I-Kaposi sarcoma

I-Kaposi sarcoma

Isibonelo somdlavuza oqala olwelweni lwegazi nemithambo ye-lymph i-kaposi's sarcoma. Emilenzeni, onyaweni, noma ebusweni, izimila ze-Kaposi's sarcoma (izilonda) zivame ukubonakala njengamachashaza abubende angenabuhlungu. Ukwengeza, izilonda zingakhula emlonyeni, ama-lymph nodes, noma esifundeni sangasese. Izilonda zamaphaphu kanye nokugaya ukudla kungenzeka ku-Kaposi's sarcoma enzima.

Ukutheleleka kwe-herpesvirus yomuntu 8 kuyimbangela eyinhloko ye-Kaposi's sarcoma (HHV-8). Ngenxa yokuthi amasosha omzimba ayayilawula, ukutheleleka kwe-HHV-8 ngokuvamile akunazimpawu kubantu abanempilo. Kodwa-ke, i-HHV-8 inamandla okubangela i-Kaposi's sarcoma kubantu abanamasosha omzimba asengozini.

Ingozi ye-Kaposi's sarcoma iphezulu kulabo abane-human immunodeficiency virus (HIV), igciwane elidala ingculaza. I-HIV ikhubaza amasosha omzimba, ivumela amangqamuzana aphethe i-HHV-8 ukuba ande. Izilonda ezihlukene zikhula ngezindlela ezingaziwa.

Iziguli ezifakelwa izitho zomzimba futhi ziphuze imithi yokucindezela amasosha omzimba azo andisa amathuba azo okuba ne-Kaposi's sarcoma. Kodwa-ke, uma kuqhathaniswa neziguli ze-AIDS, lesi sifo sivame ukuba buthakathaka futhi kulula ukusilawula kulesi sibalo.

Abesilisa abadala baseMpumalanga Yurophu, eMedithera, naseMpumalanga Ephakathi bangakwazi ukuthuthukisa uhlobo oluhlukile lwe-Kaposi's sarcoma. Lobu bubi, ngezinye izikhathi obubizwa ngokuthi i-Kaposi's sarcoma yakudala, buthuthuka kancane kancane futhi ngokuvamile buletha izinkinga ezimbalwa ezisongela ukuphila.

E-Equatorial Africa, uhlobo lwesine lwe-Kaposi's sarcoma oluthinta abantu bayo yonke iminyaka lungatholakala.

Izinhlobo ze-Kaposi sarcoma

Ubhubhane (ohambisana ne-AIDS) i-Kaposi sarcoma

I-KS ehlobene ne-AIDS iwuhlobo oluvame kakhulu e-US. Abantu abane-HIV, igciwane elibangela ingculazi, banalolu hlobo lwe-KS.

I-Human immunodeficiency virus ibizwa ngokuthi i-HIV. Umuntu one-HIV akanayo ngempela ingculaza, kodwa igciwane lingahlala isikhathi eside emzimbeni, ngokuvamile iminyaka eminingi, ngaphambi kokuba lidale ukugula okubi kakhulu. Uma isimiso somzimba sokuzivikela ezifweni sesonakaliswe kakhulu igciwane, umuntu uba nengculaza, okumenza akwazi ukungenwa izifo ezifana ne-Kaposi sarcoma-associated herpesvirus (KSHV) nezinye izindaba zezempilo ezifana ne-KS.

I-KS ithathwa njengesimo esichaza i-AIDS. Lokhu kusho ukuthi uma i-KS ibonakala kumuntu one-HIV, i-AIDS iwukuxilongwa okusemthethweni (futhi akuyona nje ukuthi une-HIV).

Amacala amancane e-KS ahlobene nengculazi abikwe e-US ngenxa yokwelapha ukutheleleka nge-HIV ngokwelashwa ngezidambisigciwane ezisebenza kakhulu (HAART). Nokho, ezinye iziguli zingase zithole i-KS phakathi nezigaba zokuqala zokwelashwa kwe-HAART.

