Kodi mukudziwa za matenda a m'mimba otchedwa Gastrointestinal Neuroendocrine Tumors (GI NETs) omwe angayambike m'mimba mwanu?

Kodi nthawi zina mumamva kupweteka m'mimba, kudzimbidwa, kapena zizindikiro zina zomwe zimawoneka ngati zikubwera nthawi zonse? Kapena mumachepa thupi popanda chifukwa chomveka? Ngakhale izi zitha kukhala zizindikiro za matenda wamba, pakhoza kukhala vuto linalake lomwe muyenera kudziwa. Lero tikambirana za vuto limodzi lotere. Limatchedwa Gastrointestinal Neuroendocrine Tumors , kapena GI NETs mwachidule. Musadandaule, tikambirana izi mosavuta.

Kodi zotupa za m'mimba (GI NETs) zimenezi ndi ziti?

Mwachidule, ma GI NET ndi mtundu wosowa wa khansa womwe umayamba m'maselo a neuroendocrine m'thupi lanu. Tsopano mwina mukudabwa kuti maselo a neuroendocrine ndi ati. Awa ndi mtundu wapadera wa selo womwe umalumikiza dongosolo lathu la mitsempha ndi dongosolo la endocrine. Ali ngati malo ang'onoang'ono otumizira uthenga. Maselo awa amapezeka m'malo ambiri m'thupi lathu, kuphatikizapo dongosolo la kugaya chakudya.

M'mimba mwanu muli njira yayitali, yofanana ndi chubu yomwe imagaya chakudya chomwe timadya, imayamwa michere, ndikuchotsa zinyalala. Ziphuphu za `GI NET` izi (zomwe kale zinkatchedwa `carcinoid tumors`) nthawi zambiri zimayamba m'matumbo ang'onoang'ono ndi m'matumbo . Komabe, zimathanso kuchitika m'mimba mwanu, appendix, ndi m'mero. Nthawi zina, zotupazi zimatha kufalikira kunja kwa matumbo, monga ku chiwindi chanu .

Ndani amene akukhudzidwa kwambiri ndi vuto la GI NET ili?

Uwu ndi matenda osowa kwambiri. Malinga ndi ziwerengero, matendawa amakhudza anthu pafupifupi 4 pa anthu 100,000 . Ngakhale m'dziko ngati United States, akuluakulu pafupifupi 8,000 okha ndi omwe amapezeka ndi matendawa chaka chilichonse.

Matendawa nthawi zambiri amakhudza anthu azaka zapakati pa 55 ndi 65. Komabe, amatha kufalikira mwa akuluakulu azaka zilizonse. Azungu ali ndi mwayi wochuluka wopeza matendawa kuposa akuda. Komanso, deta ikuwonetsa kuti akazi ali ndi mwayi wochuluka wopeza 'GI NET' iyi kuposa amuna.

Kodi zizindikiro za GI NET ndi ziti?

Nayi mfundo yofunika. Anthu ena amatha kukhala ndi zotupa izi m'thupi lawo popanda zizindikiro zilizonse . Nthawi zina zimapezeka mwangozi chinthu monga `scan` chikachitika pazifukwa zina.

Komabe, ngati zizindikiro zikuwonekera, zitha kufanana ndi za matenda wamba komanso osaopsa kwambiri. Ndicho chifukwa chake nthawi zina zimatha kuzindikirika mochedwa. Onani ngati zizindikirozi zikumveka zachilendo kwa inu:

• Kupweteka m'mimba: Ichi chikhoza kukhala chizindikiro chakuti matumbo anu atsekeka, mwina chifukwa cha chotupa cha GI NET.
• Kutsegula m'mimba:Kuyenda m'mimba pafupipafupi. Chizindikiro ichi chimapezeka kwambiri mwa anthu omwe ali ndi vuto lotchedwa ``Carcinoid Syndrome'' (zizindikiro zina zokhudzana ndi ``NET''), kapena kwa iwo omwe adachitidwa opaleshoni ya ndulu yawo kapena gawo la matumbo awo.
• Kusanza ndi kusanza: Ngati kusanza ndi kusanza kukupitirira, kungakhale chizindikiro cha matenda aakulu.
• Kuchepetsa thupi mosadziwa: Ngati muchepetsa thupi mwachangu popanda kudya zakudya zopatsa thanzi, kuchita masewera olimbitsa thupi, kapena popanda chifukwa chomveka, ndi chizindikiro chofala cha GI NETs.
• Magazi mu ndowe: Ngati ndowe yanu ndi yofiira kwambiri kapena yachedwa, izi zitha kukhala zizindikiro za kutuluka magazi m'mimba.
• Jaundice: Izi zimapangitsa kuti khungu lanu ndi maso anu oyera asinthe kukhala achikasu.
• Kutopa: Uku si kugona kokha, koma ndikumva kutopa kwambiri nthawi zonse, osatha kuchita chilichonse.

Kumbukirani, kungokhala ndi zizindikiro izi sizikutanthauza kuti muli ndi GI NET. Komabe, ngati zizindikirozi zikupitirira, ndikofunikira kuonana ndi dokotala kuti akupatseni upangiri.

Kodi ndi zifukwa ziti zomwe zimayambitsa GI NET?

Ndipotu, ofufuza zachipatala sanapeze chomwe chimayambitsa matenda a GI NETs. Komabe, apeza kuti anthu omwe ali ndi asidi wochepa m'mimba (hypochlorhydria) ali ndi mgwirizano ndi vutoli.

Kuphatikiza apo, anthu omwe ali ndi matenda enaake obadwa nawo komanso matenda enaake akhoza kukhala pachiwopsezo chachikulu chotenga matenda a GI NETs. Zina mwa matendawa ndi monga:

• Matenda ambiri a endocrine neoplasia (MEN): Pali mitundu iwiri ya izi. Mtundu umodzi (MEN1) umayambitsa glands yanu ya thyroid, parathyroid, kapena adrenal kukhala yogwira ntchito mopitirira muyeso kapena kukhala ndi zotupa. Mtundu wina (MEN2) umayambitsa glands yanu ya pancreatic, pituitary, kapena parathyroid kukhala yogwira ntchito mopitirira muyeso kapena kukhala ndi zotupa.
• Matenda a Von Hippel-Lindau: Uwu ndi matenda osowa kwambiri. Umayambitsa zotupa zomwe sizili ndi khansa (zoipa) m'thupi lonse.
• Matenda a Neurofibromatosis mtundu 1: Uwu ndi matenda osowa kwambiri. Umayambitsa zotupa pakhungu ndi mitsempha, ndipo ungakhudzenso maso ndi ziwalo zina za thupi.

Kodi madokotala amazindikira bwanji vuto la GI NET ili?

Ngati muli ndi zizindikiro zomwe zatchulidwa pamwambapa, kapena ngati pali kukayikira kulikonse pazifukwa zina, madokotala adzachita mayeso osiyanasiyana.

