rcc

I-RCC, noma i-Renal Cell Carcinoma, wuhlobo oluvame kakhulu lomdlavuza wezinso kubantu abadala. Iqala olwelweni lwamashubhu amancane ezinso. Izimpawu zingaba ezicashile ekuqaleni, kodwa ukuxilongwa kusenesikhathi nokwelashwa kuthuthukisa kakhulu imiphumela. Lo mhlahlandlela ophelele uhlola izimbangela, izimpawu, ukuxilongwa, izinketho zokwelapha kanye ne-prognosis ya I-RCC.Iyini i-Renal Cell Carcinoma (RCC)?I-Renal cell carcinoma (I-RCC) wuhlobo lomdlavuza olusuka ezinso. Izinso ziyizitho ezimise okwebhontshisi, ngayinye ilingana nesinqindi sakho, etholakala ngemuva kwezitho zakho zesisu, eyodwa ohlangothini ngalunye lomgogodla wakho. Zihluza udoti kanye noketshezi oluningi egazini lakho, olube seluphuma emchamweni wakho. I-RCC kwakheka lapho amangqamuzana anempilo enso eyodwa noma zombili eshintsha futhi akhule engalawuleki, akhe inqwaba. Lesi sisindo singaba yingozi (engenawo umdlavuza) noma sibe yingozi (umdlavuza). Iningi lomdlavuza wezinso I-RCC.Izinhlobo Ze-Renal Cell CarcinomaKunezinhlobo ezincane ezimbalwa zazo I-RCC, ngasinye sinezici ezihlukene kanye nezibikezelo. Izinhlobo ezivame kakhulu zihlanganisa: Sula Iseli RCC: Lolu uhlobo oluncane oluvame kakhulu, olubalelwa cishe ku-70-80%. I-RCC amacala. Ibonakala ngamaseli acacile noma abukeka ephaphathekile lapho ebhekwa ngesibonakhulu. I-Papillary RCC: Uhlobo lwesibili oluvame kakhulu, olubalelwa ku-10-15% wamacala. I-Papillary I-RCC inokubonakala komunwe (i-papillae). I-Chromophobe RCC: Lolu hlobo oluncane lumelela cishe u-5%. I-RCC amacala. Ngokuvamile ine-prognosis engcono kuneseli ecacile I-RCC. Ukuqoqa i-Duct RCC: Uhlobo olungavamile nolunolaka lwe I-RCC, ebalelwa ngaphansi kuka-1% wamacala. I-RCC Engahlukaniswanga: Kwezinye izimo, amangqamuzana omdlavuza awangeni kahle kunoma yisiphi isigaba esingenhla.Izici Eziyingozi ze-RCCSIzici eziningana zingandisa ingozi yokuthuthukisa I-RCC. Lokhu kubandakanya: Ukubhema: Ukubhema kuyisici esiyingozi esibalulekile, cishe esiphinda kabili ingozi I-RCC. Ukukhuluphala ngokweqile: Isisindo esiningi kwandisa ingozi I-RCC, ikakhulukazi kwabesifazane. Umfutho Wegazi Ophakeme: I-Hypertension ihlotshaniswa nengozi eyengeziwe. Umlando Womndeni: Ukuba nomlando womndeni womdlavuza wezinso kwandisa ingozi yakho. Izimo ezithile ezizuzwe njengefa, njengesifo sika-von Hippel-Lindau (VHL), i-Birt-Hogg-Dube syndrome, kanye ne-hereditary papillary renal cell carcinoma, zandisa kakhulu ingozi. Isifo Sezinso Esithuthukisiwe noma I-Dialysis: Abantu abanesifo sezinso esingamahlalakhona, ikakhulukazi labo abasebenzisa i-dialysis, basengozini enkulu. Imithi ethile: Ukusetshenziswa isikhathi eside kwezidambisi ezithile zobuhlungu, njenge-phenacetin, kuye kwaxhunyaniswa nengozi eyengeziwe (i-phenacetin ayisasetshenziswa ngokuvamile). Ukuchayeka Ezintweni Ezithize: Ukuchayeka ku-cadmium neminye imithi yokubulala ukhula kuhlotshaniswa nengozi eyengeziwe.Izimpawu