rcc renal cell carcinoma

RCC (Renal Cell Carcinoma) ndi mtundu wofala kwambiri wa khansa ya impso mwa akuluakulu. Nkhaniyi ikufotokoza za matendawa, kuphimba mitundu yake, zizindikiro, matenda, njira zothandizira, ndi prognosis.What is Renal Cell Carcinoma?Renal Cell Carcinoma (RCC), kapena khansa ya impso, imayambira m’kati mwa minyewa ya proximal convoluted tubule, mbali ya timachubu tating’ono kwambiri tosefa magazi ndi kuchotsa zinyalala. Kumvetsetsa mitundu yosiyanasiyana ndi magawo a Mtengo RCC n'kofunika kwambiri pa chithandizo chamankhwala. Mitundu ya Renal Cell CarcinomaMa subtypes angapo a Mtengo RCC zilipo, aliyense ali ndi makhalidwe osiyana ndi njira mankhwala. Mitundu yodziwika kwambiri ndi: Clear Cell Renal Cell CarcinomaMtundu wofala kwambiri, womwe umawerengera pafupifupi 70% ya Mtengo RCC milandu. Amadziwika ndi ma cell omwe amawoneka owoneka bwino kapena otumbululuka pansi pa maikulosikopu chifukwa cha kuchuluka kwa lipid. Gwero: American Cancer SocietyPapillary Renal Cell CarcinomaMtundu wachiwiri wofala kwambiri, wokhala ndi 10-15% ya milandu. Papillary Mtengo RCC Amadziwika ndi mawonekedwe a chala otchedwa papillae. Nthawi zambiri zimagwirizanitsidwa ndi zinthu zina zamtundu. Pali mitundu iwiri yayikulu: Type 1 ndi Type 2, Type 2 nthawi zambiri imakhala yaukali. Chromophobia Renal Cell Carcinomasubtype iyi ikuyimira pafupifupi 5% ya Mtengo RCC milandu. Chromophobia Mtengo RCC nthawi zambiri amakhala ndi chiyembekezo chabwinoko poyerekeza ndi maselo owoneka bwino Mtengo RCC. Maselo ndi aakulu komanso otuwa kuposa maselo omveka bwino Mtengo RCC maselo.Kutolera njira Renal Cell CarcinomaMtundu wosowa komanso wankhanza, wowerengera milandu yochepera 1%. Kusonkhanitsa duct Mtengo RCC zimachitika mu kusonkhanitsa ducts a impso, amene kunyamula mkodzo kwa chikhodzodzo. Nthawi zambiri amapezeka pakapita nthawi ndipo zimakhala zovuta kuchiza.Medullary Renal Cell CarcinomaMtundu wina wosowa komanso waukali, womwe umakhudza kwambiri anthu omwe ali ndi mawonekedwe a sickle cell. Medullary Mtengo RCC nthawi zambiri zimagwirizanitsidwa ndi zotsatira zoipa.Zizindikiro za Renal Cell Carcinomamagawo oyambirira a Mtengo RCC sangawonetse zizindikiro zowonekera. Komabe, pamene chotupacho chikukula, zizindikiro zingaphatikizepo: Magazi mumkodzo (hematuria) Kupweteka kosalekeza m'mbali kapena kumbuyo Kupweteka kapena kulemera kumbali kapena kumbuyo Kutaya thupi mosadziwika bwino Kutaya chilakolako cha kudya Kutopa Kutentha komwe sikumayambitsa matenda Kuperewera kwa magazi (kuchepa kwa maselo ofiira a magazi) Ngati mukukumana ndi chimodzi mwa zizindikirozi, ndikofunika kuti mufunsane ndi dokotala kuti mudziwe zambiri. Renal Cell CarcinomaKuzindikira Mtengo RCC Nthawi zambiri amaphatikiza kuyezetsa thupi, kuyesa kujambula, ndi biopsy. Mayesero a ImagingKujambula kumagwira ntchito yofunika kwambiri pakuzindikira ndi kupanga. Mtengo RCC. Mayeso odziwika bwino amajambula ndi awa: Kujambula kwa Computed Tomography (CT): Amapereka chithunzithunzi chatsatanetsatane cha impso ndi minofu yozungulira. Kujambula kwa Magnetic Resonance (MRI): Amapereka kusiyana kwakukulu kwa minofu yofewa ndipo ndiwothandiza kwambiri powunika kukula kwa chotupacho ndikuzindikira kufalikira kumadera omwe ali pafupi. Ultrasound: Zingathandize kusiyanitsa pakati pa misa yolimba ndi zotupa zodzaza madzimadzi mu impso. Renal Arteriography (Angiography): Kuyeza kwa X-ray kwa mitsempha ya aimpso pambuyo pobaya utoto. Amagwiritsidwa ntchito mocheperapo kusiyana ndi CT kapena MRI.BiopsyA biopsy imaphatikizapo kuchotsa chitsanzo chaching'ono cha minofu ya impso kuti chifufuze pansi pa microscope. biopsy ndiyofunika kutsimikizira matenda Mtengo RCC ndi kuzindikira subtype. Ma biopsies otsogozedwa ndi zithunzi nthawi zambiri amapangidwa pogwiritsa ntchito CT kapena ultrasound kuti awonetsetse malo omwe akukayikitsa. Magawo a Renal Cell CarcinomaGawo la Mtengo RCC imanena za kukula kwa khansayo komanso ngati yafalikira mbali zina za thupi. Kuwerengera ndikofunikira kuti mudziwe njira yoyenera yamankhwala ndikulosera zam'tsogolo. Njira ya TNM (chotupa, Node, Metastasis) imagwiritsidwa ntchito kwambiri: T (chotupa): Limafotokoza kukula ndi kukula kwa chotupa chachikulu. N (Njira): Zimasonyeza ngati khansa yafalikira ku ma lymph nodes pafupi. M (Metastasis): Zimasonyeza ngati khansa yafalikira kumadera akutali, monga mapapu, mafupa, kapena ubongo.Magawo amachokera ku I mpaka IV, ndi Gawo loyamba kukhala siteji yoyamba ndipo Gawo IV ndilopamwamba kwambiri.Treatment Options for Renal Cell CarcinomaChithandizo cha Mtengo RCC zimadalira pa zifukwa zingapo, kuphatikizapo siteji ya khansayo, thanzi lonse la wodwalayo, ndi zokonda zake. Njira zochizira zodziwika bwino ndi izi:Kuchita OpaleshoniKuchotsa chotupacho nthawi zambiri kumakhala chithandizo choyambirira cha komweko Mtengo RCC (Magawo I-III). Zosankha za opaleshoni zikuphatikizapo: Nephrectomy Pang'ono: Kuchotsa kokha chotupa ndi yaing'ono m'mphepete wathanzi minofu. Njira imeneyi imakondedwa ngati n'kotheka kuti impso zigwire ntchito. Radical Nephrectomy: Kuchotsa impso zonse, pamodzi ndi minofu yozungulira, monga adrenal gland ndi ma lymph nodes. Izi nthawi zambiri zimachitidwa pa zotupa zazikulu kapena ngati nephrectomy yapang'ono sitheka.Matenda Omwe amawatsata ndi mankhwala omwe amayang'ana kwambiri mamolekyu omwe amakhudzidwa ndi kukula kwa maselo a khansa ndi kupulumuka. Mankhwalawa amatha kukhala othandiza pochiza zapamwamba Mtengo RCC (Gawo IV) ndipo itha kugwiritsidwanso ntchito poyambira nthawi zina. Zitsanzo ndi izi: VEGF Inhibitors: Sunitinib (Sutent), Sorafenib (Nexavar), Pazopanib (Votrient), Axitinib (Inlyta), Bevacizumab (Avastin) MTOR Inhibitors: Temsirolimus (Torisel), Everolimus (Afinitor)ImmunotherapyImmunotherapy mankhwala amathandiza chitetezo cha mthupi kuzindikira ndi kuwononga maselo a khansa. Immunotherapy yawonetsa lonjezo lalikulu pakuchiza zapamwamba Mtengo RCC. Zitsanzo ndi izi: PD-1 Inhibitors: Nivolumab (Opdivo), Pembrolizumab (Keytruda) CTLA-4 Inhibitors: Ipilimumab (Yervoy) Kuphatikiza Immunotherapy: Nivolumab kuphatikiza IpilimumabZithandizo Zina Njira zina zochiritsira zitha kugwiritsidwa ntchito munthawi zina, monga: Chithandizo cha radiation: Kugwiritsa ntchito kuwala kwamphamvu kwambiri kupha ma cell a khansa. Si kawirikawiri ntchito Mtengo RCC, koma angagwiritsidwe ntchito pochiza metastases ya mafupa kapena kuchepetsa ululu. Chithandizo cha Ablation: Njira monga radiofrequency ablation (RFA) kapena cryoablation amagwiritsa ntchito kutentha kapena kuzizira kuwononga chotupacho. Izi zitha kugwiritsidwa ntchito ngati zotupa zazing'ono kwa odwala omwe sali oyenera kuchitidwa opaleshoni. Kuyang'anitsitsa Mwachidwi: Kwa zotupa zazing'ono kwambiri, zomwe zimakula pang'onopang'ono, kuyang'anitsitsa (kuyang'anitsitsa) kungakhale njira yabwino m'malo mwa chithandizo chachangu.Prognosis of Renal Cell CarcinomaKuneneratu za Mtengo RCC zimasiyanasiyana malinga ndi zinthu zingapo, kuphatikizapo siteji ya khansa, subtype, ndi thanzi lonse la wodwalayo. Kuzindikira msanga ndi kulandira chithandizo ndikofunikira kwambiri kuti zotsatira zake ziwonjezeke. Malinga ndi Pulogalamu ya National Cancer Institute ya SEER, chibale chazaka 5 zokhala ndi moyo wokhazikika Mtengo RCC (khansa yomwe sinafalikire kunja kwa impso) ndi yayikulu. Komabe, kuchuluka kwa kupulumuka kumachepa kwambiri pazigawo zapamwamba za matendawa. Zaka 5 Zopulumuka Pachibale pa Renal Cell Carcinoma Stage 5-year Relative Survival Rate Yopezeka 93% Regional 71% Kutali 15% All SEER Magawo Ophatikizidwa 76% Ziwerengerozi zimachokera pa anthu omwe adapezeka ndi matendawa. Mtengo RCC zaka zambiri zapitazo, kotero kuti chiwopsezo cha kupulumuka chikhoza kukhala chokwera tsopano chifukwa cha kupita patsogolo kwa chithandizo chamankhwala. Renal Cell Carcinoma, fufuzani njira zofufuzira pa Shandong Baofa Cancer Research Institute, odzipereka kupititsa patsogolo chisamaliro cha khansa.