Tsanangudzo uye Kurayira Kubva paGanho 0 kusvika kuSiteji IV
Melanoma ndiyo inonyanya kurwisa kanzera reganda . Chirwere cheMelanoma ndiyo nzira inoshandiswa kutsvaga ukuru hwechirwere chemalaoma uye kupi uye yakareba sei. Melanoma yakakamurwa kuva zvikamu kubva 0, iyo ndiyo nzvimbo yakaderera, kusvika ku IV, iyo ndiyo yakakwirira. Kuongorora kunokosha nokuti inobatsira nhengo yehutano yehutano uronga kuronga kwakakodzera.
Iyi melanoma image gallery inoratidza zvimwe zvezvikamu mumifananidzo. Tsvaga zvakawanda pamusoro pezvinorehwa kuva nechimwe chikwata che melanoma.
TNM Kuronga kweMelanoma
Nyanzvi dzehutano dzakauya nenzira dzakasiyana-siyana dzekugadzirisa kenza. Ichi chinyorwa chinoshandisa 2009 TNM System iyo inorayirwa neAmerican Joint Commission paCcercer. Ndiyo yakanyanya kushandiswa kushandiswa kwenyika munyika.
Mune TNM system, tsamba T, N, uye M dzinoreva:
- T = tsvina: T inoteverwa nenhamba inofanirana ne-tumor thickness.
- N = node: N inoteverwa nenhamba inofananidzwa nehuwandu hwekuita lymph node .
- M = metastasis (kupararira kure): M inoteverwa nenhamba inofanana nehuwandu hwemasastasis.
Chiremba wako anogonawo kupa Clark neBreslow nhamba-mamiriro ekurwara kwepachiviri uye kuwanda, maererano-kuti uwedzere maranoma yako uye uone kuti iwe unofunga sei.
Mukuwedzera, "T" inogona kuteverwa ne "a" isingatauri chironda, kana "b" iyo inoreva kurwara.
Kuchengetedza, kunoratidza zvirwere zvakanyanya uye zvinowanikwa pasi pe microscope, inoitika apo maranoma anopinda mucheche.
Nenzira yakawanda, iyo yakasvibisa chiremera uye kupfuura iyo iyo kenza yakapararira, yakakwirira yakatangwa. Iyo yakakwirira padanho, yakaipisisa yakareba kwenguva yakareba.
Dzidza zvakawanda pamusoro pezvikamu zvakasiyana-siyana zve melanoma uye zvavanoratidza, pasi apa.
Nhanho 0
Apo melanoma inobatwa pachigamba chekutanga uye haina kupinda mukati mechando cheganda, inozivikanwa semaranoma in situ. Inonyatsoporesa uye inogona kunzi danho rekuti 0 kana kuti harina kupa sendima.
Stage I
Mishonga yepamusoro inonyanya kushandiswa nekubviswa kushandiswa sezvo izvi zvinonzi melanomas zvisingaiti zvakapararira.
- Nhanho 1A (T1aN0M0): Tsvina haina kupararira kune nodes. Inenge isingapfuuri 1 mm uye haina kuonda. Kupona kwemakore mashanu ndiko 95 muzana.
- Chikamu IB (T1bN0M0 kana T2aN0M0): Chirwere chisina kupararira kune nodes. Inenge isingapfuuri 1 mm, asi inenge yakasuruvara kana iri pakati pe101 uye 2 mm asi haisi yeronda. Kupona kwemakore mashanu ndiko 89 muzana kusvika 91 muzana.
Zvakakosha kuziva kuti chirwere chinogona kunge chiri pasi pe1 mm uye chisingave chechirwere asi hachina kuonekwa seGadhe IA-kana ine yakakwirira yeClark yenzira yekupinda. Saizvozvowo, tumarara inogona kunge iri T1b uye inopfuura 1 mm pasina kuora kana iine yakakura yeClark level.
Stage II
Melanomas inogona kuporeswa, asi kubudirira kwezvikwata zvinopera shure kweChechi I nokuti nhamba shomanana yemasero ekenza ingangopararira kune nzvimbo dziri kure. Mukuwedzera pakuvhiya, mamwe maitiro erapi anogona kukurudzirwa.
- Chikamu IIA (T2bN0M0 kana T3aN0M0): Chirwere chisina kupararira kune nodes. Inenge pakati pe101 uye 2 mm uye ine ulcerated, kana kuti 2.01 kusvika 4 mm pasina kuora. Kupona kwemakore mashanu ndiko 77 muzana kusvika 79 muzana.
- Chikamu IIB (T3bN0M0 kana T4aN0M0): Chirwere chisina kupararira kune nodes. Inenge pakati pe201 uye 4 mm uye ine ulcerated kana kupfuura 4 mm pasina kuonda. Kupona kwemakore mashanu ndiko 63 muzana kusvika 67 muzana.
- Chikamu IIC (T4bN0M0): Chirwere chisina kupararira kune nodes. Iyo yakakura kupfuura 4 mm uye ine ulcerated. Kupona kwemakore mashanu ndiko 45 muzana.
Stage III
Sezvo chironda chacho chakatanga kugadziriswa, kuwedzera kwezvikamu zvezvikamu izvi zvakaderera kune zvakambotanga.
- Chikamu IIIA (T1a-4a, N1a-N2a, M0): Chirwere hachina kuonda. Yakapararira kusvika kumatunhu matatu, asi haazi kuwedzera. Icho chinowedzera kupararira chinoratidzika chete pamusana pekuongorora kukuru, kwete pamakiriniki ekuongorora. Kupona kwemakore mashanu ndiko 63 muzana kusvika 69 muzana.
