Zviratidzo, Zvinokonzera, Kuongororwa, uye Kurapa
Kenza yeOvarian yakave yakagadzirirwa "muurayi anyerere" nekuda kwekushaiwa kwayo zviratidzo zvinoshamisa kusvikira mamiriro acho akanyatsokura apo inogona kukonzera kurara kwepabonde, kusanzwisiswa kwehupfumi, nezvimwe. Muvhareji wehupenyu hwekugadzirisa kenza iyi ndeye 1.6 muzana chete, asi sezvo chirwere ichi chinowanzoonekwa chisati chaonekwa kusvikira chasvika pamatanho akapfuura, ndicho chechishanu chinowanzoita chikonzero chekufa kwekenza kune vakadzi.
Zvirwere zvakadai sokuvhiya uye chemotherapy zvinogona kushandiswa, kunyange kubudirira kwavo kunoderedza kuwedzera kwacho chirwere chinova.
Aina
Mhando yehutano yekuberekwa inosanganisira mukadzi, chibereko chechibereko (chikamu chezasi chechibereko), chibereko, mawere maviri, uye mavhavha maviri. Mazai maevari anenge akaenzana neamondimu uye anokonzera kukurudzirwa nekubudiswa kweii nemwedzi mumwe nomumwe. Izvo zvinokonzerawo kugadzirwa kwehomoni isrogen uye progesterone .
Kenza yeOvarian inowanzotanga kune chikamu che fallopian tube iri pedyo neyvary uye inozopararira kune ovary iyoyo. Chirwere ichi chinogonawo dzimwe nguva kubuda mu peritoneum, nhengo dzinopoteredza zviri mukati mechidziro, uye dzinopararira kune ovary. Nokuda kwechikonzero ichocho, kenza yemaawa, kenza ye fallopian tubes, uye kanhi yepisitoneal yepamusoro inowanzobatana pamwechete pavanokurukura nezvekenza.
Pane zvitatu zvinokonzerwa nekenza yemuviri (kunyange pane pane makumi matatu eine subtypes). Aya marudzi akasiyana angarapwa nenzira dzakasiyana-siyana, ane maonero akasiyana, uye anoitika kuvakadzi vezera rakasiyana-siyana.
- Zvirwere zve Epithelial ovarian zvinobva pahupamhi hwemasero (epithelial layer) kuvhara maovari uye fallopian tubes uye nhoroondo ye 90 muzana kusvika 95 muzana yekenza yevana. Ngozi yekenza iyi inowedzera nezera, uye vanhu vakawanda vari postmenopausal kana vakawana. Inonyanya kuiswa subtypes inosanganisira ekugadziriswa kwemuviri, mucinous, uye serous tumor, pamwe nehuwandu huri hukuru. Matumbu ane simba uye ekupedzisira anowanzoonekwa kune vakadzi vari pasi pemakore makumi mana.
- Zvirumbu zvinokanganisa zvinogona kunge zvakashata kana zvinotyisa uye zvinotanga mu stroma, mhuka inenge yakakomberedza mazai uye inobata mavha mavari pamwe chete. Izvi zvakaputsika muzvikamu zvakasiyana-siyana, kusanganisira granulosa cell tumor-izvo zvinotyisa mumhando yevana, inowanikwa pakati pekuberekwa nezera remakore makumi maviri, asi kazhinji isingaiti zvechisimba mumunhu mukuru-uye Sertoli cell tumor.
- Germ cell tumorum inogonawo kuva yakaipa kana yakaipa uye ndiyo inowanzozivikanwa yekenza yevhisi yevari mumuviri kune avo vanopfuura makumi matatu. Vakawanda vanoongororwa pakati pemakore gumi nemakumi matatu. Izvi zvinotanga kubuda mumakamuri ekubereka (egg) uye nhoroondo yepamusoro 3% yekenza yevana. Germ cell masumoramu inowanzoongororwa mumatangiro ekutanga asi inowedzera kukura nokukurumidza. Mamwe mashoma e-subtypes anosanganisira dysgerminomas, endodermal sinus tumor, uye matatomas asina kufanana .
- Small cell carcinoma yenyuchi haisati isiri, ichiita chete 0.1 muzana yekenza yevana.
