Dhigirii IIB Munga-kanza - Tsanangudzo, Zvirwere, uye Zvirwere
Nhanho 3B isati iri duku yemukenza yemapapu yemapapu inofungidzirwa sepamupenza wemapapu wakakura pamwe nesheji yechina, uye kunyange isingawanzopora, inoporesa. Vanenge makumi maviri kubva muzana yevanhu vane chirwere chechirwere chemapapu 3B panguva yekuongororwa, uye imwe 40 muzana yevanhu vakatofambira mberi kusvika panhete 4 .
Overview
Mutsara 3B Muchirwere wemapapu unotsanangurwa sechirwere chesimba chero chipi zvacho chakapararira kumakiromodhi akare kure kana kuti chakasvikira zvimwe zvivako mubhokisi (zvakadai semwoyo kana sophagus.)
Oncologists vanoshandisa TNM system kuti iwedzere kutsanangura matanho emukenza wemapapu. Tsanangudzo yakajeka yeTMM system inosanganisira:
T iyo inoreva chiremera chekukura:
- T1 : Chirwere chisina kupfuura 3 cm (1 ½ inches) muhukuru.
- T2 : Chirwere ichi chikuru kupfuura 3 cm asi pasi pe7 cm.
- T3 : Dumbu racho rakakura kudarika masendimita manomwe kana kuti rinopinda zvakananga chero chipi zvacho chinotevera: rusvingo rwechifuva, diaphragm , mutsara unoshandisa mutsara (phrenic nerve), membrane yakavhara nzvimbo pakati pemapapu maviri (mediastinal pleura), kana imwe yemakumbo mwoyo ( parietal pericardium ); kana chirume mumutsara mukuru bronchus anenge 2 cm pasi pe carina; kana iyo inobatanidzwa nokuwa kwepapu rose kana kuparadzanisa tumarara mumatule (s) mulobe imwechete yemapapu.
- T4 : Chirwere chemhando ipi zvayo inopinda chero ipi zvayo inotevera: nzvimbo pakati pemapapu ( mediastinum ), mwoyo, midziyo yakawanda, trachea , imwe yemaputi asingatauri tambo dzemazwi (chirevo chekare), sophagus , vertebral body, kana nzvimbo uko chechechea inoparadzaniswa mu-bronchi mbiri huru (carina); kana kuparadzanisa tumarara yeguruva (s) mune imwe nzvimbo yemapapu lobe kune rumwe rutivi rwechifuva.
N inoreva lymph nodes:
- N0 : Hapana nodesiti inobatwa.
- N1 : Tsvina yakapararira kune node dziri pedyo kune rumwe rutivi rwechifuva.
- N2 : Chirwere chacho chakapararira kune node mberi zvakare asi kune rumwe rutivi rwechifuva.
- N3 : Masero emukenza anowanikwa mumakirini emakirini kune rumwe rutivi rwechifuva kubva mumhutu, kana mune nodhi pedyo nekorlarbone kana mitsipa yemutsipa.
M inomirira chirwere chemasastatic :
- M0 : Hapana metastases aripo.
- M1 : Chirwere chakapararira (chechi) kune dzimwe nzvimbo dzomuviri kana mamwe mapapu.
Kushandisa TNM System Stage 3B inotsanangurwa se:
- Chero T, N3, M0 : Zvinoreva chiremera chemhando ipi zvayo yakapararira kune lymph nodes kune rumwe rutivi rwechifuva kubva kumarara kana kuti node pedyo nekorlarbone kana mitsipa yemutsipa, asi haina kupararira kune nzvimbo dziri kure dzomuviri.
- T4, Zvose N, M0 : Zvinoreva chiremera chemhando ipi zvayo yakakura mumhepo, yakapinda zvivako zvemukati zvakadai semwoyo kana sopu kana kuti ine chirwere chakaipa chinonyangadza. Nodha dzinogona kunge dzisingabatanidzwi, uye kana dzichibatwa, dzinogona kunge dziri pedyo nechomuviri kana kuti dzichienderera mberi muchipfuva kana mumutsipa, asi chironda chisina kupararira kune nzvimbo dziri kure dzomuviri.
Zviratidzo
Zviratidzo zvinowanzoitika padanho 3 kenza yemapapu inosanganisira chifuva chinoramba chiripo uye kupera kwekufema . Tumhe pedyo nemhepo inoenda kunogona kukonzera hemoptysis ( kukwezva ropa ). Apo bundu racho rinosanganisira nzvimbo dzakadai sedopu uye dzimwe dzimba dzechifukidzo, dysphagia (kunetseka kunomedza) uye kushaya simba kunogona kuitika. Nhamo kumusana, chifuva, uye mbabvu zvinowanzoitika kana ruzha rukuru runovapo, uye izvi zvinogona kukonzera kuwedzera kufema kufema.
Zviratidzo zvechirwere zvakadai sekuneta uye kurasikirwa kwekurema kwechido kungangovepo zvakare.
