Kushandisa zvisina kufanira izwi rokuti "kenza" kunosuruvarisa. Kanzira yechokwadi inoda chiito, kupindira mune zvekurapa mune chinangwa chekuponesa hupenyu. Asi chimbofunga kukanganisa kunogona kugadzirwa nekuudza mumwe munhu vane kenza kana zvisiri zvechokwadi. Iyi njodzi inotyisa iri kuitika kune varume 100 000 gore negore muUnited States nevarume vanopinda nenyuchi biopsy uye vanoziviswa kuti vane kenza yeprostate ine gire reGleason 6.
Asi fungidzira zvinorevei: Ko kana Gleason 6 yakasiyana-siyana yekenza yeprostate haisi chaiyo kenza?
Gleason 6 uye Kanzer?
Chisarudzo chekugadzirisa Gleason 6 sekenza yakagadzirwa zvakare muma1960; vanachiremba kare kare vaifunga kuti masero akaona kenza pasi pe microscope. Iye zvino kuedza kwechokwadi kunoratidza kuti Chikoro che 6 hachisi mhenje. Zvisinei, kuchinja pfungwa pamusoro pechinhu chakave chakanzi chirwere kubva kuma1960 chave chakaoma. Vanachiremba vakawanda mubazi reprostate vanoramba vachirumbidza zvakanyanya kurapwa kweGleason 6.
Bhuku 7 uye Pamusoro Ndeye Kanari Yechokwadi
Chikamu chekuvhiringidzika kwakabatana nechokwadi chiri pachena kuti mamwe makero ekenza yeprostate ( Gleason 7 nepamusoro ) zvirokwazvo iripo uye dzimwe nguva inouraya. Unhu hwekusachena hweGleason 6 hunogara huchivhiringidzika nekenza yepamusoro-kenza, iyo inotungamirira pakufa mune varume vanenge 30 000 gore negore.
Dambudziko rave kusava nekunyatsoongorora zvesayenzi yakagadzirirwa kunyatsobatanidza chikwata chepakutanga cheGleason, chakagadziriswa panguva yekuongororwa, kune rufu rwekenza iyo inowanzoitika makore anopfuura gumi gare gare.
Pamusana pokushayikwa kwekuziva kuti dambudziko raivepo, pane nguva yakanono yekuita zvidzidzo zvinodiwa.
Kuzononoka uku kuriwo kune chikamu chinokonzerwa nekukura kunononoka kwekenza yeprostate. Kunyange boka revarume vanofa nekenza yeprostate vanowanzogara naro kwemakore gumi kusvika makumi maviri vasati vapedzisira.
Nenguva yakareba-yakasakara pakati pekufungidzirwa uye kufa, vatsvakurudzi vakanga vasina kutarisa subtype yekenza yeprostate isingaiti rufu. Nokudaro, zvigumisiro zvezvidzidzo zvakadaro zviri kungova kuwanikwa.
Shoko rokuti "Kansa" Rinorevei Chaizvo?
Sezvo tiri kuedza kuita kunyatsosiyanisa pakati peGleason 6 nepamusoro pemhando yekenza yeprostate inotsanangura kuti shoko rokuti "kenza" rinorevei chaizvo: Masero evanhu ane simba remasastases ane kenza. Makero eC Cancer ane simba rekupararira kunze kweprostate uye mune imwe nhengo masititi . Kana kamwe masero emasitendi achiuya mune imwe nhengo, anotanga kuwedzera uye kukura mumatumbu. Apo mabheya aya anosvika kuhupamhi humwe, anotanga kukonzera kusashanda kwesimbi iyo. Kana chikamu chisina kushanda chakanyanya, chirongwa chinova chinouraya.
Kufananidzira kweMamwe Cancers
Cancers inotsanangurwa nenzvimbo yavo yakabva, iyo yakakura sei tumarara yakakura, uye gorosi yavo. Somuenzaniso, mapapu, uropi, uye prostate kanzira dzose dzinoita zvakasiyana kwazvo nokuti dzinotangira nhengo dzakasiyana. Pasinei nhengo ipi yatinenge tichitaura pamusoro payo, yakawanda tumarara, yakanyanya kuipa iyo inogona kuzvibata.
Matumbo makuru anowedzera kutyisa nokuti ane ruzivo rwakawanda rwekuchengetedza zvidzidzo zvepamusoro.
Matumbo ane utsinye ane maitiro akasiyana-siyana anogona kuonekwa achionekwa kubva kumadekisi emakoromu mashoma. Iyi basa rinoitwa nechiremba akadzidziswa anonzi chiremba.
"Bhizinesi" inyanzvi yekuongorora kuonekwa kwemasero emukenza pasi pe microscope. Kuchengetedza kunogona kushandiswa kufanotaura kuitika kwemasastases emangwana. Mazuva ano, kururamisa kwegwaro kutsunga kunowedzera kuwedzerwa nekushandiswa kwemajini maitiro anoratidza kuti maitiro ejeni anozivikanwa kuti anowanzobatanidzwa nehutsinye hwekuita.