Nhamba yekupona kwemahara yepamusoro-grade epithelial ovarian kenza (mapoka ose akabatanidzwa) makore mashanu, asi inenge 15 muzana yevanhu vanoonekwa kuti vari vapenyu mushure memakore gumi. Vatsvakurudzi vari kudzidza ikozvino "kunze" mune tariro yekuwana nzira dziri nani dzokurapa chirwere ichi. Zviratidzo zvevanhu zvinotarisana nezvimwe zvinhu, zvakadai sezera, shato uye chiremara chekenza yemukenza, mhinduro yekurapa, nezvimwe zvakawanda.
Zviratidzo
Zviratidzo zvekenza yevana vanowanzosvibiswa uye hazvina kujeka mumatanho ekutanga echirwere uye zvinowanzotarisirwa kune zvimwe, zviduku zvakashata. Kunyange zvazvo inenge makumi mapfumbamwe nezana makumi mapfumbamwe ematatu emakondomu aya atova pachikwata chepamusoro paanoongororwa, tsvakurudzo ichangobva kuwanikwa yakawana zviratidzo zvina zvinowanikwa mumatanho ekutanga. Izvi zvinosanganisira:
- Kuchinja muhutano hwemuviri, sekuzvimirira kana chirwere
- Uturu hwepelvic kana kuti kushungurudzwa
- Kazhinji inoda kuvhota kana kukurumidza kunyorera
- Kubvisa kana kuvhara mumimba
Zvimwe zviratidzo zvekenza yevavhiri kazhinji hazvionekwi kusvikira chirwere ichi chafambira mberi. Izvi zvinogona kusanganisira marwadzo panguva yepabonde, kupera kunoramba kuripo, muviri wepamuviri kana kuwedzerwa kwemvura (ascites), pakati pevamwe.
Zvimwe zviratidzo zvinokonzerwa zvakakwana kune mahomoni anokonzerwa nechirwere, kusanganisira kuwedzera kwezwi, kushivirira bvudzi kushizha, uye kusadya kwechiropa uterine ropa.
Zvinokonzera uye Zviitiko Zvengozi
Zvinosuruvarisa, hatigone kunyatsojekesa chinokonzera kenza yevana, asi vatsvakurudzi vakaona huwandu hunozivikanwa huripo hwekukudziridza. Kunyange zvazvo zviitiko zvinopisa zviitiko zvakakosha, zvinokosha kuchengeta mupfungwa kuti hutachiona hwe ovari hunoitika kune vanhu vasina mungozi kana nhoroondo yemhuri yechirwere ichi.
Zvinokonzera njodzi zvinosanganisira, asi hazvirevi kune, kukwegura; Caucasian ethnicity; nhoroondo yemhuri yeavoan, mazamu, kana kenza yekoloni; kuneta ; uye asingatauri isrogen replacement therapy.
Zvimwe zvinokonzerwa nehuwandu hwehutachiwana hwekenza yemukenza zvinosanganisira, asi hazvirevi kuva nemwana asati ava nemakore makumi matatu nemakumi maviri, kunwisa, kunyora kwepabonde, kushandisa chirwere chirwere, uye hysterectomy.
Kenza yeOvarian haina kufanana nevasikana vaduku. Kana zvikaitika, pane kazhinji mhuri yezvakaitika uye zvinowanzove yakabatana nezvinhu zvakadai semhando dze BRCA1 kana BRCA2 kuchinja. Kenza yeOvarian ndiyo yechishanu inonyanyozivikanwa nekenza yakaonekwa panguva yekubata uye inowanikwa muna 1 muna 18,000 pamuviri.
Kuziva
Kenza yeOvarian haisi kuongororwa nguva dzose. Kuongororwa kenza yevarivha inowanzodikanwa nepamusoro pekufungidzirwa kune chikamu chechiremba kunotanga kurongeka kwekufungidzira uye maitiro ekuraira anogona kuratidza chirwere chacho.
Vanachiremba vanowanzogadzirisa ultrasound transvaginal uye kuedza kweA-125 yekutanga, kunyange iyo yekupedzisira inogona kuve yakajeka mune vamwe vanhu vane kenza yekutanga yevavari uye inogona kukwidziridzwa nedzimwe mimwe zvirwere. Chiremba angatanga matanho aya mushure mekuita chiitiko chemuviri wepilvic, kana munhu angapa nezviratidzo zvemasastases (kupararira) kubva mumarara anenge achiita izvi zvinotevera.
