Chii chinonzi gomarara remukanwa?

Kenza dzemukanwa neoropharynx dzinotanga mumuromo kana pahuro. Kuziva zvekutarisira kana iwe uine imwe yeaya akashata kana uri padyo nemumwe munhu anogona kukubatsira iwe kubata. Unogona kudzidza nezve muromo wegomarara uye oropharyngeal cancers, kusanganisira njodzi, zviratidzo, maonerwo aanoitwa, uye mabatirwo aanoitwa, nekushanyira peji rino.

Miromo, buccal mucosa (mukati memuromo wemiromo nematama), mazino, mazamu, mberi zvikamu zviviri muzvitatu zverurimi, pasi pemuromo pasi perurimi, denga remapfupa remuromo (palate yakaoma), uye nzvimbo iri kuseri kwemazino ehuchenjeri ese ari chikamu chemuromo wemuromo (unonzi retromolar trigone).

Oropharynx, iri kuseri kwegomba remuromo, ndiyo chikamu chepakati chehuro. Kana muromo wako wakashama zvakanyanya, zvinoonekwa. Iyo yakapfava palate (chikamu chekuseri chedenga remuromo), tonsils, uye mativi uye kumashure madziro ehuro anoita hwaro hwerurimi (chetatu cheshure cherurimi).

Iyo oropharynx uye yemuromo mhango inokubatsira pakufema, kutaura, kudya, kutsenga, uye kumedza. Mate (spit) anogadzirwa nediki diki marara mukati memukanwa mhango uye oropharynx, izvo zvinochengeta muromo wako nehuro zvakanyorova uye zvinobatsira kugaya.

Mhando dzekenza yemukanwa

Mhando dzakawanda dzakasiyana dzemasero dzinoumba zvikamu zvakasiyana-siyana zvemuromo wemuromo uye oropharynx. Sero rega rega rine mukana wekutangisa gomarara. Iyi misiyano yakakosha nekuti inogona kukanganisa marapirwo emurwere uye kufungidzira.

Squamous cell carcinoma yemuromo wemuromo uye oropharynx

Squamous cell carcinomas, inowanzozivikanwa se squamous cell cancers, inokonzeresa dzinenge hutsinye hwese mumuromo mhango uye oropharynx. Squamous cells, masero akati sandarara, matete akatevedza muromo nepahuro, ndipo panotangira zvirwere izvi.

carcinoma in situ ndiyo nzira yekutanga ye squamous cell cancer. Izvi zvinoreva kuti masero emukenza anowanikwa chete muepithelium, mutsetse wemasero (yepamusoro masero akatenderedza mhango yemuromo uye oropharynx). Invasive squamous cell cancer, kune rumwe rutivi, inoitika apo masero egomarara anotama achipfuura epithelium uye achipinda mukati memukati memukati memuromo kana oropharynx.

Mazhinji squamous cell malignancies eoropharynx anokonzerwa nehutachiona hune njodzi yakanyanya yehuman papillomavirus (HPV) (inonzi HPV-positive cancer). Kenza yemumuromo haiwanzo kubatanidzwa neHPV. HPV-positive malignancies inowanzoitika kune vechidiki vasati vamboputa kana kunwa doro. Izvi zvakashata zvine fungidziro iri nani (prognosis) kupfuura squamous cell cancers isina kukonzerwa neHPV (HPV-negative cancer). Izvi zvinonyanya kuitika nekuda kwekuti kana HPV-positive tumors ichirapwa nechemotherapy uye nemwaranzi, inoderera.

Verrucous carcinoma igomarara re squamous cell risingawanzo kubata muromo nematama. Igomarara regiredhi repasi (iro rinokura zvishoma nezvishoma) risingawanzopararira kune dzimwe nhengo dzemuviri.

Salivary gland cancers

Zvirwere izvi zvinogona kutanga mumatumbu emukanwa nepahuro. Adenoid cystic carcinoma, mucoepidermoid carcinoma, uye polymorphous low-grade adenocarcinoma yose mienzaniso yemararamiro maduku emate. Kuti unzwisise zvimwe nezve magomarara aya, pamwe nebenign salivary gland tumors, ndapota shanyira webhusaiti yedu.

Lymphomas

Matonsi uye nheyo yerurimi ine immune system (lymphoid) tishu, uko kenza inodanwa lymphomas inogona kutanga. Kuti uwane rumwe ruzivo nezve magomarara aya, ona Asiri-Hodgkin Lymphoma uye Non-Hodgkin Lymphoma muvana.

Benign mapundu

Mazhinji marudzi emamota anorwara uye shanduko-yakafanana nebundu inogona kutanga mumuromo kana pahuro, seizvi:

• Peripheral giant cell granuloma
• Fibroma
• Granular cell tumarara
• Schwannoma
• Neurofibroma
• Pyogenic granuloma
• Oral hemangioma

Aya mamota asiri egomarara anotanga kubva kumhando dzakasiyana dzemasero uye ane zvakawanda zvinokonzeresa. Zvimwe zvacho zvinogona kukonzeresa matambudziko, asi zvinogona kunge zvisiri zvekutyisidzira hupenyu. Marapirwo akajairika emhando idzi dzemamota kuvhiyiwa kuti abvise zvachose sezvo asingaite kudzoka zvakare (kudzoka).

Zvikonzero zvegomarara remuromo

Kunzwisisa zvinosiyana zvinokonzeresa gomarara zvichabatsira mukudzivirira chirwere ichi. Chirwere chegomarara chemukanwa chakagara chichibatanidzwa nevanopfuura makore makumi mana, saka zera rinowanzotaurwa sechinhu chine njodzi. Zera revanhu vanobatwa negomarara rinogona kureva chikamu chenguva mune biochemical kana biophysical maitiro emaseru ekuchembera anobvumira shanduko yakaipa, kana inogona kuratidza kuti immune system kugona kuderera nezera. Zvichangoburwa (kunopera 40-2008) zvinotitungamira kugumisa kuti vasiri kuputa vari pasi pemakore makumi mashanu ndivo vari kukurumidza kukurumidza chikamu chegomarara remuromo, zvichiratidza shanduko yemabviro echirwere ichi nenzvimbo dzinowanzo itika. nharaunda yemuromo. Zvirwere zvegomarara zvine chekuita nekuputa mukati memuromo, kenza dzine chekuita nefodya, uye kenza dzine chekuita nedoro zvese zvadzikira, asi nzvimbo dzepamuromo dzepamuromo dzakabatanidzwa neHPV2011 viral cause dzawedzera. Nekuda kweizvozvo, vanhu vazhinji vanonongedzera kune mbiri idzi mbiri dzakasiyana (yemuromo neoropharyngeal) se "gomarara remuromo" kana vachitaura kune veruzhinji, izvo zvisiri izvo asi zvichionekwa sezvakajairika mukutumira mameseji.

Nekudaro, pane kusasimba kwe immune system kana zera, zvinowanzoitika kuti kuwedzera kukuvadzwa kubva kune zvimwe zvinhu zvakaita sekushandisa fodya, kunwa doro, uye zvirwere zvisingaperi zvehutachiona seHPV ndizvo zvikonzero zvikuru. Semuenzaniso, kukura kwekenza kungada makumi emakore akawanda ekusvuta. Kushandiswa kwefodya munzira ipi neipi, zvisinei, ndicho chisakiso chikuru chegomarara remukanwa rechokwadi muvanhu vanopfuura makore 50. Vanosvuta fodya vanotora inenge 75 muzana yevanhu vakaonekwa vaine makore 50 zvichikwira munguva yakapfuura. Reshiyo iyi iri kufamba, uye zvikamu zvakati hazvisati zvazivikanwa nekuburitswa, sezvo data nyowani ine chekuita nekudzikiswa kwefodya iri kukurumidza kushandura simba. Nekuti fodya nedoro zvinoita synergistically, njodzi yako inosimudzwa zvakanyanya kana iwe ukabatanidza izvo zviviri. Avo vanoputa nekunwa vane njodzi yakapetwa ka15 yekubatwa negomarara remukanwa pane vasingaite. Iyo HPV16 viral aetiology hairatidzike sekuda kuti fodya kana doro rishande zvakabatana, uye HPV16 inomiririra yakanyatso siyana uye yakazvimirira chirongwa chechirwere muoropharynx.

Fodya nedoro zvinonyanya kusiyanisa makemikari, asi nekuti isu tine humwe hutongi pamusoro pazvo, zvinogona zvakare kunzi nyaya dzemararamiro. Kunze kwazvo, kune zvimiro zvemuviri senge ultraviolet mwenje exposure. Zvirwere zvemuromo, pamwe chete nezvimwe zvirwere zveganda, zvinokonzerwa nechinhu ichi. Kenza yemuromo imwe yemhando yekenza yemuromo iyo yakadzikira mukupararira mumakumi mashoma emakore apfuura. Izvi zvinonyanya kuitika nekuda kweruzivo rwakavandudzwa rwezvinokuvadza zvekugara kwenguva refu kwezuva uye kushandiswa kwemafuta ekudzivirira zuva kudzivirira pazviri. Chimwe chinhu chemuviri ndeye x-ray kuratidzwa. MaRadiographs aigara achiwanikwa panguva yekuongororwa, uye akachengeteka muhofisi yemazino, asi ramba uchifunga kuti kuratidzwa kwemwaranzi kunovaka nekufamba kwenguva. Yakabatanidzwa kune akati wandei gomarara remusoro nemutsipa.

Zvinhu zvipenyu zvinosanganisira mavhairasi uye fungus, izvo zvave zvichibatanidzwa nemuromo zvakaipa munguva yakapfuura. Iyo papillomavirus yemunhu, kunyanya HPV16, yakave yakanyatsobatanidzwa mune oropharyngeal cancers (Oropharynx, chigadziko cherurimi, tonsillar mbiru, uye crypt, pamwe nematani pachawo. ), asi muvanhu vashoma chete ndivo vakabatanidzwa mumuromo. gomarara pamberi pemuromo. HPV ihutachiona hwepabonde hunobata vanhu vanosvika mamiriyoni makumi mana muUnited States nhasi. HPV inouya mumhando mazana maviri akasiyana, mazhinji acho achionekwa seakachengeteka. Vazhinji vekuAmerica vanozotapukirwa neHPV pane imwe nguva muhupenyu hwavo, uye vamwe vanozoonekwa kune oncogenic / kenza-inokonzera marara. Zvisineyi, chikamu chimwe chete kubva muzana chevanhu vane hutachiona ndivo vane immune system kuHPV40 strain, inova ndiyo inonyanya kukonzera chirwere chemuviri wechibereko (pamwe chete neHPV18), anus uye kenza yepeni, uye ikozvino zvakare inozivikanwa chikonzero cheoropharyngeal cancer. Somugumisiro, tinoda kujeka. Kunyangwe iwe wakatapukirwa nehutachiona hweHPV, hazviratidzi kuti uchabata gomarara remuromo. Ruzhinji rwemasoja emuviri evanhu anobvisa utachiona gomarara risati ratanga. Shanduko mutsika dzevatano dzevechidiki mukati memakumi mashoma emakore apfuura, uye izvo zvichiri kuitika izvozvi, zviri kuwedzera kutapurirana kweHPV nemhando dzayo dzecarcinogenic. Zvimwe zvikonzero zvidiki zvengozi zvakabatanidzwa nehutachiona hwemukanwa asi hazvisati zvanyatsoratidzwa kuti zvine basa mukufambira mberi kwavo. Lichen planus, mamiriro ekuputika kwemuromo munyoro, uye genetic predispositions mienzaniso yeizvi.

Zviratidzo zvegomarara remukanwa

Imwe yenjodzi huru yegomarara iri nderekuti rinogona kusaonekwa mukutanga kwayo. Inogona kunge isingarwadzi, uye panogona kunge paine shanduko shoma dzinooneka dzemuviri. Nhau dzakanaka ndedzekuti, mumamiriro mazhinji, chiremba wako kana chiremba wemazino anogona kuona kana kunzwa shanduko yetishu inotangira, kana kenza chaiyo, ichiri diki kana mukutanga kwayo. Inogona kutora chimiro chemavara machena kana dzvuku rematishu mumuromo, kana diki diki diki ronda rinoita senge chironda chegomarara. Nekuda kwekuti kune akawanda mabenign tissue achinja anoitika mumuromo mako, uye nekuti chimwe chinhu chakareruka sekuruma mukati medama rako chinogona kutevedzera kutaridzika kwekuchinja kwenyama ine ngozi, zvakakosha kuve neronda chero ripi zvaro kana rakasvibiswa nzvimbo. muromo wako wakaongororwa nenyanzvi kana usina kupora mukati memazuva gumi nemana. Zvimwe zviratidzo nezviratidzo zvinosanganisira bundu risingarwadzi kana kuwanda mukati memuromo kana muhuro, kurwadziwa kana kunetseka kudya, kutaura, kana kutsenga, chero mapundu akaita sewart, kuramba kuoma, kana chiveve munharaunda yemuromo / yechiso. Nzeve isingaperi kune rumwe rutivi inogonawo kuva chiratidzo chenyevero.

Rurimi uye pasi pemuromo inzvimbo dzakajairika dzegomarara remuromo kukura kumberi (kumberi) kwemuromo, kunze kwemiromo, iyo isisiri nzvimbo yakakurumbira yechiitiko. Vanotsenga fodya vanowanzoita sulcus pakati pemuromo kana dama nenyama yakapfava (gingiva) yakakomberedza shaya yezasi ( mandible ), panogarwa plug yefodya. Huwandu hudiki hwehutsinye hwakanangana nematehwe emate huripo, pamwe neiyo ine njodzi zvakanyanya melanoma. Nepo kuwanda kwavo kuri kushoma nemamwe makuhwa emuromo, vanoverengera chikamu chine mwero chehuwandu hwezviitiko. Zvirwere zvegomarara zvemukanwa hazvina kujairika muUnited States, asi hazvizivikanwe. Dzimwe nzvimbo dzave kugara dzichionekwa, kunyanya kune vechidiki vasingasvuti, dzinosanganisira hwaro hwerurimi kumashure kwemuromo, oropharynx (kuseri kwehuro) uye pambiru dzematoni, pamwe ne tonsillar crypt uye tonsil pachayo. Kana chiremba wako wemazino kana chiremba achifungidzira nzvimbo isina mubvunzo, nzira chete yekuve nechokwadi kuti hachisi chinhu chine ngozi kuita biopsy. Iyi haisi nzira inorwadza, inokwanisika, uye inotora maminetsi mashoma. Zvakakosha kuti uve nechokwadi chekuongororwa nekukurumidza sezvinobvira. Zvinogoneka kuti chiremba wako wemazino kana chiremba wekurapa anokutumira kune nyanzvi yebiopsy. Ichi hachisi chikonzero chekunetseka, asi kuti chikamu chemaitiro ekutumirwa kunoitika pakati pavanachiremba vezvidzidzo zvakasiyana.

Zviratidzo nezviratidzo zvegomarara remuromo zvinogona kusanganisira:

• Chironda chemuromo kana chemukanwa chisingapore
• Chigamba chichena kana chitsvuku mukati memuromo wako
• Meno mavara
• Kukura kana bundu mukati memuromo wako
• Muromo unorwadza
• Nzeve kurwadziwa
• Kumedza kwakaoma kana kurwadza

Kuongororwa kwekenza yemuromo

Miedzo uye maitiro anoshandiswa kuongorora gomarara remuromo anosanganisira:

• Kuongorora kwepanyama. Chiremba wako kana chiremba wemazino achaongorora miromo yako nemuromo kuti atarise zvisiri izvo - nzvimbo dzekutsamwa, dzakadai semaronda uye machena machena (leukoplakia).

Kubviswa kwenyama yekuongorora (biopsy). Kana nzvimbo inofungidzirwa kuti yawanikwa, chiremba wako kana chiremba wemazino anogona kubvisa sampuli yemaseru ekuongororwa murabhoritari nenzira inonzi biopsy. Chiremba anogona kushandisa mudziyo wekucheka kucheka sampuli yetishu kana kushandisa tsono kubvisa sampuli. Murabhoritari, masero anoongororwa gomarara kana kuti precancerous shanduko inoratidza njodzi yegomarara remangwana.

Kana kenza yemuromo yaonekwa, chiremba wako anoshanda kuti aone huwandu (danho) regomarara rako. Kuongororwa kwegomarara remuromo kunogona kusanganisira:

• Kushandisa kamera diki kuongorora huro yako. Munguva yemaitiro anonzi endoscopy, chiremba wako anogona kupfuudza diki, inochinjika kamera ine mwenje pasi pako huro kutsvaga zviratidzo kuti cancer rapararira kunze kwemuromo wako.
• Kufungidzira bvunzo. Miedzo yakasiyana-siyana yekufungidzira inogona kubatsira kuona kana gomarara rakapararira kupfuura muromo wako. Miedzo yekufungidzira inogona kusanganisira X-ray, CT, MRI uye positron emission tomography (PET) scans, pakati pevamwe. Haasi munhu wese anoda bvunzo yega yega. Chiremba wako achasarudza kuti ndedzipi bvunzo dzakakodzera zvichienderana nemamiriro ako.

Matanho egomarara remuromo anoratidzwa pachishandiswa nhamba dzechiRoman I kusvika paIV. Danho rezasi, rakaita sedanho I, rinoratidza gomarara diki rinongoperera panzvimbo imwe chete. Chinhanho chepamusoro, chakadai sedanho IV, chinoratidza gomarara rakakura, kana kuti gomarara rapararira kune dzimwe nzvimbo dzemusoro kana mutsipa kana kune dzimwe nzvimbo dzemuviri. Danho regomarara rako rinobatsira chiremba wako kuona marapirwo aungasarudza.

Kurapa kenza yemuromo

Kurapwa kwegomarara remuromo kunotarwa nenzvimbo uye nhanho yebundu, pamwe chete nehutano hwako hwese uye zvaunofarira. Unogona kugamuchira nzira imwe chete yekurapa cancer kana musanganiswa wekurapa cancer. Kuvhiya, radiation, uye chemotherapy zvese sarudzo dzekurapa. Bvunza chiremba wako nezvezvaungasarudza.

Surgery

Kuvhiyiwa kwegomarara remuromo kunogona kusanganisira nzira dzinotevera:

Kuvhiya kubvisa bundu: Kuti uone kuti maseru ese egomarara abviswa, chiremba wako anogona kucheka bundu uye muganho wehutano hwakatenderedza. Kuvhiyiwa kuduku kunogona kushandiswa kubvisa zvirwere zviduku. Mamota akakura angada kuvhiyiwa kwakanyanya. Bundu rakakura, semuenzaniso, rinogona kumanikidza kubviswa kwepfupa reshaya yako kana chikamu cherurimi rwako.

Kuvhiya kubvisa gomarara kubva pamutsipa rapararira: Chiremba wako anogona kukurudzira kubvisa lymph nodes uye matishu ane hukama mumutsipa wako kana masero emukenza akafambira mberi kusvika kune lymph nodes mumutsipa wako kana kana pane ngozi huru yezvinoitika nekuda kwehukuru kana kudzika kwehuipi hwako (neck dissection). Chero masero emukenza akatamira kune lymph nodes yako anobviswa panguva yemutsipa dissection. Inogona zvakare kukubatsira kuona kana iwe uchizoda imwezve kurapwa mushure mekuvhiyiwa.

Kuvhiya pakugadzirisa muromo: Mushure mekunge kenza yako yabviswa, chiremba wako anogona kupa chirwere chekugadzirisa kudzorera muromo wako kuitira kuti ugone kutaura uye kudya zvakare. Kuti uvakezve muromo wako, chiremba wako anogona kushandisa ganda, tsandanyama, kana mapfupa kubva kune mamwe matunhu emuviri wako. Kuiswa kwemazino kunogonawo kushandiswa kutsiva mazino asipo.
Kuvhiya kunogona kukonzera kubuda ropa uye kutapukirwa. Chitarisiko chekuvhiyiwa kwegomarara remukanwa, pamwe nekugona kwako kutaura, kudya, uye kumedza, zvese zvinogona kukanganiswa.

Kuti ikubatsire kudya, kunwa, uye kutora mushonga, ungada chubhu. Iyo chubhu inogona kuiswa mumhino dzako uye mudumbu mako kuti ishandiswe kwenguva pfupi. Ichubhu inogona kuiswa mukati meganda rako uye mudumbu mako nekufamba kwenguva.

Chiremba wako anogona kukutumira kune nyanzvi inogona kukubatsira kugadzirisa kune shanduko.

Radiation therapy

Kuuraya cancer maseru, mwaranzi kurapa kunoshandisa yakakwirira-simba matanda akadai X-rays uye protons. Radiation therapy inowanzopiwa nemuchina uri kunze kwemuviri wako (external beam radiation), asi inogonawo kupihwa nemwaranzi mhodzi newaya dzinoiswa pedyo negomarara (brachytherapy).

Mushure mekuvhiyiwa, radiation therapy inowanzoshandiswa. Nekudaro, kana uine kenza yekutanga-yemuromo, inogona kushandiswa yega. Mune zvimwe zviitiko, radiation therapy uye chemotherapy inogona kushandiswa pamwechete. Musanganiswa uyu unovandudza kushanda kweradiation therapy uku panguva imwe chete ichiwedzera njodzi yemhedzisiro yakaipa. Radiation therapy inogona kubatsira kuderedza zviratidzo zvine chekuita negomarara uye zviratidzo, sekusagadzikana, muzviitiko zvekenza yemuromo.

Muromo wakaoma, kuora mazino, uye kupera kwebhonzo reshaya zvose zvinogona kuitika pamuromo weradiation therapy.

Usati watanga kurapwa neradiation, chiremba wako angakukurudzira kuti uone chiremba wemazino kuti uone kuti mazino ako ane hutano sezvinobvira. Chero mazino asina hutano angada kurapwa kana kubviswa. Chiremba wemazino anogona zvakare kukuraira nezve maitiro ekuchengetedza mazino ako panguva uye mushure mekurapa radiation kuti uderedze mukana wenyaya.

Kurapwa

Chemotherapy mushonga unouraya cancer unoshandisa makemikari. Chemotherapy mishonga inogona kushandiswa yoga, nemamwe chemotherapy agents, kana nemamwe marapirwo egomarara. Chemotherapy yakaratidzwa kuvandudza kushanda kweradiation therapy, nekudaro izvo zviviri zvinowanzoshandiswa pamwechete.

Chemotherapy side effects inosiyana zvichienderana nemishonga inoshandiswa. Nausea, kurutsa, uye kurasikirwa nebvudzi zvese zvinokonzeresa zvakaipa. Bvunza nachiremba wako pamusoro pezvinogona kuipa zvinokonzerwa nechemotherapy mishonga yauchapiwa.

Targeted therapy 

Mishonga inonangana nehunhu hwemaseru egomarara ayo anodyisa kuwanda kwawo anoshandiswa kurapa gomarara remukanwa. Mishonga yakanangwa inogona kushandiswa yoga kana pamwe chete nechemotherapy kana radiation therapy kuti iwane mhedzisiro yakanaka.

Mune zvimwe zviitiko, cetuximab (Erbitux) mushonga wakanangwa unoshandiswa kurapa gomarara remuromo. Cetuximab inhibits kuita kweprotein inowanikwa mumasero akasiyana-siyana ane hutano asi inonyanya kuzivikanwa mumasero egomarara. Mapundu eganda, kuvaviwa, kutemwa nemusoro, manyoka, uye kutapukirwa nezvirwere zvese zvinogona kuitika.

Kana mishonga yakajairika isingashande, mimwe mishonga yakanangwa inogona kuve mukana.

immunotherapy

Immunotherapy imhando yekurapa cancer iyo inoshandisa immune system yako. Nekuti maseru egomarara anogadzira mapuroteni anopofumadza immune system maseru, immune system yemuviri wako inogona kusarwisa cancer yako. Immunotherapy inoshanda nekukanganisa maitiro echisikigo emuviri wemuviri.

Immunotherapy inowanzochengeterwa avo vane gomarara remuromo repamusoro avo vatadza kupindura kurapwa kwechinyakare.