Umhlaza wePancreatic: Ukuqonda, Ukuxilongwa, kunye noKhetho loNyango 

Umhlaza wePancreatic sisifo apho iiseli ezinobungozi zenza kwizicubu ze-pancreas, ilungu elisemva kwesisu elidlala indima ebalulekileyo ekutyeni kunye nokulawula iswekile yegazi. Iimpawu zihlala zingacacanga kwaye zinokubandakanya iintlungu zesisu, i-jaundice, kunye nokuncipha komzimba. Ukufunyaniswa kwangoko kunye nonyango lubalulekile ekuphuculeni iziphumo.

Ukuqonda iPancreas kunye Umhlaza wePancreatic

Yintoni iPancreas?

I-pancreas lilungu ledlala elibekwe kwisisu. Idlala iindima eziphambili ezimbini:

• Umsebenzi we-Exocrine: Ivelisa ii-enzymes ezinceda ukwetyisa ukutya.
• Umsebenzi we-Endocrine: Ivelisa amahomoni afana ne-insulin kunye neglucagon elawula iswekile yegazi.

Ngenxa yendawo yayo enzulu ngaphakathi kwesisu, umhlaza wepancreatic kunokuba nzima ukuyibona kumanqanaba ayo okuqala.

Iintlobo ze Umhlaza wePancreatic

Uninzi lwe umhlaza wepancreatic Amathumba e-exocrine, ngakumbi i-adenocarcinomas. Ezi thumba zivela kwiiseli ezihambelana ne-pancreatic ducts.

• Adenocarcinoma: Olona hlobo luxhaphakileyo, lubala malunga ne-95% yamatyala.
• I-Neuroendocrine Tumors (NETs): Okuncinci okuqhelekileyo, kuvela kwiiseli ezivelisa ihomoni. Ezi zithanda ukukhula kancinci kune-adenocarcinomas.

I-Shandong Baofa Cancer Research Institute igxile kwizicwangciso zophando kunye nonyango lweentlobo ezahlukeneyo zomhlaza, kubandakanywa umhlaza wepancreatic. Ukuqonda uhlobo lomhlaza kubalulekile kucwangciso lonyango lomntu. Ndwendwela IZiko loPhando ngoMhlaza laseShandong Baofa ngolwazi oluthe kratya.

Imiba yoMngcipheko we Umhlaza wePancreatic

Ziliqela izinto ezinokonyusa umngcipheko wokukhula umhlaza wepancreatic:

• Ukutshaya: Umngcipheko omkhulu.
• Isifo seswekile: Isifo seswekile esihlala ixesha elide sinyusa umngcipheko.
• Ukutyeba: Ukutyeba ngokugqithiseleyo okanye ukutyeba kunxulunyaniswa nomngcipheko okhulayo.
• Imbali yoSapho: Ukuba nembali yosapho lwe umhlaza wepancreatic kwandisa umngcipheko.
• I-Pancreatitis engapheliyo: Ukuvuvukala kwexesha elide le-pancreas.
• Ubudala: Umngcipheko uyanda ngokukhula, ufunyaniswa kakhulu kubantu abadala.
• Izigulo ezithile zemfuzo: Okufana ne-BRCA1 / 2 utshintsho, i-Lynch syndrome, kunye ne-Peutz-Jeghers syndrome.

Iimpawu ze Umhlaza wePancreatic

Inqanaba lokuqala umhlaza wepancreatic amaxesha amaninzi akanazimpawu. Njengoko umhlaza ukhula, iimpawu zinokubandakanya:

• Iintlungu zesisu: Amaxesha amaninzi iingqaqambo ezibuhlungu kumntla wesisu ezinokuphuma ngasemva.
• Ijaundice: Ulusu kunye namehlo atyheli, ahlala ekhatshwa ngumchamo omnyama kunye nelindle.
• Ukwehla kobunzima: Ukwehla kobunzima obungachazwanga.
• Ukuphulukana noMdla: Ukuziva uhluthi ngokukhawuleza okanye ukungaziva ulambile.
• Isicaphucaphu kunye nokugabha:
• Isifo seswekile: Isifo seswekile esitsha okanye ubunzima bokulawula isifo seswekile esele sikhona.
• Utshintsho kwimikhwa yamathumbu: Kubandakanya urhudo okanye ukuqhina.

Kubalulekile ukuba udibane nogqirha ukuba ufumana nayiphi na kwezi mpawu, ngakumbi ukuba unomngcipheko umhlaza wepancreatic.

Ukuxilongwa kwe Umhlaza wePancreatic

Ukuxilonga umhlaza wepancreatic Ibandakanya indibaniselwano yovavanyo lokucinga kunye ne-biopsies:

• Uvavanyo lomfanekiso:
  • CT Scan: Ibonelela ngemifanekiso eneenkcukacha ye-pancreas kunye nezitho ezijikelezileyo.
  • I-MRI: Isebenzisa umhlaba wemagnethi ukwenza imifanekiso ye-pancreas.
  • I-Endoscopic Ultrasound (EUS): Isebenzisa i-endoscope kunye ne-ultrasound probe ukujonga i-pancreas.
  • I-PET Scan: Inokunceda ekuboneni ukuba umhlaza unwenwele na kwamanye amalungu omzimba.
• I-Biopsy: Isampulu yethishu ithathwa kwi-pancreas kwaye ihlolwe phantsi kwe-microscope ukuqinisekisa ubukho beeseli zomhlaza. Oku kunokwenziwa ngexesha le-EUS okanye ngenaliti ye-biopsy ekhokelwa ngumfanekiso.
• Uvavanyo lwegazi: Unokulinganisa amanqanaba eeprotheyini ezithile okanye i-enzymes ezinokunyuswa umhlaza wepancreatic.

Ukwenziwa kwe Umhlaza wePancreatic

Ukulinganisa kunceda ukumisela ubungakanani bomhlaza kunye nezigqibo zonyango ezikhokelayo. Inkqubo yeqonga esetyenziswa ngokuqhelekileyo yi-TNM system (iTumor, Node, Metastasis):

• T (Ithumba): Ichaza ubungakanani kunye nobungakanani bethumba lokuqala.
• N (Indawo): Ibonisa ukuba umhlaza unwenwele na kwii-lymph nodes ezikufutshane.
• M (iMetastasis): Ibonisa ukuba umhlaza unwenwele na kumalungu akude.

Iinketho zonyango ze Umhlaza wePancreatic

Unyango lwe umhlaza wepancreatic kuxhomekeke kwinqanaba lomhlaza, impilo yonke yesigulane, kunye nezinye izinto. Ukhetho lungabandakanya:

Utyando

Utyando lolona nyango lusebenzayo lwe-rectable umhlaza wepancreatic (umhlaza onokususwa ngokupheleleyo). Iindidi zotyando ziquka:

• Inkqubo yeWhipple (Pancreaticoduodenectomy): Ukususwa kwentloko ye-pancreas, inxalenye yamathumbu amancinci, i-gallbladder, kunye nenxalenye yesisu.
• Distal Pancreatectomy: Ukususwa komsila we-pancreas.
• Iyonke iPancreatectomy: Ukususwa kwe-pancreas yonke (ayifane yenziwe).

Unyango ngamachiza

I-Chemotherapy isebenzisa amayeza ukubulala iiseli zomhlaza. Ingasetyenziswa phambi kotyando (unyango lwe-neoadjuvant), emva kotyando (unyango lwe-adjuvant), okanye njengonyango oluphambili kunyango oluphambili. umhlaza wepancreatic. Amachiza aqhelekileyo e-chemotherapy aquka:

• Gemcitabine
• I-FOLFIRINOX (inhlanganisela ye-folinic acid, i-fluorouracil, i-irinotecan, kunye ne-oxaliplatin)
• I-Abraxane (i-paclitaxel albumin-bound)

Unyango ngemitha

Unyango ngemitha isebenzisa imitha ephezulu yamandla ukubulala iiseli zomhlaza. Ingasetyenziswa ngokudityaniswa nechemotherapy, ngakumbi kwindawo ephucukileyo umhlaza wepancreatic engenakususwa ngotyando.

Unyango ekujoliswe kulo

Amachiza onyango ekujoliswe kuwo ajolise kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. Ngokomzekelo, i-olaparib inokusetyenziswa kwizigulane ezineenguqu ze-BRCA.

Immunotherapy

I-Immunotherapy isebenzisa amajoni omzimba ukulwa nomhlaza. Ngelixa engekasetyenziswa ngokubanzi umhlaza wepancreatic, iphandwa kulingo lwezonyango.

Iimvavanyo zeklinikhi

Ulingo lwezonyango zizifundo zophando eziphanda iindlela ezintsha zokunyanga umhlaza. Izigulane ezine umhlaza wepancreatic Inokucinga ngokuthatha inxaxheba kulingo lwezonyango ukufikelela kunyango olutsha oluthembisayo.

Ukhathalelo lwePalliative

Ukhathalelo lwePalliative lujolise ekudambiseni iimpawu kunye nokuphucula umgangatho wobomi kwizigulana ezihambele phambili umhlaza wepancreatic. Ingabandakanya ulawulo lweentlungu, inkxaso yesondlo, kunye nenkxaso yeemvakalelo.

Amazinga okusinda kwi Umhlaza wePancreatic

Amazinga okusinda kwi umhlaza wepancreatic ziyahluka ngokuxhomekeke kwinqanaba lomhlaza kunye nezinye izinto. Ukufunyanwa kwangoko kunye nonyango kunokuphucula kakhulu iziphumo. Ngokutsho koMbutho woMhlaza waseMelika, inqanaba lokusinda leminyaka emi-5 kuzo zonke izigaba ze umhlaza wepancreatic malunga ne-12%. Nangona kunjalo, kumhlaza ofunyenwe kwinqanaba lawo lakwangoko (owasekhaya), izinga lokusinda leminyaka emi-5 limalunga nama-44%. [Umthombo: American Cancer Society]

Olu ludwe lulandelayo lubonisa amazinga okusinda kweminyaka emi-5 ngokwenqanaba:

La manani luqikelelo kwaye iziphumo zomntu ngamnye zinokwahluka.

Ukuhlala kunye Umhlaza wePancreatic

Ukuhlala kunye umhlaza wepancreatic kunokuba lucelomngeni, ngokwasemzimbeni nangokweemvakalelo. Amaqela enkxaso, iingcebiso, kunye nezinye izibonelelo zinokunceda izigulane kunye neentsapho zazo ukuba zimelane nesi sifo.