i-rcc renal cell carcinoma

I-RCC (iRenal Cell Carcinoma) lolona hlobo luxhaphakileyo lomhlaza wezintso kubantu abadala. Eli nqaku liphonononga isifo, ligubungela iintlobo zaso, iimpawu, ukuxilongwa, ukhetho lonyango, kunye ne-prognosis.What IiRenal Cell Carcinoma?IiRenal Cell Carcinoma (RCC), okanye umhlaza wezintso, uvela kunwebu lweproximal convoluted tubule, inxalenye yeetyhubhu ezincinci kwizintso ezihluza igazi kwaye zisuse inkunkuma. Ukuqonda iintlobo ezahlukeneyo kunye nezigaba ze I-RCC lubalulekile kunyango olusebenzayo. Iintlobo ze IiRenal Cell CarcinomaIintlobo ezininzi ezisezantsi ze I-RCC zikhona, nganye ineempawu ezahlukileyo kunye neendlela zonyango. Ezona ntlobo zixhaphakileyo ziquka:ISeli ecacileyo IiRenal Cell CarcinomaOlona didi lusezantsi luxhaphakileyo, lubalelwa malunga ne-70% ye I-RCC iimeko. Iphawulwa ngeeseli ezibonakala zicace okanye ziluthuthu phantsi kwe-microscope ngenxa yomxholo we-lipid ephezulu. Umthombo: American Cancer SocietyPapillary IiRenal Cell CarcinomaUhlobo lwesibini oluqhelekileyo, olubandakanya malunga ne-10-15% yamatyala. Papillary I-RCC ibonakala ngoqikelelo olufana nomnwe olubizwa ngokuba yi-papillae. Ihlala inxulunyaniswa neemeko ezithile zofuzo. Kukho iindidi ezimbini eziphambili: Uhlobo loku-1 kunye noHlobo lwesi-2, kunye noHlobo lwesi-2 ngokubanzi luba ndlongondlongo. Chromophobe IiRenal Cell CarcinomaOlu hlobo luncinane lumele malunga ne-5% ye I-RCC iimeko. Chromophobe I-RCC ngokwesiqhelo inombono ongcono xa kuthelekiswa neseli ecacileyo I-RCC. Iiseli zinkulu kwaye zimhlophe kuneseli ecacileyo I-RCC iiseli.Ukuqokelela Umbhobho IiRenal Cell CarcinomaI-subtype enqabileyo kunye ne-aggressive, ibalwa ngaphantsi kwe-1% yamatyala. Ukuqokelela umbhobho I-RCC ivela kwimibhobho yokuqokelela yezintso, ehambisa umchamo kwi-bladder. Idla ngokufunyaniswa kwixesha elizayo kwaye kunokuba ngumngeni ukunyanga.Medullary IiRenal Cell CarcinomaEnye i-subtype enqabileyo kunye nendlongondlongo, echaphazela ngokukodwa abantu abane-sickle cell trait. I-Medullary I-RCC idla ngokunxulunyaniswa neziphumo ezibi.Iimpawu ze IiRenal Cell CarcinomaIzigaba zokuqala ze I-RCC isenokungabonakalisi zimpawu zibonakalayo. Nangona kunjalo, njengoko ithumba likhula, iimpawu zingabandakanya: Igazi kumchamo (hematuria) Intlungu eqhubekayo ecaleni okanye umva Iqhuma okanye ubunzima kwicala okanye umqolo Ukulahleka kobunzima obungachazwanga Ukulahleka kokutya Ukukhathala Umkhuhlane ongabangelwa lusulelo I-anemia (inani eliphantsi leeseli ezibomvu zegazi) Ukuba ufumana nayiphi na kwezi mpawu, kubalulekile ukuba udibane nogqirha ukuxilongwa ngokufanelekileyo. IiRenal Cell CarcinomaUkuxilonga I-RCC Ngokwesiqhelo kubandakanya indibaniselwano yovavanyo lomzimba, iimvavanyo zomfanekiso, kunye ne-biopsy. I-RCC. Iimvavanyo zomfanekiso eziqhelekileyo ziquka: Iskena seComputed Tomography (CT): Inika imifanekiso eneenkcukacha ezinqamlezileyo zezintso kunye nezicubu ezijikelezileyo. Umfanekiso weMagnetic Resonance (MRI): Inika umahluko obalaseleyo weethishu ezithambileyo kwaye iluncedo ngakumbi ekuvavanyeni ubungakanani bethumba kunye nokufumanisa ukusasazeka kwizakhiwo ezikufutshane. I-Ultrasound: Inokunceda ukwahlula phakathi kobunzima obuqinileyo kunye nama-cysts azaliswe lulwelo kwizintso. I-Renal Arteriography (iAngiography): Uvavanyo lwe-X-ray lwemithambo yezintso emva kokuba idayi itofwe. Isetyenziswe ngaphantsi kwe-CT okanye i-MRI.I-BiopsyA biopsy ibandakanya ukususa isampuli encinci yezicubu zezintso ukuze ihlolwe phantsi kwe-microscope. I-biopsy iyimfuneko ukuqinisekisa ukuxilongwa I-RCC kwaye umisele udidi olusezantsi. Iibiopsies ezikhokelwa ngumfanekiso ziqhele ukwenziwa kusetyenziswa i-CT okanye i-ultrasound ukuqinisekisa ukujoliswa ngokuchanekileyo kwendawo ekrokrisayo. Izigaba ze IiRenal Cell CarcinomaInqanaba le I-RCC ibhekisa kubungakanani bomhlaza nokuba sele unwenwele kwamanye amalungu omzimba. I-Staging