Koj puas paub txog tus mob qog noj ntshav uas tsis tshua muaj neeg hu ua Sarcomatoid Carcinoma? Cia peb tham kom meej!

Kab mob qog noj ntshav ua rau peb txhua tus ntshai me ntsis, puas yog? Tab sis tsis yog txhua tus kab mob qog noj ntshav zoo ib yam. Hnub no peb yuav tham txog ib hom kab mob qog noj ntshav uas tsis tshua muaj thiab nyuaj. Nws hu ua Sarcomatoid Carcinoma. Lub npe yuav zoo li txawv rau koj, tab sis cia peb sim piav qhia nws yooj yim. Cov kws kho mob hu qhov no ua hom kab mob qog noj ntshav uas loj hlob sai heev, thiab ua rau neeg mob hnyav heev .

Sarcomatoid Carcinoma yog dab tsi?

Hais yooj yim xwb, Sarcomatoid Carcinoma yog kev sib xyaw ua ke ntawm ob hom mob qog noj ntshav. Uas yog, nws muaj cov yam ntxwv ntawm ob qho tib si carcinoma thiab sarcoma. Tam sim no cia peb saib seb carcinoma thiab sarcoma yog dab tsi.

• Mob qog nqaij hlav: Qhov no yog hom mob qog nqaij hlav uas feem ntau tshwm sim. Nws pib nyob rau hauv cov nqaij uas npog qhov chaw ntawm peb cov kabmob lossis daim tawv nqaij. Peb hu cov nqaij no ua cov nqaij epithelial vim tias lawv yog ua los ntawm cov hlwb epithelial.
• Sarcoma: Qhov no tsis tshua muaj ntau dua li mob qog nqaij hlav. Sarcomas pib nyob rau hauv cov chaw xws li pob txha, cov ntaub so ntswg sib txuas (piv txwv li, pob txha mos, cov leeg), thiab cov ntaub so ntswg mos (piv txwv li, cov leeg nqaij, cov rog, cov hlab ntsha). Lawv yog ua los ntawm ib hom cell hu ua mesenchymal cells.

Yog li, nyob rau hauv cov ntaub ntawv ntawm sarcomatoid carcinoma, ib tug qog uas muaj cov hlwb thiab cov nqaij ntshiv uas cuam tshuam nrog ob qho tib si carcinoma thiab sarcoma tsim. Cov qog no loj hlob sai heev thiab tuaj yeem kis (metastasize) mus rau ntau qhov chaw ntawm lub cev. Thaum qhov no kis mus, cov nqaij ntshiv noj qab haus huv hauv lub cev raug puas tsuaj.

Qhov no tshwm sim ntau zaus rau qhov twg ntawm lub cev?

Thaum koj hnov ​​lub npe hu ua sarcomatoid carcinoma, tej zaum koj yuav xav tias nws yog los ntawm koj lub ntsws . Txawm li cas los xij, hom mob qog noj ntshav no, uas muaj cov yam ntxwv zoo li ob qho tib si carcinoma thiab sarcoma, kuj tuaj yeem tshwm sim rau lwm qhov ntawm lub cev. Piv txwv li:

• Tawv nqaij
• Pob txha
• Qhov ncauj
• Cov qog thyroid
• Lub mis
• Plab
• Txoj hnyuv me
• Siab
• Pancreas
• Lub tsev menyuam
• Prostate
• Lub zais zis
• Cov raum
• Qhov chaw nyob nruab nrab ntawm lub hauv siab (qhov no hu ua "Mediastinum". Tej yam xws li lub plawv, trachea, thiab thymus gland nyob ntawm no)

Mob qog nqaij hlav sarcomatoid, uas pib hauv lub ntsws, lawv hais tias kis tau sai heev. Ua li no, nws tuaj yeem kis mus rau ntau qhov chaw ib zaug, xws li cov qog adrenal, lub hlwb, pob txha, siab, raum, peritoneum, pancreas, tawv nqaij, thiab lub plawv.

