Isimila sikaWilms

Ithumba likaWilms wuhlobo olungajwayelekile lomdlavuza wezinso oluhlasela kakhulu intsha. Yaziwa nangokuthi i-nephrblastoma, futhi iwumdlavuza wezinso ovame kakhulu ezinganeni. Isimila sikaWilms sihlasela intsha ephakathi kweminyaka emithathu nemine ubudala, futhi siye sinciphe kakhulu ngemva kwalokho.

I-Wilms' isisu ngokuvamile kuvame ukulimaza inso eyodwa, nakuba ngezinye izikhathi kungase kuthinte izinso zombili ngesikhathi esisodwa.

Intuthuko ekuhlonzweni nasekulashweni kwesimila sikaWilms yenze ngcono indlela yokubikezela (ukubikezela) kwezingane ezinalesi sifo ngokuphawulekayo phakathi neminyaka yonke. Iningi lezingane ezine-Wilms' tumor zine-prognosis evumayo uma zithola ukwelashwa okufanele.

Izimpawu zesimila sikaWilms

Izimpawu nezimpawu zesimila sikaWilms ziyahlukahluka kakhulu, futhi ezinye izingane azibonisi zimpawu ezisobala. Kodwa izingane eziningi ezinethumba likaWilms zithola eyodwa noma ngaphezulu yalezi zimpawu nezimpawu:

• Isisindo sesisu ongasizwa
• Ukuvuvukala kwesisu
• Ubuhlungu besisu

Ezinye izimpawu nezimpawu zingafaka:

• Fever
• Igazi emchameni
• Isicanucanu noma ukuhlanza noma kokubili
• ukuqunjelwa
• Ukulahlekelwa kwesifiso
• Ukuphelelwa umoya
• Umfutho wegazi ophezulu

Yini ebangela isimila sikaWilms?

Akukacaci ukuthi yini ebangela isimila sikaWilms, nokho ufuzo lungadlala indima kwezinye izimo.

Lapho i-DNA yamaseli iba nephutha, kuba nomdlavuza. Amaphutha avumela amaseli ukuthi ande futhi ahlukane ngesilinganiso esingalawuleki, okuwavumela ukuthi aphile lapho amanye amaseli engabe efile. Kuvela isimila emangqamuzaneni anqwabelene. Lokhu kwenzeka kumaseli ezinso ku-Wilms' tumor.

Isimila sikaWilms sibangelwa amaphutha e-DNA adluliselwa kusuka kumzali kuya enganeni ngephesenti elincane lezimo. Ezimweni eziningi, akukho ukuxhumana okwaziwayo phakathi kwabazali nezingane okungase kubangele umdlavuza.

Ukuxilongwa kwesimila sikaWilms

Kusetshenziswa izivivinyo eziningana ukuze kuqinisekiswe ukuhlonzwa kwesimila seWilms futhi kunqume ukuthi lesi sifo siyisiphi isigaba. Lezi zivivinyo zingabandakanya:

• I-Ultrasound: ngokuvamile ukuhlolwa kokuqala okwenziwayo, kusebenzisa amaza omsindo esikhundleni se-X ray ukwenza umfanekiso wendawo.
• Iskena se-CT/CAT: yenza ukubuka okuningiliziwe kwezingxenye ezihlukene zesitho ngama-X ray. Kuwusizo kakhulu ekutholeni izimila kanye nokubona ukuthi umdlavuza ususabalele yini (i-metastasized).
• I-MRI: isebenzisa amaza omsakazo nozibuthe abanamandla ukwenza izithombe ezinemininingwane yezingxenye zangaphakathi zomzimba. Lokhu kuvumela odokotela ukuthi babone ukuthi umdlavuza ukunoma yiliphi igazi elikhulu izitsha eduze nezinso.
• Ama-X-ray: ukubheka noma yiziphi izindawo ezinemetastasized, ikakhulukazi emaphashini.
• Izikena zethambo: isebenzisa amanani amancane ezinto ezikhipha imisebe ukuze igqamise noma yiziphi izindawo zamathambo anesifo.
• Ukuhlolwa kwelebhu: njengokuhlolwa kwegazi nokuhlolwa komchamo ukuhlola impilo evamile yengane kanye nokuthola noma yimiphi imiphumela emibi (njengezibalo eziphansi zamangqamuzana egazi abomvu noma amhlophe) yokwelashwa.

Ukwelashwa kwesimila sikaWilms

Ukwelashwa kwe-Wilms tumor kuncike ezintweni ezimbalwa. Isigaba somdlavuza ngesikhathi sokuxilongwa, kanye nesimo, noma i-histology, yamangqamuzana omdlavuza, sibalulekile. Iningi lamathumba eWilms ane-histology “ethandekayo,” okusho ukuthi kulula ukuyelapha.

Uhlelo lwesiteji lusetshenziswa odokotela ukukhombisa ubukhulu besimila. Ukuze kuzuzwe ithuba eliphakeme kakhulu lokwelapha, isimila esinolaka kakhulu siphathwa ngohlelo lwezokwelapha olunamandla. Ingane enesimo esingathandeki kakhulu izothola umthamo omncane wemithi, enciphisa imiphumela emibi yesikhathi eside.

Izigaba ezivame kakhulu yilezi:

• Isigaba I: Umdlavuza utholakala enso eyodwa kuphela futhi ungasuswa ngokuphelele ngokuhlinzwa. Cishe ama-41% awo wonke amathumba eWilms asesiteji I.
• Isigaba II: Umdlavuza ususabalele ngalé kwezinso endaweni ezungezile, kodwa ungasuswa ngokuphelele ngokuhlinzwa. Cishe ama-23% asesiteji II.
• Isigaba III: Umdlavuza awusakazeki ngale kwesisu, kodwa awukwazi ukususwa ngokuphelele ngokuhlinzwa. Cishe ama-23% asesiteji III.

Ukuhlinzwa kuvame ukwenziwa ukwelapha isimila seWilms. Ku-nephrectomy enkulu, udokotela ohlinzayo ususa:

• isimila
• inso yonke
• i-ureter (ishubhu elithwala ukuchama lisuka ezinso liye esinyeni)
• i-adrenal gland (indlala ehlezi phezu kwezinso)
• izicubu ezinamafutha ezizungezile

Uma umdlavuza ukuzo zombili izinso, odokotela abahlinzayo bavame ukukhipha umdlavuza omningi ngangokunokwenzeka futhi balondoloze izicubu zezinso ezinempilo ngangokunokwenzeka ukuze bagweme ukufakelwa izinso.

Zonke izinhlelo zokwelapha ngokuvamile zihlanganisa kokubili ukuhlinzwa kanye ne-chemotherapy. Izigaba ezithuthuke kakhulu nazo zingadinga ukwelashwa ngemisebe. Kokubili ukwelashwa kunezingozi zesikhathi esifushane nezesikhathi eside.

Imiphumela yesikhashana (noma yesikhashana) ingase ihlanganise:

• isicanucanu nokuhlanza
• ukulahlekelwa ukudla
• izilonda zomlomo
• ukhathala
• ukulahlekelwa izinwele
• amasosha omzimba abuthakathaka
• ukopha noma ukulimaza

Imiphumela yesikhathi eside (noma sekwephuzile) ingase ihlanganise:

• ukuthuthukiswa komdlavuza wesibili (njenge-leukemia)
• ubuthakathaka kwezinye izitho zangaphakathi, njengenhliziyo
  Nokho, izinzuzo zokwelashwa zidlula kude lezi zingozi.