rcc

I-RCC, okanye iRenal Cell Carcinoma, lolona hlobo luqhelekileyo lomhlaza wezintso kubantu abadala. Iqala kulwelo lwemibhobho emincinane ezintso. Iimpawu zinokuthi zingabonakali ekuqaleni, kodwa ukuxilongwa kwangaphambili kunye nonyango luphucula kakhulu iziphumo. Esi sikhokelo sibanzi siphonononga oonobangela, iimpawu, ukuxilongwa, iindlela zonyango, kunye noxilongo lwe I-RCC.Yintoni iRenal Cell Carcinoma (RCC)?Renal cell carcinoma (I-RCC) luhlobo lomhlaza olusuka kwizintso. Izintso ngamalungu amile okwembotyi, ngalinye lilingana nenqindi lakho, elibekwe emva kwamalungu esisu sakho, elinye kwicala ngalinye lomnqonqo wakho. Bahluza inkunkuma kunye nolwelo olugqithisileyo egazini lakho, oluthi ke lukhutshelwe kumchamo wakho. I-RCC iifom xa iiseli eziphilileyo kwenye okanye zombini izintso zitshintsha kwaye zikhule ngaphandle kolawulo, zenza ubunzima. Obu bunzima bunokuba buhlungu (bungenamhlaza) okanye bube bubi (umhlaza). Uninzi lomhlaza wezintso I-RCC.Iintlobo zeRenal Cell CarcinomaKukho iindidi ezininzi ze I-RCC, ngalinye lineempawu ezahlukeneyo kunye noqikelelo. Ezona ndidi zixhaphakileyo ziquka: Sula i-RCC yeSeli: Olu lolona didi lusezantsi luxhaphakileyo, lubalelwa malunga ne-70-80% ye I-RCC iimeko. Ibonakala ngeeseli ezicacileyo okanye ezibonakala ziluthuthu xa ijongwe phantsi kwemakroskopu. I-Papillary RCC: Uhlobo lwesibini oluqhelekileyo, olubalelwa kwi-10-15% yamatyala. Papillary I-RCC inoqikelelo olufana nomnwe (papillae). I-Chromophobe RCC: Olu hlobo luncinane lumele malunga ne-5% ye I-RCC iimeko. Ngokuqhelekileyo ine-prognosis engcono kuneseli ecacileyo I-RCC. Ukuqokelelwa kombhobho weRCC: Uhlobo olunqabileyo nolundlongondlongo lwe I-RCC, ibalwa ngaphantsi kwe-1% yamatyala. I-RCC engahlelwanga: Kwezinye iimeko, iiseli zomhlaza azihambelani kakuhle kulo naluphi na udidi olungentla.IiFactors Risk for RCCSIzinto ezininzi zinokunyusa umngcipheko wokuphuhlisa. I-RCC. Ezi ziquka: Ukutshaya: Ukutshaya ngumngcipheko obalulekileyo, malunga nokuphinda kabini umngcipheko woku I-RCC. Ukutyeba: Ubunzima obugqithisileyo bunyusa umngcipheko we I-RCC, ingakumbi kumabhinqa. Uxinzelelo lwegazi oluphezulu: Uxinzelelo lwegazi lunxulumene nomngcipheko owongeziweyo. Imbali yoSapho: Ukuba nembali yosapho yomhlaza wezintso kwandisa umngcipheko wakho. Iimeko ezithile ezizuzwe njengelifa, ezifana nesifo se-von Hippel-Lindau (VHL), i-Birt-Hogg-Dube syndrome, kunye ne-hereditary papillary renal cell carcinoma, kwandisa kakhulu ingozi. Isifo sezintso esikwinqanaba eliphambili okanye i-Dialysis: Abantu abanesifo sezintso ezingapheliyo, ngakumbi abo bakwi-dialysis, banomngcipheko omkhulu. Amayeza athile: Ukusetyenziswa kwexesha elide leentlungu ezithile, ezifana ne-phenacetin, ziye zadibaniswa nomngcipheko okhulayo (i-phenacetin ayisasetyenziswa ngokuqhelekileyo). Ukuvezwa kwizinto ezithile: Ukuvezwa kwi-cadmium