Puas muaj ntau hom no thiab?

Yog lawm, Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau faib cov mob qog nqaij hlav sarcomatoid ua tsib hom tseem ceeb hauv xyoo 2015. Txhua hom no hu ua "mob qog nqaij hlav tsis yog qog me me uas tsis sib txawv." "Qee zaum tsis sib txawv" txhais tau tias cov qog nqaij hlav sib txawv txawv heev uas nyuaj rau hais tias lawv yog hom twg. Mob qog nqaij hlav tsis yog qog me me yog ib hom mob qog nqaij hlav uas loj hlob thiab kis tau sai.

Tsib hom no yog:

• Pleomorphic carcinomas: Cov no feem ntau muaj cov yam ntxwv ntawm carcinoma. Txawm li cas los xij, tsawg kawg 10% ntawm lawv feem ntau muaj cov yam ntxwv sarcoma. Qhov no yog hom sarcomatoid carcinoma feem ntau.
• Kab mob qog nqaij hlav spindle-cell carcinoma: Hom kab mob qog nqaij hlav no tau nws lub npe los ntawm txoj kev uas nws cov cell zoo li nyob rau hauv lub tshuab microscope. Lawv ntev, nyias, thiab zoo li cov spindles ntawm lub log tig.
• Mob qog nqaij hlav loj heev: Qhov no muaj cov qog nqaij hlav loj uas teeb tsa zoo ib yam li cov qog nqaij hlav sarcomas. Cov no feem ntau tsim nyob rau sab saud ntawm lub ntsws.
• Carcinosarcoma: Qhov no suav nrog cov nqaij ntawm qee hom mob qog nqaij hlav, xws li adenocarcinoma thiab squamous cell carcinoma. Nws kuj suav nrog cov nqaij sarcoma uas tsis zoo thiab tsis loj hlob zoo.
• Pulmonary blastoma: Qhov no yog ib hom adenocarcinoma uas zoo li cov nqaij ntsws ntawm tus menyuam hauv plab. Cov hlwb mesenchymal (zoo li sarcomas) kuj pom tau.

Leej twg yuav muaj feem ntau dua los tsim qhov no?

Kab mob qog nqaij hlav Sarcomatoid feem ntau tshwm sim rau cov txiv neej . Nws yog qhov tshwj xeeb tshaj yog rau cov neeg uas tam sim no siv cov khoom lag luam luam yeeb lossis tau siv lawv yav dhau los . Lub hnub nyoog nruab nrab ntawm kev kuaj mob yog nyob ib puag ncig 65 xyoo.

Qhov no feem ntau tshwm sim li cas?

Qhov no yog ib hom mob qog noj ntshav uas tsis tshua muaj neeg paub . Sarcomatoid Carcinoma yog ib feem pua ​​me me ntawm txhua yam mob qog noj ntshav hauv lub ntsws, ntawm 0.1% thiab 0.4%.

Cov tsos mob ntawm qhov no yog dab tsi?

Cov tsos mob uas koj ntsib nyob ntawm seb qhov twg mob qog noj ntshav tau kis mus rau hauv koj lub cev. Yog tias koj muaj mob qog noj ntshav sarcomatoid ntawm lub ntsws, koj yuav muaj cov tsos mob xws li:

• Hnoos (tsis tu ncua)
• Ua pa nyuaj (ua tsis taus pa)
• Mob hauv siab
• Ntshav nrog cov hnoos qeev
• Poob phaus yam tsis muaj laj thawj

Vim li cas ho muaj tej yam zoo li no tshwm sim?

Cov kws kho mob ntseeg tias qhov ua rau mob qog nqaij hlav sarcomatoid yog ib qho txheej txheem hu ua "Epithelial-Mesenchymal Transition (EMT)." Hauv lwm lo lus, qhov no yog thaum cov hlwb epithelial mob qog nqaij hlav hauv cov qog nqaij hlav tsis yog me me hloov pauv, thiab qee qhov ntawm lawv hloov mus ua cov hlwb mesenchymal. Cov hlwb qog nqaij hlav uas tau hloov pauv li no kis mus thoob plaws lub cev sai heev.

