Kusvuta uye Kunwa Zvishoma Nezvishoma Kuwedzera Kungozi Yemuromo Wekenza
Overview
MuUnited States uye kumativi ose enyika, kuwanda kwekenza yemuromo, kana kenza inobata miromo, muromo wemuromo, uye huroti, yakakosha mune chikamu nokuti vanhu vazhinji vanonwa uye vanoputa. Izvi zvakabatanidzwa panjodzi, kunwa uye kusvuta, zvinoshandisa kuwedzera huwandu hwemunhu hwekuita kenza yemuromo-asi zvakadaro kupfuura chero njodzi inokonzerwa nemunhu mumwe nomumwe.
Nzira yakajeka yekudzivirira kenza yemuromo ndeyokurega kunwa uye kusvuta; zvisinei, isu tose tinoziva kuti kupera kwakaoma kune vanhu vakawanda vanovimba nezvinodhaka uye doro kana kushandisa zvinodhaka zvinodhaka uye doro.
Statistics
Inenge 85 kubva muzana yemusoro neyemutsipa kanzura ndeyomukondombera. (Musoro nemutsipa makondombera zvakasiyana nemakemikari europi.) Uyezve muUnited States, 3 muzana yevanhu vose vane chirwere chinouraya pakati pevarume uye 2 muzana yezvose zvinopisa zvinokonzerwa nevakadzi vane mishonga yemukondombera.
Kenza yemumuromo inokanganisa varume vakawanda kupfuura vakadzi, uye varume veAfrica-America vane mikana yakawanda kupfuura varume vachena kuti vape kenza yemuromo. Pakupedzisira, kenza yemuromo yakawanda kwazvo kune vanhu vane makore makumi mana nekure.
MuSouth-East Asia, kuputika makumi mana kubva muzana yemakondani ose ari kanzura dzomuromo. Munyika dzakabudirira, yehuwandu hwekenza iyo inopinza kanzura inoputira kusvika 4 muzana.
Mukana wekuti munhu mumwe nomumwe achakura nekenza yemuromo munguva yeupenyu hwake inenge 1.1 muzana.
Gore negore, kenza yemuromo inouraya vanhu vanenge 8000 muUnited States. Uyezve, vanenge 42 000 vanhu muUnited States vanoonekwa kuti vane chirwere ichi chegore gore negore.
Muna 2012, vanenge 300 000 vanhu vari muUnited States vaine kenza yemuromo. Kuisa nhamba iyi nenzira yakajeka, vanhu veCincinnati vanenge vanenge 300 000 vanhu.
Pasinei nokufambira mberi mumagadzirirwo ekuongorora uye ekuvhiya, nhamba yevanhu vari kurarama makore mashanu mushure mekunge aongororwa nekenza yemuromo, kana kuti makore mashanu ekupona, yakave yakafanana kune makumi mana emakore: pakati pe50 ne55 muzana.
Mune mamwe mazwi, anenge hafu yevanhu vanoonekwa kuti nhasi nemukenza wemuromo vachafa mukati memakore mashanu anotevera. Izvi zvinowanzochengetedzwa nokuti kunyange zvazvo tichigona kubata kenza yemuromo kare, vanhu vane chirwere ichi vanowanzouya kuzorapwa kare, vane zvirwere zvakanyanya uye zvakanyanya.
Anatomy Oral Cancer
Nyaya dzakawanda dzomumuromo dzinokanganisa zvikamu zviviri zvetatu zverurimi. Kunyanya, aya kanzura inokura kubva pasi (dorsal) uye (lateral) nhengo dzorurimi. Musoro (dorsal) chikamu cherurimi rwako rwakaoma neanoravira. Chikamu chepakati chenyu rurimi chakashata.