• X-ray: Izi zitha kujambula zithunzi za zomwe zili mkati mwa thupi. Komabe, nthawi zina chotupa cha GI NET chimakhala chachikulu kwambiri kapena chaching'ono kwambiri kuti chiwonekere pa X-ray. Zikatero, dokotala wanu angakulangizeni mitundu ina ya ma scan.
• Kujambula kwa CT (computed tomography):Izi zimagwiritsa ntchito kompyuta ndi ma X-ray angapo kuti apange mawonekedwe a ziwalo ndi mafupa anu amitundu itatu (3D). CT scan ingawonetse zinthu monga kukula kwa chotupacho komanso ngati chafalikira ku chiwindi kapena madera ena.
• Kujambula zithunzi zamaginito (MRI): Kuyesa kumeneku kumagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti apange zithunzi zomveka bwino za ziwalo ndi mafupa anu.
• Endoscopy: Mu njira imeneyi, madokotala amagwiritsa ntchito endoscope, chida chopyapyala, chofanana ndi chubu chokhala ndi kuwala ndi kamera kutsogolo, kuti ayang'ane mkati mwa njira yanu yakumtunda yakugaya chakudya. Chubu ichi chikhoza kulowetsedwa kudzera pakamwa panu kapena m'matumbo. Colonoscope imagwiritsidwa ntchito kuyang'ana gawo la pansi la njira yanu yakugaya chakudya.
• Endoscopic ultrasound (EUS): Imeneyi imagwiritsa ntchito endoscope ndi mafunde amphamvu kwambiri kuti ijambule zithunzi za dongosolo logaya chakudya. Endoscope imayikidwa kudzera pakamwa kapena m'matumbo, ndipo chofufuzira kumapeto chimatumiza mafunde a mawu m'njira yogaya chakudya. Ma echo omwe amatuluka m'kati mwake amapanga zithunzi zotchedwa sonograms.
• Kujambula kwa positron emission tomography (PET): Kuyesa kumeneku kumazindikira zotupa za neuroendocrine pogwiritsa ntchito utoto wapadera (womwe wapangidwa makamaka kuti uzindikire maselo a neuroendocrine chotupa).
• Kufufuza za khansa: Iyi ndi njira yodziwika kwambiri yoyesera yomwe imagwiritsidwa ntchito kutsimikizira matendawa. Pa izi, chidutswa chaching'ono cha minofu chimatengedwa kuchokera pamalo okayikitsa ndikuwunikidwa pogwiritsa ntchito maikulosikopu kuti muwone ngati pali maselo aliwonse a khansa.

Kodi pali mitundu yosiyanasiyana ya zotupa za neuroendocrine?

Inde, madokotala amagwiritsa ntchito njira yowunikira kuti apeze magulu a zotupazi. Zimawathandiza kukonzekera chithandizo chawo. Gawo la chotupa limatsimikiziridwa pofufuza maselo a khansa pogwiritsa ntchito maikulosikopu. Amawona kuchuluka kwa maselo omwe akugawikana, kuchuluka kwa maselo omwe akugawikana mwachangu, komanso kufanana kwa maselo ndi maselo a khansa kuposa maselo athanzi. Nayi magawo a `GI NET`:

• Giredi 1 (chotupa cha mtundu wotsika): Maselo amenewa amagawikana pang'onopang'ono kwambiri. Izi zikutanthauza kuti chotupacho chimakula pang'onopang'ono kwambiri.
• Giredi 2 (chotupa chapakati): Liwiro lomwe maselowa amagawikana ndi lochepa.
• Giredi 3 (chotupa chapamwamba): Maselo amenewa amagawikana mofulumira kwambiri, kotero chotupacho chimakula mofulumira kwambiri.

Kodi mankhwala a matenda a m'mimba otchedwa Gastrointestinal Endocrine Tumors (GI NETs) ndi ati?

Pali njira zingapo zochizira matenda a GI NETs. Madokotala amasankha chithandizo chabwino kwambiri kwa inu kutengera zinthu zambiri, kuphatikizapo kuchuluka kwa khansa yanu, zotsatirapo zake zomwe zingachitike chifukwa cha chithandizo, thanzi lanu lonse, komanso zomwe mumakonda. Pali njira zingapo zazikulu zochizira: kuyang'anira mwachangu, opaleshoni, ndi chithandizo chamankhwala.

Kodi Kuyang'anira Mogwira Ntchito N'chiyani?

Ngati chotupacho chikukula pang'onopang'ono ndipo chili ndi chiopsezo chochepa chofalikira ku ziwalo zina za thupi, madokotala angakupatseni chithandizo chotchedwa "active surveillance." Izi zikuphatikizapo kuyang'anitsitsa nthawi ndi nthawi , m'malo moyamba chithandizo chachikulu nthawi yomweyo.