Mishonga
Nezvo zvisingawanzoitiki, chikwata chechirwere chemapapu 3B chinofungidzirwa chisingaiti ( chirwere hachizoporesa kenza), asi hachirevi. Kune avo vane utano hwakanaka, kusanganiswa kwekemotherapy kana chemotherapy uye remishonga inonzi radiation inowanzokurudzirwa. Kana vanhu vasingakwanisi kubvumira chemotherapy, kurapa kwemaawa kunogona kushandiswa chete. Kunyange zvazvo chirwere chemaawa chisingawanzopiwa nechinangwa chekuporesa chirwere, chinogona kubatsira mukurapa zviratidzo zvakadai sekurwadziwa, kupererwa kwemhepo, nekukanganiswa.
Mishonga mitsva yakadai seyakananga kurapwa uye immunotherapy iri kuita mutsauko kune vanhu vane zvikamu zvepamusoro zvekenza yemapapu. Munhu wose ane kamudiki kadiki kemapapu yemapapu anofanira kunge ane kufungidzirwa kwema molecular (kuongorora kwejeni) yakaitwa pamarara. Mishonga yekurapa kuchinja kwe EGFR , ALK rearrangements , uye reRR1 rearrangements zvakagamuchirwa, uye zvinodhaka zvinotarisa zvimwe zviitiko zviri kuongororwa mumakiriniki ekuedzwa. Mune zvimwe zviitiko, kurapwa uku kwakabvumira vanhu kuti vararame nemukenza wemapapu kazhinji sechimiro chezvirwere zvisingaperi.
Immunotherapy inzira inofadza , ine mishonga yokutanga inogamuchirwa muna 2015. Mishonga iyi yakaguma ne "mhinduro dzinogara kwenguva refu" -inzwi rezvinyorwa zvinogona kushandurwa kureva kurarama kwenguva refu-kune vamwe vanhu vane kenza yemapapu yakakura. Zvimwe zvezvinodhaka izvi zviri kushandiswawo pamwe chete kuti zvirape zvikamu zvepamusoro zvekenza yemapapu. Muna 2018 imwe immunotherapy drug, Imfinzi (durvalumab) yakagamuchirwa zvakananga kuti kurapwa kwechigarire chisingaverengeki chechitatu musingaiti chekenza yemapapu emapapu. Inoshandiswa mushure mekemotherapy uye remishonga inonzi radiation, uye yakawanikwa yekuvandudza kupfuurira-kusina kusununguka.
Nemhaka yokuti migumisiro yehutano iri murombo , National Cancer Institute inotaura kuti vanhu vose vane chirwere chepamupa 3 chepamupa vanofanira kufungidzirwa kuti vanogona kuongororwa kwechiremba -iyo inotarisa mishonga mitsva pamwe nekurapwa kwekenza yemapapu emapapu.
Prognosis
Iko makore mashanu okupukunyuka kwechikwata nechikamu che3B yemukenza wemapapu zvinosuruvarisa chete 5 muzana. Nenguva yekupona kwemazuva mashoma (nguva iyo 50 muzana yevarwere vari vapenyu uye 50 muzana yakapfuura) inenge mwedzi gumi nemapfumbamwe nekurapa. Ramba uchiyeuka kuti idzi nhamba idzi nhamba dzaiwanika musati mishonga mitsva-yakadai semamwe mazano ekurapa uye immunotherapy-yakanga yakabvumirwa pakurapa kenza yemapapu.
Support
Zvidzidzo zvinoratidza kuti kudzidza zvese zvaunogona nezvekenza yako kunobatsira nemigumisiro. Kune hupfumi hwehupenyu pahutaneti, asi zvinogona kuva zvakaoma kuziva kwatinofanira kutarisa mashoko akanaka. Tarisa mazano aya ekuwana ruzivo rwekenza yakavimbika paIndaneti . Pamwe chinhu chakakosha zvikuru chaungaita ndechekudzidzira kuva iwe mumutevereri wako mukuchengetedzwa kwekenza . Mishonga yemukenza yemapapu iri kuchinja nokukurumidza, uye inogona kuva yakaoma kunyange vadzidzisi vekenza yemapapu kuti varambe vachienzanisa zvose zvitsvakurudzo.
Nzira yakanaka yekutsvaga zvose zvakatsigirwa uye ruzivo rwakanaka ndeyekubatanidzwa mumapoka ekutsigira kenza yemapapu kana rubatsiro rutsigiro. Unogona kunzwa zvishoma pamusoro pemapoka emukenza emapapu pane kutaura, mapoka evanhu vane kenza, asi izvo mapoka aya asingagoni kuwanda sei in depth. Iko hashtag #LCSM inomirira mutapu wemapapu social media. Kunyanya zvose, usarasa tariro. Zvose zviri kurapwa uye kuponeswa kwemupenza wemapapu zvave zvichivandudzwa. Muna 2015 pakanga pane zvimwe zvirwere zvitsva zvinogamuchirwa nemukenza wemapapu kupfuura kare, uye mamwe marapirwo ari kuongororwa mumakiriniki.
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