Zvimwe zviitiko zvekufungidzira, zvakadai seTCT, MRI, uye PET zvinongororwa, pamwe chete nedzimwewo kuongororwa kweropa zvinogona kutumwa (kunyanya kuona kana kenza, kana iripo, yakapararira). Bhiopsy inodiwa zvose kusimbisa kuongorora uye kuziva rudzi rwekenza yevana vanowanikwa.
Mushure mekunge uongorororwa, kuiswa kwechirwere kunokosha zvikuru kuitira kuti uone hutano hwakakodzera zvakanyanya. Izvi zvinogona kuitwa nekubatanidzwa kwechirwere chinowanikwa pane zvidzidzo zvebiopsy uye zvidzidzo zvekufungidzira, asi kazhinji zvinoda kuvhiyiwa.
Kurapa
Kurapa kwekenza yevarivha inotarisana nemhando, chikwata, uye girafu rekenza yevana, pamwe nezvimwe zvinhu zvakadai sezera uye hutano huzhinji.
Kune matatu matatu ekutanga kurapwa kwekenza yevana. Kuvhiya kunosanganiswa nemakemikrasi ndiyo inowanzojairika yekurapa kwevose asi matanho ekutanga echirwere. Radiation therapy haisati yashandiswa asi inogona kukurudzirwa kune vamwe vakadzi vane mitambo yakawanda mumimba yavo.
- Kuvhiya: Kubviswa kwewavary uye fallopian tube kune rumwe rutivi kunogona kufungwa kune avo vanotarisira kuchengetedza kubereka kwavo . Kuvhiya kana kurotoreduction kunogona kuonekwa sekubvisa huwandu hwemarara (uye metastases) sezvinobvira kuitira kuti kuwedzere kushanda kwekemotherapy.
- Chemotherapy: Chemotherapy inoshandiswa kupedza masero ekenza anosara mushure mekuvhiyiwa, kana kuti kuderedza dambudziko rekudzoka kana pasina kenza yekare inosara. Iyo inogonawo kugoverwa yoga sechirwere chemotherapy kuderedza zviratidzo.
- Targeted therapy: Izvi zvinosanganisira kurapwa nemishonga inotarisa nzira dzakananga mukukura kwekenza masero. Nemhaka yekutarisa kwavo, ivo kazhinji, asi kwete nguva dzose, vane zvishoma zvinokonzerwa nezvinowanzoitwa chemotherapy remishonga. Kune mhando mbiri dzezvinorapwa zvirongwa: izvo zvinotarisirwa kudzivisa kuumbwa kwemasvondo matsva eropa nemamota, uye izvo zvinotarisa nzira inokonzera masero ekukura.
Mishonga yemakiriniki iri kuenderera mberi kudzidza kudzidza pamwe chete nemishonga inotevera, pamwe chete nemishonga mitsva, yakadai semishonga inorapwa . Maererano neNational Cancer Institute, vanhu vanoonekwa kuti vane kenza yemaawa inofanirwa kuongorora kutora chikamu muchipatara chekuedza.
Shoko Rinobva
Parizvino, nguva yakawanda epithelial ovarian cancers inowanikwa mune zvikamu zvekare zvechirwere. Sezvo isu tisina chirongwa chekuongorora kuongorora, zvakakosha kuziva zviratidzo uye kutsvaga kurapwa kana ukaona chero ani zvake-kunyange kana iwe uchifunga kuti vangave pasina.
Kana iwe kana mudiwa wako uchangobva kuongororwa nekenza yemaawa, iwe unganzwa uchitya zvikuru sezvaunotarisa nhamba dzinopoteredza chirwere. Pasinei nehuwandu hwemhando idzi, kurapwa kwechirwere ichi chiri kuwedzera sezvazviri kuponesa, uye mazhinji emakiriniki ezuva ranhasi ari kutsvaga nzira itsva uye dzakanakisisa dzokurapa varwere.
> Sources:
> Hoppenot, C., Eckert, M., Tienda, S., uye E. Lengyel. Ndivanaani Vaya Vakapukunyuka Kwenguva Yakareba veHigh-Grade Serous Ovarian Cancer? . Gynecologic Oncology . 2018. 148 (1): 204-212.
> National Cancer Institute. Ovarian Epithelial, Fallopian Tube, uye Primary Peritoneal Cancer Treatment (PDQ) -Health Professional Version. Updated 01/19/18. https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq