I-gastrointestinal carcinoid tumor

I-gastrointestinal carcinoid tumor

Uhlobo olungavamile lomdlavuza olukhula olwelweni lomgudu wokugaya ukudla lubizwa ngokuthi i-gastro-intestinal carcinoid tumor. Lapho amangqamuzana eqala ukwanda ngokungalawuleki, umdlavuza ukhula. ukuze uthole ukuqonda kangcono ukuthi uyini umdlavuza nokuthi ukhula futhi usakazeka kanjani.

Ukwazi ngohlelo lwe-gastrointestinal kanye nohlelo lwe-neuroendocrine kuyasiza ekuqondeni izimila ze-carcinoid emathunjini.

Umdlavuza okhula kancane obizwa ngokuthi ama-carcinoid tumors ungakhula ezindaweni eziningi kuwo wonke umzimba wakho. Umgudu wokugaya ukudla (isisu, i-appendix, ithumbu elincane, ikholoni, noma i-rectum) noma amaphaphu kulapho izimila ze-carcinoid, iqoqo elingaphansi lamaqhubu e-neuroendocrine, zivame ukuvela khona.

Izimpawu zokuqala ze-carcinoid tumors ngokuvamile azikho. Amahomoni adala izimpawu nezimpawu ezifana nesifo sohudo noma ukuguquguquka kwesikhumba angakhiqizwa futhi akhishwe amathumba e-carcinoid emzimbeni. Ukuhlinzwa kanye nemithi kuvame ukusetshenziswa ekulawulweni kwezimila ze-carcinoid.

Izimpawu nezimpawu zamathumba e-carcinoid emathunjini

Iningi le-GI carcinoids likhula kancane. Ngokuvamile ziveza izimpawu ezingacacile, uma zikhona. Odokotela neziguli bathambekele ekubhekeni kwezinye, izizathu ezingase zisabalele kakhulu kuqala lapho bezama ukuthola ukuthi kwenzekani. Lokhu kungase kumise ukuxilongwa izinyanga noma ngisho neminyaka. Nokho, abanye babonisa izimpawu ezisiza ekuxilongweni.

Izimpawu ngendawo yesimila

Izimpawu umuntu angaba nazo ku-GI carcinoid isisu ngokuvamile kuya ngokuthi ikhula kuphi.

isithasiselo

Imvamisa, abantu abane-appendix tumors ababonisi zimpawu. Uma i-appendix ikhishwa ukuze kwelashwe enye inkinga, ngokuvamile lokhu kulapho kutholakala khona isimila. I-appendicitis ngezinye izikhathi ingabangelwa isimila esivimbela umzila phakathi kwe-appendix nawo wonke amathumbu. Ngenxa yalokho, kuvela izimpawu ezinjengomkhuhlane, isicanucanu, ukuhlanza, nobuhlungu besisu.

Amathumbu amancane noma ikholoni

Amathumbu angase agoqe futhi avaleke okwesikhashana uma isimila siqala emathunjini amancane. Ngenxa yalokho, ungathola amajaqamba ngezikhathi ezithile, ubuhlungu besisu, ukukhathala, ukuqunjelwa, isifo sohudo, isicanucanu, nokuhlanza. Ngaphambi kokuba kutholakale isimila se-carcinoid, lezi zimpawu zingase ziqhubeke iminyaka. Ngaphambi kokuba isimila sime ngokuphelele (sivimbe) amathumbu, sibangele ubuhlungu obukhulu besisu, isicanucanu, nokuhlanza, kanye nesimo esingase sibe yingozi empilweni, ngokuvamile kufanele sikhule sibe sikhulu impela.

I-bile duct evamile (esuka esibindini) kanye ne-pancreatic duct (esuka ku-pancreas) igeleza ingene emathunjini ngembobo ye-ampula ye-Vater, evalwa ngezikhathi ezithile isimila se-carcinoid. I-bile ingakwazi ukusekela lapho lokhu kuphazamiseka, okungabangela isikhumba namehlo ukuba abe phuzi (i-jaundice). I-pancreatitis, engaholela ekuvuvukeni kwamanyikwe futhi ibangele ubuhlungu besisu, isicanucanu, nokuhlanza, nayo ingalethwa ukunqwabelana kwama-pancreas.

Ukopha emathunjini ngezinye izikhathi kungase kubangele isimila carcinoid. I-anemia (amangqamuzana abomvu egazi anganele) okuhambisana nokukhathala nokuphelelwa umoya kungase kubangele lokhu.

I-rectum

Izimila ze-rectal carcinoid zivame ukutholakala phakathi nokuhlolwa okujwayelekile, nakuba zingabangela ubuhlungu nokopha okuvela ku-rectum nokuqunjelwa.

