PET / CT Inobatsira Hodgkin Lymphoma Zvimwe Zvakakwana
Lymphomas ndiwo kanzira inosanganisira marudzi emasero machena anonzi lymphocytes. Lymphomas inowanzorongwa seHodgkin kana kuti kwete Hodgkin lymphomas .
Kune marudzi mashanu eHodgkin lymphoma, kana HL. Izwi rokuti classical HL rinoreva zvinotevera zvina zvinowanzosiyana: nodular sclerosing HL, yakavhenganiswa nemasero eHL, lymphocyte-rich classical HL uye lymphocyte-yakapedzwa HL.
Chechi yechishanu ndeye nodular lymphocyte-predominant HL, uye haifaniri kuonekwa sechikoro cheHL.
Zviratidzo . Vanhu vane HL vanogona kusimbisa zviratidzo zvakasiyana, asi chiratidzo chakakurumbira chinowedzera lymph node (s) uye hapana chimwe chinhu. Lymph nodes dzinogona kuwedzerwa mumutsipa, mazamu, kana kugomera, kana mukati mebhokisi. Zvisiri zvishoma, avo vane Hodgkin lymphoma, kana HL, vanogona kuora muviri, fivha, kuvhuvhuta kana kudonhedzera kutuka usiku - pamwe chete kunonzi "zviratidzo zveB." Kuvapo kwechimwe chete chezviratidzo izvi kunokodzera kuva neB zviratidzo.
Risk Factors . Kuva nematambudziko hazvireve kuti iwe zvechokwadi uchawana HL. Ichokwadi, vanhu vakawanda vane HL havana zivo dzinozivikanwa. Zvizivikanwa zvinokonzera ngozi zvinosanganisira kutapukisa mononucleosis, kana kuti mono ; age- peak age groups for HL iri muma20s na 70s / 80s; nhoroondo yemhuri; nzvimbo yakakwirira yezvematongerwo enyika; uye utachiona hweHIV.
Kuongororwa uye Kushambadzira . Maererano neAmerica Cancer Society, vanachiremba vanogona kusarudza kubva nenzira dzakasiyana-siyana kuti vatore mhando yezvinyorwa zvinosanganiswa, kana bhiopsy, kuongororwa nekuongorora zvishoma.
Apo PET / CT iripo, inoshandiswa pakugadzira. PET / CT magero anosanganisira CT uye PET, kana positron emission tomography kuziva kuti kenza yakapararira zvakadini uye kuti yakakura sei.
Nezve PET nePET / CT
PET inoshandisa fomu inoshandiswa shuga, kana FDG, iyo inotorwa kumusoro, kazhinji, neHodgkin lymphoma masero zvakanaka, kana sechiremba vanotaura, nevanokurumidza.
Maererano nefizikiki, chimiro chemashizha chakafanana nechai-ray, asi, kubatana kwakabatana kubva paPET-CT kunenge nguva 10-20 yakakwirira kudarika kubudiswa kubva kune-x-ray nguva dzose. Kuongorora kwakadaro kunobatanidzwa nezvinobatsira asiwo kune ngozi dzinogona kuitika kubva kune inonzi mazai emvura uye ngozi yechirwere. Nokudaro, chiyero-chekubatsira chinofanirwa kuongororwa zvakaringana kune mumwe nomumwe mushure mekudzidza.
PET kuongorora kunowanzova yakaoma kupfuura CT pakuona lymphoma. Semuenzaniso, PET inogona kuratidza chirwere mumakirini emagetsi anoenderana-siyana uye kubatsira kutarisa zvirwere zviri kunze kwemakirini, asi zvisingaoneki pa CT. PET inowanzobatanidzwa neCCT kubvumira kufananidza nzvimbo dzepamusoro-soro remhepo paPET scan nekuonekwa kwakajeka kwemahara iyo CT. Inofananidzwa nemifananidzo yakawanda, kushandiswa kwePET / CT pachikamu chekutanga kunogona kukanganisa kushandiswa uye kunotungamirira kuhutano hwakasiyana mumatambudziko akawanda.