Cov kev hloov pauv ntawm cov cell thiab kev loj hlob sai no feem ntau cuam tshuam nrog kev hloov pauv caj ces hauv cov cell . Koj paub, peb cov noob caj ces yog cov lus qhia uas qhia cov cell yuav ua li cas. Kev hloov pauv caj ces yog kev hloov pauv lossis qhov yuam kev hauv cov lus qhia ntawd. Cov kws tshawb fawb tau pom ntau qhov kev hloov pauv caj ces uas cuam tshuam nrog mob qog nqaij hlav sarcomatoid.

Cov yam txaus ntshai uas cuam tshuam rau qhov no yog dab tsi?

Ib qho yam ua rau muaj kev pheej hmoo yog ib yam dab tsi uas ua rau muaj feem yuav muaj mob. Hauv cov mob qog nqaij hlav sarcomatoid, kev haus luam yeeb yog qhov tseem ceeb thiab paub zoo tshaj plaws uas ua rau muaj kev pheej hmoo. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ntawm 80% thiab 90% ntawm cov neeg uas muaj mob qog nqaij hlav ntsws no yog cov neeg haus luam yeeb tam sim no lossis yav dhau los.

Tsis txhob hnov ​​qab tias kev tso kev haus luam yeeb tuaj yeem tiv thaiv koj ntawm ntau yam kab mob ntsws, suav nrog mob qog noj ntshav zoo li qhov no.

Tus kws kho mob paub qhov no li cas?

Koj tus kws kho mob yuav xub kuaj koj thiab, yog tias tsim nyog, ua qee cov txheej txheem thaij duab. Txawm li cas los xij, kom paub tseeb tias qhov no yog mob qog nqaij hlav sarcomatoid, yuav tsum tau kuaj cov qog nqaij hlav kom paub tseeb tias cov qog nqaij hlav zoo.

• Kev Thaij Duab: Tus kws kho mob yuav ua CT scan kom pom qhov twg mob qog noj ntshav nyob. Yuav kom pom tau sab hauv lub cev meej dua, yuav ua CT/PET scan lossis F-fluorodeoxyglucose (FDG)-PET scan. CT/PET scan muab ob qho kev kuaj (CT thiab PET) ua ke tib lub sijhawm. Fluorodeoxyglucose yog ib yam tshuaj uas raug txhaj rau hauv lub cev thaum lub sijhawm PET scan. Nws sib sau ua ke nyob ib puag ncig cov hlwb qog noj ntshav, ua rau lawv pom tseeb dua ntawm qhov scan.

• Kev kuaj mob qog nqaij hlav: Kev kuaj mob qog nqaij hlav yog kev kuaj mob qog nqaij hlav los ntawm kev siv lub tshuab microscope los kuaj cov qauv ntawm cov nqaij mob qog nqaij hlav uas tau muab los ntawm kev kuaj nqaij. Kev pom ntawm cov cell tuaj yeem pab tus kws kho mob txiav txim siab seb nws puas yog mob qog nqaij hlav sarcomatoid thiab, yog tias yog, nws yog hom qog nqaij hlav twg (piv txwv li, pleomorphic carcinoma, spindle cell carcinoma).

• Kev tshuaj ntsuam kab mob:Qhov kev kuaj no nrhiav cov tshuaj hu ua antigens uas cuam tshuam nrog qee hom cell. Qee cov antigens tuaj yeem txheeb xyuas lub cell ua qhov tsis zoo lossis malignant.

Yuav kho li cas?

