Zviratidzo zvepancreatic cancer zvinogona kusanganisira jaundice, marwadzo mudumbu rekumusoro rinopinda kumashure, kusati kwatarisira kwechirwere cheshuga, danda rakaoma mudumbu rekumusoro, uyewo zviratidzo zvisiri izvo zvakadai seyeusea, kuora muviri, kurasikirwa zvekudya, uye dzimwe nguva kuora mwoyo. Zvinosuruvarisa, zviratidzo zvepakutanga zvisinganzwisisiki uye zvisinei, zviratidzo zviri pachena-izvo zvingangodaro zvichiita kuti mumwe munhu atsvake kuongororwa kwechiremba-anowanzoshayikwa kusvikira chirwere chacho chiri mumatanho akapfuura.
Zviratidzo Zvakare
Pane zviratidzo zvakawanda zvinosangana nekenza yepancreatic, kunyange zvazvo dzakawanda idzi dzinowanzokonzerwa nemamiriro mashoma. Izvi zviratidzo zvinonyevera zvinogona kusiyana zvichienderana nokuti kanaya iri mumusoro wepakresi kana muviri wemuviri nemiswe.
Painless Jaundice (Kuwedzera Urine uye Stool Changes uye Itching)
Jaundice , kuchena kwechivara cheganda uye vatsvene vemaziso, ndizvo zvinokonzerwa nekuvaka-bilirubin paganda uye iripo inenge 30 muzana yevanhu panguva yekuongororwa. Bilirubin inogona kuunganidza apo chirwere chepancreatic chikamu kana kuti chakavhara zvachose bhinzi bile duct (a duct inotakura bile kubva muchiropa kusvika mumucheche muduku) uye inonyanya kufanana nekenza muchero wepakreas. Nekenza yepancreatic, jaundice inowanzoshaya marwadzo, kusiyana nemamwe mimwe migumisiro ye jaundice (yakadai se hepatitis kana gallstones ) iyo inowanzobatanidzwa nekurwadziwa.
Iko kuvaka-bilirubin kunogonawo kukonzera mashesi kuti ave akajeka uye ivhu-kufanana, pamwe nekusviba kwemuti (cola mavara). Zvigadziko zvinogonawo kunge zvine simba, rinoshamisa.
Kazhinji kasakanganiswa nechiganda cheganda, ganda rinopisa (kazhinji rakaoma) rinokonzerwa nekuvaka-up ye-bile salt muganda.
Jaundice inogona kuva chiratidzo chepakutanga chepancreatic kankere mumusoro wepascreas nekuda kwekudzivirirwa kwe bile bile duct, asi zvinogonawo kuitika nekenza huru mumuswe kana muviri wepakreas, kana kuti aya kanzira inopararira kuchiropa (chiropa metastases) ).
Mimba uye Mutsara
Nhamo mukati, kumusoro kwepamuviri inopinda mumusana chiratidzo chinowanzova chekenza yepancreatic, inowanikwa munharaunda makumi manomwe kubva muzana yevanhu panguva yekuongororwa. Izvo zvinowanzoonekwa nemamota mumuswe wepascreas. Uku kurwadziwa kunowanzopedza maawa matatu kana mana mushure mekudya kana kana pavete pasi. Kusiyana neizvi, marwadzo anowanzowedzera apo munhu akagara uye anotenderera mberi.
Diarrhea
Dhairrhea inogona kuitika nekuda kwekusava nehutachiwana mumatumbo maererano nekushayikwa kwemakemikari epacreatic anobatsira kudya zvokudya. Dhairrhea dzimwe nguva chiratidzo chekutanga chekenza yepancreatic. Zvigadziro zvinogonawo kuva nekunhuhwirira kwakasvibirira, kuonekwa sefrithy kana mafuta, uye kunyorera, dzimwe nguva zvichiita kuti zvive zvakaoma kuputika.
Nausea uye Kuedza
Nausea nekurutsa hazvishamisi kune vanhu vane kenza yepancreatic, zvisinei kuti kazhinji havazivikanwi mumatanho ekutanga echirwere chacho. Kusuruvara kwakanyanya kungava chiratidzo chekudzivirira mukati memucheto (gastric outlet) kana kuti chikamu chepamusoro chemukati mudumbu (duodenum) inokonzerwa nekumanikidzwa kubva mumarara.
Unintentional Weight Loss
Kamwe kamwe uye kusingazivikanwi kurasikirwa kwekurema kunowanzoratidza kuti chimwe chinhu chakakanganiswa nemishonga. Kurasikirwa kunorema kwekungoita , pamwe chete nekuderera kwechido, kunogona kuva imwe yekutanga zviratidzo zvekenza yepancreatic.
Vamwe vanhu vanogonawo kuona kuti vanonzwa vachikurumidza, kunyange kana vachidya zvokudya zvishomanana.
Kusarudzwa kusingatarisirwi kwechirwere cheshuga
Kutanga kusingatarisirwi kworudzi rwechirwere cheshuga (zvakadai sekutsvaga mune mumwe munhu asina mungozi , zvakadai sekuwedzeredza muviri) mumunhu anopfuura makore makumi maviri nemashanu anogona kuva chiratidzo chekenza yepancreatic. Izvo zvinoitika kana pancreas isingakwanisi kubudisa insulin yakakwana nekuda kwekuvapo kwemarara.
Ropa rinovhara
Ropa rinovhara uye kenza zvinogona kufamba mumaoko, uye dzimwe nguva ropavha ndiro chiratidzo chekutanga chechirwere. Nekenza yepancreatic, ropa rinoputika rinogona kuitika munzvimbo dzinoverengeka mumuviri munguva inopfuura (kutama thrombophlebitis).
Kakawandisa mabheti eropa pasina chikonzero chakajeka kunokodzera kuongororwa.
Mimba yemimba
Vamwe vanhu vangaona hutu hwakaoma mukati memumimba-kumusoro ndiko kuti gallbladder. Kubatanidzwa kwegorovhesi inogona kunzwika uye jaundice (kana maronda kana chirwere chenduru chisipo) inozivikanwa seCarvoisier chiratidzo. Ichi ndicho chiratidzo chakasimba kwazvo kuti kenza yepancreatic inogona kuvapo.
Kuora mwoyo
Ichokwadi hazvizoshamisi kuti uora mwoyo mushure mekudzidza iwe une kenza yepancreatic, asi tiri kudzidza kuti kuora mwoyo dzimwe nguva chiratidzo chekutanga chekenza. Sezvo kuora mwoyo kunowanzotangira kuongororwa, inofungidzirwa kuti kuchinja kwehupenyu hwepanyama kunobatanidza nekenza ndicho chinokonzera, panzvimbo pekuita zvekudzidza nezvechirwere. Maererano nekuongorora kwe 2017 kwekutsvakurudza, kutanga kwekuora mwoyo vasati vasangana nekenza yepancreatic yakawanda zvikuru kupfuura kune dzimwe mimwe makondombera.
Kazhinji Zviratidzo
Zviratidzo zvisingawanzozivikanwi, asi dzimwe nguva zvinongororwa nekenza yepancreatic, kazhinji inowanikwa kana kenza iri mberi. Izvi zvinogona kusanganisira:
Yakakura Lymph Node Pamusoro peCollarbone
Chirwere chakareruka (chibvunda) chinonzi lymph node chinogona kuonekwa kunze kwekororobone kuruboshwe (chirevo chepraclavicular) chinogona kuitika. Izvi zvinoshandiswa kune mishonga sezvinonzi Virchow's node.
Misa muBelly Button
Bundu kana mashoma anowanikwa mubhomba remuviri (umbilicus) haisi isiri uye anonzi sehanzvadzi Mary Joseph muduleti.
Paraneoplastic Syndromes
Paraneoplastic syndromes zvikamu zvezviratidzo zvinosangana nemahomoni kana zvimwe zvinhu zvakavanzwa nemasero ekenza. Imwe ye syndromes iyi inogona kuonekwa nekenza yepancreatic inosanganisira kusanganiswa kweganda rinogunzva maronda (nekuda kwekuputika kwemafuta ari pasi peganda), zviputi zvinoputika (arthritis), uye nhamba yakawedzera yerudzi rwemachena masero eropa anozivikanwa se eosinophils .
Kazhinji Panyaya Dzemakumbo
Kazhinji kenza yepancreatic inowanikwa muexocrine masero, anokonzera mapenicenti epacreatic anobatsira mukudya. Izvo zvinowanikwa mumasero endocrine (masero anoita mahomoni) kazhinji, asi kwete nguva dzose, anonyora mahomoni anowedzera zviratidzo. Zvizhinji zve "neuroendocrine" matumbo zvinogona kutungamirira kukurasikirwa kwekurema. Zvimwe zvezvi zvinogona kusanganisira:
Insulinomas
Insulinomas inokonzera insulini inotungamirira kushuga yakaderera yeropa ( hypoglycemia ). Zviratidzo ndezvomushuga wakaderera weropa, zvakadai sokupenya kwemaziso, kutuka, kuzvidya mwoyo, uye kukurumidza kwemwoyo.
Glucagonomas
Glucagonomas secrete glucagon, hormone inowedzera shuga yeropa. Izvi zvinogona dzimwe nguva zvinokonzera chirwere cheshuga, nezviratidzo zvekuwedzera nyota, kugara uchidhonza, uye kuora kurasikirwa kwave kuchijairika. Zvinogonawo kukonzera chirwere uye kusakwana kwezvokudya zvinoita kuti muromo nerurimi ruve marwadzo.
Gastrinomas
Gastrinomas secrete gastrin, hormone inogona kukonzera kubuda ropa mumaronda emulonda ( peptic ulcer ), asidi reflux, uye kurwadziwa mumimba.
Somatostatinomas
Somatostatinomas zviremara izvo zvinokonzera somatostatin, hormone iyo iyo inokurudzira kusunungurwa kwemamwe mahomoni. Zviratidzo zvinogona kusanganisira chirwere, kurwadziwa mumimba, kunhuhwirira zvigaro, zviratidzo zvechirwere cheshuga, uye jaundice.
VIPomas
VIPomas kazhinji inovhara vasoactive intestinal peptide (VIP), inotungamirira kumararamiro (kazhinji mvura yakanyanya uye inoshamisa), kushungurudza, kusuruvara, kurwadziwa kwepamuviri nekuputika, uye kuputika kwechiso nehuro.
Matambudziko
Mukenza wepancreatic unogona kutungamirira kumatambudziko pamusana pezvikonzero zvakasiyana-siyana, kusanganisira kumanikidzwa kune zvivako zvakapoteredza, kusakwanisa kwezvinhu zvinokonzerwa nemaitiro evanhu vanowanzoita pancreatic cells, kusagadzikana kwekenza pachayo, kana kupararira (metastase) kubva mumarara.
Zvinetso zvinogona kuisa:
Pancreatic Insufficiency
Mishonga yepancreatic inowanzoitika mumasero (exocrine masero) anobudisa enzyme dzepancreatic. Ipakreas inowanzobereka makapu makumi masere emakemikisi aya zuva rega rega, iyo inokonzera kusimba kwemudumbu uye kubatsira mune kuparara kwemafuta, mapuroteni, uye makhahydrates. Apo bundu rinotora pamusoro pemasero aya, kushaiwa kwemakemikari kunogona kukonzera malabsorption, chibereko chemuviri, nekushaya zvokudya zvinovaka muviri, kunyange nechingwa chekudya. Kusagadzikana kwepancretic kunowanikwa mu80 muzana kune 90 muzana yevanhu vane kenza yepancreatic uye inobatwa ne pancreatic enzyme replacement .
Bhuku Rakavhara Kuvharwa
Kuvhiringidzika kwebhinzi yakazara bhutano inonyanya kurwisana kwekenza yepancreatic uye inogona kuvapo panguva yekuongororwa. Kunyangwe kana chirwere chisingaitike, stent inogona kuiswa kuburikidza ne endoscopy , nzira inosanganisira kuisa bhuti mumuromo uye kuisungira pasi uye muitiro yakazara bile duct.
Dumbu kana Kudukuka Kwechibvumirano
Kuvharidzirwa (kunokonzerwa nechirwere chinokura kunogona kuitika munharaunda iyo mukati mechipfuva inopinda mumucheche muduku (gastric outlet) kana muchikamu chekutanga chemukati mudumbu (the duodenum) Kana izvi zvikaitika, stent inogona kuiswa kuti kuchengetedza nzvimbo idzi dzizarurire, kana kuti panzvimbo, chirwere chinogona kuitwa kudarika kupfigirwa.
Chirwere cheshuga
Sezvakataurwa pamusoro apa, kutanga kwechimbichimbi uye kusatarisirwe kwechirwere cheshuga kunogona kuzivisa kuvapo kwekenza yepancreatic. Kunyange kana isingavepo panguva yekuongororwa, inenge 85 kubva muzana yevanhu vane chirwere ichi chichaita kuti insulin isakanganise kana chirwere cheshuga pane imwe nguva.
Cachexia
Cancer cachexia , inozivikanwawo sekenza-related anorexia-cachexia syndrome (CACS), chirwere chinosanganisira kuora muviri, kusuruvara kwemaviri uye kurasikirwa kwechido, kunyange zvazvo zvichida kunotanga kunyange kusati kwasara kurasikirwa. Inofungidzirwa kuti iripo kusvika ku80 muzana yevanhu vane kenza yepancreatic panguva yekuongorora.
Cachexia inogona kuva chikonzero chaicho chekufa mu20 muzana yevanhu vane kenza. Pamusoro pe "carexia" chaiyo, zvisinei, kushaiwa kwepencreatic enzyme kunogona kukonzera kusadya kwezvokudya uye kuwedzera kuora muviri, zvichiita ichi chinhu chakakosha kugadzirisa chero munhu anonzi ane kenza yepancreatic.
Ropa rinovhara
Sezvakataurwa, ropa rakadzika ( deep vein thrombosis ) iyo dzimwe nguva inoparadzana uye inofamba kumapapu ( mishonga yemapurini ) haisi kungowedzera kwekenza yepancreatic-inogona kuva chiratidzo chokutanga chayo. Izvo zvinowanzove zvakajairika pane imwe nguva nehosha. Vanhu vane chirwere chepancreatic vanogonawo kuwedzera kubuda ropa pavanopfupa ropa kupfuura vanhu vane mamwe marudzi ekenza, saka kurapwa kunoda kunyatsoongororwa.
Pain
Marwadzo anokonzerwa nekenza yepancreatic anogona kuva akaoma kwazvo, asi kune dzimwe nzira dzakasiyana-siyana dzekudzivirira chirwere chekenza . Kazhinji, nzira dzakasiyana dzakasiyana dzakabatanidzwa, dzakadai semishonga inorwadza, remishonga inonzi radiation kumudumbu, uye "chivako ichi," nzira inodzivisa mitsipa kumimba inotapa zviratidzo zvinorwadza kuuropi. Nehutano hwemaopioid ikozvino, zvinokurudzirwa kuti vanhu vane chirwere chepancreatic vanofunga kubvunzurudza nemarwadzo kana chirwere chekuchengetedza chirwere chepamusoro kuti vaone kuti vanowana kuchengeteka kwakakwana, kwakakwana, uye panguva yakakodzera kurwadziwa kana zvichidiwa.
Nguva Yokuona Chiremba
Kana ukacherechedza chimwe chezviratidzo zviri pamusoro, ona chiremba wako pakarepo. Zvakawanda zvezviratidzo zvekenza yepancreatic yekutanga kune zvimwe zvinokonzera, asi dzakawanda dzadzo dzinokosha zvikuru kuti dziongorore zvakare. Zviratidzo inzira yomuviri wedu wokutiudza chimwe chinhu chisina kunaka. Zvakakosha kuva netsanangudzo, uye kana iwe usingaiti, bvunza zvakare. Kana iwe usiri kuwana mhinduro, funga kuwana imwe pfungwa.
Vamwe vanhu vakazeza kuona chiremba uye zvichiita zvirwere zvepancreatic kanzera nekuda kwekurumbira kwechirwere. Ichokwadi kuti, kana yakawanikwa, dzakawanda zvekenza iyi yakareba zvakanyanya kusvika pakubviswa nekuvhiyiwa, asi kune zvimwe zvirongwa zvekurapa zviripo. Mukuwedzera, kuongororwa kwekenza iyi nokukurumidza zvichibvumira vanhu navanachiremba vavo kudzivirira zvimwe zvezvinetso zvechirwere ichi, uye mukuita kudaro, kuvandudza hupenyu hwehupenyu kunyange kana kenza iripo.
> Sources:
> Mazuva Ano uye Kuwedzera Kurapa muPancreatic Cancer , Springer Verlag, 2017.
> Khadka, R., Tian, W., Xin, H., na R. Koirala. Dambudziko reNjodzi, Kutarisisa Kwepakutanga uye Kuparara Kwakakwana Pamigumisiro yeChichi pakati peKancancatic Cancer uye Chirwere Cheshuga Mellitus: Kuchinja uye Kufambira Mberi, Kuongorora. International Journal of Surgery . 2018 Mar 10. (Epub mberi kwekudhinda).
> Laquente, B., Calsina-Berna, A., Caromona-Bayonas, A. et al. Kutsigira Kunotsigira muPancreatic Ductal Adenocarcinoma. Clinical and Translational Oncology . 2017. 19 (11): 1293-1302.
> Sebti, J., Desseigne, F., naP. Saltel. Prodromal Kushungurudzika muPancreatic Cancer: Kudzokorora Kuongororwa paVane Mumiriri. Kutsigira uye Kubatsira Vanotsigira . 2015. 13 (3): 801-7.