Zotupa zachilendo mu kapamba? Tiyeni tiphunzire za (Intraductal Papillary Mucinous Neoplasm - IPMN) m'njira yosavuta!

Kodi matenda amenewa ali ndi dzina lalitali bwanji? Mwina mukudzifunsa kuti `Intraductal Papillary Mucinous Neoplasm` kapena `(IPMN)` ndi chiyani. Dzinali likhoza kumveka loopsa komanso lovuta kulimvetsa, koma tiyeni tisunge mosavuta. Inu kapena munthu amene mumamudziwa mwina munamvapo za vutoli. Chifukwa chake, tisachite mantha ndikupeza kuti ndi chiyani kwenikweni.

Kodi `IPMN` kwenikweni ndi chiyani?

Mwachidule, IPMN ndi chotupa chodzaza madzimadzi, kapena chotupa, chomwe chimapangika mkati mwa ducts ya kapamba wanu. Izi si khansa kwenikweni, koma madokotala amaona kuti ndi "zoopsa." Izi zikutanthauza kuti si khansa tsopano, koma zitha kukhala khansa mtsogolo.

Taganizirani izi, nthawi zina zimakhala ngati chomera chaching'ono. Zingakhale mtengo waukulu kapena ayi. Umu ndi momwe chotupa cha `(IPMN)` chilili. Ofufuza amakhulupirira kuti pakati pa 20% ndi 30% ya anthu omwe amadwala khansa ya kapamba, kapena anthu awiri kapena atatu mwa khumi, khansayo inayamba ngati `(IPMN)`. Anthu ena amatha kukhala ndi chotupa ichi kwa zaka zambiri osawonetsa zizindikiro zilizonse. `(IPMN)` imachiritsidwa ndi opaleshoni, kapena kuyang'aniridwa mosamala kwa nthawi yayitali.

Kodi `IPMN` nthawi zonse imakhala khansa?

Ayi, si ma IPMN onse omwe amakhala khansa . Ndicho chinthu choyamba kumvetsetsa. Komabe, ena amatha kukhala pancreatic ductal adenocarcinoma (PDAC). PDAC ndi mtundu wofala kwambiri wa khansa ya kapamba. Khansa ya kapamba ndi mtundu wosowa kwambiri wa khansa. Imakhala pafupifupi 3% ya khansa zonse ku United States. Komabe, khansa ya kapamba ndi yomwe imapha 7% ya khansa zonse. Tsoka ilo, nthawi zambiri sizipezeka msanga, pomwe chithandizo chingakhale chothandiza kwambiri.

Ndani amene akukhudzidwa kwambiri ndi vutoli?

N'zovuta kwa madokotala kunena ndendende kuchuluka kwa anthu omwe ali ndi zotupazi, chifukwa nthawi zambiri sizimayambitsa zizindikiro ndipo sizipezeka. Komabe, kafukufuku wasonyeza kuti matendawa amapezeka kwambiri mwa amuna azaka zapakati pa 50 ndi 70 .

Kodi chimachitika ndi chiyani m'thupi ndi `(IPMN)` iyi?

Ma IPMN ali ndi madzi okhuthala ngati jelly mkati. Madokotala amatcha mucin. Pamene zotupa zachilendozi, zopanda khansa ziyamba kusanduka khansa, zimayamba kupanga madzi ambiri otchedwa mucin. Taganizirani ngati baluni yodzaza ndi madzi. Mucin iyi ikadzala, imatha kutseka ducts za kapamba mu kapamba wanu. Ma ducts awa ndi machubu ang'onoang'ono omwe amathandiza kugaya chakudya. Akatsekeka, angayambitse kutupa kwa kapamba (pancreatitis) .Imeneyi ikhoza kukhala vuto lopweteka kwambiri. Nthawi zina kutupa kwa kapamba ndi chizindikiro choyamba cha IPMN.

Kodi zizindikiro za IPMN ndi ziti?

