Kana kenza inokanganisa mapfupa, izvi zvinowanzoitika nekuda kwekenza isiri-bone iyo yakatanga kune imwe nzvimbo mumuviri uye inopararira, kana kuti yakagadziriswa, kumapfupa. Kusiyana neizvi, chinongororwa apa chiri pane avo kanzura inotanga mumapfupa, anozivikanwawo sepakutanga mapfupa emukenza.
Kenza yepfupa yemapfupa inonyanya chikamu chakakura, chine mhando dzakasiyana siyana dzezvakaipa, dzimwe dzisina kunyanya kuwanikwa; zvisinei, izvi, osteosarcoma, chondrosarcoma, uye Ewing sarcoma ndezvimwe zvinowanzoitika.
Anozivikanwa Zvinokonzera
Kunyange zvazvo zvikonzero zvinokonzera kenza yemapfupa zvisingazivikanwi zvakajeka, kuchinja muDNA yemasero anouraya anozivikanwa kuva akakosha. Muzviitiko zvakawanda, kuchinja uku kunowanikwa nechiitiko uye hausi kupfuudzwa kubva kuvabereki kuenda kuvana.
Masayendisiti akadzidza maitiro ekufambira mberi kuedza kunzwisisa njodzi dzinobatanidzwa. Osteosarcoma ndiyo yechitatu inowanzoshambadza yakawanda inokanganisa mapfupa muvechiri kuyaruka, yakatangira chete neukemia uye lymphoma. Chondrosarcoma inowanzonziwo kanhi yepamusoro yekenza yemapfupa, asi inonyanya kuwanzana kune vanhu vakuru kudarika vana nevechiri kuyaruka, vane makore akaenzana ekuzivikanwa kwemakore 51. Kuchengeta sarcoma inowanzoongororwa muvechidiki, uye muvhareji wemakore ekuongororwa makore gumi nemashanu.
Osteosarcoma Risk Profiles
Osteosarcoma ndiyo inonyanyozivikanwa sepayipi yemapfupa kanzira yose. Iko kune maitiro mashomanana anozivikanwa kuti awedzere maitiro ekuvandudza iyo. Vanhu vane chirwere chisingawaniki cheziso rinonzi renotinoblastoma inowanikwa nhaka inowedzera mungozi yekuvandudza osteosarcoma.
Uyezve, avo avo vakamborapwa nekenza vachishandisa radiotherapy uye chemotherapy vane ngozi yakawanda yekuvandudza osteosarcoma gare gare muupenyu.
Zvichiitika, vanachiremba vazhinji vanobvumirana kuti mapfupa akavhuniwa uye akakuvara uye kukuvara kwemitambo hakuiti kuti osteosarcoma. Zvisinei, kukuvadzwa kwakadaro kunogona kuunza anste-oarosarcoma yakanga yave iripo kana kuti imwe tumarara yemapfupa kuchipatara, saka kune chokwadi chakabatana pakati pezviviri-zvinongova kuti kukuvara kwemagetsi hakuratiki kunokonzera osteosarcoma.
Zera, zvepabonde, uye zvemarudzi-Zvimwe zvinetso zvekutengesa
Osteosarcoma inonyanya kukanganisa zvikwata zviviri zvezera remakore-chikwata chekutanga chiri mumakore ekuyaruka uye chechipiri ndechevakuru vakuru.
- Muvatana vakwegura, osteosarcoma inowanzobva kune rimwe remafupa, zvakadai seavo vanobatwa nechirwere chemafupa (kwenguva yakareba, chirwere chePaget ).
- Pakati pevanhu vaduku, osteosarcoma inonyanya kudarika vasati vava nemakore mashanu, uye chiitiko chepamusoro chinowanikwa panguva yekukura kwevechiri kuyaruka. Paavhareji, mumiririri "wezera rakakwana" re osteosarcoma muvanhu vaduku makore gumi nemasere nekuda kwevasikana uye nemakore gumi nemasere evakomana.
