Ngokutsho kwe-International Agency for Research on Cancer of the World Health Organisation, ngo-2020, iTshayina yayineziganeko ezintsha zomhlaza ezimalunga nezigidi eziyi-4.57, apho umhlaza wemiphunga umalunga ne-820,000. Ngokutsho kwe-"Guidelines for Lung Cancer Screening and Early Diagnosis and Treatment in China" yeZiko leSizwe loMhlaza laseTshayina, izinga lokuxhaphaka kunye nokufa komhlaza wemiphunga eTshayina limalunga ne-37% kunye ne-39.8% yezibalo zehlabathi, ngokulandelelana. La manani adlula kakhulu inani labemi baseTshayina, elimalunga ne-18% yabemi behlabathi.
Inkcazo kunyeIintlobo ezincinciyoMhlaza weMiphunga
Inkcazo:Umhlaza wemiphunga oyintloko obangelwa yi-bronchogenic, owaziwa ngokuba ngumhlaza wemiphunga, yeyona tumor iphambili ixhaphakileyo ebangela isifo semiphunga ephuma kwi-trachea, kwi-mucosa ye-bronchial, kwi-bronchi encinci, okanye kwiindlala ezikwimiphunga.
Ngokusekelwe kwiimpawu ze-histopathologicalUmhlaza wemiphunga ungahlulwahlulwa ube ngumhlaza wemiphunga ongengoweeseli ezincinci (80%-85%) kunye nomhlaza wemiphunga ongengoweeseli ezincinci (15%-20%), onezinga eliphezulu lomhlaza. Umhlaza wemiphunga ongengoweeseli ezincinci uquka i-adenocarcinoma, i-squamous cell carcinoma, kunye ne-large cell carcinoma.
Ngokusekelwe kwindawo yesiganeko, umhlaza wemiphunga ungahlulwahlulwa njengomhlaza wemiphunga ophakathi kunye nomhlaza wemiphunga ongaphandle.
Ukuxilongwa Kwezifo Zomhlaza Wemiphunga
Umhlaza Wemiphunga Ophakathi:Ibhekisa kumhlaza wemiphunga ovela kwi-bronchi engaphezulu kwenqanaba lesegmental, ikakhulu equkai-squamous cell carcinoma kunye nomhlaza wemiphunga weeseli ezincinci. Ukuxilongwa kwezifo ngokuqhelekileyo kunokufumaneka nge-fiber bronchoscopy. Ukususwa komhlaza wemiphunga ophakathi ngotyando kuyingxaki, kwaye kudla ngokukhawulelwa ekususweni ngokupheleleyo kwemiphunga yonke echaphazelekayo. Izigulana zinokuba nobunzima bokunyamezela le nkqubo, kwaye ngenxa yenqanaba eliphambili, ukuhlaselwa kwendawo, ukusasazeka kwe-mediastinal lymph node, kunye nezinye izinto, iziphumo zotyando zisenokungabi zifanelekileyo, kunye nomngcipheko ophezulu wokusasazeka kwethambo.
Umhlaza Wemiphunga Ojikelezayo:Ibhekisa kumhlaza wemiphunga owenzeka ngaphantsi kwe-bronchi ye-segmental,ikakhulu kubandakanya i-adenocarcinoma. Ukuxilongwa kwezifo kudla ngokufumaneka nge-percutaneous transthoracic needle biopsy ekhokelwa yi-CT.Kwimisebenzi yezonyango, umhlaza wemiphunga ongaphandle udla ngokuba neempawu ekuqaleni kwaye udla ngokufunyaniswa ngengozi ngexesha lovavanyo lomzimba. Ukuba ufunyanwe kwangethuba, utyando lolona khetho luphambili lonyango, kulandele i-adjuvant chemotherapy okanye unyango olujoliswe kulo.
Kwizigulane zomhlaza wemiphunga ezingafanelekiyo utyando, ezinokuxilongwa okuqinisekisiweyo kwesifo esifuna unyango olulandelayo, okanye ezifuna ukulandelwa rhoqo okanye unyango emva kotyando,unyango oluqhelekileyo nolufanelekileyo lubaluleke kakhuluSingathanda ukukwazisa kuUDkt. An Tongtong, ingcali edumileyo kwi-thoracic oncology enamava angaphezu kweminyaka engama-20 kwi-medical oncology kwiSebe le-Thoracic Oncology, kwiSibhedlele soMhlaza kwiYunivesithi yaseBeijing.
Ingcali Edumileyo: UDkt. An Tongtong
Ugqirha oyiNtloko, uGqirha wezonyango. Unamava ophando kwi-MD Anderson Cancer Center eMelika, kwaye lilungu lekomiti yolutsha ye-Chinese Anti-Cancer Association Lung Cancer Professional Committee.
