Uyalwazi yini umdlavuza ongavamile obizwa ngokuthi i-Sarcomatoid Carcinoma? Ake sixoxe ngokuningiliziwe!

Umdlavuza usesabisa kancane sonke, akunjalo? Kodwa akuwona wonke umdlavuza ofanayo. Namuhla sizokhuluma ngohlobo lomdlavuza olungavamile noluyinkimbinkimbi. Lubizwa ngokuthi i-Sarcomatoid Carcinoma. Igama lingase lizwakale lingavamile kuwe, kodwa ake sizame ukulichaza kalula. Odokotela babiza lokhu ngokuthi uhlobo lomdlavuza olukhula ngokushesha kakhulu nolunolaka .

Kuyini i-Sarcomatoid Carcinoma?

Kalula nje, i-Sarcomatoid Carcinoma iyinhlanganisela yezinhlobo ezimbili zomdlavuza. Okusho ukuthi, inezici ze-carcinoma kanye ne-sarcoma. Manje ake sibone ukuthi i-carcinoma kanye ne-sarcoma ziyini.

• I-Carcinoma: Lolu uhlobo lomdlavuza oluvame kakhulu. Luqala ezicutshini ezimboze ubuso bezitho zethu noma isikhumba. Lezi zicubu sizibiza ngokuthi izicubu ze-epithelial ngoba zakhiwe ngamaseli e-epithelial.
• I-Sarcoma: Lokhu akuvamile kakhulu kune-carcinoma. Ama-Sarcoma aqala ezindaweni ezifana namathambo, izicubu ezixhumene (isib. i-cartilage, imisipha), kanye nezicubu ezithambile (isib. imisipha, amafutha, imizwa). Akhiwe uhlobo lweseli olubizwa ngokuthi amaseli e-mesenchymal.

Ngakho-ke, uma kwenzeka i-sarcomatoid carcinoma, kwakheka isimila esiqukethe amaseli nezicubu ezihlobene ne-carcinoma kanye ne-sarcoma. Lawa mathumba akhula ngokushesha kakhulu futhi angasakazeka (asakazeke) ezingxenyeni ezahlukene zomzimba. Uma lokhu kusakazeka, izicubu ezinempilo emzimbeni ziyalimala.

Kukuphi lapho lokhu kwenzeka khona kakhulu emzimbeni?

Uma uzwa igama elithi sarcomatoid carcinoma, cishe uyihlobanisa namaphaphu akho . Kodwa-ke, lolu hlobo lomdlavuza, olunezici ze-carcinoma kanye ne-sarcoma, lungavela nakwezinye izingxenye zomzimba. Isibonelo:

• Isikhumba
• Ithambo
• Umlomo
• Indlala yegilo
• Amabele
• Isisu
• Amathumbu amancane
• Isibindi
• I-Pancreas
• Isibeletho
• I-prostate
• Isinye
• Izinso
• Isikhala esiphakathi kwesifuba (lokhu kubizwa ngokuthi "i-Mediastinum". Izinto ezifana nenhliziyo, i-trachea, kanye ne-thymus gland zilapha)

Kuthiwa i-Sarcomatoid carcinoma, eqala emaphashini, isakazeka ngokushesha okukhulu. Ngale ndlela, ingasakazeka ezindaweni eziningana ngesikhathi esisodwa, njengezindlala ze-adrenal, ubuchopho, amathambo, isibindi, izinso, i-peritoneum, i-pancreas, isikhumba kanye nenhliziyo.

Ingabe kukhona izinhlobo ezahlukene zalokhu futhi?

Yebo, i-World Health Organization (WHO) yahlukanisa i-sarcomatoid carcinoma ngezinhlobo ezinhlanu eziyinhloko ngo-2015. Uhlobo ngalunye lwalezi zinhlobo lubizwa ngokuthi "i-non-small cell lung carcinoma ehlukanisiwe kahle." "I-not-small cell lung carcinoma ehlukanisiwe kahle" kusho ukuthi amangqamuzana ahlukanisiwe ngendlela engavamile kangangokuthi kunzima ukusho ukuthi aluhlobo luni ngempela. Umdlavuza wamaphaphu ongewona amangqamuzana amancane uhlobo oluvamile lomdlavuza wamaphaphu okhula futhi usakazeke ngokushesha.

Lezi zinhlobo ezinhlanu yilezi:

• I-Pleomorphic carcinomas: Lezi zinezici ze-carcinomas kakhulu. Kodwa-ke, okungenani u-10% wazo uvame ukuba nezici ze-sarcoma. Lolu uhlobo oluvame kakhulu lwe-sarcomatoid carcinoma.
• I-Spindle-cell carcinoma: Lolu hlobo lomdlavuza luthola igama lalo ngenxa yokuthi amangqamuzana awo abukeka kanjani ngaphansi kwe-microscope. Amade, mancane, futhi afana nezipini zesondo elijikelezayo.
• I-Giant cell carcinoma: Lokhu kunamaseli amakhulu ahlelwe ngendlela efana nama-sarcomas. Lawa avame ukwakheka engxenyeni engenhla yamaphaphu.
• I-Carcinosarcoma: Lokhu kufaka phakathi izicubu ezivela kwezinye izinhlobo ze-carcinoma, njenge-adenocarcinoma kanye ne-squamous cell carcinoma. Kufaka phakathi nezicubu ze-sarcoma ezingavamile, ezingakhuli kahle.
• I-pulmonary blastoma: Lolu uhlobo lwe-adenocarcinoma olufana nezicubu zamaphaphu zomntwana osanda kuzalwa. Amaseli e-mesenchymal (njenge-sarcomas) nawo angabonakala.

Ubani onamathuba amaningi okuthuthukisa lokhu?

I-Sarcomatoid Carcinoma ivame kakhulu kwabesilisa . Ivame kakhulu kubantu abasebenzisa imikhiqizo kagwayi noma abake bayisebenzisa esikhathini esidlule . Isilinganiso seminyaka yokuxilongwa sicishe sibe yiminyaka engama-65.

Kuvamile kangakanani lokhu?

Lolu uhlobo lomdlavuza olungavamile kakhulu . I-Sarcomatoid Carcinoma ibangela iphesenti elincane kakhulu lawo wonke umdlavuza wamaphaphu, phakathi kuka-0.1% no-0.4%.

Ziyini izimpawu zalokhu?

Izimpawu ozibonayo zincike ekutheni umdlavuza usakazeke kuphi emzimbeni wakho. Uma une-sarcomatoid carcinoma yamaphaphu, ungase ube nezimpawu ezifana nalezi:

• Ukukhwehlela (okuqhubekayo)
• Ubunzima bokuphefumula (ukuphelelwa umoya)
• Ubuhlungu besifuba
• Ukopha nge-mucus
• Ukwehlisa isisindo ngaphandle kwesizathu

Kungani kwenzeka into efana nale?

Odokotela bakholelwa ukuthi imbangela enkulu ye-sarcomatoid carcinoma inqubo ebizwa ngokuthi "i-Epithelial-Mesenchymal Transition (EMT)." Kalula nje, lokhu kwenzeka lapho amangqamuzana e-epithelial anomdlavuza ku-non-small cell lung carcinoma eshintsha, futhi amanye awo aguquka abe amangqamuzana e-mesenchymal. Amangqamuzana anomdlavuza ashintshe ngale ndlela asakazeka ngokushesha kakhulu emzimbeni wonke.

Lezi zinguquko zamaseli kanye nokukhula okusheshayo kuvame ukuhlotshaniswa nokuguqulwa kwezakhi zofuzo emaseli . Uyazi, izakhi zofuzo zethu ziyimiyalelo etshela amaseli ukuthi aziphathe kanjani. Ukuguqulwa kwezakhi zofuzo kuwushintsho noma iphutha kulezo miyalelo. Ososayensi bathole izinguquko eziningana zezakhi zofuzo ezihlobene ne-sarcomatoid carcinoma.

Yiziphi izinto eziyingozi ezithinta lokhu?

Isici esiyingozi yinto ekhulisa amathuba okuthola isifo. Endabeni ye-sarcomatoid carcinoma, ukubhema kuyisici esiyingozi esiyinhloko nesaziwa kakhulu. Kuyaphawuleka ukuthi phakathi kuka-80% no-90% wabantu abathola lo mdlavuza wamaphaphu bangabantu ababhemayo noma abake bababhema.

Ungakhohlwa ukuthi ukuyeka ukubhema kungakuvikela ezifweni eziningi zamaphaphu, okuhlanganisa nomdlavuza onjengalona.

Udokotela ukubona kanjani lokhu?

Udokotela wakho uzokuhlola kuqala futhi, uma kudingeka, enze izinqubo ezithile zokuthwebula izithombe. Kodwa-ke, ukuze kuqinisekiswe ukuthi lokhu kuyi-sarcomatoid carcinoma, kudingeka i-biopsy ukuze kuhlolwe amangqamuzana omdlavuza.

• Ukuthwebula izithombe: Udokotela angenza i-CT scan ukuze abone ukuthi umdlavuza ukuphi. Ukuze uthole umbono ocacile wangaphakathi lomzimba, kungenziwa i-CT/PET scan noma i-F-fluorodeoxyglucose (FDG)-PET scan. I-CT/PET scan ihlanganisa izivivinyo ezimbili (i-CT ne-PET) ngesikhathi esisodwa. I-Fluorodeoxyglucose iyikhemikhali efakwa emzimbeni ngesikhathi se-PET scan. Iqoqana eduze kwamangqamuzana omdlavuza, okwenza abonakale kakhulu lapho kuthwetshulwa.

• I-Histopathology: I-Histopathology ukuhlolwa nge-microscope kwesampula yezicubu zomdlavuza ezithathwe ku-biopsy. Ukubonakala kwamaseli kungasiza udokotela ukuthi anqume ukuthi ngabe yi-sarcomatoid carcinoma futhi, uma kunjalo, uhlobo luni lwayo (isb., i-pleomorphic carcinoma, i-spindle cell carcinoma).

• I-Immunohistochemistry:Lolu vivinyo lubheka izinto ezibizwa ngokuthi ama-antigen ahlotshaniswa nezinhlobo ezithile zamaseli. Amanye ama-antigen angabona iseli njengelingajwayelekile noma eliyingozi.

Iphathwa kanjani?

Ukwelashwa okuphumelela kakhulu kwalo mdlavuza ukuhlinzwa ukuze kususwe lonke isimila. Ukwelashwa ngamakhemikhali kungasiza ekubulaleni noma yimaphi amangqamuzana omdlavuza asele ngemva kokuhlinzwa. Kodwa-ke, isikhathi esiningi, umdlavuza ususakazeke ngesikhathi utholakala, ngakho-ke ukuhlinzwa kungase kungenzeki. Uma kunezinkinga ezifana nobuhlungu, ukopha, noma ubunzima bokuphefumula, ukwelashwa ngemisebe nakho kunganikezwa.

Endabeni ye-sarcomatoid carcinoma, ukuhlolwa kwezokwelapha kungaba yindlela engcono kakhulu yokwelapha. Ukuhlolwa kwezokwelapha kuyisifundo esihlola ukuphepha nokusebenza kahle kwezindlela ezintsha zokwelapha. Ososayensi okwamanje bacwaninga izindlela zokwelapha ezingasiza ekwandiseni isikhathi ongaphila ngaso nalo mdlavuza. Ezimbili zazo yilezi:

• Ukwelashwa okuqondiwe: Lokhu kuhilela ukugxila ezicini ezithile ezibangela ukuba amangqamuzana omdlavuza ande ngokungalawuleki.
• Ukwelashwa nge-immunotherapy: Lokhu kuvuselela amasosha omzimba wakho, kusize ekutholeni nasekubhubhiseni amangqamuzana omdlavuza.

Yini esingayenza ukuze sinciphise ingozi?

Ngokukhetha ukungayisebenzisi imikhiqizo kagwayi, unganciphisa ingozi yakho yokuthola i-sarcomatoid carcinoma, kanye neminye imidlavuza eminingi yamaphaphu. Lesi yisinyathelo esibaluleke kakhulu ongasithatha.

Ingabe lokhu kungelapheka ngokuphelele?

Eqinisweni, i-sarcomatoid carcinoma uhlobo lomdlavuza oluvame ukuba nzima ukwelapha ngokuphelele. Kodwa-ke, njengoba ososayensi befunda kabanzi ngezici zamaseli alezi zimila, njengokuguqulwa kwezakhi zofuzo, bayakwazi ukuthuthukisa izindlela zokwelapha ezintsha ezibaqondisa. Uma utholakala unalesi sifo, ungase ufanelekele ukuhlanganyela ovivinyweni lomtholampilo oluhlola izindlela zokwelapha ezintsha. Buza udokotela wakho ngalokhu.

Uzophila isikhathi esingakanani nalesi sifo?

Kunzima ukusho ukuthi uzohlala isikhathi esingakanani kulesi simo, kodwa kubalulekile ukuqaphela. Ngokwesilinganiso, isilinganiso sokusinda singaba yizinyanga eziyi-10. Izinga lokusinda leminyaka emihlanu lingaba ngu-15%. Kodwa-ke, lezi zibalo azisebenzi kuwo wonke umuntu ngokufanayo. Kunezici eziningi ezingathinta isimo sakho:

• Uhlobo oluthile lweseli kumdlavuza.
• Yiziphi izinguquko zezakhi zofuzo ezenzekile?
• Isikhathi esithathayo kusukela ekuqaleni kwezimpawu kuya ekutholakaleni kwesifo.
• Ukuthi umdlavuza usukhule kangakanani futhi wabhubhisa kangakanani izicubu ezinempilo.
• Ukuthi umdlavuza ususabalale kangakanani.
• Ingabe udokotela angakwazi yini ukususa ngokuphelele isimila somdlavuza?

Ngakho-ke, kubaluleke kakhulu ukukhuluma ngokukhululekile ngakho konke lokhu nodokotela wakho ukuze uthole ukuqonda okunembile ngesimo sakho.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

Uma uthola ukuthi une-carcinoma ye-sarcomatoid, ungase uzizwe ukhathazekile kakhulu futhi udidekile ngoba lezi zinhlanzana zihlukahlukene futhi ziyinkimbinkimbi. Kubalulekile ukukhuluma ngokukhululekile nodokotela wakho mayelana nezinketho zakho zokwelashwa kanye nendlela yesikhathi esizayo yesifo. Udokotela wakho angakuchazela ukuthi yini ongayilindela ngokusekelwe ezicini zamangqamuzana akho omdlavuza nokuthi umdlavuza utholakala kuphi emzimbeni wakho.

Nazi ezinye imibuzo ongayibuza udokotela wakho:

• Ingabe umdlavuza wami usabalele?
• Umdlavuza wami unzima kangakanani?
• Hlobo luni lokwelashwa olunconywayo?
• Yimiphi imiphumela emibi okufanele ilindelwe ekwelashweni?
• Ucabanga ukuthi kungaba ngumqondo omuhle kimi ukuthola umbono wesibili wezokwelapha?
• Ingabe ngidinga ukusebenza nochwepheshe bokunakekelwa kweziguli ezidambisa ubuhlungu?
• Ingabe ngiyafaneleka ukubamba iqhaza esivivinyweni somtholampilo?

Udokotela wakho angakunikeza ulwazi oludingayo, akuthumele ezivivinyweni zemitholampilo uma ufanelekile, futhi akusize uthole ukunakekelwa kokwelapha ubuhlungu.

Izinto okudingeka sizikhumbule

Kulungile, ngakho-ke, kusukela kulokho esikhulume ngakho nge-Sarcomatoid Carcinoma, nazi izinto eziyinhloko okufanele uzikhumbule:

• Lolu uhlobo lomdlavuza olungavamile kakhulu nolunolaka olusakazeka ngokushesha okukhulu.
• Lokhu kubonisa izici ze-carcinoma kanye ne-sarcoma.
• Ukubhema kuyisici esiyinhloko esiyingozi salokhu.
• Izimpawu zincike ekutheni umdlavuza ukuphi. Emaphashini, izimpawu zingase zihlanganise ukukhwehlela nobunzima bokuphefumula.
• Kudingeka ukuhlolwa okukhethekile (i-biopsy, i-imaging) ukuze kutholakale ukuthi kukhona yini isifo.
• Izindlela zokwelapha ziyinkimbinkimbi. Ngaphezu kokuhlinzwa, ukwelashwa ngamakhemikhali, kanye nokwelashwa ngemisebe, izindlela zokwelapha ezintsha (izindlela zokwelapha eziqondiwe, ukwelashwa nge-immunotherapy) nazo ziyacatshangelwa.
• Nakuba amathuba okululama ngokuphelele ephansi, ucwaningo olusha lunikeza ithemba.
• Kubaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho ngesimo sakho bese uthola konke ngokucacile.

Ngiyethemba ukuthi lolu lwazi luzokusiza. Uma uneminye imibuzo mayelana nalokhu, sicela ukhululeke ukuxhumana nodokotela.

I- Sarcomatoid carcinoma, umdlavuza, umdlavuza wamaphaphu, ukubhema, izimpawu zomdlavuza, ukwelashwa komdlavuza, i-carcinoma