ukwelashwa kwe-renal cell carcinoma pathology ichaza izibhedlela

Ukuqonda I-Renal Cell Carcinoma: I-Pathology Outline & Hospital Treatment OptionsUkwelashwa kwe-renal cell carcinoma (RCC) kudinga indlela ehlukahlukene, ehlanganisa ubuchwepheshe be-pathology, i-radiology, kanye ne-oncology. Lo mhlahlandlela ophelele uhlola uhlaka lwe-RCC lwe-pathology, uveza izici ezibalulekile zokuxilonga, isiteji, kanye nezinketho zokwelashwa ezitholakala ezibhedlela eziphambili.

I-Renal Cell Carcinoma: I-Pathological Overview

I-Renal cell carcinoma (ukwelashwa kwe-renal cell carcinoma pathology ichaza izibhedlela) wuhlobo oluvame kakhulu lomdlavuza wezinso, osuka kumangqamuzana e-epithelial we-renal tubules. Ukuxilongwa okunembile kwe-pathological kubalulekile ekuqondiseni izinqumo zokwelashwa nokubikezela i-prognosis. Ukuhlolwa kwe-Histological kwembula izinhlobo zamangqamuzana ezihlukene, okuthinta ulaka kanye nokusabela kokwelashwa. Ama-subtypes ayinhloko afaka i-clear cell RCC (ccRCC), i-papillary RCC, i-chromophobe RCC, nezinye. I-subtype ngayinye ibonisa izici eziyingqayizivele ze-microscopic, ezinomthelela ekubikezelweni namasu okwelapha.

I-Clear Cell Renal Cell Carcinoma (ccRCC)

I-ccRCC ilandisa ngamacala amaningi e-RCC. Ngokwe-Pathologically, ibonakala nge-cytoplasm ecacile kumaseli wesimila ngenxa yobuningi be-glycogen kanye nokuqukethwe kwe-lipid. Lawa maseli ngokuvamile abonisa iphethini ehlukile yokukhula, ukwakha izidleke noma ama-tubules. Ukuba khona kwezinguquko ezithile zofuzo, njengokuguqulwa kofuzo lwe-VHL, kuvame ukubonwa.

I-Papillary Renal Cell Carcinoma

I-Papillary RCC ihlukaniswa ngephethini yayo yokukhula kwe-papillary, enamaseli akha amahlamvu athambile noma ama-papillae. Ngokungafani ne-ccRCC, i-cytoplasm ayicaci kahle. Kunezinhlobo ezimbili ezincane ezikhona: thayipha 1 kanye nohlobo 2, nohlobo 2 oluhlotshaniswa nesifo esibi kakhulu.

I-Chromophobe Renal Cell Carcinoma

I-Chromophobe RCC ayijwayelekile futhi ibonakala ngamaseli ane-cytoplasm ephaphathekile, eosinophilic nezici zenuzi ezingenalutho. Ivame ukuba nephethini ehlukile yokukhula, ukwakha izidleke noma amashidi.

Amanye ama-Subtypes

Kukhona ezinye izinhlobo ezimbalwa ezingavamile ezikhona, ezihlanganisa ukuqoqa i-duct carcinoma, i-medullary RCC, ne-RCC engahlukaniswanga. Lezi zinhlobo ezincane zivame ukudinga ubuchwepheshe obukhethekile ukuze kuhlolwe futhi kuhlelwe ukwelashwa.

Izigaba kanye Nezibikezelo Zezinto ku-RCC

Ukuma kwe-pathological, okusekelwe ohlelweni lwe-TNM (usayizi wesimila, ukubandakanyeka kwe-nodal, ne-metastasis ekude), kubalulekile ekunqumeni izinga lesifo. Lolu lwazi, eceleni kohlobo oluthile lwe-RCC kanye nezinye izici zokubikezela ezifana nebanga (ukuthi amangqamuzana omdlavuza abonakala enolaka kangakanani ngaphansi kwesibonakhulu), kuthonya amasu okwelapha. Lapho isiteji siphezulu, yilapho ukwelashwa ngokuvamile kuba kubanzi.

Izinketho Zokwelashwa Kwe-Renal Cell Carcinoma

Ukukhethwa kokwelashwa kuncike ezintweni ezehlukene, okuhlanganisa isigaba, ibanga, kanye nempilo yesiguli iyonke. Izinketho zisukela ekuhlinzweni (ingxenye ye-nephrectomy noma i-radical nephrectomy), ukwelapha okuhlosiwe, ukwelashwa kwamasosha omzimba, nokwelashwa ngemisebe.

Ukususwa Ukuhlinzwa

Ukususwa ngokuhlinzwa kwesimila ngokuvamile kuwukwelashwa okuyinhloko kwe-RCC yendawo. I-nephrectomy eyingxenye igcina izicubu zezinso ezinempilo, kuyilapho i-nephrectomy enkulu ihilela ukususa yonke izinso nama-lymph nodes azungezile. Okukhethwa kukho kuncike ezicini eziningana, okuhlanganisa ubukhulu nendawo yesimila, kanye nokusebenza kwezinso kwesiguli.

Ukwelapha Okuhlosiwe

Izindlela zokwelapha ezihlosiwe, njenge-tyrosine kinase inhibitors (TKIs), ziqondise ngokuqondile amaprotheni angavamile aqhuba ukukhula kwe-RCC. Le mithi iguqule ukwelashwa kwe-RCC okuthuthukisiwe, yathuthukisa amazinga okusinda. Izibonelo zifaka i-sunitinib, i-sorafenib, ne- pazopanib.

I-Immunotherapy

I-Immunotherapy ihlanganisa amasosha omzimba ukuze alwe namaseli omdlavuza. Ama-Checkpoint inhibitors, njenge-nivolumab ne-ipilimumab, ayizindlela zokwelapha ezisebenzayo ze-RCC ethuthukisiwe. Le mithi isebenza ngokukhulula amabhuleki amasosha omzimba, iwavumela ukuthi abone kangcono futhi ahlasele amangqamuzana omdlavuza.

Ukwelapha Ngemisebe

Ukwelapha ngemisebe kungase kusetshenziswe ezimweni ezithile, njengokunakekelwa kwe-palliative yesifo esithuthukisiwe noma kuhlanganiswe nezinye izindlela zokwelapha.

Ukukhetha Isibhedlela Esilungile Sokwelashwa kwe-RCC

Ukukhetha isibhedlela esifanele ukwelashwa kwe-renal cell carcinoma pathology ichaza izibhedlela kubalulekile. Bheka izikhungo ezinamaqembu anolwazi oluningi olubandakanya odokotela bomchamo, izazi ze-oncologists, ama-pathologists, kanye nama-radiologists agxile kumdlavuza we-genitourinary. I-Shandong Baofa Cancer Research Institute (https://www.baofahospital.com/) uyisibonelo sesibhedlela esizinikele ekuhlinzekeni ukunakekelwa okuphelele komdlavuza, esinochwepheshe abanolwazi ekuxilongeni nasekwelapheni i-renal cell carcinoma. Cabangela izici ezifana namakhono ezobuchwepheshe, ukubandakanyeka kocwaningo, nezinsizakalo zosekelo lwesiguli lapho wenza isinqumo sakho.

Isiphetho

Iphumelele ukwelashwa kwe-renal cell carcinoma pathology ichaza izibhedlela kudinga ukuxilongwa okunembile, isiteji esinembile, kanye nohlelo lokwelapha oluhambisanayo. Ngokuqonda izici ze-RCC ze-pathological, izinhlobo zayo ezihlukahlukene ezihlukahlukene, nezinketho zokwelashwa ezitholakalayo, iziguli zingenza izinqumo ezinolwazi ngokubambisana nethimba lazo lezempilo. Ukukhetha okufanele esibhedlela kubalulekile ukuze kube nomphumela ongcono kakhulu.