Iithumba ezingaqhelekanga kwi-pancreas? Masifunde nge-(Intraductal Papillary Mucinous Neoplasm - IPMN) ngendlela elula!

Yintoni esi sifo esinegama elide? Usenokuba uzibuza ukuba yintoni i-'Intraductal Papillary Mucinous Neoplasm' okanye i-'(IPMN)'. Igama lisenokuvakala liyoyikisa kwaye kunzima ukuliqonda, kodwa masiligcine lilula. Wena okanye umntu omaziyo usenokuba ukhe weva ngale meko. Ngoko ke, masingaphakuzeli size sifumanise ukuba yintoni kanye kanye.

Yintoni kanye kanye i-'IPMN'?

Ngamafutshane, i-IPMN sisigaqa esizaliswe lulwelo, okanye i-cyst, esakha ngaphakathi kwimibhobho yepancreas yakho. Ezi azingomhlaza ngokwenene, kodwa oogqirha bazijonga "njengezingaphambi komhlaza." Oku kuthetha ukuba azingomhlaza ngoku, kodwa zinokuba ngumhlaza kwixesha elizayo.

Cinga ngayo, ngamanye amaxesha ifana nesityalo esincinci. Isenokuba ngumthi omkhulu okanye ingabi ngumthi omkhulu. Yiyo loo nto le `(IPMN)` injalo. Abaphandi bakholelwa ukuba phakathi kwama-20% nama-30% abantu abafumana umhlaza wepancreatic, okanye abantu ababini okanye abathathu kwabalishumi, umhlaza waqala njenge`(IPMN)`. Abanye abantu banokuba nale thumba iminyaka emininzi ngaphandle kokubonisa zimpawu. `(IPMN)` inyangwa ngotyando, okanye ngoqwalaselo olucokisekileyo ixesha elide.

Ingaba i-'IPMN' ihlala ingumhlaza?

Hayi, ayizizo zonke ii-IPMNs eziba ngumhlaza . Yiloo nto yokuqala ekufuneka uyiqonde. Nangona kunjalo, ezinye zinokukhula zibe yi-pancreatic ductal adenocarcinoma (PDAC). I-PDAC lolona hlobo luqhelekileyo lomhlaza we-pancreatic. Umhlaza we-pancreatic luhlobo lomhlaza olungaqhelekanga. Ubandakanya malunga ne-3% yazo zonke iintlobo zomhlaza e-United States. Nangona kunjalo, umhlaza we-pancreatic ubandakanya i-7% yazo zonke iintlobo zomhlaza ezifayo. Ngelishwa, awusoloko ufunyaniswa kwangethuba, xa unyango lunokuba luncedo kakhulu.

Ngubani ochaphazeleka kakhulu yile meko?

Kunzima koogqirha ukutsho ngokuthe ngqo ukuba bangaphi abantu abanale thumba, kuba abahlali bebangela iimpawu kwaye ababonakali. Nangona kunjalo, uphando lubonise ukuba zixhaphake kakhulu kumadoda aphakathi kweminyaka engama-50 ukuya kwengama-70 .

Kwenzeka ntoni emzimbeni ngale `(IPMN)`?

Ii-IPMN ziqulathe ulwelo olujiyileyo, olufana nejeli ngaphakathi. Oogqirha balubiza ngokuba yi-mucin. Xa ezi thumba ziqhelekileyo, ezingenalo umhlaza ziqala ukujika zibe ngumhlaza, ziqala ukuvelisa olu lwelo lubizwa ngokuba yi-mucin. Cinga ngalo njengebhaluni encinci ezaliswe ngamanzi. Xa le mucin iqokelelana, inokuvala imijelo yepancreas kwipancreas yakho. Le mijelo yimibhobho emincinci enceda ekugayeni ukutya. Xa ivalekile, inokubangela ukudumba kwepancreas (pancreatitis) .Oku kungaba yimeko ebuhlungu kakhulu. Ngamanye amaxesha oku kudumba kwepancreas luphawu lokuqala lwe-IPMN.

Zithini iimpawu ze-IPMN?

Abantu abaninzi abanale meko abaziva begula okanye bengenazo iimpawu ezithile. Yiyo loo nto ingxaki ngale nto. Uninzi lwexesha, olu hlobo lwethumba lufunyanwa ngengozi xa bevavanywa enye imeko. Nangona kunjalo, abanye abantu banokufumana iimpawu ezifana nezi:

• Iintlungu zesisu ezihlala zihleli: Abanye abantu banokuba neentlungu zesisu emva kokutya. Oku kunokubangela nokulahlekelwa ngumdla wokutya.
• Ukwehla kobunzima obungalindelekanga: Ukuba unciphisa ubunzima ngaphandle kokuzama, oko kukwaluphawu.
• Isicaphucaphu nokuhlanza.
• Umqolo obuhlungu.
• Indle/isitulo esinamafutha: Ukuba isitulo sibonakala sinamafutha.

Ngamanye amaxesha, la mathumba anokubangela iimpawu ezifana nezinye izifo. Umzekelo:

• I-Jaundice: Ukutyheli kolusu ngenxa yokuvaleka kwemibhobho yenyongo.
• Isifo seswekile esisandul’ ukuqalisa: Amanqanaba aphezulu eswekile egazini ngenxa yomonakalo kwipancreas ngokwayo.
• I-Pancreatitis: Imeko ebangelwa kukuvaleka kwemibhobho ye-pancreatic.

Yintoni ebangela i-IPMN?

Abaphandi bakholelwa ukuba ii-IPMN zikhula xa kukho utshintsho (iinguqu) kwiijini ezilawula ukukhula kweeseli zethu okanye ezithintela ukwakheka kweethumba. Oku kuthetha ukuba ezinye zeenkqubo zokuzikhusela zomzimba wethu ziba buthathaka. Ukuba umntu kusapho lwakhe wayenomhlaza wepancreatic (PDAC) , amanye amalungu alo sapho asemngciphekweni omkhulu wokufumana ii-IPMN.

Oogqirha bayibona njani le nto?

Oogqirha basebenzisa kakhulu uvavanyo olwahlukeneyo lwe-`(imaging)` ukuze baxilonge i-`(IPMN)`. Kula vavanyo, uvavanyo olukhethekileyo olubizwa ngokuba yi-`Magnetic Resonance Cholangiopancreatography (MRCP)` lubaluleke kakhulu. Olu luvavanyo olusebenzisa umatshini we-`(MRI)`. Oku kungathatha imifanekiso ecacileyo yesibindi sakho, imibhobho yenyongo, inyongo yenyongo, ipancreas, kunye nemibhobho yenyongo yenyongo. Oogqirha basebenzisa olu vavanyo ukuze babone ukuba kukho naluphi na utshintsho kwimibhobho yenyongo yenyongo.

Ezi ``(IPMN)`` zahlulwe zibe ziintlobo ezintathu eziphambili:

• Uhlobo lwe-duct eyintloko (MD-IPMN): Ezi ziithumba ezivala i-duct eyintloko yepancreas yakho. Oku kunokubangela ukuba i-duct eyintloko ibe nkulu, okanye yande. Ububanzi be-duct eyintloko buhlala bumalunga ne-3.5 milimitha. Ukuba inkulu kune-5 milimitha, isenokuba luphawu lokuba inokuba ngumhlaza.
• Uhlobo lwe-branch duct (BD-IPMN): Ezi zii-tumor ezikhula kwi-ducts ezincinci ezifana ne-branch ezifana ne-branch ezisuka kwi-duct ephambili. Ezi tumor zihlala zingenabungozi .
• Uhlobo oluxutyiweyo (MT-IPMN): Ezi ziithumba ezikhula kwimibhobho ephambili kunye neyamasebe epancreas.

Ngaba kukho ezinye iimvavanyo zokuxilonga i-'IPMN'?

Ewe, kukho nezinye iimvavanyo. Oogqirha banokwenza uvavanyo olubizwa ngokuba yi-Endoscopic Ultrasound (EUS). Olu vavanyo lungathatha imifanekiso ecacileyo yepancreas kunye nethumba. Ngexesha lovavanyo, isampuli encinci yethumba, ebizwa ngokuba yiFine-Needle Aspiration (FNA), inokuthathwa (biopsy). Emva koko isampuli ihlolwa phantsi kwe-microscope ukuze kuchongwe uhlobo lweeseli (dysplasia) (nokuba iiseli zibonakala zingaqhelekanga na) kunye novavanyo lwemfuza ukuze kuchongwe umngcipheko wokuba ibe ngumhlaza.

Yintoni i-'Dysplasia'? Kutheni ibalulekile?

``I-Dysplasia'' ithetha nje ukuba iiseli zakho zibonakala zingaqhelekanga xa zijongwa nge-microscope.

• ``I-dysplasia yezinga eliphezulu'' ithetha ukuba iiseli zakho zifana kakhulu neeseli zomhlaza kuneeseli eziphilileyo. Oko kuthetha ukuba umngcipheko uphezulu.
• I-dysplasia ekumgangatho ophantsi ithetha ukuba ezinye iiseli zifana neeseli zomhlaza, kodwa kukholeleka ukuba umngcipheko wokuba ngumhlaza uphantsi.

Oogqirha basebenzisa ulwazi malunga nemeko (i-dysplasia) kunye nolwazi lwemfuza lwethumba ukuze bahlele ii-IPMN zibe ziintlobo ezine eziphambili. Le yingxaki enzulu kancinci, kodwa ndiza kuyigcina ilula:

1. Ii-IPMN zohlobo lwesisu: Ezi zihlala zikhula kwimibhobho yesebe yepancreas. Zihlala zine-dysplasia ekumgangatho ophantsi. Abantu abangaphezu kwama-90% abanolu hlobo lwethumba bayaphila emva kweminyaka eli-10 bexilongiwe.

2. Ii-IPMN zohlobo lwamathumbu: Ezi zinokufumaneka kwimibhobho ephambili kunye neyamasebe epancreas. Zisenokuba ne-dysplasia ephezulu kwaye ekugqibeleni zinokukhula zibe ngumhlaza wepancreas. Malunga nama-70% abantu abanolu hlobo lwe-tumor baphila iminyaka emi-5 emva kokufunyaniswa ukuba bane-tumor. Eli nani lehla liye kuma-50% ngeminyaka eli-10.

3. Ii-IPMN zohlobo lwe-Pancreatobiliary: Ezi zinokufumaneka nakwii-ducts eziphambili kunye ne-branch, kwaye zikwanayo ne-dysplasia ephezulu. Ukuya kuthi ga kwi-80% yabantu abanolu hlobo lwe-tumor banokufumana umhlaza we-pancreatic ohlaselayo.

4. Ii-IPMN zohlobo lwe-Oncocytic: Ezi luhlobo lwethumba olungaqhelekanga. Zikhula kwi-duct ephambili ye-pancreatic kwaye zine-dysplasia ephezulu. Malunga nesiqingatha sabantu abanolu hlobo lwethumba baya kuba nomhlaza we-pancreatic ohlaselayo.

Kubalulekile: Musa ukothuka zezi ndlela zokwahlulahlula kunye nezibalo. Olu lulwazi nje oluqhelekileyo. Ngugqirha wakho kuphela onokukuxelela ngqo ukuba imeko yakho injani.

Ziphathwa njani ii-IPMN?

Ukuba i-IPMN ithathwa njengengozi ephantsi , oogqirha badla ngokucebisa ukuba kuqhutyekwe nokuhlolwa ngokusondeleyo kwesi sifo.Oku kungenxa yokuba uninzi lweethumba ezingengobungozi (IPMN) azibi ngumhlaza. Nangona kunjalo, ukuba unethumba kumjelo oyintloko wepancreas yakho, oko kuthetha ukuba usemngciphekweni omkhulu, ugqirha wakho unokucebisa utyando lokususa ithumba. Nazi ezinye zemizekelo:

• Utyando lwe-distal pancreatectomy: Oku kuquka ukususa umsila kunye/okanye umzimba we-pancreas. Olu tyando lwenziwa ukuba kukho iithumba kwimibhobho ephambili kuloo ndawo.
• Ukususwa kwepancreatectomy iyonke: Oku kuquka ukususa ipancreas yonke, inyongo, i-common bile duct, iindawo zesisu kunye namathumbu amancinci, kwaye rhoqo i-spleen. Olu lutyando olukhulu.
• Inkqubo yeWhipple (pancreaticoduodenectomy): Olu tyando lunokucetyiswa kwiithumba ezikwimibhobho ephambili yentloko yepancreas (eyona ndawo ibanzi apho ipancreas idibana khona namathumbu amancinci). Lubandakanya ukususa intloko yepancreas, inxalenye yokuqala yamathumbu amancinci (i-duodenum), i-gallbladder, inxalenye ye-bile duct, kunye ne-lymph nodes ezikufutshane.

Ziziphi iingxaki ezinokubakho ngenxa yolu tyando?

Njengakwezinye iintlobo zotyando olukhulu, kukho iingxaki ezinokubakho. Ayizizo zonke iimeko ezifanayo. Kungoko ke, kungcono ukubuza ugqirha wakho ngeengxaki ezithile onokuhlangabezana nazo.

Kuthatha ixesha elingakanani ukuchacha emva kotyando olunje?

Oku kuyahluka kumntu nomntu. Nangona kunjalo, uninzi lwabantu kufuneka bahlale esibhedlele iintsuku ezimbalwa emva kotyando lwepancreas. Kungathatha iiveki okanye iinyanga ukuba baphile ngokupheleleyo.

Ngaba kufuneka ndifumane unyango lwe-chemotherapy okanye i-radiation emva kotyando?

Ezinye izifundo zibonise ukuba i-chemotherapy kunye/okanye unyango lwe-radiation lunokuba luncedo emva kotyando. Nangona kunjalo, kufuneka uqwalasele nemiphumo emibi yonyango. Ngamanye amaxesha iziphumo ebezingalindelekanga zinokuba ngaphezu kweenzuzo zonyango. Buza ugqirha wakho ngolwazi oluthe kratya malunga noku.

Ugqirha wam uthe masijonge i-'IPMN'. Kuthetha ukuthini oko?

Oku kuthetha ukuba uvavanyo lwakho lubonise ukuba i-IPMN yakho ayinabungozi kwaye akunakwenzeka ukuba ibe ngumhlaza. Oogqirha baza kuqhubeka bejonga la mathumba angenabungozi ngovavanyo lwemifanekiso (njenge-MRCP). Oku kuthetha ukuthi, "Masiyijonge le nto size sibone ukuba kukho into etshintshayo na."

Ndingenza ntoni ukunciphisa umngcipheko wokuba ne-IPMN?

Abaphandi bakholelwa ukuba la mathumba abangelwa lutshintsho kwizakhi zofuzo. Ngoko ke, akukho nto unokuyenza ngokukodwa ukuthintela ukuphuhliswa kwe-IPMN. Nangona kunjalo, oku kulandelayo kunokunceda ukunciphisa umngcipheko wakho wonke womhlaza wepancreatic kwaye kukuncede uvavanye umngcipheko wakho we-IPMN:

• Funda ngembali yezonyango yosapho lwakho.Ukuba kukho umntu kusapho lwakho okhe waba nomhlaza wepancreatic (PDAC), usemngciphekweni omkhulu wokufumana i-IPMN.
• Umhlaza wepancreatic unxulunyaniswa nokutshaya. Ukuba usebenzisa icuba (iicuba, ii-beedis, ii-cigar), zama ukuyeka.
• Nciphisa utywala obuselayo, okanye uyeke ngokupheleleyo.
• Zama ukugcina ubunzima obusempilweni.
• Zama ukuthintela isifo seswekile sohlobo lwesibini ngokutya ukutya okunempilo kunye nokuzilolonga. Ukuba unesifo seswekile, sebenzisana nogqirha wakho ukulawula amanqanaba eswekile egazini lakho.

Ungaphila ixesha elingakanani ne-IPMN?

Njengakuyo nayiphi na imhlaza, ukuxilongwa kwangoko kunye nonyango zezona zinto zibalulekileyo ekuqinisekiseni ukuba uphila. Ngokubanzi, malunga nama-95% abantu abafunyaniswe kwaye banyangwe ngaphambi kokuba i-IPMN ibe ngumhlaza wepancreatic basaphila emva kweminyaka emihlanu emva kokuxilongwa. Ukuba unemibuzo malunga nemeko yakho, ugqirha wakho ngoyena mthombo wolwazi ulungileyo.

Ndine-IPMN engeyongozi. Ndingazinyamekela njani?

Uninzi lwexesha, la mathumba awabi ngumhlaza. Nangona kunjalo, kuyinto eqhelekileyo ukuziva uxinezelekile kwaye uxhalabile ngenxa yengcinga ethi, "Mhlawumbi kusenokwenzeka." Ukuba uvakalelwa ngolu hlobo, thetha nogqirha wakho ngayo. Uza kukuchazela ukuba kutheni usemngciphekweni omncinci wokuba nomhlaza wepancreatic. Uza kukucebisa ngezinto onokuzenza ukunciphisa umngcipheko wakho wokuba nomhlaza wepancreatic.

I-Intraductal Papillary Mucinous Neoplasm (IPMN) ligama elide, ngamanye amaxesha elididayo lethumba elenzeka kwimibhobho yepancreatic kwaye linokuba ngumhlaza wepancreatic. Eli thumba lidla ngokungabangeli zimpawu kwaye lidla ngokufunyanwa ngengozi ngexesha lovavanyo olwenziwe ngezinye izizathu.

Xa ugqirha wakho ekuxelela ukuba une-IPMN, usenokumangaliswa. Kodwa khumbula, ukuba nale meko akuthethi ukuba ngokuqinisekileyo uza kuba nomhlaza. Kwiimeko ezininzi, uvavanyo olongezelelweyo luya kubonisa ukuba iqhuma alinamhlaza (elingenabungozi). Ukuba iqhuma lakho alinamhlaza, ugqirha wakho uya kuqhubeka elijonga ukuze abone ukuba linobungozi obukhulu okanye ukuba linomhlaza. Kwaye, okubalulekileyo, nokuba iqhuma lakho lifunyenwe linobungozi obukhulu, malunga nama-95% abantu abaye baxilongwa kwaye banyangwa yi-IPMN ngaphambi kokuba libe ngumhlaza basaphila emva kweminyaka emihlanu emva kokuba bexilongiwe.

Nokuba imeko yakho injani na, kukho izinto onokuzenza ukunciphisa umngcipheko wokuba nomhlaza wepancreatic. Thetha nogqirha wakho ngale nto. Uya kukuvuyela ukukunceda.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke ndiyathemba ukuba ngoku uyiqonda ngcono into ebesithetha ngayo, ``(IPMN)``. Nangona esi sisihloko sinzima kancinci, masizame ukusiqonda ngokulula.

• I-IPMN sisimila esikhula kwimibhobho yepancreas kwaye sinokuba ngumhlaza. Asizizo zonke eziba ngumhlaza.
• Uninzi lwexesha, ayibonisi zimpawu kwaye ifunyanwa ngengozi ngexesha lovavanyo olunye.
• Esi sifo sichongwa ngovavanyo olufana nolu `(MRCP)` kunye no `(EUS)`.
• Unyango lunokubandakanya ukujongwa okanye utyando , kuxhomekeke kuhlobo kunye nomngcipheko wesi sifo.
• Ukufunyanwa kwangoko kunye nonyango zezona zinto zibalulekileyo.
• Musa ukoyika ukuba uxelelwa ukuba une-IPMN. Thetha nogqirha wakho uze wenze isigqibo ngesicwangciso sonyango esifanelekileyo kwimeko yakho.
• Kwakhona cinga ngotshintsho kwindlela yokuphila (ukuyeka ukutshaya, ukugcina ubunzima obusempilweni, njl.njl.) olunokunciphisa umngcipheko womhlaza wepancreatic.

Ukuba uneminye imibuzo malunga noku, ungathandabuzi ukubuza ugqirha wakho. Hlala usempilweni!

I- Pancreas, i-IPMN, umhlaza, umhlaza we-pancreatic, i-tumor, iimpawu, unyango