ukwelashwa kwe-renal cell carcinoma

Ukwelashwa kwe-renal cell carcinoma (RCC) kuhilela izindlela ezahlukahlukene, okubandakanya ukuhlinzwa, ukwelashwa okuhlosiwe, i-immunotherapy, kanye nokwelashwa ngemisebe. Ukukhetha kwe ukwelashwa kuncike ezicini ezifana nesigaba somdlavuza, impilo yesiguli iyonke, kanye nalokho umuntu akuthandayo. Ukutholwa kusenesikhathi kanye nokungenelela ngesikhathi kubalulekile ukuze kuthuthukiswe imiphumela.Ukuqonda I-Renal Cell CarcinomaI-Renal cell carcinoma (RCC) wuhlobo oluvame kakhulu lomdlavuza wezinso kubantu abadala. Isuka olwelweni lwe-proximal convoluted tubule, ingxenye yezinso ehlunga igazi futhi ikhiphe ukungcola. Nakuba imbangela yangempela ye-RCC ingacaci ngaso sonke isikhathi, izici ezithile zobungozi zihlotshaniswa namathuba akhulayo okuba nesifo. Lezi zici eziyingozi zihlanganisa ukubhema, ukukhuluphala, umfutho wegazi ophakeme, nezimo zofuzo ezifana nesifo sika-von Hippel-Lindau (VHL). Ngo I-Shandong Baofa Cancer Research Institute, sizibophezele ekunikezeni ulwazi oluphelele futhi oluthuthukisiwe ukwelashwa izinketho zeziguli ze-RCC.Izinhlobo Ze-Renal Cell CarcinomaKunezinhlobo ezimbalwa ezincane ze-RCC, ngayinye enezici ezihlukile kanye nezimpendulo ezingase zihluke ukwelashwa. I-subtypes evame kakhulu ihlanganisa: Sula iseli RCC: Lolu uhlobo oluvame kakhulu, olubalelwa ku-70-80% wamacala. I-Papillary RCC: Uhlobo lwesibili oluvame kakhulu, olumele cishe i-10-15% yamacala. I-Chromophobe RCC: Uhlobo olungajwayelekile, olwakha cishe u-5% wamacala. Iqoqo le-RCC ye-duct: Ifomu elingavamile nelinolaka le-RCC.Izinketho Zokwelashwa Ze-Renal Cell Carcinoma ukwelashwa indlela ye-RCC incike ezintweni ezimbalwa, okuhlanganisa isigaba somdlavuza, impilo yesiguli iyonke, kanye nohlobo oluthile lwe-RCC. Okuvamile ukwelashwa Izindlela zokwelapha zihlanganisa ukuhlinzwa, ukwelashwa okuhlosiwe, i-immunotherapy, kanye nokwelashwa ngemisebe. ukwelashwa kwe-renal cell carcinoma, ikakhulukazi uma umdlavuza utholakala ezinso. Izinketho zokuhlinzwa zihlanganisa: I-Radical nephrectomy: Lokhu kuhilela ukususwa ngokuphelele kwezinso ezithintekile, kanye nezicubu ezizungezile njengezindlala ze-adrenal nama-lymph nodes. I-nephrectomy eyingxenye: Lokhu kuhilela ukukhipha kuphela isimila kanye nengxenye encane yezicubu ezinempilo, ukulondoloza izinso eziningi ngangokunokwenzeka. Le ndlela yokwelapha ngokuvamile ikhethwa kumathumba amancane noma lapho isiguli sinenso eyodwa kuphela. Imithi yokwelapha ehlosiwe yimithi eqondisa ngokukhethekile amangqamuzana abandakanyeka ekukhuleni nasekuphileni kwamangqamuzana omdlavuza. Lezi zindlela zokwelapha zingasebenza ikakhulukazi ku-RCC ethuthukisiwe. Izindlela zokwelapha eziqondiwe ezijwayelekile zihlanganisa: I-VEGF inhibitors: Le mithi ivimba umzila we-vascular endothelial growth factor (VEGF), obalulekile ekwakhekeni kwemithambo yegazi emisha ehlinzeka ngamathumba. Izibonelo zifaka