Kazhinji kacho, kenza yemuromo inogona kukanganisa kana miromo kana zvikamu zvemukati wemuromo zvinosanganisira zvinotevera:
- mukati mematama (buccal mucosa)
- roof of the mouth (hard palate)
- nzvimbo duku iri seri kwemazino ekuchenjera (retromolar trigone)
- the gums (gingiva)
Kanzura dzomumuromo dzimwe nguva dzinogona kukura kubva kumashure kwehuro kana pharynx . Kunyanya zvakanyanya, marariya anogona kukura kubva ku oropharynx uye hypopharynx .
Iyo oropharynx inosanganisira zvinotevera:
- soft palate
- kurutivi uye kumashure masvingo ehuro
- kudzokera chikamu chetatu chemutauro
- toni
Iyo hypopharynx ndiyo chikamu chepasi pehuro. Icho pharynx inotora 5-inch long tube iyo inobatanidza imba chaiyo pakati pemhuno uye kupinda kweeophagus uye larynx (windpipe). Zvokudya nemhepo zvinopfuura nepakati pe hypopharynx munzira yavo kuenda mudumbu nemapapu, maererano.
Nzvimbo yechipfuva chinouraya (kenza) mumuromo mutsara kana pharynx inokosha nokuti nzvimbo inogona kukanganisa mararamiro ehutano (chirwere) uye kurapa.
Pakupedzisira, kenza yemuromo inogona kukanganisa chero chikamu chemuromo, muromo nemuromo.
Iro Mishonga Yemakwenzi Inogadzirwa
Kazhinji kenza yemumuromo inonyanya kushandiswa kwekenza yekenza . Masero mashoma ane masevi mashoma, akapfava anotambanudza muromo wemuromo uye pharynx.
Chirwere chekenza chinotanga kuumbwa mushure mekuchinjwa kunopera pakukura kwema molecular. Kamwe kamwe masero anonyangadza akazonyangarika pamakemikari, kuonekwa kwemasero aya kunoshanduka. Sezvo mamwe masero anochinja pakuonekwa, kenza yemuromo inowanikwa, kana kuonekwa, uye zviratidzo zvinotanga kuratidza.
Nharo dzisina kufanana dzomukondombera dzinowanika uye dzinogona kusanganisira salivary gland tumor, sarcomas, uye melanoma.
Risk Factors
Zvinokonzera njodzi zvinotsanangurwa sechinhu chipi nechipi kana chimiro chinowedzera chiitiko (ngozi) yekuvandudza zvirwere.
Heano mamwe emuromo wechirwere zvinokonzera ngozi:
- doro
- fodya
- HPV16 (human papilloma virus type 16 iyo inobatanidza nekuwedzera kwemaitiro emakirini ematani)
- kudya kunoshaya muchero nemiriwo
- kuwedzera kwezuva zuva (inowedzera ngozi yekenza yemuromo)
- immunosuppression (weakened immune system)
- betel quid chewing (a stimulant drugs inowanikwa muIndia subcontinent iyo inonyanya kufanana necheku fodya uye inowanzosanganiswa nefodya)
- womukanwa kunwa (chikafu chemuSouth America chinopfumbira mu caffeine uye chakaitwa ne yerba mate)
Zviratidzo
Heano zvimwe zviratidzo zvinogona kuitika uye zviratidzo zvekenza yemuromo. (FYI: Chiratidzo chinhu chipi nechipi chinoonekwa chechirwere, asi, chiratidzo chiratidzo icho murwere anonyunyutira uye naizvozvo anozviisa pasi.)
- mavara machena mukati memuromo (leukoplakia)
- gumbo rinopisa risingaendi
- ganda (pamuromo) kana chironda chisingaendi
- bundu mukati memuromo
- kurwadziwa pakucheka
- kurwadziwa pakumedza
- kuvhuvhuta glands (lymph nodes)
- jaw kurwadziwa
- rurimi marwadzo
- mazino akasvinura
- kusununguka mazino
Zvimwe zviratidzo zvepamusoro zvekenza yemuromo zvinosanganisira zvinotevera:
- kuonda
- kufugama kweropa
- dambudziko kudya (dysphagia)
- hoarseness
- kunetseka kufema
Kazhinji, vanhu vane kenza yepamuromo vanoratidza zviratidzo zvekare uye zviratidzo zvechirwere kune zvimwe zvinokonzera. Nokudaro, vanhu ava vanouya nekenza iyi munguva yekurwara apo urwere huri hwakaoma. Uyezve, vanachiremba vanonyanya kutarisirwa (vanachiremba vemhuri vanochiremba kana vanogadzirira) dzimwe nguva vanocherechedza kukosha kwepakutanga-danho remuromo wekenza zviratidzo nezviratidzo.
