Kana kenza yako yepazamu yakapararira kune lymph nodes yako zvisarudzo zvekurapwa zvinowanzova zvehasha. Nekutanga kwemazamu emakondomu, hatigoni kuva nechokwadi chekenza inogona kupararira (metastasize). Sezvo metastases inokonzera 90 muzana yekufa kwekenza yemazamu, kuziva nguva yekubata nehasha, uye apo kurapwa kweAdjuvant sekemikirini inogona kunge yakanyanyisa, inokosha.
Apo kenza yepamu inopararira kune lymph nodes iyo yakanyatsotsanangura "chinangwa" chekuita mastasize. Aya kanzura, kana akasara ari oga, angangodaro akapararira mumuviri wose uye pakupedzisira anokonzera rufu.
Ndezvipi zvirwere zvekenza yepese zvakapararira kune lymph nodes, uye izvi zvinorevei pane zvaunofunga?
Nei Lymph Nodes Inokosha muBeer Cancer
Kenza yepabonde inotanga nemasero mashomanana, ayo anosangana pamwe chete mumatumbu ako. Vanogona kunge vakadzika musasa mune mukaka apo mukaka wemukaka unogadzirwa: mukaka wako maruche uye maziso. Sezvo aya masero ari kukura uye achiparadzanisa, anogonawo kupinda mumapupa ari pedyo.
Chirwere chinokura chinogona kukonzera sero kana kuti clump yemasero. Ichi chekuchengetedza kenza yemukenza inogona kushandisa ropa rako kana lymph system seyakagadzirwa nemigwagwa kuitira kuti inogona kufamba mumuviri wako wose. Yako lymph system inoshanda neropa rako rinopararira kupa mishonga kumasero ako ose, pamwe nekubvisa michina yemarara.
I- lymph nodes ndiyo "gomba rinodzimira" mumugwagwa mukuru uyu, uko lymphatic fluid inonatswa, yakasanganiswa nemasero emuviri (lymphocytes), uye yakadzokera kumashure mumararamiro enyu anoshambadza.
Saka, kana kenza yemusana isina kukonzera ichiita kuti iine lymph node yako, zvinogona zvakare kuti kenza inogona kutumirwa kune dzimwe nhengo dzomuviri wako.
Kana iwe uine hutachiona, lymph nodes yako pedyo nenharaunda yakakanganisika inogona kuvhuvhuta nekuti yakawana magciwane. Uye kana iwe ukava nekenza yemazamu, lymph nodes mu armpit yako (axillary lymph nodes) ndiyo nzvimbo yakajairika iyo masero ekenza inogona kugara, zvichiita kuti node idzi dzidzike.
Kuongororwa Kushandisa Sentinel Lymph Node Biopsy
Chirwere chemuviri pachacho chine mamwe lymph nodes, iyo inoita lymphatic fluid uye inoipfuura pamwe chete. Mvere dzemazamu dzakawanda dzinowanzoenda kune yako axilla kana nzvimbo yepasi. Kuchengeta nhengo dzemuviri dzisina kusimba nzvimbo inofanira kunge iri chikamu chekuchirapa chifu chekuongorora, uyewo mazamu ekuzviongorora . Kupfigira lymph nodes kunogona kuva uchapupu hwokuti kenza yakapararira mberi kwepamuviri wako, asi nzira chete yekuziva nayo ndeyekuti yakave yakabviswa uye yakaedzwa.
Pane maitiro maviri e lymph node biopsy. Mune lynph node biopsy , dye uye majekesi anokonzerwa nemagetsi anokonzerwa mukenza yako yebonde. Nhamba yekutanga kana node iyo dye inofamba nayo inonzi inonzi lymph nodes-yekutanga nhamba iyo kenza ingatarisirwa kufamba nayo.
Chimwe chinhu chinoshandiswa kumusana we lymph node biopsy ndeyekuita lymph node dissection ye axillary. Mune nzira iyi, dzose dzemakirini nhengo dzinogona kuwanika mumukati wako dzinobviswa.
Tadzidza kuti kuwana masero emukenza mumakirini ako emaketinel ishoko rakanakisisa yekufananidzira kana kuti kwete kenza inowanikwa mune imwe yeiyo yako yakasara yemaitiro.
Axillary lymph nodes inowanzova nzvimbo yekutanga iyo kenza yemazamu inopararira asi pane zvimwe zvisiri izvo. Kenza yepabonde nechepakati pebhokisi rako inogona kunyura kuti iine lymph nodes pakati pemabere ako. Apo lymph nodes dzinobviswa dzinotumirwa kudhipatimendi rehutano kuti ritarise pazviri pachena uye pasi pe microscope.
Lymph Node Mamiriro
Mushumo wehutachiona pamusoro pe "lymph node" yako "chimiro" inotaurira kana kana kwete chero chiratidzo chekenza chiripo mumakumbo ako emakumbo akabviswa.
Iwe unogona kunzwa mazwi akadai se macrometastases kana micrometastases kana chiremba wako achikurukura nodes ako. Macrometastases inotaura nezvekupararira kwekenza kune lymph nodes iyo inoratidzika kune ziso rakashama. Micrometastases pane kunoreva uchapupu hwekenza mune lymph nodes iyo inogona kuonekwa pasi pe microscope.
Kana lymph nodes yako yakajeka nekenza, nhengo yako ye lymph node inonzi yakashata uye yakarongwa N0 maererano netsika dzeTMM dzekenza yemazamu. Kana uchinge uine tumarara duku uye node dzakachena, hazvisi nyore kuti iwe unoda chemotherapy.
Kana iwe une kenza masero mumakirini ako, kenza yako inganzi iine lymph node-positive . Kubva paTMM staging, tumora yako ingadai yakanzi N1, N2, kana N3 inotarirwa kuti ingani lymph nodes ine kenza dzemasera uye kuti kure kure nechiremera ma node akanaka anowanikwa.
Zvimwe Zviitiko Zvinokosha Mukurapa uye Kurapa
Lymph node chiitiko chimwe chezvinhu zvikuru pakuita zvisarudzo pamusoro pekurapa kenza yepazamu, asi pane zvimwe zviedzo zvinotora basa mune zvose zvekurapa uye kufungidzira zvakare. Izvi zvinosanganisira:
- Chiremera chekukura: Chiremera chinotyisa chinotora basa mukutarisa kwekenza yebonde .
- Nzvimbo yemakirmone yekugamuchira: Makero ako emukenza achaongororwa kuti aone mamiriro ako ehommone receptor , kureva kuti, kana kuti kwete kanomwe masero ako ane receptors zveestrogen kana progesterone kumusoro, sezvo izvozvo zvinobatsira kutungamirira kusarudzwa kwekurapa.
- HER2 chimiro: Kukura kwevanhu chinonzi epidermal receptor 2 , kana chiripo pamakenza ako emukenza, inobatsirawo pakuongorora uye kurapwa.
- Tumorire giredhi: Tumor grade ndiyo imwe yehutsinye hwekenza uye izvi zvinogona kutungamirira nzira dzokurapa.
- Kuvapo kwehupi hupi zvayo: Kana kenza yako yakapararira kune dzimwe nzvimbo dzomuviri, somuenzaniso, mapfupa ako kana mapapu ako, izvi zvinokosha mukusarudza nzira dzokurapa.
Mishonga Yevanhu Vane Mazano Akanaka
Kana iwe uine node node biopsy uye haina kunaka, iwe haufaniri kunge uchida kuva ne-axillary lymph node dissection. Kusiyana neizvi, kana iwe une kenza dzemasere dziripo mune sentinel lymph node yako, dissiction ye-axillary inogona kuiswa pamwe chete nekuvhiyiwa kwekenza yako. Kana lymph nodes yako yakanaka, iwe uchada kuzokurukura zvimwe zvirongwa zvekurapa neoncologist yako mushure mekuvhiyiwa.
Kushandisa lymph nodes kunoratidza kuti kenza yakaratidza kuti unokwanisa kupararira mberi kwepamuviri wako uye iwe uchaudzwa kuti uve neAdjuvant systemic therapy sechem chemotherapy kuuraya chero mimwe masero emukenza anoramba ari mumuviri wako. Chirwere cheAdjuvant chinoreva kurapwa kunopiwa kwete nokuti chero kenza inowanikwa, asi nokuti inofungidzirwa kuti panogona kunge kune mamwe masero emukenza aripo.