kunye neminye imichiza yokutshabalalisa ukhula iye yanxulunyaniswa nomngcipheko owongeziweyo.Iimpawu ze-RCCKumanqanaba okuqala, I-RCC ayinakubanga naziphi na iimpawu ezibonakalayo. Njengoko i-tumor ikhula, iimpawu zinokuvela, kuquka: Igazi kuMchamo (Hematuria): Le yenye yeempawu eziqhelekileyo. Umqolo Obuhlungu: Intlungu kwicala elinye lomqolo ongaphantsi, awuhambelani nokulimala. Isigaxa okanye uMsa ecaleni okanye ngasemva: Ubunzima obucacileyo kwisisu okanye kwindawo yecala. Ukwehla kobunzima: Ukwehla kobunzima obungachazwanga. Ukudinwa: Ukudinwa okuzingisayo nokungachazwanga. Umkhuhlane: Umkhuhlane ongekho ngenxa yosulelo. I-anemia: Inani eliphantsi leeseli ezibomvu zegazi. Ukuxilongwa kwe-RCCUkuba ugqirha wakho uyakrokrela I-RCC, mhlawumbi baya kwenza iimvavanyo ezininzi ukuqinisekisa ukuxilongwa nokufumanisa ubungakanani bomhlaza. Olu vavanyo lungabandakanya: Uvavanyo loMzimba: Ugqirha uya kukuhlola kwaye akubuze ngembali yakho yezonyango kunye neempawu. Uvavanyo lomchamo: Iimvavanyo zomchamo zinokubona igazi kumchamo kunye nezinye izinto ezingaqhelekanga. Uvavanyo lwegazi: Uvavanyo lwegazi lunokuhlola ukusebenza kwezintso kwaye lujonge iimpawu zomhlaza. Uvavanyo lomfanekiso: I-Computed Tomography (CT) Scan: I-CT scan inikeza imifanekiso ecacileyo yezintso kunye nezicubu ezijikelezileyo. Olu lolona vavanyo lwemifanekiso luxhaphakileyo olusetyenziselwa ukuxilonga I-RCC. Umfanekiso weMagnetic Resonance (MRI): I-MRI isebenzisa imagnethi kunye namaza erediyo ukwenza imifanekiso eneenkcukacha. Ingasetyenziselwa ukuvavanya ngakumbi amathumba abonwa kwi-CT scans. I-Ultrasound: I-Ultrasound isebenzisa amaza omsindo ukwenza imifanekiso. Ingasetyenziselwa ukwahlula phakathi kwamathumba aqinileyo kunye nama-cysts azaliswe ngamanzi. IArteriogram yezintso: I-arteriogram isebenzisa idayi etofelwe kwimithambo yezintso ukujonga ukuhamba kwegazi ezintso. I-Biopsy: I-biopsy ibandakanya ukususa isampulu encinci yethishu kwithumba lezintso ukuze ihlolwe phantsi kwe-microscope. Oku akusoloko kuyimfuneko, kodwa kunokuba luncedo ekuqinisekiseni ukuxilongwa kunye nokumisela i-subtype ye I-RCC.I-RCCOnce yeqonga I-RCC ufunyaniswe, umhlaza umiselwe ukufumanisa ubungakanani besifo. Ukulinganisa kunceda oogqirha bacwangcise unyango olungcono. 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 umhlaza usasazeke kwiindawo ezikude (i-metastasis) .Amanqanaba ukusuka kwi-I ukuya kwi-IV, kunye nenqanaba le-IV lelona liphambili.Iinketho zonyango lwe-RCCTreatment for I-RCC kuxhomekeke kwinqanaba lomhlaza, impilo yomguli ngokubanzi, kunye nezinye izinto. Ukhetho lonyango lunokubandakanya: Utyando: I-Radical Nephrectomy: Ukususwa kwezintso zonke, izicubu ezijikelezileyo, kwaye ngamanye amaxesha i-lymph nodes ekufutshane. Olu lolona nyango luqhelekileyo lwendawo I-RCC. I-Nephrectomy engaphelelanga: Ukususwa kwe-tumor