ibalulekile ekumiseleni indlela yonyango efanelekileyo kunye nokuxela kwangaphambili i-prognosis. Inkqubo yesiteji ye-TNM (iTumor, Node, Metastasis) iqhele ukusetyenziswa: T (Ithumba): Ichaza ubungakanani kunye nobungakanani bethumba lokuqala. N (Indawo): Ibonisa ukuba umhlaza unwenwele na kwii-lymph nodes ezikufutshane. M (iMetastasis): Ibonisa ukuba ingaba umhlaza uye wanwenwela kwiindawo ezikude, njengemiphunga, amathambo, okanye ingqondo.Amanqanaba aqala ukusuka ku-I ukuya ku-IV, inqanaba lokuqala lilelona nqanaba lokuqala kwaye iSigaba IV sesona siphambili. IiRenal Cell CarcinomaUnyango lwe I-RCC kuxhomekeke kwizinto eziliqela, kuquka inqanaba lomhlaza, impilo yomguli, nezinto azikhethayo. Iinketho zonyango eziqhelekileyo ziquka:UtyandoUkususwa kwethumba ngokufuthi lolona nyango luphambili lwendawo I-RCC (Amanqanaba I-III). Ukhetho lotyando lubandakanya: I-Nephrectomy engaphelelanga: Ukususwa kwethumba kuphela kunye nomda omncinci wezicubu eziphilileyo. Le ndlela ikhethwa xa kunokwenzeka ukugcina ukusebenza kwezintso. I-Radical Nephrectomy: Ukususwa kwezintso zonke, kunye nezicubu ezijikelezileyo, ezifana ne-adrenal gland kunye ne-lymph nodes. Oku ngokuqhelekileyo kwenziwa kumathumba amakhulu okanye xa i-nephrectomy eyinxenye ingenzeki.Unyango ekujoliswe kulo ngamachiza ajolise ngokukodwa kwiimolekyuli ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. La machiza anokusebenza ekunyangeni inqanaba eliphezulu I-RCC (Inqanaba IV) kwaye isenokusetyenziswa kumanqanaba angaphambili kwiimeko ezithile. Imizekelo ibandakanya: I-VEGF Inhibitors: Sunitinib (Sutent), Sorafenib (Nexavar), Pazopanib (Votrient), Axitinib (Inlyta), Bevacizumab (Avastin) I-mTOR Inhibitors: Temsirolimus (Torisel), Everolimus (Afinitor)ImmunotherapyImmunotherapy amayeza anceda amajoni omzimba aqaphele kwaye ahlasele iiseli zomhlaza. I-Immunotherapy ibonise isithembiso esibalulekileyo kunyango oluphambili I-RCC. Imizekelo ibandakanya: I-PD-1 Inhibitors: Nivolumab (Opdivo), Pembrolizumab (Keytruda) I-CTLA-4 Inhibitors: Ipilimumab (Yervoy) I-Immunotherapy edibeneyo: I-Nivolumab kunye ne-IpilimumabOlunye unyangoOlunye unyango lunokusetyenziswa kwiimeko ezithile, ezinje: Unyango ngemitha: Ukusebenzisa imitha ephezulu yamandla ukubulala iiseli zomhlaza. Ayiqhelekanga ukusetyenziswa I-RCC, kodwa isenokusetyenziswa ukunyanga imetastases yamathambo okanye ukuthomalalisa iintlungu. Unyango lokukhupha amanzi: Ubuchule obufana ne-radiofrequency ablation (RFA) okanye i-cryoablation isebenzisa ubushushu okanye ukubanda ukutshabalalisa ithumba. Ezi zinokusetyenziselwa amathumba amancinci kwizigulana ezingabaviwa abalungileyo botyando. Uvavanyo olusebenzayo: Kumathumba amancinci kakhulu, akhula kade, ucupho olusebenzayo (ukubeka iliso olusondeleyo) kunokuba lukhetho endaweni yonyango olukhawulezileyo. IiRenal Cell CarcinomaIprognosis ye I-RCC iyahluka ngokuxhomekeke kwizinto ezininzi, kubandakanywa inqanaba lomhlaza, uhlobo olungaphantsi, kunye nempilo yonke yesigulana. Ukufunyaniswa kwangoko kunye nonyango lubalulekile ekuphuculeni iziphumo. Ngokutsho kwe Inkqubo ye-SEER yeNational Cancer Institute, umlinganiselo weminyaka emi-5 wokuphila ngokunxulumene nendawo I-RCC (umhlaza onganwenwanga ngaphandle kwezintso) uphezulu. Nangona kunjalo, izinga lokusinda liyancipha kakhulu kwizigaba eziphambili zesifo. Imigangatho emi-5 enxulumene neRenal Cell Carcinoma Stage 5-Year Relative Survival Rate yasekuhlaleni 93% yoMmandla 71% Mgama 15% Onke amanqanaba e-SEER adityanisiwe 76% La manani asekelwe kubantu abafunyaniswa benentsholongwane. I-RCC kwiminyaka emininzi eyadlulayo, ngoko amazinga okusinda anokuba phezulu ngoku ngenxa yokuqhubela phambili kunyango.Ukuqonda iingcali kunye nokhetho oluphezulu lonyango lwe. IiRenal Cell Carcinoma, phonononga amalinge ophando kwi IZiko loPhando ngoMhlaza laseShandong Baofa, ezinikele ekuqhubeleni phambili ukhathalelo lomhlaza.