Umdlavuza wesibindi - i-hepatocellular carcinoma

I-hepatocellular carcinoma umdlavuza oqala esibindini.

I-hepatocellular carcinoma ibangela iningi lomdlavuza wesibindi. Lolu hlobo lomdlavuza lwenzeka kaningi emadodeni kunabesifazane. Ngokuvamile kutholakala kubantu abaneminyaka engama-50 noma ngaphezulu.

I-hepatocellular carcinoma ayifani nomdlavuza wesibindi we-metastatic, oqala kwesinye isitho (njengesifuba noma ikholoni) bese usakazekela esibindi.

Ezimweni eziningi, imbangela yomdlavuza wesibindi ukulimala kwesikhathi eside kanye nokulimala kwesibindi (i-cirrhosis). I-cirrhosis ingabangelwa:

• Ukuphuza ngokweqile
• Izifo ezizimele zesibindi
• Ukutheleleka ngegciwane le-Hepatitis B noma i-hepatitis C
• Ukuvuvukala kwesibindi okuhlala isikhathi eside (okungapheli)
• Ukugcwala kwensimbi emzimbeni (hemochromatosis)

Abantu abane-hepatitis B noma i-C basengozini enkulu yomdlavuza wesibindi, noma ngabe bengakhuli i-cirrhosis.

Izimpawu zomdlavuza wesibindi zingafaka noma yikuphi okulandelayo:

• Ubuhlungu besisu noma ubumnene, ikakhulukazi engxenyeni engaphezulu kwesokudla
• Ukulinyazwa okulula noma ukopha
• Isisu esandisiwe (ascites)
• Isikhumba esiphuzi noma amehlo (i-jaundice)
• Ukwehla kwesisindo okungachazeki

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho. Ukuhlolwa komzimba kungakhombisa isibindi esandisiwe, sethenda noma ezinye izimpawu zesifo sokuqina kwesibindi.

Uma umhlinzeki esola umdlavuza wesibindi, izivivinyo ezinga-odwa zifaka:

• Iskena se-CT esiswini
• Ukuskena kwe-MRI yesisu
• I-ultrasound yesisu
• I-biopsy yesibindi
• Ukuhlolwa kokusebenza kwesibindi
• I-serum alpha fetoprotein

Abanye abantu abanethuba eliphezulu lokuthola umdlavuza wesibindi bangathola ukuhlolwa kwegazi okuvamile kanye nama-ultrasound ukubona ukuthi izicubu ziyakhula yini.

Ukuxilonga ngokunembile i-hepatocellular carcinoma, kufanele kwenziwe i-biopsy ye-tumor.

Ukwelashwa kuya ngokuthi umdlavuza usuthuthuke kangakanani.

Ukuhlinzwa kungenziwa uma isimila singakasakazeki. Ngaphambi kokuhlinzwa, isimila singaphathwa nge-chemotherapy ukunciphisa ubukhulu baso. Lokhu kwenziwa ngokuletha umuthi ngqo esibindini ngepayipi (ipayipi) noma ngokuwunikeza ngemithambo (ngo-IV).

Ukwelashwa ngemisebe endaweni yomdlavuza nakho kungasiza.

I-Ablation kungenye indlela engasetshenziswa. Ablate kusho ukubhubhisa. Izinhlobo zokukhishwa kwezimpahla zifaka phakathi ukusebenzisa:

• Amagagasi omsakazo noma ama-microwave
• I-Ethanol (utshwala) noma i-acetic acid (uviniga)
• Amakhaza amakhulu (cryoablation)

Ukufakelwa kwesibindi kunganconywa.

Uma umdlavuza ungeke ususwe ngokuhlinzwa noma usakazeke ngaphandle kwesibindi, ngokuvamile alikho ithuba lokulashwa isikhathi eside. Ukwelashwa esikhundleni salokho kugxile ekwenzeni ngcono nokwelula impilo yomuntu. Ukwelashwa kuleli cala kungasebenzisa ukwelashwa okuqondisiwe ngemithi engathathwa njengamaphilisi. Izidakamizwa ezintsha ze-immunotherapy nazo zingasetshenziswa.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Uma umdlavuza ungakwazi ukwelashwa ngokuphelele, lesi sifo ngokuvamile siyabulala. Kepha ukusinda kuyahlukahluka, kuya ngokuthi umdlavuza uthuthuke kangakanani lapho kutholakala nokuthi ukwelashwa kuphumelele kangakanani.

Shayela umhlinzeki wakho uma uthuthukisa ubuhlungu besisu obuqhubekayo, ikakhulukazi uma unomlando wesifo sesibindi.

Izindlela zokuzivikela zifaka:

• Ukuvimbela nokwelapha i-hepatitis yegciwane kungasiza ekunciphiseni ubungozi bakho. Ukugonywa kwengane ukulwa ne-hepatitis B kunganciphisa ingozi yomdlavuza wesibindi ngokuzayo.
• Ungaphuzi utshwala obuningi ngokweqile.
• Abantu abanezinhlobo ezithile ze-hemochromatosis (i-iron overload) bangadinga ukuhlolwa umdlavuza wesibindi.
• Abantu abane-hepatitis B noma i-C noma i-cirrhosis banganconywa ukuhlolwa komdlavuza wesibindi.

Isibindi cell carcinoma; Isimila - isibindi; Umdlavuza - isibindi; I-hepatoma

• Uhlelo lokugaya ukudla
• I-biopsy yesibindi
• Umdlavuza we-hepatocellular - CT scan

U-Abou-Alfa GK, uJarnagin W, uDika IE, et al. Umdlavuza wesibindi nenyongo. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 77.

UDi Bisceglie AM, uBefeler AS. Izimila hepatic kanye cysts. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 96.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza wesibindi sabantu abadala (PDQ) - inguqulo yezempilo. www.cancer.gov/types/liver/hp/ultult-liver-treatment-pdq. Kubuyekezwe ngoMashi 24, 2019. Kufinyelelwe ngo-Agasti 27, 2019.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology: umdlavuza we-hepatobiliary. Inguqulo 3.2019. www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Kubuyekezwe u-Agasti 1, 2019. Kufinyelelwe ngo-Agasti 27, 2019.