntawm cov kws kho mob oncologists, uas tshwj xeeb hauv kev mob qog noj ntshav thiab cov kab mob ntshav. Qee zaum, kev kho mob tiv thaiv kab mob qog noj ntshav xws li chemotherapy kuj tseem siv los kho nws.
Leej twg yuav muaj feem kis tau tus kab mob no tshaj?
Feem ntau pom muaj LCH rau cov menyuam mos thiab cov menyuam yaus hnub nyoog ntawm 1 thiab 15 xyoos. Cov neeg laus tsis tshua muaj, tab sis nws tsis yog ua tsis tau.
Raws li kev suav lej, tsuas muaj ib lossis ob tug ntawm txhua lab tus menyuam mos yug los muaj tus kab mob no txhua xyoo. Qhov no txhais tau tias nws yog ib qho mob tsis tshua muaj .
Cov tsos mob ntawm LCH yog dab tsi?
LCH tsis cuam tshuam rau txhua tus menyuam tib yam. Txawm hais tias qee tus menyuam tsuas yog muaj ib qho chaw ntawm lawv lub cev raug mob, lwm tus yuav muaj ntau qhov chaw ntawm lawv lub cev raug mob. Yog li ntawd, cov tsos mob sib txawv nyob ntawm qhov chaw ntawm lub cev raug mob. Cia peb saib seb lawv yog dab tsi.
| Qhov chaw ntawm lub cev uas raug kev txom nyem | Cov tsos mob uas pom tau |
|---|---|
| Cov pob txha | LCH cuam tshuam rau cov pob txha li ntawm 80% ntawm cov neeg mob. Tej zaum yuav muaj pob lossis o ntawm qhov chaw xws li lub taub hau, pob txha nyob ib ncig ntawm lub qhov muag, tom qab pob ntseg, pob txha puab tsaig, ceg, pob txha nraub qaum, thiab lub duav. Tej zaum yuav muaj lossis tsis muaj mob. Tsis tas li ntawd, tej zaum yuav pom mob taub hau, mob caj dab/mob nraub qaum, nyuaj rau taug kev, thiab ceg tawv. |
| Tawv nqaij | Cov pob khaus uas feem ntau tshwm sim yog pob khaus ntawm daim tawv nqaij. Lub kaus mom menyuam mos yog ib yam mob uas tsis kho tau uas tshwm sim rau ntawm tus menyuam lub taub hau. Cov pob liab, tawv nqaij yuav tshwm sim rau ntawm qhov chaw mos, qhov chaw mos, lub plab, lub hauv siab, thiab nraub qaum. Cov no yuav tawm thiab khaus lossis mob. Cov rau tes kuj tseem yuav hloov xim lossis poob tawm. |
| Qhov ncauj | Cov hniav xoob lossis xoob, cov hniav thim rov qab, cov pos hniav o, cov qhov txhab ntawm daim di ncauj, tus nplaig, sab hauv ntawm lub puab tsaig, lossis ntawm lub ru tsev ntawm lub qhov ncauj. |
| Siab los yog Spleen | Lub siab lossis tus po loj tuaj yeem ua rau lub plab o, qhov muag thiab daim tawv nqaij daj (jaundice), khaus, qaug zog heev, thiab yooj yim raug mob lossis los ntshav. |
| Cov pob txha pob txha | Kab mob ntshav tsis txaus, ntsej muag dawb paug, qaug zog, thiab tsis xav noj mov vim yog cov qe ntshav liab txo qis. Muaj kab mob ntau zaus thiab kub taub hau vim yog cov qe ntshav dawb txo qis. Mob ntshav yooj yim vim yog cov qe ntshav dawb txo qis. |
| Lub Cev Endocrine (Lub Cev Endocrine - Cov Tshuaj Hormones) | Yog tias lub qog pituitary raug cuam tshuam: nqhis dej ntau dhau thiab tso zis ntau zaus (ntshav qab zib insipidus), kev loj hlob qeeb, kev laus ntxov lossis qeeb, hnyav nce. Yog tias lub qog thyroid raug cuam tshuam: o ntawm lub qog, ua pa nyuaj. |
| Pob ntseg | Mob pob ntseg ntau zaus, muaj cov kua tawm hauv pob ntseg, pob ntseg liab, khaus hauv pob ntseg, mob pob ntseg, thiab hnov tsis tau lus. |
| Qhov muag | Qhov muag o, o saum qhov muag, pom kev tsis meej. |
| Cov qog ntshav | O thiab mob hauv cov qog (lumps) hauv caj dab, qhov tso, lossis qhov ncauj tsev menyuam. |
| Lub paj hlwb nruab nrab | Mob taub hau, kiv taub hau, ntuav, taug kev nyuaj, tsis muaj zog (ataxia), hais lus lossis pom kev nyuaj, qaug dab peg, hloov pauv tus cwj pwm thiab kev nco. |
| Lub ntsws | Qhov no feem ntau tshwm sim rau cov neeg laus, tshwj xeeb tshaj yog cov neeg haus luam yeeb. Mob hauv siab, hnoos qhuav, ua pa nyuaj, ntsws tawg (pneumothorax). |
| Txoj hnyuv plab | Mob plab, ntuav, raws plab, muaj ntshav hauv cov quav, thiab kev loj hlob tsis zoo vim tsis muaj zaub mov txaus. |
Qhov tseem ceeb yog tias cov tsos mob no kuj tuaj yeem pom hauv ntau lwm yam kab mob. Yog li ntawd, tsis txhob ntshai LCH tsuas yog vim koj muaj ib lossis ob qho ntawm cov tsos mob no. Tab sis yog tias cov tsos mob no tseem muaj, nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib kws kho mob thiab tau txais kev kuaj mob kom raug.