kuphela kunye nenani elincinci lezicubu ezijikelezileyo. Oku kudla ngokukhethwa kumathumba amancinci okanye xa umsebenzi wezintso kufuneka ugcinwe. Uvavanyo olusebenzayo: Kumathumba amancinci, akhula ngokucothayo, ukujonga okusebenzayo (ukulinda okubukhali) kunokuba lukhetho. Oku kubandakanya ukubeka iliso rhoqo ngovavanyo lokucinga ukubona ukuba ithumba liyakhula. Unyango lokukhupha amanzi: Ezi ndlela zisebenzisa ubushushu okanye ukubanda ukutshabalalisa ithumba. I-Radiofrequency Ablation (RFA): Isebenzisa amaza erediyo ukutshisa kunye nokutshabalalisa ithumba. I-Cryoablation: Isebenzisa ingqele egqithisileyo ukukhenkceza nokutshabalalisa ithumba. Unyango olujolisiweyo: La machiza ajolise kwiimolekyuli ezithile ezibandakanyekayo ekukhuleni kweeseli zomhlaza kunye nokuphila. Iindlela zonyango ezijoliswe kuzo eziqhelekileyo I-RCC ziquka: I-VEGF Inhibitors: Ezinje nge-sunitinib (Sutent), sorafenib (Nexavar), pazopanib (Votrient), axitinib (Inlyta), kunye ne-cabozantinib (Cabometyx). La machiza athintela ukukhula kwemithambo yegazi emitsha ekufuneka amathumba akhule. I-mTOR Inhibitors: Njenge temsirolimus (Torisel) kunye ne-everolimus (Afinitor). La machiza avimba iprotheni ebizwa ngokuba yi-mTOR enceda iiseli zomhlaza zikhule kwaye zahlukane. HIF-2α Inhibitor: I-Belzutifan (Welireg) kwizigulane ezine-RCC ehambelana ne-VHL. I-Immunotherapy: La machiza anceda amajoni omzimba ukulwa umhlaza. I-immunotherapies eqhelekileyo ye I-RCC ziquka: I-PD-1 Inhibitors: Njenge nivolumab (Opdivo) kunye pembrolizumab (Keytruda). La machiza avala iprotein ebizwa ngokuba yiPD-1 enceda iiseli zomhlaza ukuba zibaleke amajoni omzimba. I-CTLA-4 Inhibitors: Njenge-ipilimumab (Yervoy). Eli chiza lithintela iprotheyini ebizwa ngokuba yi-CTLA-4 ekwanceda iiseli zomhlaza ukuba zibaleke amajoni omzimba. I-Interleukin-2 (IL-2): I-cytokine evuselela amajoni omzimba. Unyango ngemitha: Unyango ngemitha isebenzisa imitha ephezulu yamandla ukubulala iiseli zomhlaza. Ayiqhelekanga ukusetyenziselwa I-RCC, kodwa isenokusetyenziswa ukunyanga i-metastases okanye ukuthomalalisa iintlungu. Uvavanyo lweklinikhi: Ukuthatha inxaxheba kulingo lwezonyango kunokunika ufikelelo kunyango olutsha noluthembisayo.Iprognosis ye-RCCThe prognosis for I-RCC kuxhomekeke kwizinto eziliqela, kuquka inqanaba lomhlaza, i-subtype ye I-RCC, impilo yomguli ngokubanzi, nonyango olufunyenweyo. Ukufunyaniswa kwangoko kunye nonyango lubalulekile ekuphuculeni iziphumo. Ngokuqhelekileyo, izigulane ezineendawo zokuhlala I-RCC (inqanaba I-III) babe neprognosis elungileyo. Umyinge weminyaka emi-5 wokusinda kwinqanaba I I-RCC iphezulu kakhulu, kaninzi idlula kuma-90%. Nangona kunjalo, i-prognosis yezigulane ezine-metastatic I-RCC (inqanaba IV) alithandeki kangako, kunye nesantya seminyaka emi-5 sokusinda malunga ne-10-20%. Nangona kunjalo, unyango olutsha olufana nonyango