Kuchinja Kwekufungidzira Kwemazuva Ano NezveKenza yeProstate
Pamberi pePSA kuongorora uye nenyuchi bhiopsy yakave yakawanda mumavambo ekuma1990, kenza yeprotate yaiwanzoongororwa mushure mokunge ichinge ichishandiswa.
Mushonga weMetastatic prostate haisi pachena kuti inotyisa uye inouraya. Kwemakore akawanda ekutarisira varume vane kenza yemastastatic prostate, vanachiremba vakagadzira pfungwa yekuzvidzivirira: yakawanda, yose-inosanganisira kunetseka pamusoro pehutachiona hwekenza yeprostate. Zvinonzwisisika, mafungiro aya ekufungisisa akapararira-pamusoro pemafungiro avo nekenza yekare yepatate ye prostate paakatanga kuve yakakurumbira nekuda kwekuwedzera kwekushandisa kwePSA kuongorora uye nenyuchi biopsies. Saka, kwemakore akawanda, vanachiremba vave vachifunga zvisina kururama kuti dzose dzekutanga-staged cancer yekenza dzichava metastatic kana isingateereri.
Tingaziva Sei Kuti Gleason 6 Subtype yeCrostate Cancer Haichaparadzi?
Zvidzidzo kuongororwa nekuguma kwenguva yakareba kwevarume vane Gleason 6 yakachena uye pakupedzisira kwapera. Zvidzidzo izvi zvaifanira kuitika kuvarwere vanovhiya nokuti kubviswa kweprostate kubviswa kunobatsira kunyatsoongorora gland rose. Kuvhiya ndiyo nzira bedzi yekusimbisa kuti chiyero chepachikoro chinonzi bhiopsy chinoratidza Gwaro 6 chaiva chakarurama uye kuti nzvimbo yepamusoro-grade yechirwere yakanga isisipo.
Kubvisa yose prostate kuitira kuti inogona kunyatsoongororwa nehutachiona ndiyo nzira chete yekuziva kuti 100 muzana yekenza mu prostate ichokwadi yeBakala 6. Zvino, zvidzidzo zvakawanda zvekuvhiya zvekare zvinokwana zviuru zvevarume zvakatarisira vanopfuura 10 makore 'mushure mekushanda, ave apera. Iko kusingagumi kutsva ndechekuti Gwaro 6 harina kumira.
Wakave Uchiita Madaktari Akaita Chirwere Chikuru Here?
Chirwere cheprostate chinoratidzirwa nenzira inoshamisa uye isina kukwana. Nhamba gumi nemaviri-inotungamirirwa nenyuchi inonzi biopsies inoparadzaniswa kuburikidza nerusvingo rwemashure mu prostate pasina chero kuedza kutsvaga chimwe chinhu chisingaoneki. Izvo zvinoshamisa izvi zvakashanda zvakajeka nokuti prostate iri gland duku, pamusoro pehukuru hwehuni. Izvo zvinokonzera ndezvokuti nokuti kuputika kunenge kusinganzwisisiki, vanogona kurasikirwa nekenza yepamusoro yekenza prostate (Gleason 7 kana pamusoro).
Kanzera yeprostate inowanzoitwa multifocal ; izvi zvinoreva kuti zvipfeko zvinogona kuwanikwa munzvimbo inopfuura chikamu chimwe cheprostate gland. Aya matanho akasiyana anogona kuva emakero akasiyana. Imwe nzvimbo inogona kunge iri Gleason 6 uye imwe nzvimbo inogona kuratidza Gleason 8. Saka, kana nheyo dzisina kuiswa mujeni, zvinokwanisika kuti biopsy ione Gleason 6 apo chaizvoizvo Gleason 8 aripo zvakare. Zvidzidzo zvakaitwa kusvika nhasi zvinoratidza kuti kana mumwe chete pavarume vana vanofamba zvakanaka vakaita 12-core random needle biopsy inoratidza Gleason 6 chaizvoizvo vasina kuongorora zvirwere zvepamusoro-grade pane imwe nzvimbo mu prostate.
Vachingovimba netsika iyi yetsvina, vanachiremba vanogona kunyengedzwa mukutenda murwere ane Gleason 6 chete apo pane dzimwe nguva chikoro chaicho chiri nani. Iyi ndiyo yekutanga yekutenda kwenhema kuti Gleason 6 inokwanisa kugadziriswa. Varume vanorwara ne "Gleason 6," avo vakabata kurapwa, uye gare gare vakave nekenza zvakare, vakatungamirira vanachiremba kuti vatende kuti maGenason 6 anokonzera kenza avo vakanga vaita mishonga. Isu iye zvino tinoziva kuti zvakadzokorora, izvo zvaifungidzirwa kuti zvinouya kubva kuGleason 6, zvaive chaizvoizvo zvinowanzoitika kune varume vaiva neGleason 7 kana kuti yepamusoro yekenza yeprostate yakanga yakavanzwa kune imwe nzvimbo yeprostate uye yakanga isingaoneki neprotected original biopsy .