Anthu ambiri omwe ali ndi vutoli samva kudwala kapena kukhala ndi zizindikiro zinazake. Vuto ndi limeneli. Nthawi zambiri, mtundu uwu wa chotupa umapezeka mwangozi akamayesedwa matenda ena. Komabe, anthu ena angakumane ndi zizindikiro monga:

• Kupweteka m'mimba kwa kanthawi: Anthu ena amatha kumva kupweteka m'mimba akadya. Izi zingayambitsenso kulephera kudya.
• Kuchepetsa thupi mosayembekezereka: Ngati muchepetsa thupi popanda kuyesetsa, chimenechonso ndi chizindikiro.
• Kusanza ndi kusanza.
• Kupweteka kwa msana.
• Chimbudzi/chimbudzi chamafuta: Ngati chimbudzicho chikuoneka chamafuta.

Nthawi zina, zotupazi zimatha kuyambitsa zizindikiro zofanana ndi matenda ena. Mwachitsanzo:

• Jaundice: Khungu limakhala lachikasu chifukwa cha kutsekeka kwa ndulu.
• Matenda a shuga atsopano: Kuchuluka kwa shuga m'magazi chifukwa cha kuwonongeka kwa kapamba palokha.
• Pancreatitis: Matenda omwe amayamba chifukwa cha kutsekeka kwa ducts za pancreatic.

Kodi n’chiyani chimayambitsa IPMN?

Ofufuza amakhulupirira kuti ma IPMN amakula pakakhala kusintha (kusintha) kwa majini komwe kumayang'anira kukula kwa maselo athu kapena kuletsa zotupa kuti zisapangidwe. Izi zikutanthauza kuti chitetezo cha mthupi lathu chimafooka. Ngati wina m'banjamo adadwala khansa ya kapamba (PDAC) , ena m'banjamo ali pachiwopsezo chachikulu chotenga ma IPMN.

Kodi madokotala amazindikira bwanji izi?

Madokotala amagwiritsa ntchito kwambiri mayeso osiyanasiyana a `(imaging)` kuti adziwe `(IPMN)`. Mwa awa, mayeso apadera otchedwa `Magnetic Resonance Cholangiopancreatography (MRCP)` ndi ofunikira kwambiri. Iyi ndi mayeso pogwiritsa ntchito makina a `(MRI). Izi zitha kujambula zithunzi zomveka bwino za chiwindi chanu, ndulu, ndulu, kapamba, ndi ndulu. Madokotala amagwiritsa ntchito mayesowa kuti awone ngati pali kusintha kulikonse m'mitsempha ya kapamba.

Zotupa za ``(IPMN)`` izi zagawidwa m'mitundu itatu ikuluikulu:

• Mtundu wa duct yayikulu (MD-IPMN): Izi ndi zotupa zomwe zimatseka duct yayikulu ya kapamba wanu. Izi zingayambitse duct yayikulu kukula, kapena kukulirakulira. M'mimba mwake mwa duct yayikulu nthawi zambiri imakhala pafupifupi mamilimita 3.5. Ngati ndi yayikulu kuposa mamilimita 5, ikhoza kukhala chizindikiro chakuti ili ndi mwayi waukulu wokhala ndi khansa.
• Mtundu wa duct ya nthambi (BD-IPMN): Izi ndi zotupa zomwe zimapangidwa m'mitsempha yaying'ono yonga nthambi yomwe imafalikira kuchokera ku duct yayikulu. Zotupa izi nthawi zambiri zimakhala zopanda vuto .
• Mtundu Wosakanikirana (MT-IPMN): Izi ndi zotupa zomwe zimayamba m'mitsempha yayikulu komanso nthambi za kapamba.

Kodi pali mayeso ena oti azindikire `IPMN`?

Inde, pali mayeso ena. Madokotala angachitenso mayeso otchedwa Endoscopic Ultrasound (EUS). Izi zitha kujambula zithunzi zomveka bwino za kapamba ndi chotupacho. Pa mayesowa, chitsanzo chaching'ono cha chotupacho, chotchedwa Fine-Needle Aspiration (FNA), chingatengedwe (biopsy). Kenako chitsanzocho chimawunikidwa pansi pa maikulosikopu kuti adziwe mtundu wa maselo (dysplasia) (ngati maselowo akuwoneka osazolowereka) ndi kuyezetsa majini kuti adziwe chiopsezo choti chikhale khansa.