Isisu

Izimila ze-Carcinoid ezikhula esiswini ngokuvamile zikhula kancane futhi ngokuvamile azibangeli izimpawu. Ngezinye izikhathi zitholakala lapho isisu sihlolwa nge-endoscopy efuna ezinye izinto. Ezinye zingabangela izimpawu ezifana ne-carcinoid syndrome.

Ama-hormone enziwe ngamathumba e-carcinoid

Ezinye izimila ze-carcinoid zingakhulula ama-hormone egazini. Lokhu kungabangela izimpawu ezahlukene kuye ngokuthi yimaphi amahomoni akhishwayo.

I-Carcinoid syndrome

Cishe isimila se-carcinoid esisodwa kweziyi-1 sikhipha izinto ezanele ezifana ne-hormone egazini ukuze zibangele izimpawu ze-carcinoid syndrome. Lokhu kubandakanya:

• Ukushisa kobuso (ubomvu nomuzwa ofudumele)
• Uhudo olunzima
• Ukushisa
• Ukushaya kwenhliziyo okusheshayo

I-Cushing syndrome

Amanye amathumba e-carcinoid akhiqiza i-ACTH (ihomoni ye-adrenocorticotropic), into ebangela ukuthi izindlala ze-adrenal zenze i-cortisol eningi (i-steroid). Lokhu kungabangela i-Cushing syndrome, enezimpawu ezilandelayo:

• Inzuzo yesisindo
• Ubuthakathaka bemisipha
• Ushukela ophezulu wegazi (ngisho nesifo sikashukela)
• Umfutho wegazi ophezulu
• Ukwanda kwezinwele zomzimba nobuso
• Iqhubu lamafutha ngemuva kwentamo
• Isikhumba sishintsha njengama-stretch marks (abizwa ngokuthi ama-striae)

Zollinger-Ellison syndrome

I-Gastrin, i-hormone ekhiqizwa izimila ze-carcinoid, itshela isisu ukuthi sikhiqize i-asidi. I-Zollinger-Ellison syndrome, lapho isisu sikhiqiza i-asidi eyeqile, ingalethwa ngokuthatha i-gastrin eningi. Amazinga aphezulu e-asidi angabangela ukucasuka kolwelwesi lwesisu ngisho nezilonda zesisu, ezingaba buhlungu, zibe nesicanucanu, futhi zibangele ukulahlekelwa ukudla.

Izilonda ezimbi kakhulu zingase ziqale ukopha. Uma ukopha kukuncane, kungase kubangele i-anemia (ukuntuleka kwamangqamuzana egazi abomvu), okungabangela izimpawu ezifana nokukhathala nokuphelelwa umoya. Indle ingaba mnyama futhi ihlale uma ukopha kubi kakhulu. Ukopha okusongela ukuphila kungenzeka.

Uma i-asidi yesisu ingena emathunjini amancane, ingalimaza ulwelwesi lwamathumbu futhi ibhubhise ama-enzyme okugaya ngaphambi kokuba afeze umsebenzi wawo wokudiliza ukudla. Ukuncipha kwesisindo kanye nesifo sohudo kungase kubangele lokhu.

Ukuxilongwa kwezicubu ze-carcinoid emathunjini

Ukuhlolwa nezinqubo ezisetshenziselwa ukuxilonga izimila ze-carcinoid zihlanganisa:

• Ukuhlolwa kwegazi. Uma unesimila se-carcinoid, igazi lakho lingase libe namazinga aphezulu amahomoni akhiqizwe yisimila se-carcinoid noma imikhiqizo edalwe lapho lawo mahomoni ehlukaniswa umzimba.
• Ukuhlolwa komchamo. Abantu abanezimila ze-carcinoid banamazinga amaningi ekhemikhali emchameni wabo akhiqizwa lapho umzimba uphula ama-hormone akhiqizwa izimila ze-carcinoid.
• Ukuhlola ukuhlolwa. Ukuhlolwa kwezithombe, okuhlanganisa i-computerized tomography (CT) scan, imaging resonance magnetic (I-MRI), i-positron emission tomography (PET), i-X-ray kanye nezikena zemithi yenuzi, zingasiza udokotela wakho akhombe indawo yesimila se-carcinoid.

• Ububanzi noma ikhamera ebona ngaphakathi komzimba wakho. Udokotela wakho angase asebenzise ishubhu elide, elincanyana elifakwe ilensi noma ikhamera ukuze ahlole izindawo ezingaphakathi emzimbeni wakho.

   

  I-endoscopy, ebandakanya ukudlulisa ububanzi emphinjeni wakho, ingasiza udokotela wakho ukuthi abone ngaphakathi kwepheshana lakho lesisu. I-bronchoscopy, isebenzisa i-scope edlulisa umphimbo wakho nasemaphashini akho, ingasiza ekutholeni izimila ze-carcinoid yamaphaphu. Ukudlulisa ububanzi nge-rectum yakho (i-colonoscopy) kungasiza ukuxilonga izimila ze-rectal carcinoid.