Osteosarcoma inowanzoshamwaridzana nekuenzaniswa nezvimwe zvirwere; inofungidzirwa kuti vanenge 400 vanhu vaduku vanopfuura makore makumi maviri vane hutano vane osteosarcoma gore negore muUnited States. Vakomana vanobatwa kakawanda mune zvidzidzo zvakawanda, uye chiitiko muhuduku hwevana veAfrica chinopfuvura zvishoma pane vatsvene.
Njodzi Zviitiko Zvinoshandiswa Kuvanhu Vaduku
- Kuvapo kwemwe huwandu husingawanzo kenza yemukenza syndromes
- Zera pakati pemakore gumi nemakumi matatu
- Kureba kwakakwirira
- Murume pabonde
- African-American race
- Kuvapo kweimwe zvirwere zvemapfupa
Njodzi Zviitiko Zvinoshandiswa Kuvanhu Vakura
Zvimwe zvirwere zvepfupa zvakadai sechirwere chePaget , kunyanya kupfuura kwenguva, zvinosanganiswa nehuwandu hwehutachiona.
Kunyange zvakadaro, mungozi yakakwana yakaderera, ine chete chikamu chimwe kubva muzana chevaya vane chirwere chePaget vese vachigadzira osteosarcoma.
Kushandiswa kwemhepo kunonyanya kukonzerwa nengozi, uye nokuti nguva inenge iri pakati pejekiti yekenza uye kuonekwa kweansteosarcoma inowanzove yakanyanya (somuenzaniso, makore gumi kana kupfuura), izvi zvinowanzobatsira zvikuru kumapoka ekukwegura.
Genetic Predispositions
Kuisa mazita eti genetic syndromes kune osteosarcoma kunosanganisira:
- Bloom syndrome
- Diamond-Blackfan anemia
- Li-Fraumeni syndrome
- Paget's disease
- Retinoblastoma
- Rothmund-Thomson syndrome (inonziwo poikiloderma congenitale)
- Werner syndrome
- Kurasikirwa kwebasa re p53 uye retinoblastoma tumor suppressor jeni kunofungidzirwa kuva nebasa rinokosha mukusimudzira osteosarcoma.
Kunyange zvazvo germine (mazai nehuta) kushanduka kwep53 uye retinoblastoma mazamu zvisingawanzoitiki, majeni aya anoshandurwa muhuwandu hwehutachiona hwemakumbo, saka pane kuwirirana nekuvandudzika kweasteosarcoma. Germination mutations mu p53 gene inogona kukonzera njodzi yakakura yekudzivirira zvirwere zvinosanganisira osteosarcoma iyo yakatsanangurwa seLi-Fraumeni syndrome .
Kunyange zvazvo kuchinjwa mumararamiro ekudzvinyirira majene uye oncogenes zvakakosha kubudisa osteosarcomas, hazvisi pachena kuti ndezvipi zvezviitiko izvi zvinoitika kutanga uye nei kana kuti zvinoitika sei.
Osteosarcomas Kune Vane Zvirwere zvePaget
Ikoko pane saratani isingawaniki yeosteosarcomas ine urombo husina kunaka. Maviri acho anowanzoitika kuvanhu vanopfuura makore makumi matanhatu. Matumbu acho makuru panguva yekuonekwa kwavo uye vanoita kunge vari kukuvadza, zvichiita kuti zvive nyore kuwana chizere chekuvhiya kushandiswa (kubviswa), uye mapapiro emapapu anowanzotangira.
Nzira yeupfumi ndeyeyekwegura. Vanokura mune imwechete yezana yevanhu vane chirwere chePaget, kazhinji kana mapfupa mazhinji akabatwa. Mota aya anowanzoitika muchiuno, chidya chehudyu chiri pedyo nehudyu, uye muruwoko resimbi pedyo nebandauko; ivo zvakaoma kurapa chirwere, kunyanya nekuda kwezera remurwere uye ukuru hwechiremera.