Kodi `Dysplasia` ndi chiyani? N’chifukwa chiyani ili yofunika?

"Dysplasia" imangotanthauza kuti maselo anu amawoneka osazolowereka akamawonedwa ndi maikulosikopu.

• "High-grade dysplasia" zikutanthauza kuti maselo anu ali ngati maselo a khansa kuposa maselo athanzi. Izi zikutanthauza kuti chiopsezo ndi chachikulu.
• Matenda a dysplasia otsika amatanthauza kuti maselo ena amaoneka ngati maselo a khansa, koma chiopsezo chosanduka khansa chimakhulupirira kuti n'chochepa.

Madokotala amagwiritsa ntchito chidziwitso chokhudza vuto (dysplasia) ndi chidziwitso cha majini cha chotupacho kuti agawane ma IPMN m'magulu anayi akuluakulu. Nkhaniyi ndi yozama pang'ono, koma ndiyesetsa kuimvetsa mosavuta:

1. Ma IPMN amtundu wa m'mimba: Izi nthawi zambiri zimayambira m'mitsempha ya nthambi ya kapamba. Nthawi zambiri zimakhala ndi dysplasia yotsika. Anthu opitilira 90% omwe ali ndi chotupa chamtunduwu amakhala ndi moyo zaka 10 atapezeka ndi matendawa.

2. Ma IPMN amtundu wa m'mimba: Izi zimapezeka m'mitsempha yayikulu komanso nthambi za kapamba. Akhoza kukhala ndi dysplasia yapamwamba kwambiri ndipo pamapeto pake amatha kukhala khansa ya kapamba. Pafupifupi 70% ya anthu omwe ali ndi chotupa chamtunduwu amakhala ndi moyo zaka 5 atapezeka ndi matendawa. Chiwerengerochi chimatsika kufika pa 50% pofika zaka 10.

3. Ma IPMN amtundu wa Pancreatobiliary: Awa amapezekanso m'mitsempha yayikulu ndi nthambi, ndipo ali ndi dysplasia yapamwamba kwambiri. Anthu okwana 80% omwe ali ndi chotupa chamtunduwu amatha kudwala khansa ya kapamba yoopsa.

4. Ma IPMN amtundu wa Oncocytic: Awa ndi mtundu wosowa kwambiri wa chotupa. Amakula mu duct yayikulu ya pancreatic ndipo amakhala ndi dysplasia yapamwamba. Pafupifupi theka la anthu omwe ali ndi chotupa chamtunduwu adzadwala khansa ya pancreatic yoopsa.

Chofunika: Musachite mantha ndi magulu ndi ziwerengerozi. Izi ndi mfundo wamba. Dokotala wanu yekha ndi amene angakuuzeni bwino momwe mulili.

Kodi ma IPMN amachiritsidwa bwanji?

Ngati IPMN ikuonedwa kuti ndi chiopsezo chochepa , madokotala nthawi zambiri amalimbikitsa kupitiliza kuyang'anitsitsa chotupacho.Izi zili choncho chifukwa zotupa zambiri zosaopsa (IPMN) sizimakhala khansa. Komabe, ngati muli ndi chotupa mu duct yayikulu ya kapamba wanu, zomwe zikutanthauza kuti muli pachiwopsezo chachikulu, dokotala wanu angakulangizeni opaleshoni kuti muchotse chotupacho. Nazi zitsanzo zina:

• Kuchotsa kapamba wa mbali ina: Izi zimaphatikizapo kuchotsa mchira ndi/kapena thupi la kapamba. Opaleshoni iyi imachitika ngati pali zotupa m'mitsempha yayikulu m'derali.
• Kuchotsa Pancreatectomy yonse: Izi zimaphatikizapo kuchotsa kapamba wonse, ndulu, njira yolumikizira ndulu, ziwalo za m'mimba ndi matumbo ang'onoang'ono, komanso nthawi zambiri ndulu. Iyi ndi opaleshoni yaikulu.
• Njira ya Whipple (pancreaticoduodenectomy): Opaleshoni iyi ingalimbikitsidwe pa zotupa zomwe zili m'mitsempha yayikulu ya mutu wa kapamba (gawo lalikulu kwambiri lomwe kapamba limalumikizana ndi matumbo ang'onoang'ono). Ikuphatikizapo kuchotsa mutu wa kapamba, gawo loyamba la matumbo ang'onoang'ono (duodenum), ndulu, gawo la ndulu, ndi ma lymph nodes apafupi.