i-sunitinib (Sutent), i-sorafenib (Nexavar), pazopanib (Votrient), i-axitinib (Inlyta), ne-cabozantinib (Cabometyx). ama-mTOR inhibitors: Le mithi ivimba umgomo wezilwane ezincelisayo we-rapamycin (mTOR), olawula ukukhula kwamangqamuzana kanye nokugayeka kokudla. Izibonelo zifaka i-temsirolimus (Torisel) kanye ne-everolimus (Afinitor).I-ImmunotherapyImmunotherapy ihlanganisa amandla amasosha omzimba okulwa nomdlavuza. Imithi ye-Immunotherapy ye-RCC ihlanganisa: Ama-immune checkpoint inhibitors: Le mithi ivimba amaprotheni avimbela amasosha omzimba ukuba ahlasele amangqamuzana omdlavuza. Izibonelo zifaka i-nivolumab (Opdivo), pembrolizumab (Keytruda), ipilimumab (Yervoy), kanye ne-atezolizumab (Tecentriq). I-Nivolumab ivame ukuhlanganiswa ne-ipilimumab yezifo ezithuthukisiwe. Ama-Cytokines: I-high-dose interleukin-2 (IL-2) kanye ne-interferon-alpha (IFN-α) ama-cytokines angashukumisa isimiso somzimba sokuzivikela. Nokho, le mithi ingaba nemiphumela engemihle ephawulekayo futhi ayisasetshenziswa kakhulu manje ngenxa yokutholakala kwemishanguzo emisha yokuzivikela ezifweni.I-Radiation TherapyRadiation therapy isebenzisa imisebe enamandla amakhulu ukubulala amangqamuzana omdlavuza. Akuyona into eyinhloko ukwelashwa kwe-renal cell carcinoma, kodwa ingasetshenziswa ekwelapheni izinhlungu noma ezinye izimpawu ezibangelwa umdlavuza osekhulile osusakazekele kwezinye izingxenye zomzimba. Kwesinye isikhathi isetshenziswa ngemuva kokuhlinzwa uma kunobungozi ukuthi umdlavuza uzobuya noma uma isimila singakwazanga ukususwa. I-Stereotactic body radiation therapy (SBRT) iletha imithamo ephezulu yemisebe endaweni eqondiwe ngokunembile futhi ngezinye izikhathi isetshenziselwa izimila zezinso.Izigaba zeRenal Cell Carcinoma kanye NokwelashwaIsigaba se-RCC siyisici esibalulekile ekunqumeni okufanele. ukwelashwa sondela. Isiteji sisekelwe kusayizi nendawo yesimila, kungakhathaliseki ukuthi sisabalele kuma-lymph nodes aseduze, nokuthi ingabe sesiye sametastasized ezithweni ezikude.Isiteji I-Renal Cell CarcinomaIthumba livaleleke ezinso futhi linobubanzi obungu-7 cm noma ngaphansi. Ukwelashwa ngokuvamile kuhilela ukususwa ngokuhlinzwa kwesimila, kungaba nge-nephrectomy engaphelele noma eqinile.Isigaba II Renal Cell CarcinomaIthumba likhulu kuno-7 cm kodwa lisavalelwe izinso. Ukwelashwa ngokuvamile kuhilela i-radical nephrectomy.I-Stage III Renal Cell CarcinomaIthumba selisakazekele kuma-lymph node aseduze noma selikhule laba yimithambo emikhulu noma izicubu ezizungezile. Ukwelashwa ingase ibandakanye i-radical nephrectomy, i-lymph node dissection, kanye nokwelashwa okungenzeka kwe-adjuvant (isb., ukwelashwa okuhlosiwe noma i-immunotherapy) .Isigaba IV Renal Cell CarcinomaUmdlavuza uye wametastasized ezithweni ezikude, njengamaphaphu, amathambo, noma ubuchopho. Ukwelashwa izinketho zingase zihlanganise ukuhlinzwa ukuze kukhishwe isimila esiyinhloko (i-cytoreductive nephrectomy), ukwelashwa okuhlosiwe, i-immunotherapy, ukwelapha ngemisebe, noma inhlanganisela yalezi zindlela. Ukuhlolwa komtholampilo kungase futhi kube inketho.Ukuphila Ne-Renal Cell CarcinomaUkuphila ne-RCC kungaletha izinselele ezihlukahlukene, ngokomzimba nangokomzwelo. Kubalulekile ukuba nohlelo oluqinile lokusekela kanye nokufinyelela ekunakekelweni kwezempilo okuphelele. Iziguli zingase zibe nemiphumela engemihle evela ukwelashwa, njengokukhathala, isicanucanu, isifo sohudo, nokuqubuka kwesikhumba. Ukuphatha le miphumela engemihle kuyingxenye ebalulekile yokunakekelwa komdlavuza. Ukwengeza, ukulondoloza indlela yokuphila enempilo, okuhlanganisa ukudla okulinganiselayo nokuzivocavoca okuvamile, kungasiza ekuthuthukiseni inhlalakahle yonke. E-Shandong Baofa Cancer Research Institute, ithimba lethu elizinikele lihlinzeka ngokunakekelwa kozwelo nokwenza komuntu siqu ukwelashwa uhlela ukusiza iziguli ukuthi zilawule i-RCC yazo futhi zithuthukise izinga lempilo yazo. Sitholakala eJinan Innovation Zone, futhi umgomo wethu uhambisana neqhinga elithi 'Made in China 2025'. Intuthuko Yakamuva Yokwelapha I-Renal Cell CarcinomaInsimu ye-RCC ukwelashwa ilokhu ivela njalo, kuthuthukiswa izindlela zokwelapha nezindlela ezintsha. Intuthuko yakamuva ihlanganisa: Inhlanganisela ye-Immunotherapy: Ukuhlanganisa izidakamizwa ezahlukene ze-immunotherapy, njenge-nivolumab ne-ipilimumab, kubonise imiphumela ethuthukisiwe kwezinye iziguli ezine-RCC ethuthukisiwe. Ukwelashwa Okuhlosiwe Okuthuthukisiwe: Isizukulwane esisha semithi yokwelapha ehlosiwe iyathuthukiswa ngokusebenza okuthuthukisiwe kanye nemiphumela engemihle embalwa. Umuthi Owenziwe Ngokwakho: Abacwaningi basebenzela ukuhlonza ama-biomarker angasiza ukubikezela ukuthi yiziphi iziguli okungenzeka ziphendule okuthile ukwelashwas.Prognosis for Renal Cell CarcinomaUkubikezela kwe-RCC kuyahlukahluka kuye ngokuthi umdlavuza ungakanani, impilo yesiguli iyonke, kanye nempendulo ukwelashwa. Ukutholwa kusenesikhathi nokungenelela okufika ngesikhathi kubalulekile ukuze kuthuthukiswe imiphumela. Iziguli ezine-RCC yendawo ezihlinzwa zinethuba elikhulu lokwelashwa. Kodwa-ke, ukubikezela akulungile ezigulini ezine-RCC ethuthukisiwe. Ucwaningo oluqhubekayo lugxile ekuthuthukiseni okusha nokuphumelela kakhulu ukwelashwas ukuthuthukisa ukubikezelwa kwazo zonke iziguli ezine-RCC.Izivivinyo Zomtholampilo Izivivinyo zezokwelapha izifundo zocwaningo ezihlola okusha ukwelashwas noma izindlela ze-RCC. Ukubamba iqhaza ocwaningweni lomtholampilo kunganikeza ukufinyelela kumakhambi asezingeni eliphezulu angakatholakali kabanzi. Iziguli ezinentshisekelo yokufunda kabanzi mayelana nokuhlolwa kwemitholampilo kufanele zikhulume nodokotela wazo.Isibonelo Idatha: Amazinga Okusinda Ngesiteji Isilinganiso Sokusinda Seminyaka engu-5 Isigaba I 81-93% Isigaba II 74-91% Isigaba III 53-83% Isigaba IV 8-20% Umthombo: I-American Cancer Society (www.cancer.org)