Kutora dzimwe nguva kunokosha, kunyanya apo pfupa rinopera nekuda kwekenza, iyo inowanzoitika.
Parosteal uye Periosteal Osteosarcomas
Aya ndiwo mahedheni ayo anonzi akatumidzwa nekuda kwekugara mukati mefupa; iyo inowanzowedzera masimba osteosarcomas anokonzerwa nepamusoro pepafu musangano pamwe nehupamhi hwemhuka inopoteredza bone, kana periosteum. Hazviwanzopindi kusvika kumativi emukati emapfupa uye hazviwanzove zvakanyanya kuipa maosteosarcomas.
Nzira yehutachiona yeparosteal osteosarcoma inopesana neyeiyo inonzi osteosarcoma: inowanzoonekwa kune vakadzi kupfuura varume, inowanzoonekwa mumakore makumi maviri kusvika makumi mana ekukwegura, uye inowanzobuda kumashure kwehudyu, pedyo nemabvi akabatanidzwa , kunyange zvazvo pfupa chero ripi zvaro mumasaga rinogona kuchinjwa.
Higher-Risk Osteosarcoma Prognosis
Zvimwe zvinhu zvinokuvadza zvakabatanidzwa kune zviri nani uye zvakanyanya kuwedzera, asi zvinosuruvarisa, izvozvi zviitiko hazvina kuve zvakabatsira pakuziva varwere vanogona kubatsirwa kubva pane zvakanyanya zvakanyanya kana kuti zvisinganyanyi kuronga maitiro ekurapa asi vachichengetedza zvibereko zvakanaka. Zvinhu zvinozivikanwa kuti zvinokonzera zviitiko zvinosanganisira zvinotevera.
Primary Primary Tumor Site
Pamakumbo anowanikwa mumakumbo nemakumbo, izvo zviri kure nemutumbi wemumuviri, kana torso, zvine maitiro akanaka.
Zvironda zvepamusoro zvinoumba mucheka uye musana dzinobatanidzwa nehuwandu hwekugadzirisa nekufa, kunyanya nekuti zvakaoma kukwanisa kubviswa kushandiswa kwakakwana kwekenza munzvimbo idzi. Musoro nemutsipa maosteosarcomas munharaunda uye mumuromo zvinenge zviri nani kudarika zvimwe zvikamu zvepamusoro mumusoro nomutsipa, zvichida nokuti vanouya kuzotanga kufungwa.
Hipbone osteosarcomas inosvika 7 kusvika ku9 mapfumbamwe yeosteosarcomas yose; kupona kwemajeri kwevarwere vari makumi maviri kusvika ku47 muzana.
Varwere vane multifocal osteosarcoma (inotsanangurwa sevakawanda mapfupa emapfupa asina chirwere chakajeka chakajeka) vane urombo husina kunaka.
Localized vs. Metastatic Disease
Varwere vane zvirwere zvinowanika munzvimbo (kurega kupararira kune nzvimbo dziri kure) vane huwandu hwakanaka huri nani kune vane varwere vane chirwere chemasastatic. Vanenge makumi maviri kubva muzana vevarwere vachave nemasitasiti anoonekwa pamatsotsi ekuongorora, uye mapapu ave nzvimbo yakajairika. Kufanirwa kwevarwere vane chirwere chemasastatic kunoratidzika kuti kwakagadziriswa zvikuru nenzvimbo dzemaitiro emagetsi, nhamba yemasitema, uye kushandiswa kwekushandisa kwechirwere chetachiona.
Kune avo vane chirwere chemastastatic, chirevo chinoratidzika chiri nani nemashoma emapapu uye apo chirwere chacho chakapararira kune rimwe mapapu chete, panzvimbo pemapapu maviri.
Tumor Necrosis Pashure Chemotherapy
Tumor necrosis pano inoreva mishonga ine kenza iyo "yakafa" zvichibva pakurapa.