ekujoliswe kulo kunye nonyango lokhuselo lomzimba luphucule kakhulu imbonakalo yezigulana ezininzi ezihambele phambili I-RCC. Uphando oluqhubekayo kunye nokuhambela phambili kunyango kunika ithemba kwiziphumo eziphuculweyo kwixesha elizayo.Uthintelo lwe-RCCW ngelixa kungekho ndlela iqinisekisiweyo yokuthintela I-RCC, unokuthatha amanyathelo okunciphisa umngcipheko wakho, kuquka: Yeka Ukutshaya: Ukuba uyatshaya, ukuyeka yeyona nto ibalulekileyo onokuyenza ukuze unciphise umngcipheko wakho. Gcina Ubunzima obusempilweni: Ukunciphisa umzimba ukuba utyebe kakhulu okanye utyebe kakhulu kunokunceda ukunciphisa umngcipheko wakho. Lawula uxinzelelo lwegazi oluphezulu: Sebenza nogqirha wakho ukulawula uxinzelelo lwegazi lakho. Kuphephe Ukuchanabeka Kwizinto ezithile: Nciphisa ukuba sesichengeni sakho kwi-cadmium kunye nemichiza yokutshabalalisa ukhula. Thetha noGqirha wakho malunga neMbali yoSapho: Ukuba unembali yosapho lwakho lomhlaza wezintso, xoxa ngomngcipheko wakho kunye nogqirha wakho. UPhando lweRCC eShandong Baofa Cancer Research InstituteAt IZiko loPhando ngoMhlaza laseShandong Baofa, sizinikele ekuqhubeleni phambili ukuqonda kunye nonyango lwe I-RCC. Uphando lwethu lujolise ekuphuhliseni iindlela ezintsha zonyango kunye nokuphucula iziphumo kwizigulane ezinesi sifo. Sikholelwa ukuba ngophando oluqhubekayo kunye nentsebenziswano, sinokwenza umehluko omkhulu kubomi balabo abachaphazelekayo ngumhlaza wezintso.RCC Staging Example Stage Tumor Size (T) Lymph Nodes (N) Metastasis (M) I T1 (≤7 cm) N0 M0 II T2 (>7 cm, inqunyelwe kwizintso) N0 M0 III T3 (Yandisa kwiimvini ezinkulu ze-Npericia okanye i-Npericia i-Npericia okanye i-Npericia) (Yanabela kwii-lymph nodes zengingqi) M0 IV T4 (Yandisa ngaphaya kwe-Gerota's fascia) Nayiphi na i-N M1 (i-Distant metastasis) *Qaphela: Le theyibhile inika isishwankathelo esenziwe lula. Qhagamshelana nengcali yezonyango malunga nenqanaba elichanekileyo.RCC: Indlela yeSigulane-CentreUkuqonda ubunzima be I-RCC ibalulekile ekubhaqweni kwangaphambili kunye nolawulo olusebenzayo. Ukusuka ekuqondeni imiba esemngciphekweni ukuya ekubambeni ukhetho lonyango, ukuxhobisa abantu ngolwazi kuyabanceda baqhube uhambo lwabo lokhathalelo lwempilo ngokufanelekileyo. Ngononophelo olukhethekileyo kunye nophando olusisiseko kunyango lomhlaza, ngakumbi malunga I-RCC, cinga ngokuphonononga izibonelelo ezikhoyo kumaziko afana IZiko loPhando ngoMhlaza laseShandong Baofa.I-Disclaimer: Olu lwazi lulwazi ngokubanzi kunye neenjongo zolwazi kuphela, kwaye aluquki iingcebiso zonyango. Kubalulekile ukudibana nengcali yokhathalelo lwempilo kuyo nayiphi na inkxalabo yezempilo okanye ngaphambi kokuba wenze naziphi na izigqibo ezinxulumene nempilo yakho okanye unyango.Imithombo: Umbutho womhlaza waseMelika: www.cancer.org Iziko leSizwe loMhlaza: www.cancer.gov Iklinikhi yaseMayo: www.mayoclinic.org