unyango iseli enkulu yomhlaza wemiphunga unyango

Umhlaza wemiphunga yeseli enkulu (LCLC) luhlobo olunobundlavini lomhlaza wemiphunga weseli ongeyonxalenye encinci (NSCLC). Iindlela zonyango zihlala zibandakanya indibaniselwano yotyando, ichemotherapy, unyango lweradiation, unyango olujoliswe kuyo, kunye ne-immunotherapy, elungiselelwe inqanaba lomguli ngamnye, impilo iyonke, kunye neempawu ezithile zethumba. Inkqubela phambili yakutsha nje kwiprofayili yemolekyuli kunye neyeza lomntu siqu ziphucula iziphumo zabo bafunyaniswa bene-LCLC.Ukuqonda iSeli enkulu yoMhlaza weMiphungaYintoni eNkulu yoMhlaza weMiphunga yeSeli?Unyango lomhlaza wemiphunga weseli enkulu (LCLC) luhlobo lomhlaza wemiphunga weseli engeyiyo encinci. Ifumana igama layo kwiiseli ezinkulu, ezikhangeleka ngendlela engaqhelekanga ezibonwa phantsi kwemakroskopu. I-LCLC ithande ukukhula kwaye isasazeke ngokukhawuleza, isenza ukuxilongwa kwangoko kunye nonyango lubaluleke kakhulu. Ngelixa ixhaphake kakhulu kunezinye iindidi ze-NSCLC, ukuqonda iimpawu zayo kubalulekile kulawulo olusebenzayo.Iizinto zoMngcipheko kunye noThinteloNgokufanayo nezinye iimhlaza zemiphunga, ukutshaya yeyona nto iphambili kwi-LCLC. Eminye imingcipheko ibandakanya ukuchanabeka kumsi wecuba, iradon, iasbestos, kunye nezinto ezithile zemizi-mveliso. Ukuyeka ukutshaya, ukuphepha ukuvezwa kwi-carcinogens eyaziwayo, kunye nokugcina impilo enempilo yeyona ndlela ingcono yokukhusela. Ukuhlolwa rhoqo kunye nokuhlolwa komhlaza wemiphunga kubantu abasemngciphekweni omkhulu kunokunceda ekubhaqweni kwangoko kwaye kunokubakho ukuphucula unyango umhlaza wemiphunga yeseli enkulu iziphumo.Unyango Ukhetho lweCell Enkulu yeLung CancerSurgeryUtyando ludla ngokuba ngumgca wokuqala wonyango lwe-LCLC yenqanaba lokuqala, xa ithumba lihlala kwindawo kwaye alizange lisasazeke kwiindawo ezikude. Inkqubo yotyando inokubandakanya ukususa inxalenye yemiphunga (wedge resection okanye segmentectomy), i-lobe yonke (lobectomy), okanye umphunga wonke (pneumonectomy). Ukhetho lotyando luxhomekeke kubungakanani kunye nendawo yethumba, kunye nomsebenzi wemiphunga jikelele wesigulane. Amaqela otyando eShandong Baofa Cancer Research Institute anamava kakhulu kwezi nkqubo.ChemotherapyChemotherapy lunyango olucwangcisiweyo olusebenzisa amayeza okubulala iiseli zomhlaza kuwo wonke umzimba. Ihlala isetyenziswa ngokudityaniswa notyando okanye unyango lwemitha, okanye njengonyango oluphambili lwe-LCLC yenqanaba eliphezulu. Iirejimeni zechemotherapy eziqhelekileyo ze-LCLC ziquka amachiza asekelwe kwiplatinam (afana ne-cisplatin okanye i-carboplatin) edityaniswe nezinye ii-agent ze-chemotherapy. Imiphumo emibi ye-chemotherapy ingabandakanya isicaphucaphu, ukukhathala, ukulahleka kweenwele, kunye nomngcipheko wokosuleleka. Ingasetyenziselwa ukunyanga i-LCLC ngeendlela ezininzi: njengonyango oluphambili lwezigulane ezingabaviwa botyando, njengonyango lwe-adjuvant emva kotyando lokubulala naziphi na iiseli zomhlaza eziseleyo, okanye ukukhulula iimpawu ezifana neentlungu okanye ukuphefumla kwisifo esiphezulu. Iindidi zonyango lwemitha olusetyenziselwa i-LCLC lubandakanya unyango lwemitha yangaphandle (EBRT) kunye ne-stereotactic body radiation therapy (SBRT). Olu nyango lusebenza ngokukodwa kwizigulane ezinokuguqulwa kofuzo oluthile kumathumba abo. Iithagethi eziqhelekileyo kwi-LCLC ziquka i-EGFR, i-ALK, i-ROS1, kunye ne-BRAF. Phambi kokuba baqalise unyango olujoliswe kuyo, abaguli bahlala bevavanywa ngokwemolekyuli ukuze baqinisekise ukuba amathumba abo analo naluphi na olu tshintsho lunokwenzeka. Ukuba ufuna uncedo, i-Baofa Cancer Research Institute inokubonelela ngeenkonzo zovavanyo lwemfuza.I-ImmunotherapyImmunotherapy ibopha amandla amajoni omzimba okulwa umhlaza. I-immune checkpoint inhibitors, njenge-pembrolizumab, i-nivolumab, kunye ne-atezolizumab, luhlobo lwe-immunotherapy oluvimba iiprotheni ezithintela amajoni omzimba ekuhlaseleni iiseli zomhlaza. I-Immunotherapy ibonise iziphumo ezithembisayo ekunyangeni i-LCLC, ngakumbi kwizigulana ezinamathumba abonisa amanqanaba aphezulu e-PD-L1. Ingasetyenziswa njengonyango lodidi lokuqala lwe-LCLC yenqanaba eliphezulu okanye emva kokuba unyango lwechemotherapy luphumelele.Ukuqhubela phambili kwiSeli enkulu yeLung Cancer TreatmentIprofayili yeMolekyuli ibandakanya ukuhlalutya izicubu zethumba lesigulana ukuchonga utshintsho oluthile lwemfuza okanye ezinye iinguqulelo zeemolekyuli ezinokuthi ziqhube ukukhula komhlaza. Olu lwazi lunokunceda oogqirha bakhethe unyango oluchanekileyo olujoliswe kuyo okanye i-immunotherapy kwisigulane ngasinye. Isizukulwana esilandelayo sequencing (NGS) bubuchule obuqhelekileyo obusetyenziswa kwiprofayili yemolekyuli, evumela ukufunyaniswa kwangaxeshanye uguqulo lwemfuza oluninzi. unyango umhlaza wemiphunga yeseli enkulu kwisigulana ngasinye ngokusekwe kwiprofayili yemolekyuli yethumba, impilo iyonke, kunye nezinto abazithandayo. Le ndlela ijolise ekwandiseni ukusebenza konyango ngelixa unciphisa iziphumo ebezingalindelekanga. Iyeza lomntu ngamnye libaluleka ngakumbi kulawulo lwe-LCLC, njengoko livumela oogqirha ukuba bakhethe isicwangciso sonyango esifanelekileyo kwisigulane ngasinye.Izilingo zeClinicalIzilingo zeClinical zizifundo zophando ezivavanya unyango olutsha okanye indibaniselwano yonyango lwe-LCLC. Ukuthatha inxaxheba kulingo lwezonyango kunokunika izigulane ukufikelela kunyango lwe-cutting-edge olungekafumaneki ngokubanzi. Izilingo zeklinikhi ziyinxalenye ebalulekileyo yokuqhubela phambili ukhathalelo lomhlaza, kwaye izigulane kufuneka zixoxe noogqirha bazo ukuba ngaba ukuthatha inxaxheba kulingo lwezonyango yinto efanelekileyo kubo.I-Prognosis and Survival RatesI-prognosis ye-LCLC iyahluka ngokuxhomekeke kwizinto ezininzi, kubandakanywa inqanaba lomhlaza ekuxilongweni, impilo yesigulane ngokubanzi, kunye nempendulo kunyango. I-LCLC yasekuqaleni enyangwa ngotyando ine-prognosis engcono kune-LCLC yenqanaba eliphezulu elithe lasasazeka kwiindawo ezikude. Ukuqhubela phambili kwonyango, njengonyango olujoliswe kuyo kunye ne-immunotherapy, luphucule amazinga okuphila kwizigulane ezine-LCLC kwiminyaka yamuva. Imilinganiselo ye-5-Year Survival ye-Non-Small Cell Lung Cancer (NSCLC) yi-Stage1 Stage 5-Year Survival Rate Localized 63% Regional 36% Distant 8% Zonke i-SEER Stages 26% * Qaphela: Ezi zilinganiso zokusinda zisekelwe kwidatha evela kwi-National Cancer Institute's Surveillance, i-EndLide yeNkqubo ye-Epide, i-Epide ye-Epide ye-Epide. Umhlaza WemiphungaUkuphila nge-LCLC kunokuba lucelomngeni, kodwa kukho izibonelelo ezikhoyo zokunceda izigulana kunye neentsapho zazo zijamelane neziphumo zomzimba nezeemvakalelo zesi sifo. Amaqela enkxaso, iingcebiso, kunye nokhathalelo lokuthomalalisa unokunika uncedo oluxabisekileyo. Ukugcina impilo esempilweni, kuquka ukutya okunesondlo nokuzilolonga rhoqo, nako kunokuphucula umgangatho wobomi. Ukuxoxa ngezinto ezikuxhalabisayo kunye nemibuzo kunye neqela lakho lezempilo kubalulekile ekulawuleni i-LCLC ngempumelelo.Ukufumana iNkxaso kunye neZiboneleloImibutho emininzi inika inkxaso kunye nezibonelelo kubantu abafunyaniswe bene-LCLC kunye neentsapho zabo. Ezi zibonelelo zibandakanya izixhobo zemfundo, amaqela enkxaso, iinkqubo zoncedo lwemali, neenzame zokuxhasa. Ukuqhagamshelana nezi zixhobo kunokubonelela ngenkxaso ebalulekileyo kunye nesikhokelo kulo lonke uhambo lomhlaza.IiReferensi: Umbutho waseMelika we-Clinical Oncology (ASCO): Umhlaza weLung - Iseli engeyincinci: Izibalo.