Kana uri kuedza kuongorora gedhi remupenza wemapapu rako unogona kunzwa uchivhiringidzika. Zvinorevei kana wako oncologist achitaura pamusoro pe "TNM" uye izvi zvinopindirana sei nezvikamu? Ngatitarisei zvinoreva imwe neimwe yetsamba idzi, kuti vanachiremba vanoshandisa sei izvi kuti vagadzire kenza, uye izvo zvinoguma zvinoreva nenzira yekurapa.
The TNM System
Nhengo yeTMM inotarirwa nemukenza wemapapu inogona kuvhiringidza kune ani zvake kuti anzwisise, regai mumwe munhu achangobva kurohwa nemashoko emukenza wemapapu kuongororwa. Nharaunda yeTMM inopindirana sei nemakamu emapapu emapapu , sechikamu chechipiri uye chitubu chechina?
Zvinotaurwa Netsamba
Zita rimwe nerimwe reTNM rinomiririra kukura kana kupararira kwekenza sezvinotevera:
- T -Inotanga kuwanda kwechiremera. Chiremera chinowanzopiwa mumentimita (cm). Kuti uchinzwisise izvi mumasendimita, masendimita mashanu anenge akaenzana ne 2 masentimita.
- N - N inomirira lymph nodes uye inotaurira kana chirwere chacho chakapararira kune lymph nodes, uye kana zvakadaro, kure kure nechiremera chavari.
- M - M inomirira mastasisis , ndiko kuti, kupararira kwemarara kune dzimwe nhengo dzomuviri.
Chikonzero nei kuvepa kunokosha
Nhamba yeTMM inobatsira vanachiremba kunzwisisa kuti yakawanda sei kenza uye, saka, izvo zvakanakisisa zvokurapa ndezvipi zvechirwere ichocho. Iyo inogonawo kubatsira kubatsira kufungidzira kuti chirevo chekufungidzira chii kune mumwe munhu ane kenza yemapapu.
Nhamba yeTMM yakagadzirirwa pasi rose nezvemapurogiramu emapapu muzviuru zvevanhu uye kufananidzwa kwehuwandu hwekenza yemapapu nemhinduro yekurapa uye kufungidzira.
Izvozvo zvakati, zvakakosha zvikuru kunzwisisa kuti pane zvakawanda zvinokanganisa kufungidzira kwekenza yemapapu inopfuura mberi kwepakati.
Utano hwako hukuru, rudzi rwemapapu emapapu une, kana kuti iwe hauna "tarisa" mararamiro ekuchinja kwemuviri wako, uye kunyange hutano hwako hunogona kuita basa mune zvehutano huchashanda zvakanakisisa iwe uye izvo zvinorehwa nomunhu mumwe nomumwe .
TNM Staging Breakdown
Iwe uchaona kuti tsamba dzako dzeTNM dzichava nenhamba dzinovatevera. Ngatitarisei kuti nhamba dzakasiyana dzinorevei:
T-Tumor Size
- Tx - Kukura kwechirwere hazvizivikanwi, kana masero emukenza anongowanikwa mu sputum .
- T0 - Hapana humwe humwe uchapupu hwomukamhina mukuru.
- Tis - Carcinoma in situ - Chirwere chiripo chete mumasero akavhara mugwagwa uye haana kupararira kune maviri.
- T1 - Tumumire pasi kana kuti yakaenzana ne3 cm (1 ½ inches).
- T1a - Pasi pane kana yakaenzana ne2 cm.
- T1b - Yakakura kudarika 2 cm asi yakaderera kana yakaenzana ne3 cm.
- T2 - Chirwere ichi chikuru kupfuura 3 cm asi pasi pemasendimita manomwe. T2 matumbu anogona kukanganisa chikamu chenzira, asi haana kuita kuti pneumonia iite kana kupisa mapapu ( atelectasis ). Vangangodaro vakapararira kusvika kumarara kumativi emapapu. Zvinogona kunge dziri pedyo ne- bronchus huru asi inenge 2 cm (anenge inch) kubva munzvimbo iyo maronchus inoparadzanisa kuenda kumapapu ose.
- T2a - Yakakura kudarika 3 cm asi yakaderera kana yakaenzana ne5 cm.
- T2b - Yakakura kudarika 5 cm asi yakaderera kana yakaenzana ne7 cm.
- T3 - Tumumhuri inopfuura 7 cm, kana pasi pemasendimita manomwe asi ine dhiyo rakasiyana mune rimwechete. T3 matumire anowedzerawo matumasi ari pasi pemasendimita manomwe asi anopindira kubatanidzwa kwemapapu ( pleura ), rusvingo rwechifuva, chidimbu , chinonzi bronchus, kana kurara mukati memaminitsi maviri emunharaunda iyo bronchus inoparadzanisa kuenda kumapapu . Chirwere chinosarudzwawo seT3 kana chiri pasi pe7 cm asi chinosanganiswa ne pneumonia kana kuputsika kwemapapu ose.
- T4 - Chirwere chemhando chero ipi zvayo, asi nechimwe chinyunyu mune rimwe dibe yakasiyana kune rumwe rutivi rwemuviri, kana chirwere chinopinda masimba mubhokisi zvakadai semwoyo, mishonga yeropa yakakura pedyo nemwoyo, trachea , runyanga rwesara (nerve pedyo ne trachea), iyo mediastinum (nzvimbo iri pakati pemapapu), inophagus , kana nzvimbo iyo inonzi bronchus inoparadzanisa kuenda kumapapu maviri.