ze-RCCEzigabeni zokuqala, I-RCC ingase ingabangeli noma yiziphi izimpawu eziphawulekayo. Njengoba i-tumor ikhula, izimpawu zingase zibe, kuhlanganise: Igazi emchameni (Hematuria): Lesi esinye sezimpawu ezivame kakhulu. Ubuhlungu Beqolo: Ubuhlungu ohlangothini olulodwa lwe-back back, abuhlobene nokulimala. I-Lump noma IMisa Eceleni noma Emuva: Isisindo esizwakalayo esiswini noma endaweni eseceleni. Ukuncipha Kwesisindo: Ukuncipha kwesisindo okungachazeki. Ukukhathala: Ukukhathala okuphikelelayo nokungachazeki. Umkhuhlane: Umkhuhlane ongabangelwa ukutheleleka. I-anemia: Isibalo esiphansi samaseli abomvu egazi.Ukuxilongwa kwe-RCCUma udokotela wakho esola I-RCC, cishe bazokwenza izivivinyo eziningana ukuze baqinisekise ukuxilongwa nokuthola izinga lomdlavuza. Lezi zivivinyo zingabandakanya: Isivivinyo Somzimba: Udokotela uzokuhlola futhi akubuze ngomlando wakho wezokwelapha kanye nezimpawu zakho. Ukuhlolwa komchamo: Ukuhlolwa komchamo kungathola igazi emchameni nokunye okungavamile. Ukuhlolwa kwegazi: Ukuhlolwa kwegazi kungahlola ukusebenza kwezinso futhi kubheke izimpawu zomdlavuza. Ukuhlolwa Kwezithombe: I-Computed Tomography (CT) Scan: I-CT scan inikeza izithombe ezinemininingwane yezinso nezicubu ezizungezile. Lokhu ukuhlolwa kwesithombe okuvame kakhulu okusetshenziselwa ukuxilonga I-RCC. I-Magnetic Resonance Imaging (MRI): I-MRI isebenzisa izinkambu kazibuthe namaza omsakazo ukuze idale izithombe ezinemininingwane. Ingasetshenziselwa ukuqhubeka nokuhlola izimila ezibonwa kuma-CT scan. I-Ultrasound: I-Ultrasound isebenzisa amaza omsindo ukudala izithombe. Ingasetshenziselwa ukuhlukanisa phakathi kwamathumba aqinile nama-cyst agcwele uketshezi. I-Renal Arteriogram: I-arteriogram isebenzisa udayi ojovwe emithanjeni yezinso ukuze ibone ngeso lengqondo ukugeleza kwegazi ezinso. I-Biopsy: I-biopsy ihilela ukukhipha isampula elincane lethishu eqhumeni lezinso ukuze lihlolwe ngaphansi kwesibonakhulu. Lokhu akudingekile ngaso sonke isikhathi, kodwa kungasiza ekuqinisekiseni ukuxilongwa nokunquma uhlobo oluncane lwe I-RCC.Isiteji se-RCCOnce I-RCC uma kutholakala, umdlavuza uhlelwa ukuze kutholwe izinga lesifo. Ukwenza isiteji kusiza odokotela bahlele ukwelashwa okungcono kakhulu. Uhlelo lwesiteji lwe-TNM (Tumor, Node, Metastasis) luvame ukusetshenziswa: T (Isimila): Ichaza ubukhulu kanye nobukhulu besimila esiyinhloko. N (Inodi): Ibonisa ukuthi umdlavuza ususabalele yini kuma-lymph nodes aseduze. I-M (i-Metastasis): Ibonisa ukuthi umdlavuza ususabalele ezindaweni ezikude (i-metastasis).Izigaba zisukela ku-I kuye ku-IV, kanti isigaba IV sihamba phambili kakhulu.Izinketho Zokwelapha ze-RCCTUkwelashwa I-RCC kuncike esigabeni somdlavuza, impilo yesiguli iyonke, nezinye izici. Izinketho zokwelapha zingabandakanya: Ukuhlinzwa: I-Radical Nephrectomy: Ukususwa kwazo zonke izinso, izicubu ezizungezile, futhi ngezinye izikhathi ama-lymph nodes