Pashure pemakemikari uye chirwere, chirwere chechirwere chinotarisa tumor necrosis mumubhedha wakabviswa. Varwere vane inenge 90 muzana necrosis mukutanga tumorori mushure memakemikirini vane zvirwere zviri nani pane vanorwara necrosis shoma.
Zvisinei, vanotsvakurudza vanocherechedza kuti zvishoma necrosis hazvifanirwe kududzirwa kuti zvinoreva kuti chemotherapy haina kubudirira; kurapwa kwemitengo yevarwere vane chiduku kana kwete necrosis mushure mokurohwa chemotherapy kune yakakwirira kwazvo kupfuura kuporesa mitero yevarwere vasingagamuchiri chemotherapy.
Chondrosarcoma Risk Profile
Ichi ndicho chirwere chinotyisa chemastikiti-anobudisa masero, uye rinomiririra anenge 20 muzana yezvose zvinotakura mapfupa emapfupa . Chondrosarcoma inogona kubuda pachayo kana kuti yechipiri, mune izvo zvinozivikanwa se "kuora kunorwadza" kwezviremara zvinorwara (zvakadai se osteochondroma kana benign enchondroma). Zvinhu zvinokuvadza zvinosanganisira:
- Zera: Kazhinji inowanikwa kune vanhu vanopfuura makore makumi mana; zvisinei, iyo inowanikwawo mudiki, uye painoita, inowanzova yepamusoro-gorosi yakaipa inogona kugadziriswa.
- Gender: Inowanikwa nehuwandu hunowirirana huri pakati pevakomana vose.
- Nzvimbo: Inogona kuitika mune rimwe pfupa, asi kune chimiro chekufambira muhupbone uye thighbone. Chondrosarcoma inogona kubuda mune mamwe mapfupa akarenda, akadai se-scapula, nenyundo, uye skull.
- Genetics: Vakawanda exostoses syndrome (dzimwe nguva inonzi multiple osteochondromas syndrome) inokonzerwa nemamiriro ezvinhu anokonzera kukanganisa kwakawanda pamapfupa emunhu, anonyanya kugadziriswa. Exostoses inogona kurwadza uye inotungamirira kumapfupa erwere uye / kana kuputsika. Chirwere chacho chinonzi genetic (inokonzerwa nekuchinja kwechimwe chero chemajini matatu EXT1, EXT2, kana EXT3), uye varwere vane chirwere ichi vane ngozi yakawanda ye chondrosarcoma.
- Zvimwe Mhemberero Yenhengo: An enchondroma inobata chirwere chekateti chinokura mufupa. Vanhu vanowana zvakawanda zvezviremara izvi vane chirwere chinonzi multiple enchondromatosis. Vanewo mukana wekuwedzera wekudzidzira chondrosarcoma.
Ewing Sarcoma Risk Profile
Ichi inonyanya kuwanzana pakati pevatsvene (zvichida kwete yeSpejian kana Hispanic) uye zvishoma kudarika pakati peAsia America uye zvisingawanzoitiki pakati peAfrica America. Kubvisa zviremara zvinogona kuitika chero ipi zvayo, asi zvinowanzoonekwa mumakore ekuyaruka uye hazvina kufanana pakati pevaduku nevana vaduku. Hazviwanzokwi kune vakwegura vakuru.
Zvinenge zvose Kubvisa tumarara masero ane shanduko dzinosanganisira gene EWS, inowanika pa chromosome 22. Kuitwa kwejeni reEWS kunotungamirira kukura kwemasero uye nekukura kwekenza, asi nzira chaiyo iyo inoitika haisati yasvika zvakajeka.
> Sources:
> America Cancer Society. Miedzo yeOsteosarcoma. https://www.cancer.org/cancer/osteosarcoma/detection-diagnosis-staging/how-diagnosed.html.
> National Caner Institute. Osteosarcoma uye Malignant Fibrous Histiocytoma ye Bone Treatment (PDQ®) -Health Professional Version. https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq.