Uhlelo lwakamuva lwe-World Health Organization's Classification of Soft Tissue and Bone Tumors, olushicilelwe ngo-April 2020, luhlukanisaama-sarcomangezigaba ezintathu: sizimila zezicubu eziningi, izimila zamathambo, nezimila zazo zombili izicubu ezithambile nezithambile ezinamaseli amancane ayindilinga angahlukanisiwe.(njenge-EWSR1-non-ETS fusion round cell sarcoma).
“Umdlavuza Okhohliwe”
I-Sarcoma iwuhlobo olungavamile lweumdlavuza kubantu abadala, kubalwa mayelana1%yawo wonke umdlavuza wabantu abadala, ovame ukubizwa ngokuthi “Umdlavuza Okhohliwe.”Nokho, kuqhathaniswaevamile ezinganeni, accounting for around15% ukuya ku-20%yawo wonke umdlavuza wezingane.Ingenzeka kunoma iyiphi ingxenye yomzimba, imvamisa ku-izingalo noma imilenze(60%), kulandele iisiqu noma isisu(30%), futhi ekugcineniikhanda noma intamo(10%).
Eminyakeni yamuva nje, izigameko zezimila zamathambo nezicubu ezithambile ziye zanda kancane kancane.Izimila zamathambo eziyingozi eziyinhloko zivame kakhulu entsheni nakubantu abaneminyaka ephakathi futhi zihlanganisa i-osteosarcoma, i-Ewing sarcoma, i-chondrosarcoma, i-malignant fibrous histiocytoma, ne-chordoma, phakathi kwabanye.Izicubu ezithambile eziyingozi ezivamile zihlanganisa i-synovial sarcoma, i-fibrosarcoma, i-liposarcoma, ne-rhabdomyosarcoma.Ama-metastases amathambo avame kakhulu kubantu abaneminyaka ephakathi nasebekhulile, abanezimila ezivamile eziyinhloko umdlavuza wamaphaphu, umdlavuza webele, umdlavuza wezinso, umdlavuza wendlala yesinye, nomdlavuza wegilo, phakathi kwabanye.
Ukutholwa Kusenesikhathi, Ukwelashwa Kwangaphambi kwesikhathi - Ukukhanyisa “Amathumba” Afihliwe
Ngenxa yezinga eliphezulu lokuphindaphinda kwe-sarcomas, izimila eziningi zinokuxilonga okungacacile kwangaphambi kokuhlinzwa futhi azikho izivivinyo zezithombe ezinemininingwane.Lokhu kuvame ukuholela ekutholakaleni ngesikhathi sokuhlinzwa ukuthi isimila asilula njengoba kulinganiswe ngaphambi kokuhlinzwa, okuholela ekukhishweni okungaphelele.Ukuphindaphinda kwangemva kokuhlinzwa noma i-metastasis kungenzeka, kubangele iziguli ziphuthelwe yithuba lokwelashwa elilungile.Ngakho-ke,ukutholwa kusenesikhathi, ukuxilongwa okunembile, nokwelashwa okufika ngesikhathi kunomthelela obaluleke kakhulu ekuqaguleni kweziguli. Namuhla, sithanda ukwethula uchwepheshe ohlonishwayo oneminyaka ecishe ibe ngu-20 yesipiliyoniekuxilongweni okujwayelekile kanye nokwelashwa komuntu siqu kwe-soft tissue sarcoma, futhi inconywa kakhulu yimboni kanye neziguli -UdokotelaU-Liu Jiayongovela eMnyangweni Wezamathambo Nezicubu Ezithambile esibhedlela sasePeking University Cancer.
Ukwembula Uchwepheshe Onolwazi Olujulile Lwezinhlungu Zamathambo Nenyama - uDkt.U-Liu Jiayong
Udokotela Wezokwelapha, Udokotela Omkhulu, UProfesa Ohlangene.Ufunde e-Anderson Cancer Center e-United States.
Uchwepheshe:Ukwelashwa okuphelele kwama-sarcomas ezicubu ezithambile (ukuhlinzwa kabusha nokwakhiwa kabusha; i-chemotherapy, ukwelapha okuhlosiwe, kanye ne-immunotherapy);ukwelashwa kokuhlinzwa kwe-melanomas.
Njengoba sekusondele iminyaka engama-20 yesipiliyoni sezokwelapha, uDokotela uLiu Jiayong useqongelele uchwepheshe obanzi bokwelashwa nokuhlinzwaukuxilongwa okujwayelekile kanye nezinhlelo zokwelashwa eziqondene nomuntuama-sarcomas ezicubu ezithambile ezivamile njenge-pleomorphic sarcoma engahlukanisiwe, i-liposarcoma, i-leiomyosarcoma, i-synovial sarcoma, i-adenocystic carcinoma-like sarcoma, i-epithelioid sarcoma, i-fibrosarcoma, i-angiosarcoma, ne-infiltrative fibromatosis.Unguye ikakhulukazionekhono ekuphatheni imithambo yegazi nezinzwa ngesikhathi sokususwa kwe-sarcoma yamalungu, kanye nokulungisa nokwakha kabusha ukukhubazeka kwezicubu ezithambile esikhumbeni.Udokotela uLiu ulalela ngesineke isiguli ngasinye, abuze ngokucophelela ngomlando waso wezokwelapha, futhi uthatha amarekhodi ezokwelapha ngokucophelela.Unaka ngokukhethekile izinguquko esimweni sesiguli ngezikhathi ezihlukene, njengangaphambi nangemva kokuhlinzwa, ngesikhathi sokwelashwa, ukulandelela, nokuqhubekela phambili kwesifo, ukwenza izahlulelo eziqondile nokulungiswa ngesikhathi kwezinhlelo zokwelashwa.
UDokotela uLiu Jiayong njengamanje ukhonza njengelungu le-Soft Tissue Sarcoma kanye ne-Melanoma Group ye-Chinese Anti-Cancer Association, kanye nelungu le-Bone Tumor Group ye-Beijing Society of Orthopedics ye-Chinese Medical Association.Ngo-2010, waba ngowokuqala eShayina ukuhumusha nokushicilela “Iziqondiso Zokusebenza Komtholampilo ze-NCCN ku-Soft Tissue Sarcoma,” ekhuthaza ukwelashwa okulinganiselwe okuphelele kwama-sarcomas ezicubu ezithambile.Uyaqhubeka nokulwela inqubekelaphambili ocwaningweni lwezokwelapha nolwesayensi, naphezu kokuba nomthwalo omkhulu wesiguli.Uzinikele futhi unomthwalo wemfanelo waso sonke isiguli esiselaphayo, futhi phakathi nalolu bhubhane, wabhekana nobunzima obubhekene neziguli ezifuna usizo lwezokwelashwa ngokuphendula ngokushesha ekubonisaneni nesiguli, abuyekeze imiphumela yokulandelela, futhi anikeze izincomo zokwelashwa ezifanele ngokusebenzisa izinkundla zokubonisana eziku-inthanethi ezifana Iqembu Leziguli LikaDokotela Omuhle.
Icala lakamuva
UMnu. Zhang, isiguli esineminyaka engu-35 ubudala, wabhekana nokulahlekelwa umbono kungazelelwe ekuqaleni kuka-2019. Ngemva kwalokho, wahlinzwa i-enucleation yeso lesobunxele ngenxa yokwanda okuqhubekayo kwengcindezi ye-intraocular.I-postoperative pathology yembula i-pseudotumor yokuvuvukala.Ehlobo lalo nyaka ofanayo, kwatholakala izigaxana zamaphaphu eziningi ngesikhathi sokuhlolwa kokulandelela, kodwa awekho amaseli e-tumor atholwe nge-need biopsies.Ukuhlolwa okwengeziwe kokulandelela kwembula ama-metastases amaningi amathambo namaphaphu.Ukubonisana ezibhedlela zendawo nezisezingeni eliphezulu kwatholakala ukuthi unethumba elivuvukalayo le-myofibroblastic.Ngo-Agasti 2022, welashwa ngethamo eliphezulu ngamakhemikhali, okwadambisa kakhulu ubuhlungu bakhe kodwa akuzange kubonise ukuthuthuka okubonakalayo kwezilonda lapho ehlolwa kabusha.Isimo sakhe somzimba sabuye saba buthaka.Naphezu kwalokhu, umndeni wakhe awuzange ulilahle ithemba.Ngemva kokufuna imibono eminingi, beza kuDokotela uLiu Jiayong ngoNovemba 2022. Ngemva kokubukeza ngokucophelela umlando wezokwelapha wesiguli, wonke amarekhodi ezokwelapha, ukuhlolwa kwe-pathological, kanye nedatha yokucabanga,UdokotelaU-Liu uhlongoze uhlobo lwe-chemotherapy oluhlanganisa umthamo ophansi we-methotrexate kanye ne-Changchun Ruibin.Lolu hlobo lokwelapha ngamakhemikhali lubiza izindleko futhi lunemiphumela engemihle emincane.Ngemva kwezinsuku ezingu-35 zomuthi, ukuhlolwa kwe-CT kokulandelela kwabonisa ukuthi ubuningi ephashini elingakwesokudla lase linyamalele, okubonisa ukulawula kahle kwesimila.Ukuhlolwa kwakamuva okwalandela esibhedlela saseBeijing South Region Oncology kubonise isimo samaphaphu esizinzile, futhi uDokotela uLiu wancoma ukuvakashelwa njalo.Isiguli nomkhaya waso manje banokuthembela okwengeziwe ekwelashweni okulandelayo, begcwele ithemba.Banomuzwa wokuthi baye babona inhlansi yokukhanya ohambweni lokwelashwa futhi bazwakalisa ukubonga kwabo okusuka enhliziyweni ngokwethula isibhengezo sikasilika sokwazisa.
Isikhathi sokuthumela: Aug-25-2023