Izimila ezingavamile kuma-pancreas? Ake sifunde nge-(Intraductal Papillary Mucinous Neoplasm - IPMN) ngendlela elula!

Iyini lesi sifo esinegama elide? Ungase uzibuze ukuthi iyini i-'Intraductal Papillary Mucinous Neoplasm' noma i-'(IPMN)'. Igama lingase lizwakale liyesabeka kancane futhi kunzima ukuliqonda, kodwa masiligcine lilula. Wena noma othile omaziyo kungenzeka ukuthi uke wezwa ngalesi simo. Ngakho-ke, masingathuki sithole ukuthi siyini ngempela.

Iyini ngempela i-'IPMN'?

Kalula nje, i-IPMN iyisigaxa esigcwele uketshezi, noma i-cyst, esakheka ngaphakathi kwemisele ye-pancreas yakho. Empeleni lokhu akusiwo umdlavuza, kodwa odokotela bakubona “njengomdlavuza ongaphambi komdlavuza.” Lokhu kusho ukuthi akusona umdlavuza manje, kodwa kungaba umdlavuza esikhathini esizayo.

Cabanga ngakho, ngezinye izikhathi kufana nesitshalo esincane. Kungaba umuthi omkhulu noma cha. Yilokho lesi simila '(IPMN)' esiyikho. Abacwaningi bakholelwa ukuthi phakathi kuka-20% no-30% wabantu abathola umdlavuza we-pancreatic, noma abantu ababili noma abathathu kwabayishumi, umdlavuza waqala njenge-'(IPMN)'. Abanye abantu bangaba nalesi simila iminyaka eminingi ngaphandle kokubonisa izimpawu. '(IPMN)' iphathwa ngokuhlinzwa, noma ngokuqapha isikhathi eside.

Ingabe i-'IPMN' ihlala ingumdlavuza?

Cha, akuwona wonke ama-IPMN aba umdlavuza . Yilokho okufanele ukuqonde kuqala. Kodwa-ke, amanye angagcina eseba yi-pancreatic ductal adenocarcinoma (PDAC). I-PDAC uhlobo oluvame kakhulu lomdlavuza we-pancreatic. Umdlavuza we-pancreatic uhlobo lomdlavuza olungavamile kakhulu. Ubalelwa cishe ku-3% wabo bonke umdlavuza e-United States. Kodwa-ke, umdlavuza we-pancreatic ubalelwa ku-7% wabo bonke abantu ababulawa umdlavuza. Ngeshwa, awutholakali kusenesikhathi, lapho ukwelashwa kungaba yimpumelelo enkulu.

Ubani othinteka kakhulu yilesi simo?

Kunzima kodokotela ukusho ngqo ukuthi bangaki abantu abanalezi zimila, ngoba zivame ukubangela izimpawu futhi azibonakali. Kodwa-ke, ucwaningo luye lwabonisa ukuthi zivame kakhulu kwabesilisa abaneminyaka ephakathi kuka-50 no-70 .

Kwenzekani emzimbeni ngale `(IPMN)`?

Ama-IPMN aqukethe uketshezi olujiyile, olufana nejeli ngaphakathi. Odokotela bakubiza ngokuthi i-mucin. Lapho la mathumba avamile, angewona umdlavuza eqala ukuphenduka umdlavuza, aqala ukukhiqiza uketshezi oluningi olubizwa ngokuthi i-mucin. Cabanga ngakho njengebhaluni elincane eligcwala ngamanzi. Lapho le mucin iqoqana, ingavimba imigudu ye-pancreatic kuma-pancreas akho. La mapayipi ayimibhobho emincane esiza ekugayeni ukudla. Uma evalekile, kungabangela ukuvuvukala kwama-pancreas (pancreatitis) .Lokhu kungaba yisimo esibuhlungu kakhulu. Ngezinye izikhathi lokhu kuvuvukala kwe-pancreas kuwuphawu lokuqala lwe-IPMN.

Ziyini izimpawu ze-IPMN?

Abantu abaningi abanalesi simo abazizwa begula noma bengenazo izimpawu ezithile. Yileyo inkinga ngalokhu. Esikhathini esiningi, lolu hlobo lwesimila lutholakala ngengozi lapho behlolwa esinye isimo. Kodwa-ke, abanye abantu bangase babe nezimpawu ezifana nalezi:

• Ubuhlungu besisu obuhlala isikhathi eside: Abanye abantu bangase babe nobuhlungu besisu ngemva kokudla. Lokhu kungabangela nokulahlekelwa yisifiso sokudla.
• Ukwehlisa isisindo okungahlosiwe: Uma wehlisa isisindo ngaphandle kokuzama, lokho nakho kuyimpawu.
• Isicanucanu nokuhlanza.
• Ukuhlungu obusemhlane.
• Indle/indle enamafutha: Uma indle ibonakala inamafutha.

Ngezinye izikhathi, la mathumba angabangela izimpawu ezifana nezinye izifo. Isibonelo:

• I-jaundice: Ukuphuzi kwesikhumba ngenxa yokuvaleka kwemisele yenyongo.
• Isifo sikashukela esisanda kuqala: Amazinga aphezulu kashukela egazini ngenxa yomonakalo we-pancreas uqobo.
• I-Pancreatitis: Isimo esibangelwa ukuvaleka kwemigudu ye-pancreatic.

Yini ebangela i-IPMN?

Abacwaningi bakholelwa ukuthi ama-IPMN akhula uma kukhona izinguquko (ukuguqulwa kwezakhi zofuzo) ezilawula ukukhula kwamaseli ethu noma ezivimbela ukwakheka kwamathumba. Lokhu kusho ukuthi ezinye zezinhlelo zokuzivikela zomzimba wethu ziba buthakathaka. Uma othile emndenini eke waba nomdlavuza we-pancreatic (PDAC) , amanye amalungu alowo mndeni asengozini enkulu yokuthola ama-IPMN.

Odokotela bakuthola kanjani lokhu?

Odokotela basebenzisa kakhulu izivivinyo ezahlukene ze-`(imaging)` ukuze bathole i-`(IPMN)`. Kulezi, ukuhlolwa okukhethekile okubizwa ngokuthi i-`Magnetic Resonance Cholangiopancreatography (MRCP)` kubaluleke kakhulu. Lokhu ukuhlolwa kusetshenziswa umshini we-`(MRI). Lokhu kungathatha izithombe ezicacile zesibindi sakho, imigudu ye-bile, i-gallbladder, i-pancreas, kanye nemigudu ye-pancreatic. Odokotela basebenzisa lokhu kuhlolwa ukuze babone ukuthi kukhona yini izinguquko emigudwini ye-pancreatic.

Lezi zimila "(IPMN)" zihlukaniswe ngezinhlobo ezintathu eziyinhloko:

• Uhlobo lwe-Main duct (MD-IPMN): Lezi yizimila ezivimba i-main duct ye-pancreas yakho. Lokhu kungabangela ukuthi i-main duct ibe nkulu, noma ivuleke. Ububanzi be-main duct buvame ukuba ngamamilimitha angu-3.5. Uma inkulu kunamamilimitha angu-5, kungaba uphawu lokuthi kungenzeka ukuthi ibe nomdlavuza.
• Uhlobo lwe-branch duct (BD-IPMN): Lawa ama-tumors akha emigudwini emincane efana negatsha ehluma esuka emgudwini oyinhloko. Lawa ma-tumors ngokuvamile awabi nabungozi .
• Uhlobo oluxubile (MT-IPMN): Lawa amathumba akhula kokubili emigudwini eyinhloko kanye neyamagatsha e-pancreas.

Ingabe kukhona ezinye izivivinyo zokuxilonga i-'IPMN'?

Yebo, kunezinye izivivinyo. Odokotela bangenza nokuhlolwa okubizwa ngokuthi i-Endoscopic Ultrasound (EUS). Lokhu kungathatha izithombe ezicacile ze-pancreas kanye nesimila. Phakathi nalolu vivinyo, isampula encane yesimila, ebizwa ngokuthi i-Fine-Needle Aspiration (FNA), ingathathwa (i-biopsy). Isampula bese ihlolwa ngaphansi kwe-microscope ukuthola uhlobo lwamaseli (i-dysplasia) (ukuthi amaseli abukeka engajwayelekile yini) kanye nokuhlolwa kofuzo ukuthola ingozi yokuba nomdlavuza.

Kuyini i-'Dysplasia'? Kungani ibalulekile?

"I-Dysplasia" isho ukuthi amangqamuzana akho abukeka engajwayelekile uma ebhekwa ngesibonakhulu.

• "I-dysplasia yezinga eliphezulu" isho ukuthi amangqamuzana akho afana kakhulu namangqamuzana omdlavuza kunamangqamuzana anempilo. Lokho kusho ukuthi ingozi iphakeme.
• I-dysplasia yezinga eliphansi isho ukuthi amanye amangqamuzana abukeka njengamaseli omdlavuza, kodwa kukholakala ukuthi asengozini encane yokuba umdlavuza.

Odokotela basebenzisa ulwazi mayelana nesimo (i-dysplasia) kanye nolwazi lwezakhi zofuzo lwesimila ukuze bahlukanise ama-IPMN abe izinhlobo ezine eziyinhloko. Lokhu kuyindaba ejulile kancane, kodwa ngizokugcina kulula:

1. Ama-IPMN ohlobo lwesisu: Lawa avame ukuvela emigudwini yamagatsha e-pancreas. Ngokuvamile ane-dysplasia yezinga eliphansi. Abantu abangaphezu kuka-90% abanalolu hlobo lwesimila baphila iminyaka eyi-10 ngemva kokuxilongwa.

2. Ama-IPMN ohlobo lwamathumbu: Lawa angatholakala kokubili emigudwini eyinhloko kanye neyamagatsha e-pancreas. Angase abe ne-dysplasia yezinga eliphezulu futhi ekugcineni angaphenduka umdlavuza we-pancreas. Cishe ama-70% abantu abanalolu hlobo lwesimila bayaphila eminyakeni emi-5 ngemva kokuxilongwa. Leli phesenti lehla laya ku-50% ngeminyaka eyi-10.

3. Ama-IPMN ohlobo lwe-Pancreatobiliary: Lawa angatholakala futhi emigudwini emikhulu kanye neyamagatsha, futhi ane-dysplasia yezinga eliphezulu. Abantu abangafika ku-80% abanalolu hlobo lwesimila bangaba nomdlavuza we-pancreatic ohlaselayo.

4. Ama-IPMN ohlobo lwe-Oncocytic: Lawa uhlobo lwesimila olungavamile. Akhula emgudwini oyinhloko we-pancreatic futhi ane-dysplasia yezinga eliphezulu. Cishe ingxenye yabantu abanalolu hlobo lwesimila bazoba nomdlavuza we-pancreatic ohlaselayo.

Okubalulekile: Ungakhathazeki ngalezi zigaba kanye nezibalo. Lokhu kumane nje kuwulwazi olujwayelekile. Udokotela wakho kuphela ongakutshela kahle ukuthi isimo sakho siyini.

Iphathwa kanjani i-IPMN?

Uma i-IPMN ibhekwa njengengozi ephansi , odokotela bavame ukuncoma ukuqhubeka nokuqapha isimila.Lokhu kungenxa yokuthi iningi lezimila ezingenabungozi (i-IPMN) azibi umdlavuza. Kodwa-ke, uma unesimila emgudwini oyinhloko we-pancreas yakho, okusho ukuthi usengozini enkulu kancane, udokotela wakho angase akuncome ukuhlinzwa ukuze kususwe isimila. Nazi ezinye izibonelo:

• Ukususwa kwe-distal pancreatectomy: Lokhu kuhilela ukususa umsila kanye/noma umzimba we-pancreas. Lokhu kuhlinzwa kwenziwa uma kukhona izimila emigudwini eyinhloko kuleyo ndawo.
• Ukususwa kwe-pancreatectomy ephelele: Lokhu kuhilela ukususa wonke ama-pancreas, i-gallbladder, i-common bile duct, izingxenye zesisu kanye namathumbu amancane, futhi ngokuvamile i-spleen. Lokhu kuwukuhlinzwa okukhulu.
• Inqubo ye-Whipple (pancreaticoduodenectomy): Lokhu kuhlinzwa kunganconywa ngezimila ezisezindleleni eziyinhloko zekhanda le-pancreas (ingxenye ebanzi kakhulu lapho i-pancreas ixhumana khona namathumbu amancane). Kuhilela ukususa ikhanda le-pancreas, ingxenye yokuqala yamathumbu amancane (i-duodenum), i-gallbladder, ingxenye ye-bile duct, kanye nama-lymph node aseduze.

Yiziphi izinkinga ezingaba khona ngenxa yalokhu kuhlinzwa?

Njenganoma yikuphi ukuhlinzwa okukhulu, kunezinkinga ezingaba khona. Akuzona zonke izimo ezifanayo. Ngakho-ke, kungcono ukubuza udokotela wakho ngezinkinga ezithile ongase ubhekane nazo.

Kuthatha isikhathi esingakanani ukululama ngemva kokuhlinzwa okunje?

Lokhu kuyahlukahluka kuye ngomuntu nomuntu. Kodwa-ke, abantu abaningi kudingeka bahlale esibhedlela izinsuku ezimbalwa ngemva kokuhlinzwa kwe-pancreatic. Kungathatha amasonto noma izinyanga ukululama ngokuphelele.

Ingabe kufanele ngithole ukwelashwa ngamakhemikhali noma ngemisebe ngemva kokuhlinzwa?

Ezinye izifundo zibonise ukuthi ukwelashwa ngamakhemikhali kanye/noma ngemisebe kungaba usizo ngemva kokuhlinzwa. Kodwa-ke, kufanele futhi ucabangele imiphumela emibi yokwelashwa. Ngezinye izikhathi imiphumela emibi ingase ibe ngaphezu kwezinzuzo zokwelashwa. Cela udokotela wakho ulwazi olwengeziwe ngalokhu.

Udokotela wami uthe kufanele kuqashwe i-'IPMN'. Kusho ukuthini lokho?

Lokhu kusho ukuthi ukuhlolwa kwakho kukhombisile ukuthi i-IPMN yakho ayinabungozi futhi cishe ngeke ibe nomdlavuza. Odokotela bazoqhubeka nokuqapha lezi zimila ezingenabungozi ngokuhlolwa kwezithombe (njenge-MRCP). Lokhu kusho ukuthi, "Masiqaphele lokhu futhi sibone ukuthi kukhona yini okushintshayo."

Yini engingayenza ukuze nginciphise ingozi yami yokuthola i-IPMN?

Abacwaningi bakholelwa ukuthi lezi zimila zibangelwa izinguquko ezakhiweni zofuzo. Ngakho-ke, akukho ongakwenza ngqo ukuvimbela i-IPMN ukuthi ingakhuli. Kodwa-ke, okulandelayo kungasiza ekunciphiseni ingozi yakho iyonke yomdlavuza we-pancreatic futhi kukusize uhlole ingozi yakho ye-IPMN:

• Funda ngomlando wezokwelapha womndeni wakho.Uma othile emndenini wakho eke waba nomdlavuza we-pancreatic (PDAC), usengozini enkulu yokuthola i-IPMN.
• Umdlavuza we-pancreatic uhlotshaniswa nokubhema. Uma usebenzisa ugwayi (ugwayi, ama-beedis, ama-cigarette), zama ukuyeka.
• Nciphisa ukuphuza utshwala, noma uyeke ngokuphelele.
• Zama ukugcina isisindo esinempilo.
• Zama ukuvimbela isifo sikashukela sohlobo lwesibili ngokudla okunempilo kanye nokuzivocavoca. Uma unesifo sikashukela, sebenzisana nodokotela wakho ukulawula amazinga kashukela egazini lakho.

Ungaphila isikhathi esingakanani ne-IPMN?

Njenganoma yimuphi umdlavuza, ukuxilongwa kusenesikhathi kanye nokwelashwa yizinto ezibaluleke kakhulu ekunqumeni ukusinda. Sekukonke, cishe abantu abangu-95% abaxilongwa futhi belashwe ngaphambi kokuba i-IPMN ibe umdlavuza we-pancreatic basaphila eminyakeni emihlanu ngemva kokuxilongwa. Uma unemibuzo ngesimo sakho, udokotela wakho ungumthombo wolwazi ongcono kakhulu.

Ngine-IPMN enempilo. Ngingazinakekela kanjani?

Esikhathini esiningi, la mathumba awabi umdlavuza. Kodwa-ke, kuvamile ukuzizwa ucindezelekile futhi ukhathazekile ngenxa yomcabango othi, "Mhlawumbe kungenzeka." Uma uzizwa ngale ndlela, khuluma nodokotela wakho ngakho. Uzochaza ukuthi kungani usengozini encane yokuba nomdlavuza we-pancreatic. Uzokweluleka nangezinto ongazenza ukuze unciphise ingozi yakho yokuba nomdlavuza we-pancreatic.

I-Intraductal Papillary Mucinous Neoplasm (IPMN) igama elide, ngezinye izikhathi elididayo lesimila esakheka emigudwini ye-pancreatic futhi esingaba umdlavuza we-pancreatic. Lesi simila ngokuvamile asibangeli zimpawu futhi sivame ukutholakala ngengozi ngesikhathi sokuhlolwa okwenziwe ngezinye izizathu.

Uma udokotela wakho ekutshela ukuthi une-IPMN, ungase ushaqeke. Kodwa khumbula, ukuba nalesi simo akusho ukuthi nakanjani uzoba nomdlavuza. Ezimweni eziningi, ukuhlolwa okwengeziwe kuzobonisa ukuthi iqhubu alinawo umdlavuza (elibi). Uma iqhubu lakho lingenawo umdlavuza, udokotela wakho uzoqhubeka nokuliqapha ukuze abone ukuthi liyingozi yini noma liyingozi yini. Futhi, okubalulekile, noma ngabe iqhubu lakho litholakale liyingozi kakhulu, cishe abantu abangu-95% abatholwe futhi belashwa yi-IPMN ngaphambi kokuba libe nomdlavuza basaphila eminyakeni emihlanu ngemva kokutholakala benalo.

Kungakhathaliseki ukuthi isimo sakho sinjani, kunezinto ongazenza ukuze unciphise ingozi yokuba nomdlavuza we-pancreatic. Khuluma nodokotela wakho ngalokhu. Uzokujabulela ukukusiza.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke ngithemba ukuthi usuyaqonda kangcono lokho ebesikhuluma ngakho, ``(IPMN)``. Nakuba lesi kuyisihloko esiyinkimbinkimbi kancane, ake sizame ukusiqonda kalula.

• I-IPMN iyisimila esikhula emigudwini yepancreas futhi sinamandla okuba umdlavuza. Akuwona wonke aphenduka umdlavuza.
• Esikhathini esiningi, ayibonisi zimpawu futhi itholakala ngengozi ngesikhathi sokuhlolwa okunye.
• Lesi sifo sitholakala ngokuhlolwa okufana ne-`(MRCP)` kanye ne-`(EUS)`.
• Ukwelashwa kungafaka phakathi ukubhekwa noma ukuhlinzwa , kuye ngohlobo kanye nobunzima besimila.
• Ukutholwa kusenesikhathi kanye nokwelashwa kubaluleke kakhulu.
• Ungesabi uma utshelwa ukuthi une-IPMN. Khuluma nodokotela wakho bese unquma uhlelo lokwelashwa olungcono kakhulu ngesimo sakho.
• Futhi cabanga ngezinguquko zendlela yokuphila (ukuyeka ukubhema, ukugcina isisindo esinempilo, njll.) ezinganciphisa ingozi yomdlavuza we-pancreatic.

Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukubuza udokotela wakho. Hlala uphilile!

I- Pancreas, i-IPMN, Umdlavuza, Umdlavuza we-Pancreatic, Isimila, Izimpawu, Ukwelashwa