- Chikamu IIIB: Ichi chikamu chakaoma uye mamiriro ezvinhu akawanda anokwanisa:
- T1b-T4b, N1a-N2a: Chirwere chacho chinonzi ulcerated. Yakapararira kusvika kumatunhu matatu, asi haazi kuwedzera. Icho chinowedzera kupararira chinoratidzika chete pamusana pekuongorora kukuru, kwete pamakiriniki ekuongorora.
- T1a-T4a, N1b-N2b: Chirwere hachina kuonda. Yakapararira kusvika kune nhatu nodes, uye node dzinowedzerwa nekuda kwechironda.
- T1a / b-T4a / b, N2c: Chirwere chinogona kuonda kana kuti kwete. Dumbu racho rapararira paganda riri pedyo ne melanoma (satellite metastasis) kana kune lymph chiteshi chiri pedyo ( mumitambo yekutenderera ), asi lymph nodes pachavo hadzina melanoma.
Kugara kwegore rose kwemakore mashanu kwechikamu ichi 30% kune 59%.
- Stage IIIC:
- T1b-T4b, N1b kana N2b: Chirwere chacho chinonzi ulcerated. Iyo maranoma yakapararira kusvika kumakumbo matatu emakumbo, ayo akawedzerwa nekuda kwekenza.
- Chero T, N3: Chirwere chinogona kuva chero upi noupi uye chinogona kuonda kana kuti kwete. Iyo maranoma yakapararira kune mana kana kupfuura mamwe node ari pedo, kana pane zviputi (matted) nodes ne melanoma mavari, kana pane satellite kana in-transit metastase uye kenza yakapararira kune lymph nodes iri pedyo.
Kupona kwemakore mashanu ndiko 24 muzana kune 29 muzana.
Stage IV
Iyi nhanho yemaranoma inobatanidza ne metastasis kunze kwemakiromita emunharaunda kune nzvimbo dziri kure mumuviri zvakadai sepapu, chiropa, kana uropi, kana kune nzvimbo dziri kure dzeganda. Hazvinawo nhengo ye lymph node kana kuwanda kunofungidzirwa. Kupona kwemakore mashanu kunotangira kubva pa7 kusvika ku19 muzana.
Chidimbu cheMatanho
| Stage | Mamiriro |
| IA | Tumhanho ≤ 1.0 mm pasina kuonda; kwete lymph node kupinda; hapana masi maasastases ari kure |
| IB | Tumhanho ≤ 1.0 mm nechirwere kana Clark level IV kana V; tumhondoro 1.01-2.0 mm tisina kuonda; kwete lymph node kupinda; hapana masi maasastases ari kure |
| IIA | Tumhanho 1.01-2.0 mm nechirwere ; tumha 2.01-4.0 mm tisina kuora; kwete lymph node kupinda; hapana masi maasastases ari kure |
| IIB | Tumhanho 2.01-4.0 mm nekurwara |
| IIB | Tumha> 4.0 mm pasina kuonda; kwete lymph node kupinda; hapana masi maasastases ari kure |
| IIC | Tumha> 4.0 mm nechirwere ; hapana kubatana kunobata; hapana masi maasastases ari kure |
| IIIA | Kutinhira kwehupi humwe hutete husina kusuruvara neine chine lymph node |
| IIIB | Kutinhira kwehupi humwe hutete husina kusuruvara neviri kusvika katatu lymph nodes yakanaka |
| IIIC | Tumorwe chero ipi zvayo yakakura uye ine mana kana kupfuura yakawanda yemaitiro emakiromita kana mazamu matted kana in-transit yakawana (s) / satellite (s) isina metrosiyo yemaitiro emumakumbo kana kusanganiswa kwema-transit met (s) / satellite (s), OR ulcerated melanoma uye metastatic lymph node (s) |
| IV | Kutinhira kwehupi humwe hutete nemamwe nodes uye chero zvipi zvacho zvakasara |
Izwi Nezvokupona Nhamba Dzakatorwa neSiteji
Iwe unganzwa uchitya nehupenyu hunoratidzwa pamusoro apa, asi chengetedza zvinotevera mupfungwa. Nhamba nhamba nhamba, kwete vanhu. Vanofanotaura kuti zviyamu zvinokonzerwa nei, asi havatauri zvishoma nezvokuti iwe, somunhu oga, ungapindura sei kurapwa . Mukuwedzera, kurapa kuri kuwedzera. Mishonga mitsva yakagamuchirwa, uye zvakawanda zviri kuongororwa mumakiriniki. Nhamba inowanzova nemakore akawanda, uye inogona kunge isina kuratidza kuti mumwe munhu angapindura sei kurapa nhasi.
Treatment Plans
Sezvatambotaurwa, kurapwa kwemaranoma kunowirirana zvikuru pane imwe nzvimbo. Nyaya dzinotevera dzinokurukura maitiro ekurapa kubva pachigamba:
- Matanho Okutanga Mishonga yeMaranoma (Stage I neGadziriro II)
- Melanoma Treatment Options (Stage III neGumbo IV)
> Sources:
> Balch, C., Gershenwald, J., Soong, S. et al. Shanduro yekupedzisira ye 2009 AJCC Melanoma Staging uye Kuronga. Nyaya yeCliniki Oncology . 2009. 27 (36): 6199-6206.
> Mahar, A., Compton, C., Halabi, S. et al. ChinyorwaKubvunzurudzwa kweChinical Prognostic Tools muMelanoma. Annals of Oncology Surgery . 2016. 23 (9): 2753-61.