Kuongororwa, Kutarisa, uye Kurapa kweMystine Node Metastases
Kanza yemaperembudzi inowanzopararira kune lymph nodes vasati vapararira kune dzimwe nzvimbo dzomuviri. Ndezvipi zvinonzi lymph nodes yemukenza wemapapu zvakapararira kune, chiremba wako anoziva sei kana kenza yemapapu yako yakapararira kune lymph node yako, uye izvi zvinorevei pane zvamunoita uye kuraira?
Overview
Kenza yemaperembudzi inogona kupararira ( metastasize ) munzira nhatu dzinokosha. Inogona kupararira kuburikidza:
- the lymphatic system
- ropa
- munharaunda iri pedyo nechomuviri
(Ikozvino yava kufunga kuti mutsa wemapapu, kusiyana nemamwe mimwe kenza, inogona kupararira mumhepo zvakare).
Apo mitezo yemukenza yemapapu inofamba nenzira ye lymphatic system inotakurwa kune lymph nodes uko inogona kugara nekukura. Kanza yemaperembudzi kazhinji inopararira kune lymph nodes pedyo nechomuviri, inozivikanwa senharaunda dzemaodzanyemba, asi inogonawo kupararira kune lymph nodes kumativi ari kure. Mamwe mazwi aunogona kunzwa anotsanangura mutsa wemapapu wakapararira kune lymph nodes pedyo nechomuviri inosanganisira "chirwere chemuhara," "kupararira kwemahara," kana "zvirwere zvakanyanya munzvimbo."
Iyo Lymph Nodes Inogona Kubudirira
I-lymph node yemukenza wemapapu inopararira kune yekutanga inowanzoenderana nenzvimbo yechipfupa. Kana iwe ukaverenga kuburikidza nehupi hwehurodhiyo yako inoshuma, mazwi anotsanangura lymph node kupinda iwe inogona kuvhiringidza zvikuru. Nzira iri nyore yekufunga nezvekenza yemapapu inopararira kune lymph nodes ndiko kupatsanura nodes munzvimbo nhatu:
- Intrapulmonary lymph nodes: Iri izwi rinoreva lymph nodes iri mumapapu. Izvi zvinogona kunge zviri mhirizhonga dzemaitiro-kureva, lymph nodes inowanikwa munzvimbo dzekunze dzemapapu-kana mairasi emakirini, aripo munzvimbo yebhokisi apo maronchi uye maitiro makuru uye mishonga inopinda mumapapu ( hilum ).
- Mediastinal lymph nodes: Idzi nhengo dzemuviri dzinowanikwa munzvimbo yebhokisi pakati pemapapu ( mediastinum ).
- Extrathoracic lymph nodes: Iri izwi rinoreva lymph nodes inowanikwa kunze kwegwenzi (chifuva). Idzi dzinosanganisira lymph node supraclavicular, iri munzvimbo iri pamusoro pekororobone; uye scalene lymph nodes, iri mumutsipa, pedyo nepamusoro-soro ribhi.
Imwe nzira iyo lymph nodes inotsanangurwa inobva kune rumwe rutivi rwemuviri mavari:
- Ipsilateral lymph nodes: Izvi zvinoreva lymph nodes kune rumwe rutivi rwemuviri sechirwere.
- Contralateral lymph nodes: Mutachiona wemakiromita anonzi lymph nodes kune rumwe rutivi ("contra") rwechifuva kubva mumarara.
Zviratidzo
Iwe unogona kunge usina zviratidzo zvacho zvakabatana zvakananga nekenza yako inopararira kune lymph nodes yako. Kana iwe uine zviratidzo, izvi zvinogona kusanganisira:
- Kurerekera mumutsipa wako kana munharaunda iko kwepamusoro pe collarbone yako.
- Kusuruvara kwefema nekuda kwekumanikidzwa kubva kuremuru lymph nodes.
- Kutya nekuda kwekumanikidzwa kune mitsipa inokonzerwa nekwakwimba kwemakristini matsva mukati kana pedyo nemapapu ako.
Kuziva
Mushure mekunge mupenza wemapapu unoratidzwa, chiremba wako achakurudzira miedzo kuti aone kana chirwere chako chakapararira kune lymph nodes kana kune nzvimbo dziri kure. Kusarudza kana, uye chii, lymph nodes kenza yako yakapararira kune zvinokosha pakusarudza kurapa kwakanakisisa.