Kune avo vane estrogen receptor inorapa zvirwere, hormonal therapy inowanzotarisirwa makore mashanu kusvika gumi mushure mekurapa. Izvi zvinogona kuva tamoxifen kune avo vari premenopausal uye aromatase inhibitor kune avo vari postmenopausal. Kune vakadzi vanomira mumasopaopausal uyo achange achishandisa aromatase inhibitor, bhophosphate mishonga Zometa inokurudzirwa uye zvinoratidzika kuderedza dambudziko rekugadzira masastases emapfupa. Mapfupa ndiyo nzvimbo inowanikwa yakawanda yemasastases nekenza yemazamu.
Radiation therapy inogona kana kuti isingakurudzirwe zvichienderana nenhamba ye lymph nodes iyo inofadza, uye zvimwe zvinowanikwa mumarara ako.
Prognosis
Zviratidzo zvekare, zvinonziwo maonero, ndiyo imwe nzira iyo chiremba anotaura pamusoro pokuti matambudziko ekupona anokuchengetera sei iwe wapedza kurapa. Yeuka, kuva nekenza yemukirini imwechete mumuviri wako kune imwe yakawanda. Mishonga yakagadzirirwa kuuraya vakawanda, kana kwete yose, yekenza yemasero ako zvichibvira.
Kana iwe wakanga uine lymph nodes yakachena uye duku, borosi-yepamusoro-tumor, iwe unofungidzira mushure mokurapa zvakanaka. Kune rumwe rutivi rwomukati, kana wakanga uine lymph nodes yakawanda yakabatanidzwa kana chiremera chakakura, kurapa kwako kuchave kwakanyanya kukurudzira, uye maonero ako achava akaoma kutarisa kusvikira wapedza mapepa ose. Imwe nyaya yakabudiswa muNew England Journal yeMishonga inoratidza dambudziko guru rekudzoka kune varwere vane vana kana kupfuura maitiro emakristomu akanaka. Uyewo. chiremera chemazana chirevo chekuzvimiririra chikonzero.
Hazvina mhosva kuti kuongorora kwako kunowirirana pachiyero ichocho, tapota ziva kuti kupona kwehuwandu huri kuwedzera, kurapwa kuri kuve kwakanyatsobudirira uye kunobudirira, uye kunyange kenza yepamusoro yepabonde dzimwe nguva inogona kutarisirwa kwenguva yakareba.
Lymph Node Rating
| Lymph Node Rating | Zita reZvitsa |
| N0 | Hazvina kunaka kana zvakajeka - hazvina kenza uye hapana micrometastasis |
| N1, 2, 3: Zvakanaka (zvinosanganisira) lymph nodes | |
| N1 | Kanzira inowanikwa mu 1-3 lymph nodes pasi pemaoko kana lymph nodes mukati mezamu |
| N2 | Kanzira inowanikwa mu 4-9 lymph nodes pasi pemaoko kana lymph nodes mukati mezamu |
| N3 | Kanzira inowanikwa mu 10 kana kupfuura yerinopi nodes pasi pemaoko kana kuti yakapararira pasi kana kupfuura pamusoro pekoloni. Inogona kunge yakawanikwa munharaunda dzepasi-soro uyewo nhengo dzemuviri dzemuviri |
The Bottom Line
Kana uine lymph nodes rakanaka nekenza-kamu yemazamu epamuviri, remishonga ingangodaro yakanyanyisa uye inosanganisira chemotherapy, hormonal therapy, HER2 inorapwa kurapwa kune avo vari HER2 positive, uye zvichida mashizha. Izvozvo zvakati, vanhu vazhinji vane kenza yemukirini-positive vanogara vasina kenza-mushure mushure mekurapa, uye nhengo yakanaka ye lymph node haisi kureva kuti kenza yako ichadzoka zvakare.
Sources:
Laronga, C. Mumiririri Wemashoko: Breast Cancer Guide yekuziva nekurapa (Kunze kweBasics). Kusvika pari zvino.