I-HAART ivamise ukuvimbela ukuthuthukiswa kwe-KS ethuthukisiwe kuningi leziguli ezine-HIV. Noma kunjalo, i-KS ingenzeka ezigulini ezine-HIV elawulwa kahle ngenxa ye-HAART. Kubalulekile ukuqhubeka ne-HAART noma ngabe i-KS ibonakala.

Ezindaweni lapho ukuthola i-HAART kunzima khona, i-KS ezigulini ezine-AIDS ingathuthuka ngokushesha.

Classic (Medithera) I-Kaposi sarcoma

Abantu abadala asebekhulile abanokhokho baseMedithera, Eastern Europe, noma Middle Eastern maningi amathuba okuthi bathuthukise i-KS yakudala. Amadoda maningi amathuba okuba abe ne-KS yakudala kunabesifazane. Iningi labantu linesilonda esisodwa noma ngaphezulu emilenzeni, emaqakaleni, noma ematheni onyawo. Izilonda kulolu hlobo lwe-KS azisakazeki ngokushesha noma zakha izilonda ezintsha kaningi njengalezo ezikwezinye izinhlobo ze-KS. Nakuba engebuthakathaka njengakulabo abanobhubhane lwe-KS, amasosha omzimba alabo abane-KS yakudala angase abe namandla kancane kunokuvamile. Amasosha omzimba ngokuvamile angawohloka kancane njengoba sikhula. Abantu asebevele banokutheleleka kwe-KSHV (i-Kaposi sarcoma-associated herpesvirus) kungenzeka ukuthi bathole i-KS uma lokhu kwenzeka.

I-Endemic (African) Kaposi sarcoma

I-Endogenous KS, ngokuvamile eyaziwa ngokuthi i-African KS, ithinta izakhamuzi zase-Equatorial Africa. I-Afrika inokusabalala okukhulu kakhulu kwe-Kaposi sarcoma-associated herpesvirus (KSHV) ukutheleleka kunezinye izifunda zomhlaba, okwandisa ingozi ye-KS. Njengoba i-KS ithinta inqwaba yabantu, okuhlanganisa izingane nabesifazane, kungenzeka ukuthi ezinye izici ezicindezela amasosha omzimba e-Afrika (njengomalaleveva, ezinye izifo ezingamahlalakhona, nokungondleki) nazo zinomthelela ekuqubukeni kwalesi sifo. Abantu abasebasha maningi amathuba okuba babe ne-KS (imvamisa engaphansi kweminyaka engama-40). Akuvamile ukuthi izingane ngaphambi kokuthomba zibonise uhlobo olunolaka lwe-KS. Lolu hlobo lungathuthuka ngokushesha futhi luthinta ama-lymph nodes nezinye izitho.

Ngokomlando, uhlobo olwaluvame kakhulu lwe-KS e-Afrika lwaluyinsakavukela. Lolu hlobo lomqedazwe lwasakazeka njengoba ingculaza yayidlanga e-Afrika.

Iatrogenic (ehlobene nokufakelwa) i-Kaposi sarcoma

I-Iatrogenic, noma ehlobene nokufakelwa, i-KS igama elisetshenziswa ukuchaza i-KS ekhula kubantu amasosha abo omzimba ancishisiwe ngenxa yokufakelwa isitho somzimba. Iningi labamukeli bokufakelwa badinga imithi yokuvimbela amasosha abo omzimba ukuthi alwe (enqabe) isitho esisha. Nokho, le mithi iphakamisa ingozi yokuthi othile ongenwe i-KSHV (Kaposi sarcoma-associated herpesvirus) azothuthukisa i-KS ngokonakalisa amasosha omzimba. Izilonda ze-KS zivame ukunyamalala noma zishwabane lapho umuthi ocindezela amasosha omzimba uyekwa noma uncishiswa umthamo.

Izimpawu nezimpawu ze-Kaposi sarcoma

Izilonda esikhumbeni ziwuphawu lokuqala olujwayelekile lwe-kaposi sarcoma (KS). Izilonda zingaba nsundu, zibomvu, noma zibe nsomi ngombala. Izilonda ze-KS zingase zibe izigaxa, ama-plaque, amabala, noma izilonda eziyisicaba ezingaphakanyisiwe ngaphezu kwesikhumba esizungezile (okubizwa ngokuthi amaqhuqhuva). Nakuba zingavela kwenye indawo, imilenze noma ubuso yilapho izilonda zesikhumba ze-KS zivame ukuvela khona. Ngezinye izikhathi, izilonda emilenzeni noma ku-groyne zingavimbela uketshezi ukuthi lungashiyi imilenze. Imilenze nezinyawo kungase kube nokuvuvukala okubabazekayo ngenxa yalokho.

Ukwengeza, ulwelwesi lwamafinyila, noma ulwelwesi lwangaphakathi lwezingxenye ezimbalwa zomzimba, njengengaphakathi lomlomo nomphimbo, ingaphandle leso, nengxenye engaphakathi yamajwabu amehlo, zingaba nezilonda ze-KS. Ngokuvamile, izilonda azijabulisi futhi azicasuli.

Ukwengeza, izilonda ze-KS zingakhula ngezikhathi ezithile kwezinye izifunda zomzimba. Ingxenye yomzila womoya ingase ivinjwe izilonda zamaphaphu, okuholela ekuphefumuleni okuncane. Ubuhlungu besisu kanye nesifo sohudo kungase kulethwe izilonda ezakha emathunjini nasesiswini.

Izilonda ze-KS zingopha ngezikhathi ezithile. Uma izilonda zisemaphashini, ungakwazi ukukhwehlela igazi bese uphelelwa umoya ngenxa yalokho. Ukuphuma kwamathumbu kungase kube negazi noma kube mnyama futhi kuhlale uma izilonda zisemathunjini noma esiswini. Ukulahleka kwegazi okuvela esiswini kanye nezilonda zamathumbu kungase kwenzeke kancane ngokwanele kangangokuthi igazi lingabonakali ngokushesha esitulweni, kodwa ngokuhamba kwesikhathi, ukulahlekelwa kwegazi kungase kubangele amazinga aphansi egazi elibomvu (i-anemia). Lokhu kungase kubangele izimpawu ezihlanganisa ukukhathala kanye nobunzima bokuphefumula.

Ukuxilongwa kwe-Kaposi sarcoma

Lapho umuntu evakashela udokotela ngenxa yezinkomba noma izimpawu abanazo, udokotela uvame ukuthola i-kaposi sarcoma (KS). I-KS ingatholwa ngezikhathi ezithile phakathi nokuhlolwa komzimba okujwayelekile. Ukuhlolwa okwengeziwe kuyodingeka ukuze kuqinisekiswe ukuxilongwa uma i-KS isolwa.

Umlando wezokwelapha kanye nokuhlolwa komzimba

Uma udokotela wakho enesizathu sokusola ukuthi une-KS, uzobuzwa ngomlando wakho wezokwelapha ukuze uthole ulwazi mayelana nanoma yiziphi izifo zangaphambilini, izinqubo, izenzo zocansi, nokunye ukuchayeka okungenzeka ku-Kaposi sarcoma-associated herpesvirus (KSHV) kanye ne-HIV. Izimpawu zakho, kanye nanoma yikuphi ukukhula kwesikhumba noma izilonda okungenzeka uzibonile, kuzobuzwa udokotela.

Udokotela wakho uzocinga izilonda ze-KS esikhumbeni sakho kanye nangaphakathi emlonyeni wakho njengengxenye yokuhlolwa komzimba okuphelele azokwenza kuwe. Kunezimo lapho izilonda ze-KS zikhula ngaphakathi kwe-rectum (ingxenye yamathumbu amakhulu ngaphakathi kwe-anus). Ngesikhathi sokuhlolwa, udokotela angase akwazi ukuzwa lezi zilonda ngomunwe onamagilavu. Ngenxa yokuthi i-KS emathunjini ingabangela ukopha, udokotela angase futhi ahlole indle ukuze abone ukuthi alikho yini igazi lokulumba (elingabonakali) elikhona.

Biopsy

Okuwukuphela kwendlela yokuthi udokotela azi ngokuqinisekile ukuthi isilonda sibangelwe yi-KS iwukuba akhiphe ucezu oluncane lwethishu enxebani bese eluthumela elabhorethri ukuze luhlaziywe. Le nqubo yaziwa ngokuthi i-biopsy. Ezimweni eziningi, i-KS ingaxilongwa udokotela onokuqeqeshwa okukhethekile owaziwa nge-pathologist, ohlola amaseli kusampula ye-biopsy elabhorethri.

I-punch biopsy ngokuvamile iyona udokotela azoyisebenzisa ukuze akhiphe isampula encane kakhulu yezicubu lapho exilonga izilonda zesikhumba. Lolu hlobo lwe-biopsy luyindilinga. I-excisional biopsy uhlobo lwe-biopsy eyenziwa lapho isilonda sonke sisuswa. Ukusetshenziswa kwezinzwa zendawo kuphela ngokuvamile kwanele kulezi zinqubo (umuthi wokubamba izinombolo).

Ezinye izindawo, njengamaphaphu noma amathumbu, zingase futhi zibe nezilonda ezicutshungulwayo ngesikhathi sezinye izinqubo, njenge-bronchoscopy noma i-endoscopy, okuzoxoxwa ngayo ngokuningiliziwe ezigabeni ezilandelayo. Kuwumkhuba ojwayelekile ukuthi ungawenzi ama-biopsies kubantu asebezazi kakade ukuthi bane-Kaposi's sarcoma (KS) ngoba ama-lesion biopsies kulezi zifunda ngezinye izikhathi angabangela ukopha okukhulu.

X-Ray

Ungase uthole i-x-ray yamaphaphu akho ukuze uhlole ukuba khona kwe-KS. Esimeni lapho i-x-ray yembula okuthile okungavamile, kungase kudingeke ukuhlolwa okwengeziwe, okufana ne-CT scan, ukuze kutholakale ngokucacile ukuthi isiguli sine-KS noma esinye isimo.

Ama-x-reyi esifuba angasetshenziswa ezigulini esezivele zazi ukuthi zine-KS emaphashini ukuhlola ukuthi lesi sifo sisabela kahle kangakanani ekwelashweni.

I-bronchoscopy

I-bronchoscopy iyinqubo yokuxilonga enikeza udokotela umbono womoya wesiguli (owaziwa nangokuthi uqhoqhoqho) kanye nemigudu yomoya emikhulu yamaphaphu. Lokhu kuhlinzwa ngokuvamile kwenziwa uma uhlangabezana nezinkinga ezinjengokuphelelwa umoya noma ukukhwehlela igazi, noma uma i-x-ray yesifuba noma i-CT scan kuveza okuthile okungalungile esifubeni sakho. Noma iyiphi yalezi kungaba inkomba yokuthi i-KS engalapheki ikhona emaphashini.

Uzonikezwa isibulali-zinzwa esincane futhi ulaliswe ngaphambi kokuba inqubo ye-bronchoscopy iqale. Udokotela uyobe esefaka i-bronchoscope, okuyishubhu elincanyana, eliguquguqukayo, elikhanyayo elinekhamera yevidiyo encane exhunywe ekugcineni, emaphashini ngendlela yomlomo, i-windpipe, nangemuva komphimbo. Ngokusetshenziswa kwe-bronchoscope, isampula ye-biopsied ingatholwa endaweni engavamile lapho udokotela asola ukuthi kungaba yi-KS. I-bronchoscopy ehlanganiswe nama-biopsies nayo ingasetshenziswa njengethuluzi lokuxilonga kwezinye izimo zamaphaphu ezivamile kubantu abaphila nengculazi, njenge-pneumonia.