N - Kubatanidzwa kweLymph Nodes
- N0 - Hapana nodesiti inobatanidzwa.
- N1 - Tsvina yakapararira kune node dziri pedyo kune rumwe rutivi rwemuviri.
- N2 - Chirwere ichi chakapararira kune node kure kure asi kune rumwe rutivi rwebhokisi.
- N3 - Chirwere ichi chakapararira kune lymph nodes kune rumwe rutivi rwechifuva kubva pachirwere chepakutanga, kana chakapararira kune node pedyo nekorlarbone kana mitsipa yemutsipa.
M - Metastasis (Kuparadzira) kune dzimwe Dunhu
- M0 - Tsvina haina kupararira kune nzvimbo dziri kure.
- M1
- M1a - Chirwere chakapararira kumapapu akasiyana, kusvika kumapapu ekuputika ( zvakaipa zvinokuvadza zvinokonzera mutsara ) kana kuti yakagadzira mutsvuku pamunyengetero.
- M1b - Chirwere chakapararira kune nzvimbo dziri kure dzomuviri, dzakadai seuropi kana mapfupa.
Kufananidza kweMarayirini emakwenzi uye TNM Kuronga
Vanhu vazhinji vanonyatsoziva zvikamu zvemukenza wemapapu pane zvavari neTMM staging. Heano kuenzanisa kwemakirini emukenza emapapu uye TNM kugovera:
Dhigirii 0 Chirwere Chechirwere
- TisN0M0
- Nhanho 1A Kukwepa Kansa
- T1aN0M0
- T1bN0M0
- Nhanho 1B Kusunga Kanzira
- T2aN0M0
- Chikamu 2A Chirwere cheKenza
- T1aN1M0
- T1bN0M0
- T2aN1M0
- Nhanho 2B Kurapa Kansa
- T2bN0M0
- T2bN1M0
- T3N0M0
- Nhanho 3A Kurwara Kanzera
- T3N1M0
- T4N0M0
- T4N1M0
- T1N2M0
- T2N2M0
- T3N2M0
- Nhanho 3B Kusunga Kanzira
- T1N3M0
- T2N3M0
- T3N3M0
- T4N2M0
- T4N3M0
Chikamu 4 Chirwere Chechirwere
- Chero T, Chero N, M1a
- Chero T, Chero N, M1b
Inobva Ichinyatsozivikanwa Nechirwere Chechirwere
Kana iwe uchangobva kuonekwa kuti une kenza yemapapu , unenge uchinzwa uchitya uye uchinetseka. Iwe unogona kunge wakanzwa kuti kunyatsoziva nezvekenza yako kunogona kuvandudza migumisiro, asi ungazviita sei apo zvose zvinoita sezviri kunyorwa mumutauro wemumwe mutauro?
Tora nguva yekuzvidzidzisa iwe pachako. Taura nachiremba wako uye bvunza mibvunzo yakawanda. Dzidza nezvekuwana sei ruzivo rwakanaka rwekenza paIndaneti . Vanhu vazhinji vane kenza yemapapu vanofunga kuwana mhinduro yechipiri, uye izvi zvinokosha zvikuru. Zvinowanzokurudzirwa kuti iwe uite pfungwa iyi yechipiri pane imwe yenyika huru yeCancer Cancer Institute-yakasarudzwa nekenza yemukenza apo pane zvingave zviri kuve oncologist inonyanya kugadzirisa chirwere chenyu chepapu yemapapu. Uyewo, kana usina kenza kaduku yemukenza yemapapu, ona kuti chiremba wako akarayira kufungidzira kwemajeni (kufungidzira kwema molecular) yemarara yako .
Iva nechokwadi chokuti iwe pachako uri mutariri wekuchengetedzwa kwekenza yako. Kuti uite izvi, zvinogona kubatsira kuti ubatanidzwe kumapato emapapu emumusha paIndaneti (hehtag is #LCSM). Iyi misha inongokubhadhara chete asi inogona kukubatsira kudzidza uye kufamba nenzira yako kuburikidza nehuzhinji hwezvisarudzo zvauchasangana nazvo.
Chizhinji chezvose, tarisira kune tariro. Mishonga yemukenza wemapapu iri kuvandudza, uye kuwedzera kwehuwandu huri kuwedzera zvakare. Pakave nemishonga mitsva yakagamuchirwa nemukenza wemapapu mumakore mashomanana akapfuura kupfuura mumakumi emakore akapfuura.
> Sources:
> Edge, S. et al (Eds.). AJCC Cancer Staging Manual. 7th Edition. Springer. New York, NY. 2010.
> National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ) - Health Professional Version. Kushandurwa 03/31/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all
> Nicholson, A., Chansky, K., Crowley, J. et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Zvirongwa zvekuvandudzwa kweCentical and Pathologic Staging ye Small Cell Lung Cancer muChirangaridzo yeChitatu yeChirangaridzo cheTMM yeLung Cancer. Nyaya yeTraracic Oncology . 2016. 11 (3): 300-11.
> Rami-Porta, R., Crowley, J., uye PP. Goldstraw. The Revised TNM Staging System for Cancer Cancer . Annals of Thoracic and Cardiovascular Surgery . 2009. Vol 12, Kwete 1.