  Ukuze ubone ngaphakathi kwamathumbu akho amancane, udokotela wakho angase atuse ukuhlolwa usebenzisa ikhamera elingana nephilisi oyigwinya (i-capsule endoscopy).

• Ukukhipha izicubu ukuze kuhlolwe ilabhorethri. Isampula lesicubu sethumba (i-biopsy) ingaqoqwa ukuze kuqinisekiswe ukuxilongwa kwakho. Uhlobo luni lwe-biopsy ozolithola luncike lapho isimila sakho sitholakala khona.

  Enye indlela yokuqoqa isampula yethishu ihlanganisa ukusebenzisa inaliti ukukhipha amaseli esimila. Enye inketho kungaba ngokuhlinzwa. Izicubu zithunyelwa elabhorethri ukuze zihlolwe ukuze kutholwe izinhlobo zamaseli esimila kanye nokuthi lawo maseli abonakala enolaka kangakanani ngaphansi kwesibonakhulu.

Ukwelashwa kwesimila se-carcinoid emathunjini

Indawo yesimila, uma umdlavuza ususabalele kwezinye izingxenye zomzimba, izinhlobo zamahomoni isimila esiwakhiphayo, impilo yakho evamile, kanye nezinto ozikhethayo siqu kuzothonya indlela olashwa ngayo ngesimila se-carcinoid.

Izinketho zokwelapha zingabandakanya:

Ukuhlinzwa: Uma sitholwa kusenesikhathi, isimila se-carcinoid singasuswa ngokuphelele kusetshenziswa ukuhlinzwa. Uma izimila ze-carcinoid zithuthukisiwe lapho zitholwa, ukususwa okuphelele kungase kungenzeki. Kwezinye izimo, odokotela abahlinzayo bangase bazame ukususa isimila esiningi ngangokunokwenzeka, ukuze basize ukulawula izimpawu nezimpawu.

Imithi: Izimpawu nezimpawu ze-carcinoid syndrome zingancipha, futhi ukukhula kwesimila kungase kwehliswe, ngokuthatha izidakamizwa ezivimba ama-hormone akhiqizwa isimila.

Imijovo engaphansi kwesikhumba isetshenziselwa ukunikeza i-octreotide (i-Sandostatin, i-Bynfezia Pen), ne-lanreotide (i-Somatuline Depot). Ubuhlungu besisu, ukuqunjelwa, kanye nesifo sohudo yimiphumela engemihle engenzeka kunoma yimuphi umuthi. Ukuze uqhubeke uzama ukudambisa izimpawu ze-carcinoid syndrome, i-telotristat yomuthi (Xermelo) isetshenziswa ngezikhathi ezithile ne-octreotide noma i-lanreotide.

I-Chemotherapy: Imithi enamandla isetshenziswa ekwelapheni ngamakhemikhali ukuze kubulawe amaseli esimila. Ingalawulwa ngomjovo noma njengethebhulethi. Lapho ukuhlinzwa kungenakusetshenziselwa ukususa izimila ze-carcinoid ezithuthukile, ukwelashwa ngamakhemikhali kungase kwelulekwe.

Ukwelashwa okuhlosiwe: Ukwelashwa kwemithi okuhlosiwe kugxile ekuphambukeni okuthile okutholakala kumaseli wesimila. Imithi yokwelapha ehlosiwe ingabulala amaseli esimila ngokuvimbela lokhu kuphambuka. Kumathumba e-carcinoid athuthukile, ukwelashwa ngamakhemikhali kuvame ukuhlanganiswa nokwelashwa kwemithi okuhlosiwe.

Izidakamizwa eziletha imisebe ngqo kumaseli omdlavuza: Ekwelapheni i-peptide receptor radionuclide (PRRT), amangqamuzana omdlavuza abulawa umsakazo futhi aqondiswe umuthi. Umuthi ujovwa emzimbeni wakho ngesikhathi se-PRRT ukuze uthole izimila ze-carcinoid, lapho uhamba uye kumaseli omdlavuza, unamathele kuwo, bese uhambisa imisebe kuwo. Kulabo abanamathumba e-carcinoid athuthukile, lokhu kwelashwa kungase kube into engenzeka.

Ukwelashwa nini umdlavuza usakazekela esibindini: Ama-metastases e-Hepatic avela ezimila ze-carcinoid avamile. Ukuhlinzwa ukuze kukhishwe ingxenye yesibindi, ukufakwa kwe-hepatic artery, kanye nokusetshenziswa kokushisa nokubanda ukubulala amangqamuzana omdlavuza kuphakathi kwezindlela zokwelapha ezingase zibe khona. Amaseli esibindi we-carcinoid tumor abulawa ukwelashwa kokushisa kwe-radiofrequency ablation. I-Cryoablation ibhubhisa amangqamuzana omdlavuza ngokuwaqandisa ngokuphindaphindiwe futhi ancibilike.