Txoj kev kho mob zoo tshaj plaws rau tus mob qog noj ntshav no yog phais kom tshem tawm tag nrho cov qog. Kev kho mob chemotherapy tuaj yeem pab tua cov qog noj ntshav uas tseem tshuav tom qab phais. Txawm li cas los xij, feem ntau, tus mob qog noj ntshav tau kis mus rau lub sijhawm kuaj pom tias muaj mob, yog li ntawd kev phais yuav ua tsis tau. Yog tias muaj teeb meem xws li mob, los ntshav, lossis ua pa nyuaj, kev kho mob hluav taws xob kuj tseem yuav muab tau.

Yog hais txog mob qog nqaij hlav sarcomatoid, kev sim tshuaj kho mob yuav yog txoj kev kho mob zoo tshaj plaws. Kev sim tshuaj kho mob yog kev tshawb fawb uas sim seb puas muaj kev nyab xeeb thiab ua tau zoo ntawm cov kev kho mob tshiab. Cov kws tshawb fawb tam sim no tab tom tshawb nrhiav cov kev kho mob uas tuaj yeem pab kom koj nyob ntev dua nrog tus mob qog nqaij hlav no. Ob qho ntawm lawv yog:

• Kev kho mob tsom mus rau ib qho: Qhov no suav nrog kev tsom mus rau cov yam ntxwv tshwj xeeb uas ua rau cov hlwb qog noj ntshav loj hlob ntau yam tsis tuaj yeem tswj tau.
• Kev kho mob tiv thaiv kab mob: Qhov no ua rau koj lub cev tiv thaiv kab mob ua haujlwm zoo, pab nws nrhiav thiab rhuav tshem cov hlwb qog noj ntshav.

Peb ua tau dab tsi los txo qhov kev pheej hmoo?

Los ntawm kev xaiv tsis siv cov khoom haus luam yeeb, koj tuaj yeem txo koj txoj kev pheej hmoo ntawm kev mob qog nqaij hlav sarcomatoid, nrog rau ntau lwm yam mob qog nqaij hlav ntsws. Qhov no yog kauj ruam tseem ceeb tshaj plaws uas koj tuaj yeem ua tau.

Qhov no puas kho tau tag nrho?

Qhov tseeb, mob qog nqaij hlav sarcomatoid yog ib hom mob qog nqaij hlav uas feem ntau nyuaj kho kom zoo. Txawm li cas los xij, thaum cov kws tshawb fawb kawm paub ntau ntxiv txog cov yam ntxwv ntawm cov qog no, xws li kev hloov pauv caj ces, lawv muaj peev xwm tsim cov kev kho mob tshiab uas tsom mus rau lawv. Yog tias koj raug kuaj pom tias muaj tus kab mob no, koj yuav tsim nyog koom nrog kev sim tshuaj uas sim cov kev kho mob tshiab. Nug koj tus kws kho mob txog qhov no.

Koj yuav muaj sia nyob nrog tus kab mob no ntev npaum li cas?

Nws nyuaj rau hais tias koj yuav nyob ntev npaum li cas hauv qhov xwm txheej no, tab sis nws yog ib qho tseem ceeb uas yuav tsum paub. Qhov nruab nrab, tus nqi ciaj sia nruab nrab yog li 10 lub hlis. Tus nqi ciaj sia tsib xyoos yog li 15%. Txawm li cas los xij, cov ntaub ntawv no tsis siv rau txhua tus tib yam. Muaj ntau yam uas tuaj yeem cuam tshuam rau koj qhov xwm txheej:

• Hom cell tshwj xeeb hauv mob qog noj ntshav.
• Cov kev hloov pauv ntawm cov noob caj noob ces uas tau tshwm sim yog dab tsi?
• Txij li thaum pib muaj cov tsos mob mus txog rau thaum kuaj pom tias muaj tus kab mob, nws siv sijhawm ntev npaum li cas.
• Tus mob qog noj ntshav tau loj hlob thiab rhuav tshem cov nqaij noj qab haus huv mus deb npaum li cas.
• Tus mob qog noj ntshav tau kis mus deb npaum li cas.
• Seb tus kws kho mob puas tuaj yeem tshem tawm cov qog nqaij hlav tag nrho.

Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum tham nrog koj tus kws kho mob txog txhua yam no kom nkag siab zoo dua txog koj tus mob.

Cov lus nug tseem ceeb uas yuav nug tus kws kho mob yog dab tsi?

Thaum koj pom tias koj muaj mob qog nqaij hlav sarcomatoid, koj yuav ntxhov siab thiab tsis meej pem vim tias cov mob qog nqaij hlav no muaj ntau yam thiab nyuaj heev. Nws yog ib qho tseem ceeb uas yuav tsum tham nrog koj tus kws kho mob txog koj cov kev xaiv kho mob thiab kev mob yav tom ntej. Koj tus kws kho mob tuaj yeem piav qhia rau koj txog yam koj yuav tsum xav tau raws li cov yam ntxwv ntawm koj cov qog nqaij hlav thiab qhov chaw uas mob qog nqaij hlav nyob hauv koj lub cev.

Nov yog qee cov lus nug uas koj tuaj yeem nug koj tus kws kho mob:

• Kuv tus mob cancer puas tau kis mus rau lwm tus?
• Kuv tus mob qog noj ntshav hnyav npaum li cas?
• Koj pom zoo kom siv hom kev kho mob twg?
• Yuav tsum muaj cov kev mob tshwm sim dab tsi los ntawm kev kho mob no?
• Koj puas xav tias nws yuav yog lub tswv yim zoo rau kuv kom tau txais kev pom zoo thib ob ntawm kws kho mob?
• Kuv puas yuav tsum ua haujlwm nrog cov kws kho mob tshwj xeeb hauv kev saib xyuas palliative?
• Kuv puas tsim nyog koom nrog kev sim tshuaj kho mob?

Koj tus kws kho mob tuaj yeem muab cov ntaub ntawv uas koj xav tau rau koj, xa koj mus rau kev sim tshuaj yog tias koj tsim nyog, thiab pab koj tau txais kev kho mob palliative.

Tej yam uas peb yuav tsum nco ntsoov

Zoo, yog li, los ntawm qhov peb tau tham txog Sarcomatoid Carcinoma, ntawm no yog cov ntsiab lus tseem ceeb uas yuav tsum nco ntsoov:

• Qhov no yog ib hom mob qog noj ntshav uas tsis tshua muaj, thiab kis tau sai heev.
• Qhov no qhia txog cov yam ntxwv ntawm ob qho tib si carcinoma thiab sarcoma.
• Kev haus luam yeeb yog qhov tseem ceeb tshaj plaws rau qhov no.
• Cov tsos mob nyob ntawm seb qhov twg mob qog noj ntshav nyob. Hauv cov ntsws, cov tsos mob yuav muaj xws li hnoos thiab ua pa nyuaj.
• Yuav tsum tau kuaj tshwj xeeb (biopsy, imaging) thiaj li kuaj tau.
• Cov kev xaiv kho mob nyuaj heev. Ntxiv rau kev phais mob, kev siv tshuaj kho mob qog nqaij hlav, thiab kev siv hluav taws xob kho mob, kev kho mob tshiab (kev kho mob uas tsom mus rau tus neeg mob, kev kho mob tiv thaiv kab mob) kuj tseem tab tom raug xav txog.
• Txawm hais tias qhov muaj feem yuav rov zoo tag nrho yog tsawg, kev tshawb fawb tshiab muab kev cia siab.
• Nws yog ib qho tseem ceeb heev uas yuav tsum tham nrog koj tus kws kho mob txog koj tus mob thiab nrhiav txhua yam kom meej.

Vam tias cov ntaub ntawv no yuav pab tau koj. Yog tias koj muaj lus nug ntxiv txog qhov no, thov koj nrog kws kho mob tham.