Nzira dzeChechi dzekugadzirisa Bhiopsy Inaccuracy
Kuita kuti hutachiona hwekenza hweprotate huderedzwe, nzira yakatarwa yave iri yekurudzira chirwere chakakura kana kupiswa kwemazuva ose kune mumwe nomumwe, "kungova wakachengeteka." Kurapa munhu wose anonyatsozadzisa mukana wekusawana unyanzvi hwepamusoro-gwara uye kubvisa chikwereti chechiremba chiremba kana Kudzokazve kunowanikwa munguva yemberi. Zvinosuruvarisa, pamusoro pemakore makumi maviri ekupedzisira, mutemo uyu unoshungurudza wakakonzera kutarisirwa zvisina kufanira muvanhu vanopfuura mamiriyoni maviri uye kurapwa kunogona kukonzera kusava nemafungiro.
Iye zvino kuti vanachiremba vachiona zvipingamupinyi zvekurumbidza kurapwa kwevanhu vose, imwe sarudzo inonzi yakashanda kuongorora yakave ichiwana kugamuchirwa. Pamakore gumi apfuura, kuongororwa kwakaitwa kwakanyanya kugamuchirwa senzira yakanakisisa yekugadzirisa varume vakasarudzwa neGleason 6 kenza ye prostate. Kurongedza kwakagamuchirwa kunogamuchirwa neNational Comprehensive Care Network (NCCN), IAmerican Society of Clinical Oncology (ASCO) uye American Urological Association (AUA) senzira yakakwana yokubata Gleason 6.
Varume avo vanotanga kuonekwa kuti vane Grade 6 vanonyatsoongororwa nekuongorora nguva dzose yePSA yavo. Vanowanzopora nguva 12-nhengo yejoo yebiopsies makore ose mashomanana muchiedza chekuona chero upi hwepamusoro-gwara chirwere chingangodaro chakarasikirwa pachigadzirwa chekutanga. Sangano rekuongorora kwePSA uye nguva dzemazuva ano hazvibatsiri, asi kurapwa kwakanyanya nekuvhiyiwa kana kupiswa kwezuva kunowedzera kuipa. Zvisinei, munguva pfupi yapfuura, maitiro matsva ekutsvaga ari kuwanika ayo anopa imwe nzira kune rimwe diopsy risina.
MRI Imaging uye Biopsy
Nyuchi dzisina kunaka uye dzimwe nguva dzinokonzera zvirwere zvinopisa upenyu kana kubuda ropa. Kunyange zvazvo bhiopsy isina kuonekwa yakambofungidzirwa kuti ndiyo yegoridhe yekenza yekenza yeprotate, inofananidzwa sei nemafungiro emazuva ano neMM-multi-parametric MRI?
Mubvunzo uyu wakanyatsoongororwa muchidzidzo chikuru chinosanganisira varume mazana matanhatu vane maPAR mazinga akazvipira kuti awane MRI yakawanda-inyanzvi, bhiopsy isina kushandiswa uye kugadziriswa biopsy kuti aongorore nzira iyo ndiyo yakanyatsokwana (kuburitsa biopsy kunosanganisira makumi matatu + nendira mu iyo prostate pasi peanesthesia uye ndiyo nzira yakarurama kwazvo yekuongorora chirwere cheprotate). Zvichienzaniswa nekugadziriswa kwehuputi, bhiopsy isina kuonekwa yakaonekwa 75 muzana yevarume vaiva nechirwere chepamusoro-gwara. MRI yakasiyana-siyana yakaona 90 muzana yevarume vaiva nekliniki inokosha yekenza yeprotate.
Chidzidzo ichi chakanyatsoratidza kuti maitiro anonyatsoita, ma-multi-parametric anonyanya kururamisa kupfuura anonyanya kusarudzwa . Zvinosuruvarisa, vazhinji vanachiremba , rudzi rwechiremba avo vanopomerwa nebasa rekutarisira varikushandira vanoongorora, vanoramba vachidzidziswa mune nzira dzisina kumboitika yebhiopsy yekugadzirisa nekuongorora kenza yeprotate.
Mhedziso
Varume vane Gleason 6 havana kenza mumutauro wechokwadi wezwi. Hapana chakaipa chekugadzirisa masimba. Kusvikira munguva pfupi ichangopfuura, kukanganisa kukuru kwekushongedzwa kwakave kwave kudiwa kwekudzokorora bhiopsy dzisina nguva nenguva. Kuuya kweMRI yakasiyana-siyana kunofanirwa kunge kune imwe nzira yakakwirira. Mazuva ano, murume anowanikwa ane Gleason 6 ane sarudzo yekutanga purogiramu yekucherechedza kunze kwekudiwa kwenguva nenguva 12-nheyo yezvinyorwa zvebiopsies.