Zviratidzo, Kuongororwa, Kurapa, uye Kupararira kweScamous Cell Lung Cancer
Squamous cell carcinoma yemapapu ndiyo imwe nzira yekasi-duku duku yemukenza yemapapu . Izvozvo-zviduku zvekenza mapepa ekenza mapepa anokwana makumi mapfumbamwe emapfumbamwe emaperembudzi emapapu, uye kune aya, anenge 30 muzana ndiwo squamous cell carcinomas.
Overview
Squamous cell carcinoma inotanga mumatumbu anokonzera mhepo dzepamuviri mumapapu. Inonziwo epidermoid carcinoma.
Kazhinji squamous cell carcinomas yemapapu inowanikwa mukati, kazhinji mumabhonchi makuru anobatana ne trachea kusvika kumapapu.
Squamous cell carcinomas inobatanidza zvakasimba nekusvuta kupfuura mamwe maitiro evanhu vasati vaduku masero emukenza maperembudzi uye anowanzoonekwa kune varume kupfuura vakadzi. Vanowanzova nekukurumidza-kukura, uye nekuda kwenzvimbo yavo vanowanzowanikwa mberi kune mamwe maitiro emukenza wemapapu. Chiitiko che squamous cell carcinoma yemapapu chave chiri kuderera mumakore achangopfuura, asi chimwe chimiro chekenza yemapapu, adenocarcinoma kuwedzera. Inofungidzirwa nevamwe kuti kuwedzerwa kwezvipembenene kumidzanga kunobvumira utsi kuti huputike zvikuru mumapapu umo adenocarcinomas inowanzoitika. Izvozvo zvinokonzera, zvisinei, zvinoitika kunyange kune vanhu vasina kumboputa.
Subtypes
Squamous cell lung cancer inowedzera kugoverwa mu 4 subtypes nezvinoonekwa seiri pasi pe microscope uye maitiro avanoita.
Izvi zvinosanganisira:
- Primitive
- Classical
- Chakavanzika
- Basal
Isu tinoziva kuti pane kupesana kwepakati peva subtypes asi vari kungodzidza nezvekuti rudzi rumwe rungapindura sei zvakasiyana nemishonga yakasiyana. Kazhinji subtypes inopindura kune imwe inowanzoshandiswa chemotherapy mishonga. Chimwe chinhu chinogona kunge chiri chekemikari inokonzera kenza yemapapu.
Ichi chikamu hachina kunyanya kushandiswa pakushandisa chemotherapi mishonga nokuti inowedzera kuwedzera kukura (uye chemotherapy inowanzobudirira zvikuru pamakanzura anokurumidza kukura sezvo inosanganisa masero ekuparadzanisa).
Zviratidzo
Zviratidzo nezviratidzo zvekenza yemapapu zvinosanganisira kurwisana kunopfuurira, kukwezva ropa, kufema kwepfufu, nekufema. Sezvo squamous cell carcinomas inowanzove iri pedyo nemhepo huru, vanoita kuti zviratidzo zvive mberi kune dzimwe mhando dzekenza yemapapu. Kuvharwa kwemhepo kunogona kutungamirira kune zvirwere zvakadai sepneumonia, kana kuputsika kwechikamu chemapapu ( atelectasis ), uye chirwere chinoputika sepineumonia chinogona kuva chiratidzo chekutanga chekuti chimwe chinhu chine kunaka.
Squamous cell carcinoma ndicho chinonyanya kukonzera chimwe chinhu chinonzi Pancoast syndrome kana guru sulcus syndrome. Dambudziko repancoast rinokonzerwa nekenza yemapapu inotanga pedyo nepamusoro pemapapu uye inopinda zvivako zviri pedyo, zvakadai semashu. Zviratidzo zvinowanzobatanidza kurwadziwa kwepamuviri kunopisa mukati memukati, kushaya simba kana kunzwisisika mumaoko, kuputika kana kutuka kune rumwe rutivi rwechiso, uye neoody eyelid (Horner's syndrome).
Vanhu vane squamous cell carcinoma vanogonawo kuve nekamu yepamusoro ye calcium ( hypercalcemia ) iyo inogona kukonzera kushaya simba kwemasumbu nemakumbo.
Hypercalcemia imwe yezviratidzo zveparaneoplastic syndrome uye inokonzerwa nechirwere chekuvhara maitiro ehomoni-inoita kuti chikamu che calcium chiwedzere muropa.
Kuziva
Squamous cell carcinoma yemapapu inowanzotanga kufungidzirwa apo kusakanganiswa kunoonekwa pa x-ray. Kuwedzera kumwe kuongorora kunogona kusanganisira:
- Chest CT Scan
- Sputum Cytology . Sezvo squamous cell carcinomas inowanzoenderera mumugwagwa, samuenzaniso weputi rinogona kuona dzimwe kenza masero
- Bronchoscopy
- PET Scan . PET scan is "test" test yakagadzirirwa kutsvaga zvirwere zvinokura uye zvinowanzoitwa kutarisa humwe uchapupu hwekupararira (metastasis)
- Endobronchial Ultrasound . An endobronchial ultrasound inoshandiswa uchishandisa purogiramu yakakosha munguva yebronchoscopy.
Zvichienderana nemigumisiro, chiremba wako anowanzoda kuwana sampu yemapfupa ( mapapu anonzi chipopu ) kuti ave nechokwadi chekuongorora uye acharaira zvimwe zviedzo kuti aone kuti kana kenza yako yakapararira.
Staging
Squamous cell carcinoma yemapapu yakaputsika muzvikamu zvina :
- Nhanho 1 - Mucheche unowanikwa mukati memapapu uye hauna kupararira kune chero yeropa nhengo
- Chikamu chechipiri - Mucheche wakapararira kune lymph nodes kana kubatanidzwa kwemapapu, kana uri mune imwe nzvimbo ye-bronchus
- Nhanho 3 - Kanzera yakapararira kune zvisikwa pedyo nemapapu
- Nhanho 4 - Kanzera yakapararira (mastasized) kune imwe chikamu chemuviri, nzvimbo dzakajairika dzakave mafupa, uropi, chiropa, kana adrenal glands
Vanachiremba vanoshandisawo imwe nzira, inonyanya kuvhiringidza kusarudza pamusoro pechikamu chemupenza wemapapu chinonzi TNM staging . Mune izvi vanotarisa kuwanda kwechirwere (chinomiririrwa neT), kuti node dzinoshandiswa, kupi uye seiko (dzinomiririrwa neN), uye kana kwete kana chirwere chacho chapararira (mastasi) kune zvikamu zvemuviri kunze yemapapu, kana kune imwe mapupa (anomiririrwa ne M). Somuenzaniso, chiremba wako angatsanangura mutanha wako wemapapu seT3N2M0.
Zvinokonzera
Squamous cell carcinoma yemapapu chirwere chemapapu emapapu chakanyatsobatanidzwa nekusvuta , asi zvimwe zvinokonzera zvinogona kubatsirawo. Radon exposure mumusha ndiyo yechipiri inokonzera kukonzera yemapapu emapapu. Kushanda kwepabonde, kwakadai setizai dizeli uye nezvimwewo zvinokonzerwa nehuwandu hunokonzerwa nekugadzirwa kwekenza yemukenza yemapapu.
Genetics inogona kuitawo zvakanaka, uye mungozi wekenza yemapapu inowedzera kune vamwe vane dzimwe nhengo dzemhuri pamwe nehosha.
Mishonga
Zvichienderana nechikamu che squamous cell carcinoma yemapapu, kurapwa kunogona kusanganisira kuvhiyiwa, chemotherapy, kurapwa kwemaawa, kurapwa kwemaawa, immunotherapy, kana kusanganiswa kweizvi. Matambudziko akawanda emakiriniki ari kuenderera mberi achitsvaga nzira itsva dzekurapa kenza iyi uye kubatsira kusarudza kuti zvipi zvinorapwa zvinoshanda.
Surgery
Kuvhiyiwa kwekenza yemaperembudzi kunogona kuitika kune squamous cell carcinoma. Nechikwata cheAA squamous cell lung cancer, chirwere choga chingave chirapa. Kuvhiya kunogonawo kufungwa kune avo vane chirwere chekutanga 1B, danho II, uye chirwere chepanechitatu yemapapu emapapu, kazhinji kacho pamwe chete nemakemikirini uye remishonga inonzi radiation. Dzimwe nguva, chironda chinogona kutanga chisingaitiki asi chinogona kuderedzwa muhukuru nekemotherapy uye / kana remishonga inopisa mahara kuitira kuti kuvhiya ikozvino. Apo chemotherapy inogadziriswa kuderedza ukuru hwechirwere mushure mekuvhiyiwa inonzi "neoadjuvant chemotherapy." Munguva pfupi yapfuura, kubudirira kwave kuchiratidzwa mukushandisa immunotherapy kuti kuderedze chirwere chisingaverengeki muhukuru kuitira kuti kuvhiwa kunogona kuitwa.
Chemotherapy
Chemotherapy inogona kushandiswa yoga, pamwe chete neradio rayation, kana kuti mushure mekunge kana mushure mekuvhiyiwa kwekenza yemapapu. Squamous cell carcinoma yemapapu inopindura zvakasiyana nezvimwe zvirwere zvemapapu emapapu zvakadai sedenocarcinoma chemhemotherapy mishonga. Mishonga inowanzoshandiswa pamutambo uyu inosanganisira Platinol (cisplatin) uye Gemzar (gemcitabine). Kune avo vanobvuma kurapwa, kupfuurira ( kugadziriswa ) ne Tarceva (erlotinib) kana Alimta (pemetrexed) inogona kushandiswa.
Radiation Therapy
Radiation Therapy ingashandiswa kurapa kenza kana kuti kudzora zviratidzo zvine chokuita nokupararira kwekenza. Mishonga inogona kupiwa kunze, kana mukati ( brachytherapy ) iyo inoshandiswa nemhepo inopisa inowanikwa munzvimbo chaiyo yemapapu munguva yebronchoscopy.
Targeted Therapy
Iwe unogona kunge wakanzwa nezvekushandiswa kwezvinodhaka zvinotarisirwa kuti uite EGFR mutations mu lung lung adenocarcinoma. EGFR, kana epidermal kukura factor receptor, iprotini inobatanidzwa mukufambisa kukura kwekenza. Squamous cell carcinoma yemapapu inogonawo kurapwa nekutsvaga nzira yeEGFR, asi nenzira yakasiyana.
Panzvimbo yekutsvaga kuchinja kweEGFR, anti-EGFR maitiro ekirasi inoshandiswa kusungira EGFR kune kunze kwekenza masero. Apo EGFR yakasungwa saizvozvo, nzira yekutaridza inotaurira kuti sero kukura inogumiswa. Portrazza (necitumumab) yakagamuchirwa muna 2015 kuti ishandise pamwe chete ne chemotherapy yepamusoro ye squamous cell cancers. Mishonga yemakiriniki inoongorora mamwe mishonga, yakadai seafatinib uye zvimwe zvekurapa kenza yemukenza yemapapu.
Immunotherapy
Immunotherapy mishonga yakatanga kugamuchirwa kuitira kurapwa kwemukenza wemapapu muna 2015, uye zvino kusanganiswa kwemishonga iyi iri kuongororwa mumakiriniki ekuedzwa.
Muna 2015, yekutanga immunotherapy kurapwa kwakagamuchirwa kune vanhu vane chirwere ichi. Mishonga Opdivo (nivolumab) inoratidziro ye immunotherapy iyo, nyore nyore, inoita kuti muviri wedu uwane simba rekudzivirira zvirwere zvekenza.
Kuti unzwisise kuti mishonga iyi inoshanda sei, inogona kubatsira kufunga nezvekudzivirira kwemuviri wako semotokari. Iyo "mabheki" inotungamirirwa neprotheni inonzi PD-1. Opdivo munharaunda iyi inoshanda kudzivirira PD-1-mabheki-achibvumira maitiro ezvirwere zvekuzvidzivirira kurwisa kenza pasina kupindira-mubasa, kutora mabheki kubva pamotokari. Kurapa ikozvino kwakagamuchirwa kuvanhu vane metastatic squamous kwete-duku kemukirini yemapapu yemapapu avo muchechi wakafambira mberi kana mushure mekuda kweplatinum-based chemotherapy. (Platinum-based chemotherapy inoreva chemotherapy regimen kusanganisira Platinol (cisplatin) kana Paraplatin (carboplatin)).
Kubva panguva iyo, mamwe maviri emishonga anonzi immunotherapy akagamuchirwa, Keytruda (pembrolizumab), uye Tecentriq (atezolizumab).
Prognosis
Asati apindura mubvunzo uyu "chii chinonzi chirevo chemukenza wepamapukamumu wepamapu?" Zvakakosha kutaura pamusoro pekuti nhamba dzinotsanangura chimiro chekupona chinorevei chaizvo. Chokutanga pane zvose, munhu wese akasiyana. Nhamba dzinotitaurira kuti chii chinonzi "chiyero" kana kuti kupona, asi havatitauri chinhu pamusoro pevanhu chaivo. Zvinhu zvakawanda zvinogona kukanganisa kufungidzira kwekenza yemukenza yemapapu zvinosanganisira makore ako ekuongororwa, zvepabonde, mamiriro ehutano hwako hwose, uye mararamiro ako.
Izvo zvinobatsirawo kuchengeta mupfungwa kuti nhamba dzinochengetwa pamashoko ane makore akawanda. Sezvo mushonga mutsva unowanikwa, nhamba idzi dzingasave dzichinyatsoratidza zvaunofunga nhasi. Semuenzaniso, makore mashanu ekupona kwemupenza wemapapu akataurwa muna 2018 anobva kune avo vakaonekwa muna 2013 uye mberi. Sezvo zvirwere zvakawanda zvinokosha zve squamous cell carcinoma yemapapu zvakagamuchirwa shure kwegore ra2013, nhamba haisi kureva kuti munhu angaita sei nhasi.
Panguva imwecheteyo, pane zvimwe zviratidzo zvitsva zvinogamuchirwa kuitira kurapwa kwemukenza wemapapu mumakore mashanu apfuura, kupfuura mumakore makumi mana emakore asati apfuura. Somuenzaniso, mushonga wePirsazza hauna kuwanika apo vanhu vari mune zvidzidzo izvi vakawanikwa. Zvinorevei izvi ndezvokuti ikozvino maitiro ekupukunyuka akarasikirwa kutarisa kuti mumwe munhu anotarisirwa kuita sei pane ipi zvayo mishonga iyi itsva.
Pane tariro yakawanda kune avo vanoonekwa nekenza yemapapu nhasi, asi zvinosuruvarisa kuti nhamba dzamuchaverenga haingabatsiri pakunzwisisa tariro iyi.
Zvisizvo zviduku zvishoma zvemawere emapapu emapapu emapapu anowanzosiyana nemutambo , uye anowanzopfuura makore mashanu ari kupona ari 50 muzana (kana zviri nani) ane chirwere chechirwere chechirwere, asi maviri chete kusvika mana kubva muzana nechikamu chechina chirwere. Zvose makore mashanu ekupona kwemukenza wemapapu zvinosuruvarisa chete ne18 muzana. Zvakare zvakakosha kucherechedza kuti nhamba dziri mumitengo iyi hairatidziri kuvandudzwa nemishonga mitsva uye nzira dziripo zvino.
Kufananidza Zvirwere Zvako
Kana uchitarisa pamusoro pekufungidzira zvakakosha kuziva kuti dzose squamous cell lung mapukamusi haana kufanana. Zvechokwadi, dai paiva nevanhu 300 vane squamous cell lung carcinoma muimba, vaizove nemahara mazana matatu evanhu vane kenza. Kenza yako inogona kuva nemakemikari maitiro anowedzera kana kuderedza kufungidzira kwako. (Yourcologist yako inogona kukurukura zvimwe zveizvi newe). Mukuwedzera, kutsvakurudza kuri kutsvaga dzimwe nzira dzekufungidzira kufungidzira kweumwe munhu squamous cell carcinoma zvichienderana nekuwana kwakadai sekupararira kwemasero emumakumbo anowanikwa pane chidimbu chemvura uye nezvimwe.
Kutsungirira
Kuongororwa kwe squamous cell carcinoma yemapapu kunotyisa uye iwe unganzwa uri woga. Mutsara unoti "inotora musha" wakanga usisina kukodzera kupfuura apo uchitaura nezvekenza yemapapu. Shingairira uye kubvumira (chikamu ichocho dzimwe nguva kiyi) vadiwa venyu vanokutsigira.
Tora nguva yekudzidza nezvekenza yako. Zvidzidzo zvinotitaurira kuti vanhu vanonzwisisa zviri nani kenza yavo vanongonzwa kuti vanowedzera simba, asi zivo iyoyo dzimwe nguva inogona kuita mutsauko mukupona zvakare. Ona kana iwe unogona kuwana boka rekutsigira vanhu vane chirwere chemapapu munharaunda yenyu, kana kutora nguva yekubatana nekanakisa kanzera yemapapu emapapu paIndaneti.
Vanhu ava havangokugamuchiri chete uye vanokutsigira asi vanogona kunge vakawana ruzivo rukuru rwekutsvaga uye tsvakurudzo zvakare. Tarisa masangano emukenza emapapu akadai seLUNGevity, American Lung Association Lung Force, uye Lung Cancer Alliance. Apo kutsvaga vamwe nemukenza wemapapu mune zvekuchengetedzwa kwevanhu, i hashtag ndiyo #LCSM iyo inomirira kenza yemapapu evhidhiyo. Kana uri pasi pemakore makumi mashanu, iva nechokwadi chekutarisa Bonnie J. Addario Lung Cancer Foundation, sangano rinonyanya kufarira mukana wekenza yemapapu kune vechidiki vaduku .
Zvizhinji zvezvose, iva wako mumutsigiri wekuchengetedza kenza yako . Kurapa kwemapapu emapapu kuri kuchinja nokukurumidza, uye vanhu vari kuwedzerwa kudanwa kuti vave chikamu chinoshanda cheboka ravo rerapa. Kutaura zvazviri, kune vazhinji vanopona vari kurarama ivo vari vapenyu chete nokuti vakazvidzidzisa ivo uye vaiva vatsigiri vekutarisira kwavo. Sezvo zvakaoma kune mukuru we oncologist kuti arambe achienzanisa nekuchinja kwakakurumidza kwekurapa, vapenyu vazhinji vanopinda mukenza yemapapu vanokurudzira kuwana imwe pfungwa pane imwe yenyika huru yeCancer Institute-mahara emagariro evanhu vane kenza yemapapu inowanikwa.
Kana Mudiwa Wako Ane Cell Squamous Lung Cancer
Kurwisana nemukenza wemapapu mumunhu waunoda kunogona kuva dambudziko. Hausi iwe chete unotarisana nezvinodiwa nemunhu waunoda kubva pamakona ako, asi pfungwa yekushaya rubatsiro inogona kunge inorwadza mwoyo. Iwe unogona kuvimbiswa kuti vanhu vazhinji havana ruzivo rwekuita kana mumwe mudiwa ane kenza yemapapu. Kukumbira nezvenzira dzakananga iwe unogona kubatsira, pane kutaura "kudana neni kana iwe uchida ini," inzira iyo iwe unogona kuratidza kutarisira kwako uye kuderedza mutoro wavo. Tora nguva yekudzidza pamusoro pezvinonyatsoda kurarama nemukenza wemapapu uye kuti ungatsigira sei munhu waunoda nekenza .
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