Ngokusho kwe-International Agency for Research on Cancer of the World Health Organization, ngo-2020, iShayina yayinamacala amasha omdlavuza angaba yizigidi ezingu-4.57, kanti umdlavuza wamaphaphu ubanga amacala angaba ngu-820,000. Ngokusho kwe-“Guidelines for Lung Cancer Screening and Early Diagnosis and Treatment in China” ye-Chinese National Cancer Center, amazinga okusabalala kanye nokufa komdlavuza wamaphaphu eShayina abanga u-37% kanye no-39.8% wezibalo zomhlaba wonke, ngokulandelana. Lezi zibalo zidlula kakhulu inani labantu baseShayina, okungaba ngu-18% wabantu bomhlaba wonke.
Incazelo kanyeIzinhlobo ezincaneyomdlavuza wamaphaphu
Incazelo:Umdlavuza wamaphaphu oyinhloko we-bronchogenic, owaziwa kakhulu ngokuthi umdlavuza wamaphaphu, yisifo esivame kakhulu esiwumdlavuza oyinhloko esivela ku-trachea, i-mucosa ye-bronchial, i-bronchi encane, noma izindlala emaphashini.
Ngokusekelwe ezicini ze-histopathologicalUmdlavuza wamaphaphu ungahlukaniswa ube umdlavuza wamaphaphu ongewona owamangqamuzana amancane (80%-85%) kanye nomdlavuza wamaphaphu ongewona owamangqamuzana amancane (15%-20%), onezinga eliphezulu lomdlavuza. Umdlavuza wamaphaphu ongewona owamangqamuzana amancane uhlanganisa i-adenocarcinoma, i-squamous cell carcinoma, kanye ne-large cell carcinoma.
Kususelwa endaweni okwenzeka kuyo, umdlavuza wamaphaphu ungahlukaniswa kabanzi njengomdlavuza wamaphaphu ophakathi kanye nomdlavuza wamaphaphu ongaphandle.
Ukuxilongwa Kwezifo Zomdlavuza Wamaphaphu
Umdlavuza Wamaphaphu Ophakathi:Kubhekisele kumdlavuza wamaphaphu ovela ku-bronchi engaphezulu kwezinga lesigaba, ikakhulukazi oqukethei-squamous cell carcinoma kanye nomdlavuza wamaphaphu wamaseli amancane. Ukuxilongwa kwezifo ngokuvamile kungatholakala nge-fiber bronchoscopy. Ukuhlinzwa komdlavuza wamaphaphu aphakathi kuyinselele, futhi kuvame ukukhawulelwa ekuhlinzweni okuphelele kwamaphaphu athintekile. Iziguli zingase zibe nobunzima bokubekezelela inqubo, futhi ngenxa yesigaba esithuthukile, ukuhlasela kwendawo, ukusabalala kwama-lymph node e-mediastinal, nezinye izici, imiphumela yokuhlinzwa ingase ingabi mihle, ngengozi ephezulu yokusabalala kwamathambo.
Umdlavuza Wamaphaphu Ongaphandle:Kubhekisele kumdlavuza wamaphaphu owenzeka ngaphansi kwe-segmental bronchi,ikakhulukazi kufaka phakathi i-adenocarcinoma. Ukuxilongwa kwezifo kuvame ukutholakala nge-percutaneous transthoracic needle biopsy eqondiswa yi-CT.Emtholampilo, umdlavuza wamaphaphu ongaphandle uvame ukungabi nazimpawu ezigabeni zokuqala futhi uvame ukutholakala ngengozi ngesikhathi sokuhlolwa ngokomzimba. Uma utholakala kusenesikhathi, ukuhlinzwa kuyindlela yokwelapha eyinhloko, kulandelwe yi-adjuvant chemotherapy noma ukwelashwa okuqondiwe.
Ezigulini ezinomdlavuza wamaphaphu ezingafaneleki ukuhlinzwa, ezine-pathological diagnosis eqinisekisiwe edinga ukwelashwa okulandelayo, noma ezidinga ukulandelwa njalo noma ukwelashwa ngemva kokuhlinzwa,ukwelashwa okujwayelekile nokufanele kubaluleke kakhuluSingathanda ukukwethula ku-UDkt. An Tongtong, uchwepheshe odumile we-thoracic oncology onolwazi olungaphezu kweminyaka engama-20 lwe-medical oncology eMnyangweni we-Thoracic Oncology, eBeijing University Cancer Hospital.
Isazi Esidumile: UDkt. An Tongtong
Udokotela Oyinhloko, Udokotela Wezokwelapha. Unolwazi lokucwaninga e-MD Anderson Cancer Center e-United States, kanye nelungu lekomidi lentsha le-Chinese Anti-Cancer Association Lung Cancer Professional Committee.
Izindawo Zobuchwepheshe:Ukwelashwa ngamakhemikhali kanye nokwelashwa okuqondiswe kuma-molecule komdlavuza wamaphaphu, i-thymoma, i-mesothelioma, kanye nezinqubo zokuxilonga nokwelapha ezifana ne-bronchoscopy kanye nokuhlinzwa kwesifuba okusizwa ngevidiyo kwezokwelapha zangaphakathi.
UDkt. An wenze ucwaningo olujulile mayelana nokulungiswa kanye nokwelashwa okubanzi kwezinhlobo eziningi zomdlavuza wamaphaphu osesigabeni esithuthukile,ikakhulukazi esimweni sokwelashwa okuphelele komuntu ngamunye komdlavuza wamaphaphu ongewona amangqamuzana amancane. UDkt. An unekhono eziqondisweni zakamuva zokuxilonga nokwelapha izimila zesifuba.Ngesikhathi sokubonisana, uDkt. An uqonda ngokugcwele umlando wezokwelapha wesiguli futhi uqapha ngokuseduze izinguquko zesifo ngokuhamba kwesikhathi. Uphinde abuze ngokucophelela ngezinhlelo zokuxilonga nokwelapha zangaphambilini ukuqinisekisa ukulungiswa ngesikhathi esifanele kohlelo lokwelapha olulungiselelwe kahle kakhulu lwesiguli. Ezigulini ezisanda kutholakala ukuthi zinegciwane, imibiko ehlobene nokuhlolwa ngokuvamile ayiphelele. Ngemva kokuqonda ngokucacile umlando wezokwelapha, uDkt. An uzochaza ngokucacile isu lokwelapha lesi simo samanje esigulini kanye namalungu omndeni waso. Uzophinde anikeze isiqondiso sokuthi yiziphi izivivinyo ezengeziwe ezidingekayo ukusiza ukuqinisekisa ukuxilongwa, aqinisekise ukuthi amalungu omndeni ayaqonda ngokugcwele ngaphambi kokubavumela bona kanye nesiguli ukuba baphume egumbini lokubonisana benokuthula kwengqondo.
Amacala Akamuva
UMnu. Wang, isiguli esineminyaka engu-59 ubudala esine-lung adenocarcinoma esine-metastases eminingi emzimbeni, wafuna ukwelashwa eBeijing ngesikhathi sobhubhane ngasekupheleni kuka-2022. Ngenxa yemikhawulo yokuhamba ngaleso sikhathi, kwadingeka athole umjikelezo wakhe wokuqala we-chemotherapy esibhedlela esiseduze ngemuva kokuqinisekiswa kokuxilongwa kwesifo. Kodwa-ke, uMnu. Wang wabhekana nobuthi obukhulu be-chemotherapy kanye nesimo somzimba esibi ngenxa ye-hypoalbuminemia ehambisana nayo.
Esondela emzuliswaneni wakhe wesibili we-chemotherapy, umndeni wakhe, ukhathazekile ngesimo sakhe, wabuza ngobuchwepheshe bukaDkt. An futhi ekugcineni waphumelela ukwenza i-aphoyintimenti e-VIP Outpatient service yeSibhedlela sethu. Ngemva kokubuyekezwa okuningiliziwe komlando wezokwelapha, uDkt. An wanikeza izincomo zokwelashwa. Ngenxa yamazinga aphansi e-albumin kaMnu. Wang kanye nokusabela kwe-chemotherapy, uDkt. An walungisa uhlelo lwe-chemotherapy ngokufaka i-pemetrexed esikhundleni se-paclitaxel ngenkathi efaka ama-bisphosphonates ukuvimbela ukubhujiswa kwamathambo.
Ngemva kokuthola imiphumela yokuhlolwa kwezakhi zofuzo, uDkt. An waphinde waxhumanisa uMnu. Wang nokwelashwa okufanele okuqondiswe kuye, i-Osimertinib. Ezinyangeni ezimbili kamuva, ngesikhathi sokuvakasha okulandelayo, umndeni kaMnu. Wang wabika ukuthi isimo sakhe sesithuthukile, enezimpawu ezinciphile kanye nekhono lokwenza imisebenzi efana nokuhamba, ukuchelela izitshalo, nokushanela phansi ekhaya. Ngokusekelwe emiphumeleni yokuhlolwa okulandelayo, uDkt. An weluleka uMnu. Wang ukuthi aqhubeke nohlelo lokwelashwa lwamanje futhi ahlolwe njalo.
Isikhathi sokuthunyelwe: Agasti-31-2023