aseduze. Lokhu ukwelashwa okuvame kakhulu okwenziwe kwasendaweni I-RCC. I-Nephrectomy Eyingxenye: Ukususwa kwesimila kuphela kanye nenani elincane lezicubu ezizungezile. Lokhu kuvame ukuncanyelwa kumathumba amancane noma lapho umsebenzi wezinso udinga ukugcinwa. Ukugada Okusebenzayo: Kumathumba amancane, akhula kancane, ukugada okusebenzayo (ukulinda ukuqapha) kungase kube inketho. Lokhu kuhlanganisa ukuqapha njalo ngokuhlolwa kwesithombe ukuze kubonakale ukuthi isimila siyakhula yini. Ukwelashwa kwe-Ablation: Lezi zindlela zisebenzisa ukushisa noma amakhaza ukuze zibhubhise isimila. I-Radifrequency Ablation (RFA): Isebenzisa amaza omsakazo ukushisa nokucekela phansi isimila. I-Cryoablation: Isebenzisa amakhaza amakhulu ukuze iqhwa futhi ibhubhise isimila. Ukwelapha Okuhlosiwe: Le mithi iqondise kuma-molecule athile abandakanyeka ekukhuleni kwamangqamuzana omdlavuza kanye nokuphila. Izindlela zokwelapha ezihlosiwe ezijwayelekile ze I-RCC zihlanganisa: I-VEGF Inhibitors: Okufana ne-sunitinib (Sutent), i-sorafenib (Nexavar), pazopanib (Votrient), i-axitinib (Inlyta), ne-cabozantinib (Cabometyx). Le mithi ivimba ukukhula kwemithambo yegazi emisha edingwa yizimila ukuze zikhule. I-mTOR Inhibitors: Njenge-temsirolimus (Torisel) ne-everolimus (Afinitor). Le mithi ivimba iphrotheni ebizwa ngokuthi i-mTOR esiza amangqamuzana omdlavuza ukuthi akhule futhi ahlukane. I-HIF-2α Inhibitor: I-Belzutifan (Welireg) yeziguli ezine-RCC ehambisana ne-VHL. I-Immunotherapy: Le mithi isiza amasosha omzimba ukulwa nomdlavuza. Ama-immunotherapies ajwayelekile I-RCC zihlanganisa: I-PD-1 Inhibitors: Njenge-nivolumab (Opdivo) ne-pembrolizumab (Keytruda). Le mithi ivimba iphrotheni ebizwa nge-PD-1 esiza amangqamuzana omdlavuza ukuba agweme amasosha omzimba. I-CTLA-4 Inhibitors: Njenge-ipilimumab (Yervoy). Lo muthi uvimba iphrotheni ebizwa nge-CTLA-4 esiza namaseli omdlavuza ukuthi agweme amasosha omzimba. I-Interleukin-2 (IL-2): I-cytokine evuselela amasosha omzimba. Ukwelapha ngemisebe: Ukwelashwa ngemisebe kusebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Ayijwayele ukusetshenziselwa I-RCC, kodwa ingase isetshenziselwe ukwelapha ama-metastases noma ekudambiseni ubuhlungu. Izilingo Zomtholampilo: Ukubamba iqhaza ezivivinyweni zomtholampilo kungase kunikeze ukufinyelela ekwelashweni okusha nokuthembisayo.Isibikezelo se-RCCIsibikezelo se- I-RCC kuncike ezicini eziningana, okuhlanganisa isigaba somdlavuza, uhlobo oluncane lwe I-RCC, impilo yesiguli iyonke, kanye nokwelashwa esikutholile. Ukutholwa kusenesikhathi kanye nokwelashwa kubalulekile ukuze kuthuthukiswe imiphumela. Ngokuvamile, iziguli ezitholakala endaweni I-RCC (isigaba I-III) sinesibikezelo esihle. Izinga lokusinda leminyaka engu-5 lesigaba I I-RCC iphezulu kakhulu, imvamisa idlula ama-90%. Kodwa-ke, i-prognosis yeziguli ezine-metastatic I-RCC (isigaba IV) asithandeki kangako, ngesilinganiso sokusinda seminyaka emi-5 esingaba ngu-10-20%. Kodwa-ke, izindlela zokwelapha ezintsha ezifana nokwelashwa okuhlosiwe kanye ne-immunotherapy kuye kwawuthuthukisa kakhulu umbono weziguli eziningi ezithuthuke kakhulu I-RCC. Ucwaningo oluqhubekayo nokuthuthuka ekwelashweni kunikeza ithemba ngemiphumela ethuthukisiwe esikhathini esizayo.Ukuvimbela i-RCCWNakuba ingekho indlela eqinisekisiwe yokuvimbela I-RCC, ungathatha izinyathelo zokunciphisa ubungozi bakho, okuhlanganisa: Yeka Ukubhema: Uma ubhema, ukuyeka kuyinto ebaluleke kakhulu ongayenza ukuze unciphise ingozi yakho. Gcina Isisindo Esinempilo: Ukwehlisa isisindo uma ukhuluphele noma ukhuluphele kungasiza ekwehliseni ubungozi bakho. Lawula Umfutho Wegazi Ophakeme: Sebenza nodokotela wakho ukuze ulawule umfutho wegazi lakho. Gwema Ukuchayeka Ezintweni Ezithize: Nciphisa ukuchayeka kwakho ku-cadmium nama-herbicides. Khuluma Nodokotela Wakho Mayelana Nomlando Womndeni: Uma unomlando womndeni womdlavuza wezinso, xoxa ngobungozi bakho nodokotela wakho.Ucwaningo lwe-RCC e-Shandong Baofa Cancer Research InstituteAt I-Shandong Baofa Cancer Research Institute, sizinikele ekuthuthukiseni ukuqonda nokuphathwa kwe I-RCC. Ucwaningo lwethu lugxile ekuthuthukiseni izindlela zokwelapha ezintsha kanye nokwenza ngcono imiphumela yeziguli ezinalesi sifo. Sikholelwa ukuthi ngokucwaninga okuqhubekayo nokusebenzisana, singenza umehluko omkhulu ezimpilweni zalabo abathintekayo umdlavuza wezinso.RCC Staging Example Stage Tumor Size (T) Lymph Nodes (N) Metastasis (M) I T1 (≤7 cm) N0 M0 II T2 (>7 cm, ikhawulelwe ezinso) N0 M0 III T3 (Inwebela emithanjeni emikhulu ye-Gerota noma i-Npericia1) (Sabalale kuma-lymph nodes esifunda) M0 IV T4 (Inweba ngale kwe-Gerota's fascia) Noma iyiphi i-N M1 (I-Metastasis ekude) *Qaphela: Leli thebula lihlinzeka ngokubuka konke okwenziwe lula. Xhumana nochwepheshe bezokwelapha ukuze uthole isiteji esinembile.I-RCC: Indlela Yesiguli EsimaphakathiUkuqonda ubunzima be I-RCC kubalulekile ekuhlonzweni kusenesikhathi nokuphatha ngempumelelo. Kusukela ekuboneni izinto eziyingozi kuye ekubambeni izinketho zokwelapha, ukunika abantu amandla olwazi kubasiza ukuthi bazulazule ohambweni lwabo lokunakekelwa kwezempilo ngempumelelo. Ukuze uthole ukunakekelwa okukhethekile kanye nokucwaninga okuyisisekelo ekwelapheni umdlavuza, ikakhulukazi mayelana I-RCC, cabanga ukuhlola izinsiza ezitholakala ezikhungweni ezifana I-Shandong Baofa Cancer Research Institute.Umshwana wokuzihlangula: Lolu lwazi ololwazi olujwayelekile kanye nezinjongo zolwazi kuphela, futhi aluhlanganisi iseluleko sezokwelapha. Kubalulekile ukubonisana nochwepheshe bezempilo abaqeqeshiwe nganoma yikuphi ukukhathazeka ngezempilo noma ngaphambi kokwenza noma yiziphi izinqumo ezihlobene nempilo noma ukwelashwa kwakho.Imithombo: I-American Cancer Society: www.cancer.org I-National Cancer Institute: www.cancer.gov I-Mayo Clinic: www.mayoclinic.org