Iindawo zoBugcisa:Unyango lwe-chemotherapy kunye nonyango olujolise kwi-molecular lomhlaza wemiphunga, i-thymoma, i-mesothelioma, kunye neenkqubo zokuxilonga kunye nezonyango ezifana ne-bronchoscopy kunye notyando lwe-thoracic oluncediswa yividiyo kunyango lwangaphakathi.
UGqr. An wenze uphando olunzulu malunga nokulungiswa kwemigangatho kunye nonyango olupheleleyo olunezifundo ezininzi lomhlaza wemiphunga okwinqanaba eliphezulu,ingakumbi kwimeko yonyango olupheleleyo olulungiselelwe umntu ngamnye lomhlaza wemiphunga ongengoweeseli ezincinci. UGqr. An unobuchule kwizikhokelo zamva nje zokuxilonga kunye nokunyanga iithumba zesifuba.Ngexesha lokubonisana, uGqr. An uyayiqonda ngokupheleleyo imbali yezonyango zesigulana kwaye ujonga ngokusondeleyo utshintsho kwisifo ngokuhamba kwexesha. Ubuza ngononophelo malunga nezicwangciso zokuxilonga nezonyango zangaphambili ukuqinisekisa ukulungiswa ngexesha elifanelekileyo kwesicwangciso sonyango esilungiselelwe umntu ngamnye kwisigulana. Kwizigulane ezisandula ukuxilongwa, iingxelo kunye novavanyo oluhambelanayo zihlala zingaphelelanga. Emva kokuqonda ngokucacileyo imbali yezonyango, uGqr. An uya kuchaza ngokucacileyo icebo lonyango lwesi sifo sangoku kwisigulana nakumalungu osapho lwaso. Uya kubonelela ngesikhokelo sokuba zeziphi iimvavanyo ezongezelelweyo ezifunekayo ukunceda ukuqinisekisa ukuxilongwa, ukuqinisekisa ukuba amalungu osapho ayaqonda ngokupheleleyo ngaphambi kokuba avumele bona kunye nesigulana ukuba baphume kwigumbi lokubonisana benoxolo lwengqondo.
Amatyala akutshanje
UMnu. Wang, isigulane esineminyaka engama-59 ubudala esine-lung adenocarcinoma esine-multiple systemic metastases, safuna unyango eBeijing ngexesha lobhubhane ngasekupheleni kuka-2022. Ngenxa yemiqathango yokuhamba ngelo xesha, kwafuneka afumane umjikelo wakhe wokuqala we-chemotherapy kwisibhedlele esikufutshane emva kokuba kuqinisekiswe ukuba une-pathological cerebral. Nangona kunjalo, uMnu. Wang wafumana i-chemotherapy toxicity enkulu kunye nemeko embi yomzimba ngenxa ye-hypoalbuminemia ehambelana nayo.
Esondela kwisigaba sakhe sesibini se-chemotherapy, usapho lwakhe, luxhalabile ngemeko yakhe, lwabuza malunga nobuchule bukaGqr. An kwaye ekugqibeleni baphumelela ekwenzeni idinga kwi-VIP Outpatient Service yeSibhedlele sethu. Emva kophononongo oluneenkcukacha lwembali yezonyango, uGqr. An wanikela ngeengcebiso zonyango. Ngenxa yamanqanaba aphantsi e-albumin kaMnu. Wang kunye neempendulo ze-chemotherapy, uGqr. An walungisa irejimeni ye-chemotherapy ngokuthatha indawo ye-paclitaxel nge-pemetrexed ngelixa efaka ii-bisphosphonates ukuthintela ukutshatyalaliswa kwamathambo.
Emva kokufumana iziphumo zovavanyo lwemfuza, uGqr. An waphinda wafanisa uMnu. Wang nonyango olufanelekileyo olujoliswe kulo, i-Osimertinib. Emva kweenyanga ezimbini, ngexesha lotyelelo olulandelayo, usapho lukaMnu. Wang lwaxela ukuba imeko yakhe iphucukile, eneempawu ezinciphileyo kunye nokukwazi ukwenza imisebenzi efana nokuhamba, ukunkcenkceshela izityalo, kunye nokutshayelela umgangatho ekhaya. Ngokusekelwe kwiziphumo zovavanyo olulandelayo, uGqr. An wacebisa uMnu. Wang ukuba aqhubeke nesicwangciso sonyango sangoku kwaye enze uhlolo rhoqo.
Ixesha lokuthumela: Agasti-31-2023