Dab tsi yog qhov ua rau muaj LCH?
Hais yooj yim xwb, peb cov hlwb muaj cov noob caj noob ces uas hais kom lawv "faib tam sim no, tsum tam sim no." Kwv yees li ib nrab ntawm cov menyuam uas muaj LCH muaj kev hloov me me, lossis kev hloov pauv, hauv lawv cov noob caj noob ces hu ua 'BRAF .' Cov noob caj noob ces no ua cov protein uas tswj kev loj hlob ntawm cov hlwb. Vim yog qhov kev hloov pauv no, cov protein ntawd tsis tau txais cov lus txib kom "tsum faib." Nws zoo li lub khawm 'on' raug kaw. Yog li cov hlwb Langerhans pheej faib thiab sib koom ua ke.
Qhov no tsis yog ib yam dab tsi uas tau txais los ntawm niam txiv mus rau cov menyuam. Qhov kev hloov pauv caj ces no tshwm sim tsis tu ncua tom qab tus menyuam xeeb tub hauv niam lub tsev menyuam.
Ntxiv rau qhov gene 'BRAF', cov kws tshawb nrhiav tau pom tias tus kab mob no kuj tuaj yeem tshwm sim los ntawm kev hloov pauv hauv lwm cov gene xws li 'MAP2K1', 'RAS', thiab 'ARAF'.
Koj nrhiav tau qhov no li cas, Kws Kho Mob?
Thaum koj coj koj tus menyuam mus ntsib kws kho mob, nws yuav nug koj txog cov tsos mob ntawm koj tus menyuam ua ntej. Tom qab ntawd, lawv yuav kuaj koj tus menyuam kom zoo zoo. Vim tias LCH tuaj yeem cuam tshuam rau ntau qhov ntawm lub cev, yuav tsum tau kuaj ntau zaus kom paub meej tias kuaj tau.
| Hom kev xeem | Hais yooj yim xwb... |
|---|---|
| Kev Ntsuas Ntshav | Kev suav cov ntshav tag nrho (CBC) ntsuas tus naj npawb ntawm cov qe ntshav liab, cov qe ntshav dawb, thiab cov platelets hauv cov ntshav. Kev kuaj ntshav kuj tseem ua los xyuas cov yam xws li kev ua haujlwm ntawm daim siab. |
| Kev kuaj mob | Qhov no yog txoj hauv kev tseeb tshaj plaws los lees paub LCH.Yuav muab ib daim nqaij me me ntawm ib lub pob los yog qhov mob tso rau hauv qab tshuaj loog thiab kuaj hauv qab lub tshuab microscope kom paub tseeb tias puas muaj cov hlwb LCH. Yog tias muaj kev xav tias muaj kev koom tes nrog cov pob txha, kev kuaj cov pob txha kuj tseem yuav raug ua. |
| Kev Kuaj Genetic | Cov qauv nqaij uas tau los ntawm kev kuaj nqaij yog siv los kuaj seb puas muaj kev hloov pauv hauv cov noob 'BRAF'. |
| Kev Ntsuas Duab | Cov kev ntsuam xyuas xws li X-rays, CT scans, MRI scans, thiab PET scans tuaj yeem txiav txim siab qhov dav ntawm LCH cov teebmeem rau cov kabmob sab hauv xws li pob txha, hlwb, thiab ntsws. |
Raws li cov txiaj ntsig ntawm cov kev kuaj no, koj tus kws kho mob yuav xa koj tus menyuam mus rau kws kho mob menyuam yaus hematologist / oncologist.
Cov kev kho mob rau LCH yog dab tsi?
Tsis yog txhua tus menyuam uas muaj LCH xav tau tib hom kev kho mob. Kev kho mob nyob ntawm qhov chaw thiab qhov hnyav ntawm tus kab mob.
Cov kws kho mob faib LCH ua ob hom tseem ceeb:
1. LCH ib lub cev xwb: Tus kab mob tsuas cuam tshuam rau ib lub cev hauv lub cev xwb (piv txwv li, tsuas yog cov pob txha lossis tsuas yog daim tawv nqaij xwb).
2. LCH Ntau Lub Cev: Tus kab mob no cuam tshuam rau ob lossis ntau lub cev ntawm lub cev (piv txwv li, daim tawv nqaij thiab siab).