I-endoscopy ephezulu (ebizwa nangokuthi i-esophagogastroduodenoscopy, noma i-EGD)

I-endoscopy engenhla iyinqubo ehlola ulwelwesi lomgudu wokugaya ukudla ongenhla, okuhlanganisa umminzo, isisu, nokuqala komathumbu amancane. Ngaphambi kokuqala lokhu kwelashwa, uzoqale unikezwe imithi ezokulalisa. Ngemva kwalokho, udokotela uqondisa i-endoscope, eyishubhu elincanyana, eliguquguqukayo, elikhanyayo elinekhamera yevidiyo encane exhunywe komunye wemikhawulo yayo, yehle ngomminzo wesiguli, idlule esiswini, bese ingena emathunjini amancane. Udokotela ube esekwazi ukuhlonza izimo ezifana nezilonda, izifo, nezilonda ze-KS.

Uma udokotela ebona indawo engavamile, angathatha i-biopsy yayo esebenzisa izinsimbi zokuhlinza ezincane ezidluliselwa nge-endoscope.

I-Colonoscopy

I-Colonoscopy iyinqubo esetshenziselwa ukuhlola ingaphakathi lamathumbu amakhulu (i-colon ne-rectum). Ukuze kwenziwe lokhu kuhlola, ikholoni nerectum kuzodingeka kuhlanzwe kahle kunoma yisiphi isitulo esingaba khona. Ngokuvamile lokhu kudinga ukudla inani elikhulu le-laxative ewuketshezi ngobusuku bangaphambi kwenqubo kanye nasekuseni kwayo, ngaphezu kokuchitha isikhathi esiningi endlini yokugezela.

Ngaphambi nje kokwelashwa, uzonikezwa imithi ngomjovo we-intravenous (IV) ukuze udambise noma ukwenze ulale (sedation). Isinyathelo esilandelayo sihlanganisa ukudlulisa i- colonoscope, okuyishubhu elide, eliguquguqukayo elinekhamera yokukhanya nevidiyo enamathiselwe ekugcineni, ku-rectum nangaphakathi kwekholoni. Noma yiziphi izifunda ezisolisayo ezitholakala zingathathwa i-biopsy.

I-capsule endoscopy

Amathumbu amancane angabukwa ngenqubo eyaziwa ngokuthi i-capsule endoscopy. Ngenxa yokuthi akubandakanyi ukusetshenziswa kwe-endoscope, ayikwazi ukubhekwa njengendlela yangempela ye-endoscopy. Kunalokho, uthatha i-capsule ecishe ilingane nephilisi elikhulu lamavithamini eliqukethe umthombo wokukhanya nekhamera encane kakhulu. Udla leli capsule ukuze uthathe isithombe. I-capsule iphulwa esiswini bese idlulela emathunjini amancane, njenganoma yimuphi omunye umuthi.

Ithwebula izinkulungwane zezithombe ngenkathi ihamba emathunjini amancane, ngokuvamile athatha amahora angu-8. Ngenkathi wenza usuku lwakho oluvamile, lezi zithombe zithunyelwa ngokungenantambo kudivayisi oyigqoka okhalweni lwakho, futhi ngenkathi wenza kanjalo, iyarekhoda futhi izigcine. Ngemva kwalokho, izithombe zingadluliselwa kukhompyutha, futhi udokotela angazibuka njengevidiyo kudivayisi.

Ngesikhathi sokunyakaza kwamathumbu okubhekwa njengokujwayelekile, i-capsule ikhishwa emzimbeni ngendle bese ikhishwa. Enye yezingqinamba zalokhu kuhlolwa ukuthi akunikezi ithuba lokuthi udokotela enze i-biopsy kunoma yiziphi izindawo ezisolisayo. Ngaphambi kokuhlolwa, cishe uzoyalwa ukuthi ungadli noma yikuphi ukudla noma uketshezi cishe amahora ayi-12.

I-Enteroscopy yebhaluni kabili

Enye indlela yokuhlola amathumbu amancane ibizwa ngokuthi i-double balloon enteroscopy. I-Endoscopy ngendlela yayo evamile ayikwazi ukubheka ngokujulile emathunjini amancane ngenxa yobude bawo kanye nokugoba okuningi okuqukethe. Ukusetshenziswa kwe-endoscope ekhethekile eyakhiwe ngamashubhu amabili, elinye lawo lifakwe kwelinye, kuvumela ukuthi lezi zindaba zigwenywe kusetshenziswa le ndlela. Ngenhloso yalokhu kuhlolwa, uzolaliswa ngomuthi ofakwe emthanjeni (IV), futhi ungase ufakwe ngaphansi phakathi nesikhathi sokusebenza (ukuze ulele).

Ngemva kwalokho, i-endoscope ifakwa emzimbeni wesiguli ngomlomo noma ngendunu, kuye ngokuthi iyiphi ingxenye yamathumbu amancane okufanele ibukwe esikrinini sedivayisi. Uma i-endoscope isifakwe emathunjini amancane, ishubhu elingaphakathi, elinekhamera exhunywe ekugcineni kwalo, liya phambili cishe unyawo olulodwa kuyilapho udokotela ehlola ulwelwesi lwamathumbu. Ngemva kwalokho, ibhaluni lehange liyafuthwa bese libekwa endaweni yalo yokuqeda. Ngemva kwalesi sinyathelo, ishubhu elingaphandle liyiswa phambili lize licishe libe sekupheleni kweshubhu elingaphakathi, futhi ibhaluni lesibili lisetshenziselwa ukulivikela endaweni yalo.

Le nqubo yenziwa izikhathi eziningi ukuze kuhlinzekwe udokotela umbono wamathumbu angunyawo olulodwa ngesikhathi. Uma kwenzeka kutholwa okuthile okungalungile, udokotela angase enze ngisho ne-biopsy. Le nqubo iyinkimbinkimbi kakhulu kune-capsule endoscopy (futhi ingathatha amahora ukuqeda), kodwa inenzuzo yokuvumela udokotela ukuba enze i-biopsy noma yiziphi izilonda ezibonakala ngesikhathi sokuhlinzwa.

Isibindi, ubende, inhliziyo, nomnkantsha ngezinye zezitho ezingase zithintwe yi-KS. Lapho i-KS isivele isolwa kumuntu ngokusekelwe emiphumeleni ye-biopsies yezinye izicubu, njengesikhumba, amaphaphu, noma amathumbu, akudingekile ngaso sonke isikhathi ukuthatha i-biopsy kulezi zindawo.

Izigaba ze-Kaposi sarcoma

I-AIDS Izivivinyo zemitholampilo Uhlelo lweqembu (ACTG) lwe-KS ehlobene ne-AIDS lubheka izici ezi-3:

• Ubukhulu be- isisu (T)
• Isimo se- izivikeli mzimba (I), njengoba kukalwa ngenani lamaseli e-CD4 (uhlobo oluthile lwamangqamuzana omzimba omzimba) egazini
• Ubukhulu be isifo sesistimu (S) emzimbeni (ugula kangakanani umuntu ngenxa yomdlavuza noma i-HIV)

Ngaphansi kwesihloko esikhulu ngasinye, kukhona ama-subgroups angu-2: kungaba ngu-0 (ubungozi obuhle) noma u-1 (ubungozi obungebuhle). Okulandelayo kungamaqembu esiteji okungenzeka ngaphansi kwalolu hlelo:

T (isimila) isimo

I-T0 (ingozi enhle): Isimila sendawo

I-KS isesikhunjeni kanye/noma kuma-lymph nodes kuphela (amaqoqo alingana nobhontshisi wamaseli omzimba kuwo wonke umzimba), futhi/noma kunenani elincane kuphela lesifo olwangeni (ophahleni lomlomo). Izilonda ze-KS emlonyeni ziyisicaba kunokuba ziphakanyiswe.

I-T1 (ingozi embi): Izilonda ze-KS zisabalele. Okukodwa noma ngaphezulu kokulandelayo kukhona:

• I-edema (ukuvuvukala) noma izilonda (ukuphuka esikhumbeni) ngenxa yesimila
• I-KS yomlomo ebanzi: izilonda ezinamaqhuqhuva (eziphakanyisiwe) kanye/noma izilonda ezindaweni zomlomo ngaphandle kolwanga (uphahla lomlomo)
• Izilonda ze-KS zisezithweni ezingaphandle kwama-lymph nodes (njengamaphaphu, amathumbu, isibindi, njll.). I-Kaposi sarcoma emaphashini ngezinye izikhathi ingasho ukubikezela okubi kakhulu (umphumela).

Isimo se-I (amasosha omzimba).

Isimo sokuzivikela komzimba sihlolwa kusetshenziswa ukuhlolwa kwegazi okwaziwa ngokuthi i-CD4 count, ekala inani lamaseli amhlophe egazi abizwa ngokuthi ama-helder T cell.

I0 (ingozi enhle): Isibalo samaseli e-CD4 singamaseli angu-150 noma ngaphezulu nge-cubic millimeter ngayinye (mm³).

I1 (ingozi embi): Isibalo samaseli e-CD4 singaphansi kwamaseli ayi-150 ngemilimitha ngayinye³.

S (isifo sesistimu).

I-S0 (ingozi enhle): Akukho ukugula kwesistimu okukhona; konke lokhu okulandelayo kuyiqiniso:

• Awukho umlando wezifo ezingosomathuba (izifo ezingavamile ukubangela izinkinga kubantu abanempilo kodwa ezithinta abantu abanamasosha omzimba acindezelekile) noma i-thrush (ukutheleleka kwefungal emlonyeni).
• Azikho izimpawu ze-B ezihlala ngaphezu kwamaviki ama-2. Izimpawu B zihlanganisa:Imfiva engachazeki; ukujuluka ebusuku (okunamandla ngokwanele ukucwilisa izingubo zombhede); ukwehla kwesisindo esingaphezu kuka-10% ngaphandle kokudla ukudla
• Isikolo sesimo sokusebenza se-Karnofsky (KPS) sama-70 noma ngaphezulu. Lokhu kusho ukuthi uvuka futhi cishe isikhathi esiningi futhi uyakwazi ukuzinakekela.

I-S1 (ingozi embi): Izifo zesistimu zikhona; okukodwa noma ngaphezulu kokulandelayo kuyiqiniso:

• Umlando wezifo ezingosomathuba noma i-thrush
• Uphawu olulodwa noma ngaphezulu lwe-B lukhona
• Isikolo se-KPS singaphansi kwama-70
• Okunye ukugula okuhlobene ne-HIV kukhona, njengesifo sezinzwa (isimiso sezinzwa) noma i-lymphoma

Iqembu lezingcuphe lilonke

Uma lezi zici sezihloliwe, iziguli zinikezwa iqembu lezingcuphe lilonke (kungaba ubungozi obuhle noma ubungozi obungebuhle). Eqinisweni, njengoba i-antiretroviral therapy esebenzayo (HAART) yatholakala ukwelapha i-HIV, isimo sokuzivikela komzimba (I) asibalulekanga kangako futhi ngokuvamile asibalwa ekunqumeni iqembu lengozi:

• Ubungozi obuhle: T0 S0, T1 S0, noma T0 S1
• Ingozi embi: T1 S1

Ukwelashwa kwe-Kaposi Sarcoma

Ukwelashwa kwe-Kaposi's sarcoma kuyehluka, kuye ngalezi zici:

• Uhlobo lwesifo. Ngokomlando, i-Kaposi's sarcoma ehlobene nengculazi ibe yingozi kakhulu kunesifo sakudala noma esihlobene nokufakelwa. Ngenxa yezinhlanganisela zemithi elwa namagciwane ezisebenza ngempumelelo kanye nokuvimbela okuthuthukisiwe kwezinye izifo ezihlobene nengculazi, i-Kaposi's sarcoma ayivamile ukuvama futhi ayibi kakhulu kubantu abane-AIDS.
• Inombolo nendawo yezilonda. Izilonda zesikhumba ezisabalele kanye nezilonda zangaphakathi zidinga ukwelashwa okuhlukile ezilonda ezizimele.
• Imiphumela yezilonda. Izilonda emlonyeni nasemphinjeni zenza ukudla kube nzima, kanti izilonda emaphashini zingabangela ukuphelelwa umoya. Izilonda ezinkulu, ikakhulukazi emilenzeni engenhla, zingaholela ekuvuvukeni okubuhlungu kanye nobunzima bokuhambahamba.
• Impilo ejwayelekile. Ukukhubazeka kwamasosha omzimba okwenza ube sengozini ye-Kaposi's sarcoma nakho kwenza ukwelapha okuthile, njengemithi yokwelapha ngamakhemikhali enamandla, kube yingozi kakhulu ukuthi ungayizama. Kungokufanayo uma unolunye uhlobo lomdlavuza, isifo sikashukela esingalawulwa kahle noma yisiphi isifo esibi, esingamahlalakhona.

Isinyathelo sokuqala ekwelapheni i-Kaposi's sarcoma ehlobene ne-AIDS ukuqala ukuphuza inhlanganisela yemithi elwa namagciwane noma ukushintshela kulowo osuvele uwathatha. Le nhlanganisela izokwehlisa inani legciwane elibangela i-HIV/AIDS emzimbeni wakho kuyilapho inyusa nenani lamaseli athile omzimba omzimba. Kunezimo lapho lokhu kuwukuphela kokwelashwa okudingekayo.

Abantu abane-Kaposi's sarcoma edalwe ukufakelwa kabusha bangakwazi ukunqamula ukusetshenziswa kwezidakamizwa ezivikela amasosha omzimba uma le nketho itholakala. Kwezinye izimo, lokhu kwenza kube nokwenzeka ukuthi amasosha omzimba aqede ngokuphelele ukonakala. Ukushintsha umuthi ovikela amasosha omzimba owuthathayo uye kokunye kungase kulethe intuthuko.

Ukwelashwa kwezilonda ezincane zesikhumba kuhlanganisa:

• Ukuhlinzwa okuncane (ukusika)
• Ukushiswa (electrodessication) noma iqhwa (cryotherapy)
• Imisebe enedosi ephansi, ewusizo futhi ezilonda emlonyeni
• Umjovo wesidakamizwa se-chemotherapy i-vinblastine ngqo ezilonda
• Ukusetshenziswa kwesidakamizwa esifana ne-vitamin A (retinoid)

Noma iyiphi yalezi zindlela zokwelapha izilonda cishe izoholela ekukhuleni kwezilonda ezintsha phakathi neminyaka embalwa. Uma lokhu kwenzeka, kuvamile ukuba ukwelashwa kuphindwe.

Imisebe iwukwelashwa okujwayelekile kweziguli ezinezilonda eziningi esikhumbeni sazo. Uhlobo lwemisebe olunikezwayo kanye nezindawo zomzimba ezilashelwa ukukhula komdlavuza ziyehluka esigulini ngesiguli. Ukwelashwa ngamakhemikhali ngemithi ejwayeleke kakhulu ye-antineoplastic kungase kube usizo uma kunezilonda ezingaphezu kuka-25. Ama-lymph nodes kanye nomgudu wokugaya ukudla kungathinteka kokubili yi-Kaposi's sarcoma, engelashwa nge-chemotherapy.