Mimwe miedzo inogona kuitwa inosanganisira:
- CT scan kana MRI yechipfuva chako uye mudumbu
- PET Scan - Kunyanya kana iwe usina kamudiki kenza yemapapu emapapu
- Endobronchial Ultrasound
- Mediastinoscopy
- Lymph node biopsy - Kana lymph nodes inogona kuwanikwa nenzira yakadai se endobronchial ultrasound kana mediastinoscopy , chiremba wako angatora sampuli ye lymph node kuti iongorore nokuda kwekenza masero
Staging
Nhamba yeTMM yepamapenza yemapapu ndiyo nzira yekugadzirisa iyo inofunga nezvekukura kwechirwere chako, kuvapo kwemaitiro emakirini anokonzerwa nekenza, uye humwe humwe uchapupu hwokupararira kwechirwere chako kune nzvimbo dziri kure dzomuviri wako.
MuTMM kugovera, N inomirira lymph node kupinda:
- N0 - Hapana kupararira kwemarara kune lymph nodes
- N1 - Tsvina yakapararira kune node dziri pedyo kune rumwe rutivi rwemuviri
- N2 - Chirwere ichi chakapararira kune nodes mberi zvakare asi kune rumwe rutivi rwemuviri
- N3 - Masero eC Cancer akapararira kune lymph nodes kune rumwe rutivi rwechifuva kubva mumarara, kana kuti lymph nodes pedyo nemirasira kana mitsipa yemutsipa
Kurapa
Kurapa kwemukenza wemapapu wakapararira kune lymph nodes kunobva pachitsauko chekenza yako uye hutano hwako hwose. Kana kenza yemapapu yakapararira kune vashomanana vemazamu emakiromita ari pedyo, kurapwa kunogona kuonekwa. Kana bundu rakapararira kune lymph nodes kure kure kana kure kure, nzvimbo dzinoshandiswa kurapwa dzinowanzobatanidza chemotherapy , remishonga inonzi radiation , inotarisirwa kurapa, uye immunotherapy.
Prognosis
Kutaura kwemukenza wemapapu wakapararira kune lymph nodes kunobva pane zvinhu zvakasiyana siyana, kusanganisira iyo lymph nodes inosanganiswa, rudzi rwemapapu emapapu une, kukura kwechirwere chako, kana chirwere chako chakapararira kune dzimwe nzvimbo mumuviri wako, uye hutano hwako hwose. Matambudziko akawanda emakiriniki ari kutsvaga nzira dzakanakisisa dzokurapa mutsa wemapapu uye kupa tariro kuti kufungidzira kuchavandudza mune ramangwana.
Shoko Rinobva Mumuviri Wechirungu Inobatanidza neLung Cancer
Kusarudza kuti, kana chero nhengo dzemuviri wako mumuviri wako dzakakosha kumasero emapapu emapapu zvakakosha zvikuru mukusarudza nzira dzakanakisisa dzokurapa kwechirwere chako. Kuziva kuti ndezvipi zvidhi nodes uye ukama hwavo nehwamanda yako huru inobatsira zvikuru pakugadzira.
Zvinogona kunge zvakaoma kuziva kana lymph nodes inokonzerwa nekenza, uye kazhinji haigoni kuita zviopsies pane zvose zvingava nzvimbo. Nokuda kwechikonzero ichi, kutsvakurudza kwekuvhiya uye kufungidzira zviyero zvinotsigirwa zvikuru. Kuvapo kwemakirini nhengo mu mediastinum (nzvimbo yebhokisi pakati pemapapu) inokosha zvikuru mukuparadzanisa nzira dzekurapa (somuenzaniso, kuvhiyiwa nekuvhiya nemimwe mishonga) asi zvave zvichizivikanwa zvakaoma kudzidza. Munguva yakapfuura, chirongwa chinonzi mediastinoscopy chaiwanzoitwa kuitira kuti vanachiremba vangave vachiona zvakajeka idzi node. Penguva ino, PET inoongorora pamwe neCCT inowanzokwanisa kupa ruzivo urwu nenzira inopedzisira isingaiti.
> Sources:
> Almeida, F. et al. Pakutanga kuongororwa kwechigarire chemukirini wemukenza wemapapu yemapapu: kuongororwa uye kugadziriswa. Nhasi Maonero muPulmonary Medicine . 2010. 16 (4): 307-14.
> Riquet, M. et al. Zviratidzo zvekushandiswa kwemuviri wemakirini inopinda mumapapu emapapu uye ikozvino International Association yeChidzidzo cheLung Cancer rinotsanangurwa muzvikamu. Interactive Cardiovascular and Thoracic Surgery . 2010. 11: 260-264.
> Xia, Y., Zhang, B., Zhang, J., Li, W., Wang, K., uye H. Shen. Kuongororwa kwemametasiti lymph node mumukenza wemapapu: ndiani mukuru wekutonga ?. Zvinyorwa zveTrracic Disease . 2015. 7 (Suppl 4): S231-7.