Uhlelo lwamva nje lwe-World Health Organisation's Classification of Soft Tissue and Bone Tumors, olupapashwe ngo-Epreli 2020, luchazaii-sarcomaszibe ziindidi ezintathu: siithumba zezicubu ezininzi, iithumba zamathambo, kunye neethumba zezicubu ezithambileyo kunye nethambo ezineeseli ezincinci ezingqukuva ezingahlukanga(ezifana ne-EWSR1-non-ETS fusion round cell sarcoma).
"Umhlaza Olibalekileyo"
I-Sarcoma luhlobo olungaqhelekanga lwesifoumhlaza kubantu abadala, echaza malunga1%kuzo zonke iintlobo zomhlaza zabantu abadala, ezidla ngokubizwa ngokuba yi-“The Forgotten Cancer.” Nangona kunjalo, imalungaixhaphakile ebantwaneni, ukubala malunga15% ukuya kuma-20%zonke iintlobo zomhlaza ebantwaneni. Inokwenzeka nakweyiphi na indawo yomzimba, ikakhuluiingalo okanye imilenze(60%), ilandelwa yiisisu okanye umqolo(30%), kwaye ekugqibeleniintloko okanye intamo(10%).
Kwiminyaka yakutshanje, ukwanda kwezihlunu zamathambo nezihlunu ezithambileyo kuye kwanda kancinci kancinci. Izihlunu zamathambo eziphambili zixhaphake kakhulu kubantu abaselula nakubantu abakwiminyaka ephakathi kwaye ziquka i-osteosarcoma, i-Ewing sarcoma, i-chondrosarcoma, i-malignant fibrous histiocytoma, kunye ne-chordoma, phakathi kwezinye. Izihlunu eziqhelekileyo zezicubu ezithambileyo ziquka i-synovial sarcoma, i-fibrosarcoma, i-liposarcoma, kunye ne-rhabdomyosarcoma. Ukwanda kwe-bone metastases kuxhaphake kakhulu kubantu abakwiminyaka ephakathi kunye nabantu abadala, kunye nezihlunu eziqhelekileyo eziphambili ngumhlaza wemiphunga, umhlaza webele, umhlaza wezintso, umhlaza we-prostate, kunye nomhlaza we-thyroid, phakathi kwezinye.
Ukufunyanwa Kwangethuba, Unyango Kwangethuba – Ukukhanyisa “Iithumba” Ezifihlakeleyo
Ngenxa yesantya esiphezulu sokuvela kwakhona kwe-sarcomas, uninzi lwee-tumor alunazo iziphumo ezingacacanga ngaphambi kotyando kwaye alunazo iimvavanyo zemifanekiso eneenkcukacha. Oku kudla ngokukhokelela ekufumaniseni ngexesha lotyando ukuba i-tumor ayilula njengoko bekuqikelelwa ngaphambi kotyando, nto leyo ekhokelela ekususweni okungaphelelanga. Ukuphinda utyando okanye ukusasazeka kwe-metastasis kunokwenzeka, nto leyo ebangela ukuba izigulana ziphuthelwe lithuba elifanelekileyo lonyango. Ke ngoko,ukufunyanwa kwangoko, ukuxilongwa ngokuchanekileyo, kunye nonyango olufike ngexesha kunempembelelo ebaluleke kakhulu kwingxelo yezigulane. Namhlanje, singathanda ukwazisa ingcali ehloniphekileyo enamava aphantse abe yiminyaka engama-20.ekuxilongweni okuqhelekileyo kunye nonyango lomntu ngamnye lwe-sarcoma yezicubu ezithambileyo, kwaye inconywa kakhulu lishishini kunye nezigulane -UgqirhaULiu Jiayongevela kwiSebe leMithambo neZicwili ezithambileyo kwiSibhedlele soMhlaza kwiYunivesithi yasePeking.
Ukutyhila iNgcali enolwazi olunzulu ngentlungu yamathambo nenyama – UDkt..ULiu Jiayong
Ugqirha wezonyango, uGqirha oyiNtloko, uNjingalwazi oNcedisayo. Wafunda kwiZiko loMhlaza laseAnderson eMelika.
Ubuchule:Unyango olupheleleyo lwee-sarcomas zezicubu ezithambileyo (ukususwa nokwakhiwa ngokutsha ngotyando; i-chemotherapy, unyango olujoliswe kuyo, kunye ne-immunotherapy); unyango lotyando lwe-melanomas.
Ngamava amalunga neminyaka engama-20 yezonyango, uGqirha uLiu Jiayong uqokelele ulwazi olubanzi lwezonyango kunye nonyango lotyando kwiukuxilongwa okuqhelekileyo kunye nezicwangciso zonyango ezenzelwe wenakwii-sarcomas zezicubu ezithambileyo eziqhelekileyo ezifana ne-pleomorphic sarcoma engachazwanga, i-liposarcoma, i-leiomyosarcoma, i-synovial sarcoma, i-adenocystic carcinoma-like sarcoma, i-epithelioid sarcoma, i-fibrosarcoma, i-angiosarcoma, kunye ne-infiltrative fibromatosis. Une-ingakumbiUnobuchule bokuphatha imithambo yegazi kunye nemithambo-luvo ngexesha lokususwa kwe-sarcoma yamalungu, kunye nokulungisa nokwakha kwakhona iziphene zezicubu ezithambileyo eluswini.Ugqirha uLiu umamela ngomonde isigulana ngasinye, ubuza ngononophelo ngembali yaso yezonyango, aze athathe iirekhodi zonyango ezicokisekileyo. Unika ingqalelo ekhethekileyo kutshintsho kwimeko yesigulana ngamaxesha ahlukeneyo, njengangaphambi nasemva kotyando, ngexesha lonyango, ukulandelelana, kunye nokuqhubela phambili kwesifo, esenza izigqibo ezichanekileyo kunye nokulungiswa ngexesha elifanelekileyo kwezicwangciso zonyango.
Ugqirha uLiu Jiayong okwangoku usebenza njengelungu leSoft Tissue Sarcoma kunye neMelanoma Group yeChinese Anti-Cancer Association, kunye nelungu leBone Tumor Group yeBeijing Society of Orthopedics yeChinese Medical Association.Ngowama-2010, wayengowokuqala eTshayina ukuguqulela nokupapasha "iNCCN Clinical Practice Guidelines in Soft Tissue Sarcoma," ekhuthaza unyango oluqhelekileyo olupheleleyo lwee-soft tissue sarcomas.Uyaqhubeka nokulwela inkqubela phambili kuphando lwezonyango nolwesayensi, nangona enabantu abaninzi abagulayo. Uzinikele kwaye unoxanduva kuye wonke umguli awanyangayo, kwaye ngexesha lobhubhane, ujongane nobunzima abajongene nabo abaguli abafuna unyango ngokuphendula ngokukhawuleza kwiingcebiso zesigulana, ukuphonononga iziphumo zokulandelela, kunye nokubonelela ngeengcebiso ezifanelekileyo zonyango ngokusebenzisa amaqonga eengcebiso kwi-intanethi afana neGood Doctor's Patient Group.
Ityala lakutshanje
UMnu. Zhang, isigulana esineminyaka engama-35 ubudala, ngequbuliso wabona ukulahleka kokubona ekuqaleni kuka-2019. Emva koko, wenziwa utyando lokukhupha i-enucleation yeliso lasekhohlo ngenxa yokunyuka okuqhubekayo koxinzelelo lwangaphakathi kweso. I-pathology emva kotyando yabonisa i-pseudotumor evuthayo. Ehlotyeni lonyaka ofanayo, kwafunyanwa amaqhuqhuva amaninzi emiphungeni ngexesha lovavanyo olulandelayo, kodwa akukho ziseli ze-tumor ezifunyenweyo nge-biopsies yeenaliti. Uvavanyo olongezelelweyo lokulandelela lwabonisa ukuba kukho i-metastases ezininzi zamathambo nemiphunga. Iingcebiso kwizibhedlele zasekuhlaleni nezikumgangatho ophezulu zamfumanisa ene-inflammatory myofibroblastic tumor. Ngo-Agasti 2022, wenziwa i-chemotherapy ephezulu, eyanciphisa kakhulu intlungu yakhe kodwa ayizange ibonise ukuphucuka okubonakalayo kwizilonda emva kokuhlolwa kwakhona. Imeko yakhe yomzimba nayo yaba buthathaka. Nangona kunjalo, usapho lwakhe aluzange lulahle ithemba. Emva kokufuna izimvo ezininzi, zafika kuGqirha uLiu Jiayong ngoNovemba 2022. Emva kokuphonononga ngononophelo imbali yezonyango yesigulana, zonke iirekhodi zonyango, iimvavanyo ze-pathological, kunye nedatha yemifanekiso,UgqirhaULiu ucebise indlela yonyango lwe-chemotherapy equka i-methotrexate enedosi ephantsi kunye neChangchun Ruibin.Olu hlobo lonyango lwe-chemotherapy lunexabiso eliphantsi kwaye alunazo iziphumo ebezingalindelekanga ezininzi. Emva kweentsuku ezingama-35 zokuthatha amayeza, i-CT scan elandelayo ibonise ukuba ubunzima obukumphunga wasekunene buphelile, nto leyo ebonisa ulawulo olufanelekileyo lwethumba.Uvavanyo olusandul’ ukwenziwa kwiSibhedlele iBeijing South Region Oncology lubonise imeko yemiphunga ezinzileyo, kwaye uGqirha Liu ucebise ukuba kutyelelwe rhoqo. Isigulana kunye nosapho lwakhe ngoku banentembelo enkulu kunyango olulandelayo, benethemba. Bavakalelwa kukuba babone ukukhanya kolu hambo lonyango kwaye bavakalisa umbulelo wabo osuka entliziyweni ngokubonisa ibhanile yesilika yombulelo.
Ixesha lokuthumela: Agasti-25-2023