Kodi ndi mavuto otani omwe angakhalepo chifukwa cha opaleshoniyi?

Monga momwe zimakhalira ndi opaleshoni yaikulu iliyonse, pangakhale mavuto ena. Si aliyense amene ali ndi vuto lofanana. Chifukwa chake, ndi bwino kufunsa dokotala wanu za mavuto omwe mungakumane nawo.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa opaleshoni ngati iyi?

Izi zimasiyana malinga ndi munthu. Komabe, anthu ambiri amafunika kukhala m'chipatala kwa masiku angapo pambuyo pa opaleshoni ya kapamba. Zingatenge milungu kapena miyezi kuti achire bwino.

Kodi ndiyenera kupatsidwa chemotherapy kapena radiation therapy pambuyo pa opaleshoni?

Kafukufuku wina wasonyeza kuti mankhwala a chemotherapy ndi/kapena radiation angathandize pambuyo pa opaleshoni. Komabe, muyeneranso kuganizira zotsatirapo za mankhwalawo. Nthawi zina zotsatirapo zake zingakhale zabwino kuposa zabwino za mankhwalawo. Funsani dokotala wanu kuti mudziwe zambiri za izi.

Dokotala wanga anati ndiziyang'anira `IPMN`. Kodi zimenezo zikutanthauza chiyani?

Izi zikutanthauza kuti mayeso anu asonyeza kuti IPMN yanu ndi yabwino ndipo sizingakhale khansa. Madokotala apitiliza kuyang'anira zotupa izi zopanda vuto pogwiritsa ntchito mayeso ojambulira zithunzi (monga MRCP). Izi zikutanthauza kuti, "Tiyeni tiyang'anire izi ndikuwona ngati pali kusintha kulikonse."

Kodi ndingachite chiyani kuti ndichepetse chiopsezo changa chokhala ndi IPMN?

Ofufuza amakhulupirira kuti zotupa izi zimachitika chifukwa cha kusintha kwa majini. Chifukwa chake, palibe chomwe mungachite kuti mulepheretse IPMN kukula. Komabe, zotsatirazi zingakuthandizeni kuchepetsa chiopsezo chanu chonse cha khansa ya kapamba ndikukuthandizani kuwunika chiopsezo chanu cha IPMN:

• Dziwani mbiri ya matenda a banja lanu.Ngati wina m'banja mwanu wakhala ndi khansa ya kapamba (PDAC), muli pachiwopsezo chachikulu chotenga IPMN.
• Khansa ya kapamba imagwirizanitsidwa ndi kusuta fodya. Ngati mumagwiritsa ntchito fodya (ndudu, beedis, ndudu), yesani kusiya.
• Chepetsani kumwa mowa, kapena siyani kotheratu.
• Yesetsani kukhala ndi kulemera koyenera.
• Yesetsani kupewa matenda a shuga amtundu wachiwiri mwa kudya zakudya zabwino komanso kuchita masewera olimbitsa thupi. Ngati muli ndi matenda a shuga, gwirani ntchito ndi dokotala wanu kuti muchepetse shuga m'magazi mwanu.

Kodi mungakhale ndi moyo wautali bwanji ndi IPMN?

Monga momwe zilili ndi khansa iliyonse, kuzindikira msanga ndi kuchiza ndi zinthu zofunika kwambiri podziwa kuti munthu ali ndi matendawa. Ponseponse, pafupifupi 95% ya anthu omwe amapezeka ndi kuchiritsidwa IPMN isanatuluke khansa ya kapamba amakhalabe ndi moyo zaka zisanu kuchokera pamene yapezeka. Ngati muli ndi mafunso okhudza matenda anu, dokotala wanu ndiye gwero labwino kwambiri la chidziwitso.

Ndili ndi IPMN yabwino. Kodi ndimadzisamalira bwanji?

Nthawi zambiri, zotupa zimenezi sizimakhala khansa. Komabe, ndi zachilendo kumva kupsinjika maganizo ndi nkhawa chifukwa cha lingaliro lakuti, "Mwina zingatheke." Ngati mukumva choncho, lankhulani ndi dokotala wanu za izi. Iye adzakufotokozerani chifukwa chake muli pachiwopsezo chochepa chotenga khansa ya kapamba. Iye adzakulangizaninso zinthu zomwe mungachite kuti muchepetse chiopsezo chanu chonse chotenga khansa ya kapamba.

Intraductal Papillary Mucinous Neoplasm (IPMN) ndi dzina lalitali, nthawi zina losokoneza la chotupa chomwe chimapangika m'mitsempha ya kapamba ndipo chingayambitse khansa ya kapamba. Chotupachi nthawi zambiri sichimayambitsa zizindikiro ndipo nthawi zambiri chimapezeka mwangozi panthawi yoyezetsa magazi pazifukwa zina.

Dokotala wanu akakuuzani kuti muli ndi IPMN, mungadabwe. Koma kumbukirani, kukhala ndi vutoli sikutanthauza kuti mudzakhala ndi khansa. Nthawi zambiri, mayeso ena amasonyeza kuti chotupacho si khansa (chosaopsa). Ngati chotupa chanu si khansa, dokotala wanu adzapitiriza kuchiyang'anira kuti aone ngati chili ndi chiopsezo chachikulu kapena ngati ndi khansa. Ndipo, chofunika kwambiri, ngakhale chotupa chanu chikapezeka kuti chili ndi chiopsezo chachikulu, pafupifupi 95% ya anthu omwe adapezeka ndi IPMN ndi kuchiritsidwa asanakhale khansa amakhalabe ndi moyo zaka zisanu atapezeka ndi khansa.

Kaya muli ndi vuto liti, pali zinthu zomwe mungachite kuti muchepetse chiopsezo chanu chokhala ndi khansa ya kapamba. Lankhulani ndi dokotala wanu za izi. Iye adzasangalala kukuthandizani.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, ndikukhulupirira kuti tsopano mwamvetsa bwino zomwe takhala tikukambirana, ``(IPMN)``. Ngakhale kuti nkhaniyi ndi yovuta pang'ono, tiyeni tiyese kuimvetsa mosavuta.

• IPMN ndi chotupa chomwe chimakula m'mitsempha ya kapamba ndipo chingayambitse khansa. Si onse omwe amakhala khansa.
• Nthawi zambiri, sichisonyeza zizindikiro zilizonse ndipo chimapezeka mwangozi panthawi yoyezetsanso.
• Matendawa amapezeka kudzera mu mayeso monga `(MRCP)` ndi `(EUS)`.
• Chithandizo chingaphatikizepo kuyang'aniridwa kapena opaleshoni , kutengera mtundu ndi kuopsa kwa chotupacho.
• Kuzindikira msanga ndi kulandira chithandizo ndikofunikira kwambiri.
• Musachite mantha ngati mwauzidwa kuti muli ndi IPMN. Lankhulani ndi dokotala wanu ndipo sankhani njira yabwino kwambiri yothandizira matenda anu.
• Komanso ganizirani kusintha moyo wanu (kusiya kusuta fodya, kukhala ndi thupi labwino, ndi zina zotero) zomwe zingachepetse chiopsezo cha khansa ya kapamba.

Ngati muli ndi mafunso ena okhudza izi, musazengereze kufunsa dokotala wanu. Khalani ndi thanzi labwino!

Khansa ya Pancreatic, IPMN, Khansa, Khansa ya Pancreatic, Chotupa, Zizindikiro, Chithandizo