Zvinosuruvarisa, kushayikwa kwekutanga kwekutanga chikonzero chinonyanya chikonzero chekenza yemuromo inouraya inenge hafu yevanhu inotakura. Zvirwere zvakabatwa kare zvakanyanya kurapwa.
Kuziva
Kana chiremba kana chiremba wemazino achiona chironda chinoshungurudza, kana chisina kuchena, mumuromo mako kana muhuro mushure mekuita kuongorora kwemuviri, biopsy yakaitwa kuti ione kuti ichi chionda chii. Nebiopsy, chiduku chiduku chinotemwa chinobviswa kubva pane uye chinongororwa uchishandisa microscope mubasa.
Mukuwedzera kune chiziviso, dzimwe nzira yekuongorora inogona kushandiswa kubatsira kubatsira kuongorora kenza yemuromo kana kuongorora kana yakapararira (mastasized). Aya maedzo anosanganisira zvinotevera:
- MRI
- CT scan
- PET scan (zvakanaka pakuona metastases kana kupararira)
- chifuva uye meno x-rays
- endoscopy (tube inogadziriswa ine kamera uye chiedza pamagumo inoshandiswa kufungidzira mukati memuviri wako)
- barium kumedza (mazamu masheji e x-rays eopopus and stomach)
Staging
Nhandare, kana kuoma, kwekenza yemuromo inobva pane zvinotarisirwa neTM.
I T muTMM inoreva mararamiro eatomic emakumbo makuru. Mune mamwe mazwi, T inoreva kumwero yakakonzerwa nekenza yemukondombera yemumuromo inowanikwa muzvivako zvakapoteredza.
Zvadaro N muTMM inomirira lymph node kupararira kana kuti iyo kanhi yemuromo inopinda sei lymph node dzenharaunda. (I-lymph nodes inogona kuparadzira chiremera mumuviri wose uchishandisa lymph system.)
Pakupedzisira, M inonzi TNM inomirira mastasisita kana kuvapo kwechipiri kukuvadza kunowanikwa munzvimbo dzakasiyana-siyana dziri kure nemakumbo ekutanga.
Kune zvikamu 5 zvikuru zvemukenza wemuromo: Stage 0, I, II, III uye IV. Nenzira, Chikamu IV chinowedzera kugoverwa kuva nhatu-nhanho-IVA, IVB uye IVC-izvo zvatisingazokurukure zvakananga kuchengetedza zvinhu zvishoma nyore.
Kutsika kunogona kunetsa. Kunyange zvakadaro pano inotsanangurwa pfupi yemakondomu omuromo anowira mune imwe neimwe yezvikamu zvishanu zvikuru.
- Nhanho 0 Kanzera yemuromo inoreva kancinoma in situ , kana kenza iyo isati yapararira uye yakaramba yakanyatsotangira. Nhanho 0 kanzira inoporesa zvikuru.
- Dhigirii I kenza yemuromo inoreva chiremara chisina kupararira kune lymph nodes kana kuti nzvimbo dziri kure zvakasikwa uye yakakura pamasendimita maviri kana kupfuura pamwe nechepamusoro-soro.
- Chikamu II kenza yemuromo inoreva chiremara chisina kupararira uye chakasvibiswa pakati pe2 ne4 cm pamusana pekukura kwayo.
- Chirwere chechitatu kanwere yemuromo chinogona kureva chero chiyero chepamuviri chekutanga chinogona kana kuti chisina kupararira kune lymph nodes.
- Zvichienderana nezvishoma-shanho, mararamiro eGenheji IV anogona kureva chero chiremera chemafupa ane lymph node uye mastasti kure.
Kana uchisarudza kurapa kwakakodzera, kuisa chiremera chinoshandisa kuongororwa kunokosha. Kutsika kunogona kushandiswawo kufanotaura kufungidzira, kana maonero, kune avo vane kenza.
Kurapa
Zvichienderana nehukuru, nzvimbo uye nzvimbo, kenza yemuromo inogona kurapwa uchishandisa chirwere, radiotherapy uye chemotherapy.
Oncology mauto ane chokuita nekurapa varwere vane kenza yemuromo vanosanganisira avo vakasiyana-siyana vehutano vanopa humwe hutano hwakadai sehutano hwemazino, mazano epfungwa, rubatsiro rwemagariro evanhu uye kurapa kwekudya.
Kana chirwere chepachirwere chemuromo chinonyatsotaridzika, kana kuti chinotsanangurwa, uye chinogamuchirwa, neET (nzeve, mhuno uye nehuro, nyanzvi kana otolaryngologist) ichachibvisa.
Dzimwe nguva, zvinenge zvakaoma kuti uwane pachirwere kana chirwere chakapararira, kana kuti chechi, kune lymph nodes uye kupfuura. Muzviitiko izvi, chemotherapy uye radiotherapy inogona kushandiswa. Uyezve, chemotherapy uye radiotherapy inogona kushandiswa sechigadzirwa, kana zvimwe, kurapa kunobatsira kuvhiyiwa uye nokudaro kuderedza kupararira kwekenza.
Vanhu vanogamuchira kurapwa kwekenza yemuromo vanofanira kunyatsotevera kutevera zvakakwana chekuongorora-mwedzi yese mwedzi mitanhatu. Mukana wekuti kenza yemuromo ichadzoka iri pakati pe3 kubva muzana ne7% gore roga rega.
Prognosis
Chikamu I uye Stage II yemukondombera yepamuromo inoporesa zvikuru nemakore mashanu ekupona kwemazana anopfuura 90 muzana. Mune mamwe mazwi, nhamba yevanhu vari kurarama makore mashanu mushure mekunge mazivikanwa neChechi I uye Stage II yemukenza yemuromo inopfuura 90 muzana.
Gwara rechitatu uye gweta reStart IV rine makore mashoma ekupona kwemakore mashanu: pakati pe23 ne 58 muzana.
Mukupedzisa, kana iwe kana munhu waunoda achifungidzira kenza yemuromo chero ipi zvayo, zvakakosha kuti iwe uite musangano nechiremba wako nekukurumidza. Nokuti zviratidzo zvokutanga uye zviratidzo zvekenza yemuromo hazvina zvazvinobatsira, unofanira kugovera zvinetso zvako zvakanangana nekenza yemuromo nechiremba wako. Iwe unogonawo kukumbira kuti utumire kunyanzvi, kana ENT, kuti uwedzere kuongororwa. Chirwere chemumuromo chirwere chakakomba chinofanirwa kutarisirwa kutanga kuti ave nechokwadi chekupona.
Sources
Kim ES, Gunn G, William W, Jr., Kies MS. Chitsauko 16. Musoro uye Neck Cancer. Mune: Kantarjian HM, Wolff RA, Koller CA. eds. Iyo MD Anderson Manual yeAradic Oncology, 2e . New York, NY: McGraw-Hill; 2011. Yakasvika musi waMarch 17, 2016.
Chinyorwa chinonzi "TNM Kuronga Kwekenza YeMusoro uye Neck: Kurwisa Kufanana pakati pezvinhu zvakasiyana-siyana" neSG Patel uye JP Shah rakabudiswa muCCA: A Cancer Journal for Clinicians muna 2005
Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. Chitsauko 43. Oropharyngeal Cancer. Mu: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. The Color Atlas of Family Medicine, 2e . New York, NY: McGraw-Hill; 2013. Yakasvika musi waMarch 16, 2016.