• Mayeso ojambulira zithunzi monga CT scan.
• Kuyezetsa magazi monga kuwerengera magazi onse (CBC).
• Kuwunika thupi.

Ndi opaleshoni ziti zomwe zimachitika pa GI NET?

Mtundu wa opaleshoni yochitidwa pa GI NET imadalira zinthu monga komwe chotupacho chili komanso ngati chafalikira mbali zina za thupi.

Ndikofunikira kwambiri kuti musanachite opaleshoni, gulu lanu la opaleshoni lidziwe ngati muli ndi `(Carcinoid Syndrome)` (vuto lomwe limasonyeza zizindikiro za `neuroendocrine tumors`). Chifukwa, ngati muli ndi `(Carcinoid Syndrome)`, opaleshoni ingayambitse mavuto omwe angakhale oopsa kwa moyo. Ngati dokotala wa opaleshoni akudziwa izi, adzayesetsa kupewa mavutowa pokupatsani mankhwala apadera opaleshoni isanayambe, ikachitika, komanso itatha.

Ena mwa maopaleshoni ofala kwambiri omwe amachitidwa pa GI NET ndi awa:

• Kuchotsa gawo la m'mimba mwanu: Izi zikutanthauza kuchotsa gawo la m'mimba mwanu.
• Kuchotsa matumbo ang'onoang'ono: Izi zimaphatikizapo kuchotsa gawo la matumbo ang'onoang'ono lomwe lili ndi chotupa. Dokotala wa opaleshoni angachitenso anastomosis (kulumikizanso malekezero awiri a matumbo odulidwa pamodzi). Ma lymph nodes omwe ali pafupi ndi matumbo ang'onoang'ono nthawi zambiri amachotsedwanso ndikuwunika pogwiritsa ntchito maikulosikopu kuti awone ngati pali maselo a khansa.
• Kuchotsa Appendectomy: Madokotala amatha kuchotsa appendix yanu kudzera mu kudula kwakukulu kapena kudzera mu opaleshoni ya laparoscopic (kudula pang'ono pogwiritsa ntchito kamera).
• Kuchotsa Hemicolectomy: Pachifukwa ichi, mbali yakumanja kapena yakumanzere ya m'matumbo imachotsedwa, pamodzi ndi mitsempha yamagazi yapafupi ndi ma lymph node.
• Kuchotsa chimbudzi cha m'munsi: Madokotala amachotsa gawo la rectum yanu, koma amasiya matumbo anu onse. Izi zimakupatsani mwayi wochita matumbo mwachizolowezi.
• Kuchotsa mimba (APR): Opaleshoni iyi imachotsa anus, rectum, ndi gawo la m'mimba mwanu . Opaleshoni iyi nthawi zambiri imatsagana ndi colostomy. Izi zikutanthauza kuti pali mpata wochokera m'mimba mwanu kupita pamwamba pa mimba mwanu kuti ndowe (zinyalala zogaya chakudya) zidutse.
• Kuchotsa chiwindi: Opaleshoni iyi imachotsa ma GI NET omwe afalikira ku chiwindi.

Kodi mavuto kapena zotsatirapo zake za opaleshoniyi ndi ziti?

Maopaleshoni onsewa akhoza kukhala ndi zotsatirapo zoyipa kwambiri . Nthawi zina mungafunike thandizo lina kunyumba pamene mukuchira. Funsani dokotala wanu zomwe mungayembekezere mukatha opaleshoni inayake yomwe mukuchitidwa.

Kodi opaleshoni ya GI NET idzakhudza moyo wanga?

Inde, pakhoza kukhala zotsatirapo zoyipa . Popeza opaleshoni imeneyi nthawi zambiri imachotsa gawo la dongosolo lanu la m'mimba, pakhoza kukhala kusintha kwa momwe mumadyera ndi kumwa, ngakhale momwe mumapitira kuchimbudzi. Dokotala wanu adzakufotokozerani momwe opaleshoniyo idzakukhudzirani, komanso zomwe angachite kuti athetse mavuto aliwonse a m'mimba.

Ndi mankhwala ena ati omwe alipo pa GI NET?

Madokotala nthawi zina angaphatikizepo njira izi ndi opaleshoni:

• Chemotherapy: Izi zimagwiritsa ntchito mitundu yosiyanasiyana ya mankhwala opangidwa kuti aphe maselo a khansa.
• Chithandizo cholunjika: Izi zimagwiritsa ntchito mankhwala kapena zinthu zina zomwe zimaukira maselo a khansa okha, popanda kuvulaza maselo athanzi abwinobwino.
• Chithandizo cha Immunotherapy: Izi zimagwiritsa ntchito chitetezo cha mthupi cha thupi lanu kupha maselo a khansa kapena kuwaletsa kukula.
• Chithandizo cha radiation: Izi zimagwiritsa ntchito mphamvu yamphamvu kupha maselo a khansa kapena kuwaletsa kukula.
• Ma analogue a Somatostatin: Awa ndi mitundu yopangidwa ya mahomoni otchedwa somatostatin. Somatostatin yanu imagwira ntchito poletsa thupi lanu kupanga mahomoni ambiri.

Kodi zotsatirapo zake kapena mavuto ake ndi otani?

Chithandizo chilichonse mwa izi chimakhudza munthu aliyense mosiyana. Chifukwa chake, ndikofunikira kukambirana momveka bwino za ubwino ndi zotsatirapo za chithandizo chilichonse ndi dokotala wanu. Izi zikuthandizani kumvetsetsa momwe chithandizo chilichonse chingakukhudzireni. Dokotala wanu adzakulangizani chithandizo kutengera thanzi lanu lonse komanso zomwe mumakonda.

Kodi matenda a Endocrine m'mimba angapewedwe?

Mwatsoka, pakadali pano palibe njira yopewera matenda a GI NET. Komabe, ofufuza azachipatala apeza kulumikizana pakati pa matenda ena obadwa nawo ndi/kapena matenda ndi chiopsezo chokhala ndi zotupa za neuroendocrine. Lankhulani ndi dokotala wanu za mbiri yanu yachipatala komanso mbiri yachipatala ya banja lanu. Iye angakulimbikitseni mayeso apadera kuti azindikire zizindikiro zoyambirira za matenda a GI NET, ​​kuti zotupa zitha kugwidwa ndikuchiritsidwa msanga.

Ngati ndili ndi vutoli, ndiyenera kuyembekezera chiyani?

Kuyembekeza kwanu kumadalira nthawi yomwe khansa yapezeka ndipo chithandizo chayamba. Pafupifupi 97% ya anthu omwe amalandira chithandizo khansa isanafalikire mbali zina za thupi adzapulumuka.Patatha zaka zisanu kuchokera pamene matendawa apezeka. Ngati chotupacho chafalikira ku minofu yapafupi kapena ma lymph nodes, kuchuluka kwa moyo wa zaka zisanu kumeneku kumatsika kufika pa 95%. Pafupifupi 67% ya anthu omwe ali ndi matenda a GI NET omwe afalikira kunja kwa njira yogaya chakudya amakhala ndi moyo zaka zisanu kuchokera pamene matendawa apezeka.

GI NET ikhoza kubwereranso. Kutengera kukula, giredi, ndi komwe chotupacho chili, mungafunike kuyesedwa nthawi zonse. Mwachitsanzo, dokotala wanu angakulangizeni kuti muyesedwe ndi CT scan kamodzi pachaka kwa zaka zitatu zoyambirira mutalandira chithandizo komanso kuyezedwa thupi chaka chilichonse. Funsani dokotala wanu za nthawi yokumana ndi dokotala komanso mayeso omwe akugwirizana ndi vuto lanu.

Kodi ndimadzisamalira bwanji?

Ngati muli ndi chotupa cha m'mimba, mwina mungafunike opaleshoni. Madokotala nthawi zambiri amagwiritsa ntchito mabala otseguka, omwe ndi akulu kuposa opaleshoni ya laparoscopic. Izi zikutanthauza kuti muyenera kukhala kuchipatala kwa masiku angapo kenako n’kuchira kunyumba kwa milungu ingapo.

Kodi ndiyenera kupita ku Chipinda cha Zadzidzidzi liti?

Mungakhale ndi nthawi yoti muwone ngati khansa yanu yabwerera. Funsani dokotala wanu za zizindikiro zomwe zingakhale zizindikiro za matenda aakulu mutachita opaleshoni. Ngati mukukumana ndi zizindikiro zotsatirazi, muyenera kupita kuchipatala nthawi yomweyo:

• Kupuma movutikira mwadzidzidzi.
• Ngati malungo ali pamwamba pa madigiri 100.4 Fahrenheit (38.3 digiri Celsius).
• Ngati ululu uli waukulu, kapena ngati sungathetsedwe ndi mankhwala anu ochepetsa ululu.
• Ngati pali mafinya obiriwira komanso onunkhira bwino omwe akutuluka pa bala la opaleshoni, makamaka ngati malo ozungulira balalo akutentha kwambiri mukakhudza, kapena ngati ndi ofiira kwambiri.
• Ngati mukusanza nthawi zonse kapena mukutsegula m'mimba.

Chotupa cha m'mimba (GI NET) chingakhale matenda osintha moyo. Izi zili choncho chifukwa anthu ambiri omwe ali ndi vutoli amafunika kuchitidwa opaleshoni kuti achotse gawo lina kapena dongosolo lonse la m'mimba. Opaleshoni yanu ingasinthe momwe mumadyera, kumwa, komanso kupita kuchimbudzi. Gulu lanu lachipatala likudziwa kuti kusintha kumeneku sikophweka nthawi zonse. Ngati muli ndi mafunso kapena nkhawa, gawanani ndi dokotala wanu. Adzamvetsetsa vuto lanu ndikuthandizani kupeza mayankho.

Kodi ndi zinthu ziti zofunika kwambiri zomwe tiyenera kutenga kuchokera m'nkhaniyi?

• `GI NET` ndi mtundu wosowa kwambiri wa chotupa cha khansa , koma ndikofunikira kudziwa za icho.
• Anthu ena akhoza kukhala ndi izi popanda zizindikiro zilizonse , koma dziwani zizindikiro monga kupweteka m'mimba, kutsegula m'mimba, komanso kuchepetsa thupi mwangozi.
• Lolani izi zikule.Choyambitsa chenicheni sichinapezekebe, koma zinthu zina zobadwa nazo zitha kukhala ndi gawo.
• Pali mayeso osiyanasiyana oyesera matenda, monga `CT scan`, `MRI`, `Endoscopy`, ndi `Biopsy`.
• Njira zina zochiritsira zimaphatikizapo opaleshoni, chemotherapy, ndi radiation therapy . Dokotala wanu adzasankha chithandizo chomwe chili chabwino kwa inu.
• Kuzindikira msanga ndi kuyamba kulandira chithandizo kumawonjezera kwambiri mwayi wochira.
• Ngati muli ndi kukayikira kapena mafunso okhudza izi, musaope kulankhula ndi dokotala wanu . Iwo alipo kuti akuthandizeni.

` GI NET, Ziphuphu za m'mimba za Neuroendocrine, Khansa, Khansa ya m'mimba, Ziphuphu za Neuroendocrine, Dongosolo Logaya M'mimba, Zizindikiro