Tsis tas li ntawd xwb, cov kabmob xws li lub siab, tus po, thiab pob txha raug suav hais tias yog cov kabmob "muaj kev pheej hmoo siab", thaum cov kabmob xws li daim tawv nqaij, pob txha, thiab lub ntsws raug suav hais tias yog "muaj kev pheej hmoo tsawg." Qhov kev faib tawm no txiav txim siab txoj kev npaj kho mob.
Muaj ntau txoj kev kho mob tseem ceeb:
- Kev kho mob Steroid: Tshwj xeeb tshaj yog thaum tsuas yog daim tawv nqaij raug cuam tshuam, cov tshuaj steroid xws li prednisone yog siv ua tshuaj ntsiav lossis tshuaj pleev.
- Kev Phais Mob: Kev phais mob xws li curettage yog ua los tshem tawm cov qog LCH hauv pob txha.
- Kev kho mob qog noj ntshav: Qhov no yog ib hom tshuaj uas muab los tua cov hlwb qog noj ntshav. Vim tias cov hlwb LCH faib sai sai, cov tshuaj no tiv thaiv lawv kom tsis txhob loj hlob. Cov tshuaj no tuaj yeem muab ua tshuaj ntsiav, tshuaj txhaj, lossis ua tshuaj pleev rau ntawm daim tawv nqaij.
- Kev kho mob hluav taws xob: Siv cov hluav taws xob muaj zog heev los rhuav tshem cov hlwb LCH. Qhov no tam sim no siv tsawg heev.
- Kev kho mob rau lub hom phiaj:Rau cov menyuam yaus uas muaj qhov kev hloov pauv ntawm cov noob caj noob ces 'BRAF', muaj cov tshuaj (BRAF inhibitors) uas tsom mus rau qhov kev hloov pauv ntawd. Cov no muaj kev puas tsuaj me ntsis rau cov hlwb noj qab haus huv.
- Kev Kho Mob Tiv Thaiv Kab Mob: Txhawb kom tus menyuam lub cev tiv thaiv kab mob kom tawm tsam cov qe ntshav LCH.
- Kev hloov hlwb ntawm cov noob qes: Ib txoj kev xaiv kho mob uas xav txog rau cov mob hnyav heev uas tsis kho tau nrog lwm yam kev kho mob.
Tom qab kho mob tas, qhov xwm txheej zoo li cas lawm?
Qhov kev kwv yees rau LCH nyob ntawm ntau yam, suav nrog qhov twg ntawm lub cev uas tus kab mob tau cuam tshuam, nws kis mus deb npaum li cas, thiab nws teb zoo li cas rau kev kho mob.
- Tus nqi kho tau rau cov menyuam yaus uas tsuas muaj kev koom tes ntawm cov kab mob "tsis tshua muaj kev pheej hmoo" (ob qho tib si ib lub cev thiab ntau lub cev) yog ze li ntawm 100% . Qhov no txhais tau tias tsis muaj kev pheej hmoo ntawm kev tuag. Txawm li cas los xij, muaj kev pheej hmoo ntawm kev rov tshwm sim lossis lwm yam teeb meem mus sij hawm ntev.
- Cov menyuam yaus uas muaj cov kabmob "muaj kev pheej hmoo siab", xws li lub siab, tus po, thiab pob txha, raug cuam tshuam yuav mob hnyav dua.
Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum tau mus ntsib koj tus kws kho mob ntau xyoo, txawm tias tom qab kev kho mob tiav lawm los xij. Koj yuav tsum tau mus kuaj xyuas seb puas muaj qhov rov tshwm sim dua.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Langerhans Cell Histiocytosis (LCH) yog ib yam kab mob tsis tshua muaj uas tshwm sim los ntawm kev loj hlob tsis tswj hwm ntawm ib hom cell tiv thaiv kab mob. Feem ntau pom muaj nyob rau hauv cov menyuam yaus.
- Txawm hais tias nws tsis raug cais ua mob qog noj ntshav, cov kws kho mob oncologist kho nws siv cov tshuaj tiv thaiv mob qog noj ntshav.
- Cov tsos mob (mob tawv nqaij, pob txha, kev kis kab mob ntau zaus) sib txawv heev nyob ntawm qhov ntawm lub cev uas raug tus kab mob.
- Kev kuaj nqaij me me yog qhov tseem ceeb los kuaj mob kom meej.
- Rau ntau tus menyuam yaus, tshwj xeeb tshaj yog cov uas nyob rau hauv pawg "tsis muaj kev pheej hmoo", kev kho mob tuaj yeem kho tau tus kab mob tag nrho.
- Txawm tias tom qab kho tiav lawm los xij, nws tseem ceeb heev uas yuav tsum tau mus ntsib kws kho mob ob peb xyoos kom paub seb tus kab mob puas rov qab los dua.
- Tham txog tej lus nug lossis kev txhawj xeeb uas koj muaj txog koj tus menyuam tus mob nrog koj tus kws kho mob.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus