Qhov tsim nyob rau hauv lub cev ntawm cov hlwb nrog hloov pauv DNA yog qhov ua tau ntawm txhua cov nqaij thiab hauv ib qho kev hloov pauv. Qhov no tshwm sim ntau zaus, tab sis kev tiv thaiv kev tiv thaiv kev mob tua tau cov cell hauv lub sijhawm. Txawm li cas los xij, nrog kev txo qis ntawm qib ntawm kev tiv thaiv, nrog rau thaum muaj lwm yam cuam tshuam, qee qhov ntawm lawv yuav tawm tsam thiab pib qhia nrog kev kub ceev. Qhov no ua rau kev tsim cov neoplasms uas txawv hauv cov qauv thiab cov yam ntxwv los ntawm cov ntaub so ntswg ntawm cov khoom nruab nrog, uas lawv pib lawv txoj kev loj hlob.
Cov ceg ntawm cov tshuaj uas kawm txog cov yam ntxwv ntawm tus mob neoplasms, lawv hom thiab theem ntawm chav kawm, nrog rau txoj hauv kev los tawm tsam lawv, hu ua oncology. Nws yog qhov dav heev, vim tias nws txiav txim siab txhua yam muaj feem xyuam rau benign thiab malignant neoplasms hauv txhua tus qauv hauv lub cev. Ib qhov chaw cais ntawm cov kev tshawb fawb no, hu ua pancreatic oncology (mob caj dab), kawm txog qhov ua rau muaj cov qog ntshav hauv cov khoom no, lawv cov kev ua kom pom, cov kev paub ua ntej thiab kev kho. Ntawm qhov tod tes, lub sij hawm "pancreatic oncology" kuj txhais tau tias tsuas yog ib pawg ntawm cov pathologies uas tshwm sim nrog kev txhim kho ntawm neoplasms, thiab feem ntau - qog nqaij hlav cancer.
Cov Kev Xam Pom
Pancreatic malignancies hauv zaus yog nyob rau qhov thib 4 ntawm txhua lwm hom mob qog noj ntshav ntawm lub plab hnyuv siab raum thiab muaj tus yam ntxwv tuag coob ntawm cov neeg mob. Kev tsim cov qog sai dua, nws pib tshwm sim sai dua (kis rau nws lub hlwb mus rau lwm cov ntaub so ntswg thiab kabmob), qhov nyuaj yuav los daws nws nrog cov kev kho mob thiab qhov tshwm sim hnyav dua.
Kev faib cov tshuaj atypical sai tsim cov qog tsom
Cov tsos mob ntawm tus mob pancreatic oncology tsis yog nyob ntawm hom thiab cov khoom ntawm lub hlwb uas tau hloov zuj zus mus thiab tsim cov qog. Lawv kuj tau txiav txim siab los ntawm kev ua haujlwm hauv qog nqaij hlav hauv qog nqaij hlav, kev loj hlob ntawm tus kab mob, thiab cov yam ntxwv ntawm tus neeg mob lub cev. Feem ntau, txhua yam cuam tshuam uas ncaj qha lossis tsis ncaj rau cov qauv kev ua pov thawj ntawm cov mob neoplasms tuaj yeem txiav txim siab raws li hauv qab no:
- hom hlwb uas dhau los ua "poj koob yawm txwv" ntawm cov kab mob cancer pancreatic (tsim cov enzymes hauv plab lossis cov tshuaj hormones uas ua rau txoj hlab ua kua los yog qog ua rau lub plab hnyuv taum);
- qhov chaw ntawm lub cev (cev, Tail lossis taub hau ntawm tus txiav);
- theem ntawm kev txhim kho kev ua tsis zoo lossis txheej txheem benign (thaum ntxov, kev soj ntsuam tshwm sim tsawg heev);
- tus neeg mob lub hnub nyoog (tus neeg laus dua, qhov ntau dua yuav ua rau muaj kev tsis zoo rau lub cev nqaij daim tawv, ua rau lub siab tshaj - cov hnub nyoog laus dua 70 xyoo);
- keeb kwm yav dhau los ntawm lub cev (twb muaj tus kab mob pancreatitis lossis cov hlwv hauv nruab nrog cev, mob ntshav qab zib mellitus, kev rog rog, kab mob ntawm lub plab thiab cov hnyuv, cov cwj pwm tsis zoo, khoom noj khoom haus nrog ib qho tseem ceeb ntawm cov khoom kib thiab roj).
Tsis tas li ntawd, mob qog nqaij hlav cancer yog pom qhov txawv txav los ntawm nws lub peev xwm kom loj hlob sai thiab metastasize tsis yog nyob rau cov neeg nyob sib ze tab sis kuj nyob hauv cov plab hnyuv sab hauv.
Cov tsos mob ntawm pancreatic oncology ua ntau tshaj tawm nyob rau theem ntawm twb tau tsim thiab nquag tsim cov qog, tab sis feem ntau ntawm cov chaw kho mob, qhov mob hnyav thiab txaus ntshai ntawm pathology tsis haum rau kev siv ntawm cov cim qhia. Ntawd yog, nyob rau ntawm 2 lossis 3 theem ntawm kev mob qog noj ntshav, cov tsos mob tuaj yeem yog atypical thiab ua rau lawv tus kheej tsis zoo li daim duab ntawm lwm yam, tsis tshua muaj kev phom sij, kab mob. Tsuas yog muaj mob qog nqaij hlav ntawm hlwb 4 rau qib, nws cov tsos mob feem ntau ua yam ntxwv ntau dua.
Thaum kuaj lub qog hauv lub tshuab tsom, lub qog qog tau kuaj pom tias qhov sib koom ua ke ntawm qhov txhab thiab muaj cov yam ntxwv zoo sib xws.
Thaj tsam anatomical ntawm cov khoom hauv nruab nrog cev, qhov twg thawj tsim ntawm lub qog pib, muaj kev txiav txim siab ntau ntawm cov kev ua kom pom kev ntawm pathology. Yog li, nrog mob qog noj ntshav ntawm lub taub hau lossis ko tw ntawm tus txiav, tus neeg mob cov lus yws thiab qee qhov tsos mob yuav txawv. Cov duab hauv tsev kho mob kuj yog nyob ntawm seb cov keeb ntawm lub qog yauv tau hloov pauv thiab pib tsim cov neoplasm: epithelial lossis tsim cov enzymes thiab cov tshuaj hormones. Tab sis muaj cov tsos mob tshwm sim tsis hais hom cell lossis thaj chaw ntawm lub qog. Lawv lub xub ntiag, nrog tus neeg mob tau mob siab rau nws tus kheej thiab nrog lub sijhawm mus ntsib kws tshaj lij, pab txoj hauv kev kuaj pom tus kab mob thaum ntxov.
Cov tsos mob tshwm sim rau txhua hom mob qog ntshav
Kev tsim tawm ntawm kev mob qog nqaij hlav hlav mus los ntawm 5 theem, pib txij li 0 (xoom) degree thiab xaus nrog plaub. Ntxiv mus, 1 thiab 2 degrees tseem muaj ob qhov chaw qis (A thiab B). Ib qib twg ntawm kev muaj mob muaj cim qhia tias yuav muaj mob qog nqaij hlav cancer.
Ntawm 0 degree, tus neeg mob lub siab tsis ntxhov, vim cov hlwb tsis zoo tsuas yog pib tsim thiab muaj tseem muaj qee leej. Lawv nyob hauv lub cev thiab tsis nkag rau cov ntshav thiab cov hlab ntsha. Tus neeg mob tsis ua lus yws hlo li.
Kev nce ntawm tus naj npawb ntawm atypical hlwb ua rau kev tsim cov qog pob zeb loj txog li 2 cm inch, uas yog ib txwm muaj rau qib 1. Clinical cov cim feem ntau kuj tseem tsis tuaj, tab sis, nrog rau kev ua kom thaj chaw mob qog noj ntshav ntawm tus ciam ntawm lub txiav thiab duodenum lossis thaj chaw ntawm tus Tsov tus tw, tus neeg mob yuav pom tias tus neeg tsis xeev siab, tsis hnov mob hauv plab thiab sab laug hypochondrium.
Nrog rau mob qog noj ntshav ntawm qib 2, txuas ntxiv ntawm cov qog mus ntxiv thiab nws cov metastasis rau cov kabmob sib ze. Tus neoplasm nkag mus rau hauv cov ntaub so ntswg ntawm lub plab, plab hnyuv, bile ducts. Cov qog ntshav nkag mus rau cov ntshav thiab cov hlab ntsha. Nyob rau theem no, cov cim ntawm tus kabmob thiab kev tsis txaus siab ntawm cov neeg mob kuj tsis yog qhov tshwj xeeb thiab yuav qhia tau ntau yam kab mob ntawm lub siab, lub zais zis, lub plab hnyuv, lub plab. Yog li, cov neeg mob yws yws vim mob plab, ntuav thiab xeev siab, hloov quav thiab xim tawv nqaij, ua rau lub cev tsis zoo, ua rau poob phaus.
Qib thib peb ntawm cov kab mob pancreatic yog pom los ntawm kev sib kis tseem ceeb ntawm cov qog ua haujlwm thoob plaws lub cev thiab kev tsim cov pa metastases, tab sis kom deb li deb tau txhawm rau hauv thaj chaw nyob ze (plab hnyuv, lub plab). Qhov kawg ntawm cov kab mob pathology, plaub, yog pom los ntawm cov duab hauv chaw kho mob, uas qhia txog kev puas tsuaj loj ntawm tus txiav los ntawm thawj cov qog thiab ntau cov kabmob hauv nruab nrog vim yog tsim ntawm metastatic foci.
Cov tsos mob no muaj raws li nram no:
- mob zais cachexia (tshem tawm tus neeg mob tseem ceeb);
- tsis muaj qab los noj mov;
- mob plab heev, feem ntau puag ncig;
- kev nce hauv qhov loj ntawm lub plab vim yog lub siab thiab tus po thiab ua pob o;
- blanching los yog yellowing ntawm daim tawv nqaij thiab mucous daim nyias nyias;
- qhov hloov pauv ntawm qhov thiab xim ntawm cov quav, ua tso zis dub (nrog metastases hauv daim siab);
- cov leeg hlwb thiab lub paj hlwb nrog metastases hauv tus txha nqaj qaum thiab lub hlwb.
Kev ploj sai ntawm ib tug neeg yog qhov cim ntawm kev mob qog ntshav sai sai
Raws li tuaj yeem pom los ntawm daim ntawv teev npe no, ntau cov tsos mob ntawm tus mob pancreatic oncology tsis yog ib txwm muaj rau cov kab mob no, uas yog, paub meej tias nws muaj. Lawv yuav qhia lwm yam kab mob, thiab tsis tsuas yog lub qog nws tus kheej. Yog li ntawd, nws yog qhov tseem ceeb heev uas yuav tsum them sai sai rau cov tsos ntawm lwm yam, muaj ntau yam tshwj xeeb, cov tsos mob, uas tau txiav txim siab los ntawm kev ua kom pom cov qog ntawm cov qog tsom lossis nws cov keeb kwm (hom hlwb).
Cov tsos mob ntawm tus mob cancer, txiav txim los ntawm nws qhov chaw nyob
Txoj kev nquag tshaj plaws ntawm pancreatic malignant pathology yog mob qog ntshav ntawm lub taub hau. Nws cov kev ua kom pom kuj yog nyob ntawm theem ntawm cov txheej txheem pathological, tab sis qee cov yam ntxwv tuaj yeem qhia tau tias yuav tsum nyiam cov neeg mob thiab tus kws kho mob:
Puas yog tus txiav tawm- mob nrog girdling yam ntxwv, tsiag ntawv los ntawm kev siv khov thaum hmo ntuj, me ntsis tso rau hauv txoj hauj lwm supine nrog ob txhais ceg ncab mus rau lub plab;
- tsis tu ncua nthuav dav phlebitis (mob rau cov leeg) ntawm sab qaum lossis qis dua;
- kev ua rau lub cev poob mus ntxiv, tsis muaj zaub mov noj thiab lwm txoj hauv kev poob ceeb thawj;
- qhov tsim ntawm intoxication syndrome (tsis qab los noj mov, tsaug zog, qaug zog);
- xeev siab thiab ntuav
- cov phiaj xwm tau txiav txim siab los ntawm kev txiav txim siab ntawm tus mob qog nqaij hlav taub hau ntawm daim siab thiab lub zais zis (lub teeb thiab qhov muag ntxhiab (rog) ua paug, tso zis dub, daj daj ntawm qhov sclera thiab tawv nqaij, tawv nqaij khaus tas li.
Yog hais tias thawj lub qog tau tsim nyob rau hauv tus Tsov tus tw lossis lub cev ntawm tus txiav, tom qab ntawd nws muaj qhov cuam tshuam loj tshaj plaws rau cov txheej txheem tsim cov zom ua kom zoo thiab nws txoj kev tshem tawm. Ib qho ntxiv, ib qho kev nce ntxiv ntawm tus tw ntawm ib qho khoom hauv nruab nrog vim tias mob qog tuaj yeem cuam tshuam rau lub raum thiab cov hlab zis. Yog li ntawd, nws yuav tsum tau sau tseg cov cim cim ntau tus xeeb ceem rau qhov chaw ntawm lub pathology:
- kev loj hlob ntawm dysuric ntshawv siab (tso zis nce ntxiv, tso zis nce ntxiv);
- cov paib tshwm sim nrog rau qhov pib ntawm ntshav qab zib (nqhis dej, qhov ncauj qhuav, nce ntxiv ntawm hmo ntuj diuresis);
- sai poob phaus;
- cov quav xoob xoob nrog lub siab ua kom muaj roj (vim yog qhov nws ua tsis zoo los ntawm lub tsev tso quav thaum yaug);
- kev cuam tshuam hormonal (lub cev ntas hloov, poob libido);
- cov kev hloov hauv dermographism, lub suab vascular, microcirculation thiab cov nqaij mos trophism (thaj chaw liab rau ntawm daim tawv nqaij, tsaus muag, hnov ntawm "kub flashes", tawv nqaij mob).
Pancreatic taub hau mob cancer yog cov feem ntau ntawm cov qog hlav.
Ntawm qhov tseem ceeb rau kev tsim cov duab hauv chaw soj ntsuam yog hom hlwb uas tau yauv hloov chaw thiab pib tsim lub qog. Yog tias cov no yog cov tshuaj insulin ua rau lub hlwb, qhov tawm ntawm insulinoma nquag cuam tshuam cov piam thaj hauv cov ntshav hauv lub cev. Glucagon, uas ua rau lub cev glucagon dhau heev lawm, kuj "ua". Gastrinoma, suav nrog cov hlwb tsim cov tshuaj hormone gastrin, pib chim qhov kev cai ntawm kev ua haujlwm lub plab. Yog li no, ntawm tag nrho cov naj npawb ntawm cov tsos mob ntawm tus mob qog noj ntshav, qee cov cim txais tau hauv cov kab mob no tuaj yeem lees paub.
Yog li, nrog insulinoma uas cuam tshuam cov metabolism hauv kev ua kom tawv nqaij, daim tawv nqaij yuav qhuav thiab nkig, "jams" (tawg ntawm pob ntseg ntawm qhov ncauj) daim ntawv, eczema lossis dermatitis pib, thiab tus nplaig yuav du thiab raspberry. Gastrinoma muab cov tsos mob tshwm sim xws li mob tom qab noj mov hauv plab, hloov pauv txhua zaus thiab xwm yeem ntawm cov quav, xeev siab, thiab ntuav.
Qhov ntau dua ntawm kev nce qib thiab kev loj hlob ntawm cov neoplasm, lub hlwb atypical ntau dua nyob rau hauv lwm yam kabmob, muab cov nqaij hlav tshiab foci, qhov ua kom zoo dua qub thiab ntau dua ntawm cov duab hauv chaw soj ntsuam ua. Qhov nyuaj ntawm cov paib no yog lub hauv paus rau kev txheeb xyuas ntawm neoplasms, tab sis tsuas yog cov kev ntxiv ntawm kev soj ntsuam tuaj yeem muab cov lus teb kawg ntawm daim ntawv ntawm pathology.
Cov yam ntxwv ntawm kev kuaj mob thiab kho mob
Qhov tseem ceeb tshaj plaws kev ntsuas tus nqi yog lub ntsiab txhais ntawm "cim" ntawm malignant neoplasms. Koj tuaj yeem kawm paub ntau ntxiv los ntawm cov kab lus no. Ntxiv nrog rau hom no, tus neeg mob noj ntshav mus kawm cov ntshav qabzib, cov enzymes thiab cov tshuaj hormones. Ib txwm kev tshuaj xyuas dav dav ntawm cov ntshav thiab zis, kev txiav txim siab ntawm coagulability thiab daim siab ua haujlwm siab yog nqa tawm. Ntxiv mus, raws li kev taw qhia, cov hau kev ua haujlwm tau muab los ntawm cov hauv qab no: ultrasound, CT, MRI, endoscopy nrog qhov sib piv nruab nrab, laparoscopy, kuaj me nrog kev kuaj mob ntawm cov nqaij mos.
Pancreatic MRI muab cov ntaub ntawv kuaj mob tseem ceeb
Txoj kev xaiv ntawm kev kho mob rau cov neeg mob yog txiav txim siab los ntawm ntau yam. Qhov no yog hom qog, nws qhov chaw nyob ze, theem ntawm kev txhim kho, hnub nyoog ntawm tus neeg mob, muaj cov keeb kwm yav dhau los. Cov neeg mob nyob ntau npaum li cas tom qab kuaj pom tus mob neoplasm nyob ntawm lawv.
Feem ntau, cov kev sib koom ua ke yog xaiv, suav nrog:
- kev phais mob rau cov hom phiaj kho (tshem tawm cov qog nrog ib feem ntawm cov khoom hauv plab, plab, ib feem ntawm txoj hnyuv lossis ua tiav kev tshem tawm cov txiav);
- palliative phais, thaum lub qog tsis ua haujlwm, tab sis nws muaj peev xwm ua kom ntev lub sijhawm ntawm tus neeg mob (piv txwv li, metastases raug tshem tawm los kho qhov patency ntawm txoj hnyuv lossis cov kua tsib lub plab);
- kev siv tshuaj kho mob, lossis kev teem caij noj tshuaj nrog cytostatic ua kom pom tseeb (inhibit qhov kev loj hlob tsis tsuas yog mob hlwb, tab sis kuj yog lwm cov ntaub so ntswg); qhov no tseem suav nrog kev kho mob tsom nrog kev teem sijhawm siv tshuaj uas tsuas ua cov qog noj;
- kev kho hluav taws xob (kis rau gamma rays);
- cov khoom noj tshwj xeeb tsim los daws qhov tshwm sim ntawm tshuaj lom neeg thiab kev kho hluav taws xob.
Hmoov tsis zoo, oncological pathologies ntawm tus txiav yog muaj qhov tsis txaus ntseeg nyob rau hauv feem ntau ntawm cov mob. Tsuas yog ib feem tsib ntawm cov neeg mob muaj peev xwm nyob tau ntau xyoo tom qab kev kho mob, txawm tias nrhiav tau tus kab mob thaum ntxov. Tus so ntawm cov neeg mob, txawm hais tias kev ua haujlwm, kev siv tshuaj thiab hluav taws xob, tsuas yog muab rau 6-12 hlis xwb. Yog li, nws yog ib qho tseem ceeb kom paub txog cov cim tseem ceeb ntawm oncology thiab tig mus rau cov kws tshaj lij hauv lub sijhawm.