PET / CT yeHodgkin Lymphoma
Mirayiridzo inobva kuNational Comprehensive Cancer Network inokurudzira kushandiswa kwePET / CT yekutanga kugadzirisa uye kuongorora kwekupedzisira mhinduro kune varwere vane HL. Nokuti PET / CT yakakosha pakugadzirisa uye kupindura kupindura panguva uye mushure mekurapa, iri kushandiswawo kuedza kujekesa kurapa.
Sezvo varwere vanowedzera vachiita zviitiko mumakiriniki emakiriniki, kuongororwa kwemashure kunogona kushandiswa kune zvakasiyana-siyana zvezvakaipa, kusanganisira HL, kuedza kufanotaura chidimbu chekurapa kwakasiyana asi asiri kukurudzirwa zviripo panguva ino.
PET / CT yakanyanya kunaka pakuona lymph nodes iyo yakabatanidzwa neHodgkin lymphoma. Zvakakosha pakuona zvirwere mumapfupa emapfupa uye mune dzimwe nhengo. Chikamu cheHL chinoenderana nenhamba nenzvimbo yekuti lymph nodes dzinobatanidzwa uye zvimwe zvikamu zvakabatanidzwa. Zvidzidzo zvakaratidza kuti simba rekuona rakawedzerwa rePET / CT rinotungamirira kune 10 kusvika ku15 muzana yevarwere vane HL vachiendeswa kune rimwe danho rakanyanya kufambira mberi - kupfuura zvakanyanya, kureva, kudarika maitiro neTCT, ndoga.
Saka, vamwe varwere vangave vachiwana kurapwa kwavanoda.
Nokurapa kwemazuva ano yakarongerwa kutanga kwechikwata chechirwere cheHL, PET / CT ine chimwe chinhu chinogona kubatsira. Mune zvimwe zviitiko, kunyanya kutsanangurwa kwepakutanga kunobatanidzwa munzvimbo kana nodes kunogona kubatsira vanachiremba vachironga kupisa kwemaawa kuti irradiate nzvimbo duku, zvingave zvichisarudzira zvishoma zviduku zvine utano.
PET / CT mukurapa uye kurapa
Hodgkin lymphoma ndeimwe yemhando dzakasiyana-siyana dzinonzi lymphoma dzinonzi dzinoporesa. Anatomical staging-viewing uko mumuviri lymphoma iripo uye ichikura-inonyanya kukosha muHL, kwete chete nokuti inobatsira kuzivisa chisarudzo chekurapa, asiwo nokuti inobatsira kufanotaura kubvumirana kwese.
Varwere vane chirwere chekare-kare vanogona kugamuchira kurapwa kwemaawa chete, asi mune zvirwere zvakapfuura, chemotherapy inopiwa uye miviri inogona kushandiswa zvimwe zvekugarisa zvirwere, maererano neHutchings nevamwe vavo.
Varwere vakura vane chirwere chekutanga-chetachiwana vane hupenyu hwepasi rose hunodarika 90 muzana mumatambudziko mazhinji. Muzvirwere zvepamusoro-soro, kuponeswa kwese kuri 65-80 muzana. Muzvikamu zviviri zvekutanga-chetatu uye chirwere chepamusoro-soro, kuwedzera kuwirirana maererano nezvengozi zvinowanzoitwa.
Mukuwedzera pane imwe nzira yakanyatsojeka, PET / CT inogona kubatsira kuona chero chirwere chinoramba chiripo mushure mekurapa. Izvi zvinogona kubatsira, somuenzaniso, apo kune masara ekusimba, kana kuwedzera mubhokisi uye haisi pachena kana inoratidza chirwere chekucheka kana chinoshanda.
> Sources:
> America Cancer Society. Ndezvipi zvinokonzera ngozi kune Hodgkin chirwere?
> Hoppe RT, Advani RH, Ai WZ, et al. Hodgkin lymphoma. J Natl Compr Canc Netw . 2011; 9 (9): 1020-1058.
> Hutchings M. Inobatsira sei PET / CT kubatsira mukusarudza chirwere chevarwere vane Hodgkin lymphoma? Hematology Am Soc Hematol Dzidzo Yedzidzo . 2012; 2012: 322-7.
> Townsend W, Linch D. Hodgkin's lymphoma kuvanhu vakuru. Lancet . 2012; 380 (9844): 836-47.