Kune mapoka maviri makuru ekenza yemapapu: "kenza diki yemapapu" yakabatana zvakanyanya nekushandiswa kwefodya uye "isiri diki kenza yemapapu yemapapu", kunyanya inosanganisira adenocarcinomas (inotorwa kubva kumaseru glandular ebronchi).

Adenocarcinoma ndiyo inonyanya kuzivikanwa mhando ye'non-small cell lung cancer' (NSCLC). Inokura munzvimbo dzepamhepo dzemapapu, kunyanya munzvimbo dzepamusoro uye pedyo nepleura. Chiitiko chayo chave chichiwedzera kweanoda kusvika makore gumi. 

Kusiyana kweadenocarcinoma

Adenocarcinomas inogona kusiyanisa zvese muhukuru uye mukukurumidza kukura kwayo. Pane kunyanya maviri akasiyana histologically:

• acinar adenocarcinoma kana ichitora chimiro chesaga duku;
• papillary adenocarcinoma, apo masero anoratidza protrusions muchimiro chegurovhosi chigunwe.

Pulmonary adenocarcinoma

Lung adenocarcinoma inonyanya kubata vanoputa. Asi zvakare ndiyo mhando yakajairika yegomarara remapapu muvakadzi uye kune vasingapute.

Ndicho chikonzero chikuru chekufa (zvese zvikonzero) muvarume vari pakati pe45 ne64 yemakore muFrance, maererano neHaute Autorité de Santé (HAS).

Kusvuta fodya ndiyo inonyanya kukonzera njodzi yerudzi urwu rwegomarara. Asi kwete chete. "Kufumurwa kwebasa kungave kwakabatanidzwa," anotsanangura Dr Nicola Santelmo, Chiremba weThoracic Surgeon paClinique Rhéna muStrasbourg. Mishonga yemakemikari (yakadai seasbestos, arsenic, nickel, tar, nezvimwewo) kazhinji inowanikwa pamazinga akaderera munzvimbo yebasa yakazivikanwa neInternational Agency for Research against Cancer semapurmonary carcinogens kumurume.

Zvinotaridzawo kuti mamwe masosi ekusvibiswa kwezvakatipoteredza, kusvika padiki, njodzi dzekenza yemapapu, sekusvibiswa kwemhepo uye radon).

Zviratidzo zvepulmonary adenocarcinoma zvinowanzononoka nekuti hazvikonzere kurwadziwa chaiko. Kana bundu richikura, rinogona kukonzera zviratidzo zvakaita se:

• chikosoro kana kuoma kufema kana ichimanikidza bronchi;
• sputum yeropa (sputum);
• kusanzwisisika kuonda.

"Nhasi, zvisinei, nekuda kwekuwedzera kuri kuita scanner yekuongorora muvarwere vanoputa, tinokwanisa kuita kuongororwa kwegomarara mumatanho ekutanga, nekufungidzira kuri nani", anovimbisa chiremba anovhiya.

Kuongororwa kwakati wandei kunodiwa kuratidza kuongororwa kwegomarara remapapu.

Mifananidzo

Kufananidza kunokosha kuti uone kukura kwechirwere:

• A "complete" CT scan (dehenya, thorax, dumbu uye pelvis) nejekiseni rakasiyana kana risina kupikisa, rinopa ruzivo rwechimiro uye kukura kwekenza ipi zvayo.

The biopsy

Kana ongororo dzeradiological dzichiratidza gomarara remapapu, zvakakosha kutora sampuli yeronda, ne biopsy, kuti uwane humbowo hwe histological kana cytological. Iyi sampuli yetishu inowanzoitwa neendoscopy kana nepuncture pasi pe scanner. Dzimwe nguva, kuvhiyiwa kuchafanirwa kuitwa kutora sampuli iyi: biopsy ye lymph node kana kuwanda mumapapu.

Bronchial fibroscopic

"Abronchial endoscopy inogonawo kudikanwa, kunyanya kana bundu racho richibva mubronchus. Zvinogona zvakare kudikanwa kuti uwane sampuli yebundu kana ye lymph node kuti upedze kuongorora ”.

Ongororo yacho inoita kuti zvikwanise kuona danho rechirwere ichi, tichifunga nezvehukuru uye nzvimbo yebundu ("T"), kuvepo uye nzvimbo yemalymph nodes ("N") uye kuvapo kana kwete "metastases" iyo. ari kure akawedzera bundu remapapu (iyo "M"). Zvikamu zviviri muzvitatu zvediki cell bronchial carcinomas zvinoonekwa padanho remetastatic.

Kuongororwa kwekufema uye kushanda kwemwoyo

Pakupedzisira, kuongororwa kwekufema uye kushanda kwemwoyo kwakakosha kuitira kuti uone kana kuvhiyiwa kana chemotherapy kurapwa kunogoneka nengozi shoma yezvinetso.

“Kuzivikanwa kwacho kunoenderana nedanho regomarara racho uye marapirwo angafungwa,” anodaro nyanzvi. Inosiyana pakati peisingasviki gumi muzana pamakore mashanu mumatanho epamberi uye 10% pamakore mashanu mumatanho ekutanga. Saka kukosha kwekukurumidza kuongororwa kwakakura! Pamusoro pezvo, pakati pevarwere vese vakavhiyiwa nekuvhiyiwa (matanho ese akasanganiswa) 5 muvarwere vaviri mupenyu makore mashanu gare gare ”.

Kurapa kunoitwa kunoenderana nerudzi rwekenza yekenza, danho rayo (kureva dhigirii rekuwedzera), mamiriro ehutano hwemurwere, uye sarudzo inotorwa pamwe chete neboka rekurapa remarudzi akawanda rinounza pamwechete pulmonologist, chiremba anovhiya, radiotherapist. , radiologist, chiremba wenyukireya uye pathologist.

Chinangwa chekugadzirisa

Chinangwa chekurapa ndecheku:

• kubvisa bundu kana metastases;
• kudzora kupararira kwepulmonary adenocarcinoma;
• kudzivirira kudzokorora;
• rapa zviratidzo.

Kurapa kwakasiyana

Kune marudzi akawanda ekurapa kwepulmonary adenocarcinoma:

• kuvhiyiwa kwesection, kubviswa kwebundu rose, pamwe chete nechemotherapy, vasati vavhiyiwa kana mushure
• radiotherapy chete,
• chemotherapy chete,
• chemotherapy yakasanganiswa neradiotherapy,
• radiofrequency kana stereotaxic radiotherapy iyo inoenderana neradiation yakanangana nebundu remapapu,
• imwe systemic kurapwa (immunotherapy uye / kana yakanangwa kurapa).

"Kupindira kwekuvhiya nhasi kuri kuwedzera kunangwa uye kurongwa pahwaro hwekuongororwa kwepamberi uye kunogona kunge kuine segmentectomy kana pulmonary lobectomies (inosanganisira zvimwe kana zvisinganyanyi kukosha zvikamu zvemapapu)", anopedzisa Dr Santelmo.