Carcinoma Hepatocellular kwesibindi: diagnosis, Iimpawu and Treatment

umhlaza Primary isifo wesibindi zinqabile. Ngokubanzi somdlavuza wendlala na zasesekondari, oko kukuthi kuwenza. Nangezilonda ephambili kwesibindi libhekisela carcinoma holangio- kunye hepatocellular. Wokuhlunyelwa zezi ntlobo zomhlaza unokuba amadoda phakathi kwabafazi (ngamaxesha ambalwa). Xa abantwana, ezi nangezilonda ziphantse ziphinde zenzeke. Xa izigulane abaselula inokuphuhlisa umhlaza wesibindi, livela izicwili osandul - hepatoblastoma. Le ngezifo kunqabile. Phantse wonke eziziiprayimari yamathumba zesibindi zithathwa ukuba abe ndlongondlongo. Asezikhundleni indawo 5 yokufa kwisakhiwo somhlaza ezimbi. Okwangoku sifuna iindlela ezintsha zokulwa umhlaza wesibindi. ntuthuko Great kuphunyezwe lokubhaqwa kunye nonyango omzimba ekujoliswe kuzo.

Inkcazelo carcinoma hepatocellular

carcinoma Hepatocellular - nomhlaza iiseli zesibindi ubuze atypia. Xa kuthelekiswa namanye ephambili oncological ezimbi, andingowasemzimbeni, oko liselikho kakhulu. Le Ithumba ukwabizwa ngokuba hepatic cell carcinoma. Xa nezihlandlo carcinoma hepatocellular phakathi kwabantu yeyona inkulu 5 ehlabathini. Le Ithumba ixhaphake kakhulu kumazwe. Ibhekisela umhlaza kakhulu yaye ngokukhawuleza phambili kwaye kaninzi ebulalayo. Yinto nje uxilongo emva sifo, kodwa ndlongondlongo kunye nokukwazi iyakhula kwamanye amalungu. Oku kubangelwa zesibindi perfusion.

Zonke iintlobo zomhlaza idwelisiweyo International Classification yezifo (ICD). Njengezinye ngezifo umhlaza, iye ikhowudi yayo eyodwa, kwaye carcinoma hepatocellular. ICD-10 isetyenziswa kuwo onke amazwe ehlabathini. Xa ukuhlelwa sifo abe S22.0 ikhowudi, gama elo elithetha "cell zesibindi carcinoma." Amaninzi, le ngezifo kwenzeka ngokuchasene nentsukaphi ezingapheliyo, phantsi kwempembelelo izinto ezingalunganga.

Oonobangela kwesibindi carcinoma

Njengoko yaziwa, loo umyalezo yamathumba abuhlungu okwangoku kufundwe. Noko ke, izazinzulu kudala wabona Imiba nimqumbise uphuhliso ithumba. Akukho ngaphandle kunye hepatic cell carcinoma. Ngaye ezi ziphumo zilandelayo:

1. iziphathi Long-term iintsholongwane ezithile. Kucingelwa ukuba ezimbi ezifana kohlobo B no-C, kwandisa ingozi yokuba carcinoma hepatic ngokuphindwe ezingaphezu kwe-100. Ukongeza, ezi zifo badla nazimpawu. Ngoko ke, ukuba ukucutha umngcipheko bomhlaza kufuneka njalo unikele ngegazi phezu iintsholongwane hepatitis.
2. Isibindi ukuqina nawuphi na umyalezo. Ukutshintshwa hepatocytes kwi zomzimba nokuqina kaninzi kwenzeka ngenxa yokuba usuleleko esingapheliyo egazini, ezityiwa kotywala kunye neziyobisi.
3. Ukutya ukutya okune aflatoxin.
4. yofuzo ukuba esi sifo.
5. Ukwamkelwa amachiza hepatotoxic.

Ukuba azibandakanyi idwelisiweyo ayeke izinto, Umngcipheko wokuhlaselwa hepatocellular carcinoma sakugcina. Noko ke, akukho namnye sinazo kulo thumba. Njengezinye ngezifo umhlaza, oko kunokubangela ukusuka sesichengeni ionizing radiation, ukutshaya, ukungondleki kakuhle, uxinezeleko, njalo-njalo. D.

Le Pathogenesis of carcinoma hepatocellular

Ngenxa yoko, nangokurhala esinganyangekiyo iiseli isibindi eziqhelekileyo ziqala ukuba akuguquki ezifunekayo ithumba. Yintoni kanye kukhokelela kuyo bengaziwa. Ngenxa yesenzo intsholongwane wesibindi esiqwini kukuthi ebushushwini babo, umzimba edematous, yaye kubuhlungu. ukunyuka permeability semithambo, zibe zizele zinegazi elibandayo. Ngenxa yoko, umsebenzi isibindi kuphazamisekile. Ngaphandle kwento yokuba umzimba atshabalalise amasuntswana viral, oko kuchaphazela ezinye izinto ezinobungozi evela ukutya. Konke oku kukhokelela yenguqu cell. I kernel lukhula ubukhulu, kukho icytoplasm kunye nezinye organelles ngoku lutshintshelwe kwimida ethile. Emva koko, iseli uqalisa bababele unmotivated. It ufumana ezininzi nuclei, hepatocyte yokucolwa in badlwengulwe. Esiseleni, nethumba uqalisa nokulungelelanisa ziiproteni naa ngokukhawuleza egazini. Ngaloo ezihlangene hepatitis C kunye Hepatocellular carcinoma.

Kumele kukhunjulwe ukuba lohlobo isifo phantse lonk ikhokelela kwesibindi okanye umhlaza. Kwiimeko ezininzi, ukuba sele kwafunyaniswa ukuba xa kuvela iingxaki. Elinye igama kohlobo C - "kumbulali ithenda". Oku kungenxa yokungabikho epheleleyo ukwenza izinto kwezonyango sifo kangangeminyaka emininzi, yaye ukufa kumbovu ngenxa ngokunqunyanyiswa ukusebenza kwesibindi.

Ukwahlukanisa carcinoma hepatocellular

Hepatocellular carcinoma isibindi wohlulwe iintlobo eziliqela kwezonyango kunye morphological. Ukongeza, nethumba zihlelwe ngokwe nqanaba kuphuhliso kunye neqondo ubungnqongqo. Kuxhomekeka umfanekiso esiludumbo bodwa ongatshintshiyo, omkhulu neentlobo kwentamo zomhlaza wesibindi. Njengento iintlobo ezahlukeneyo hepatocellular fibrolamellar carcinoma. Ngokwalo mfanekiso lonyango iintlobo 6 cell zesibindi carcinoma. Phakathi kwabo:

1. Gepatomegalichesky inketho.
2. ifomu Icteric.
3. ngobuwena Febrile zomhlaza wesibindi.
4. ifomu Ascites.
5. ukhetho Acute esiswini.
6. umhlaza wesibindi kuwenza.

Amaninzi kukho indibanisela Ukrainian lunee ntlobo ezininzi clinical. Inqanaba umhlaza Isibindi-iseli kuxhomekeke kubukhulu thumba kunye nokwanda kwawo kwiindawo nkovu ezikufuphi kunye namanye amaziko.

carcinoma Hepatocellular: zesifo

Iimpawu kungaxhomekeka kuhlobo bezonyango belo carcinoma. Kwiimeko ezininzi, ezi zigaba zokuqala zomhlaza akanayo mpawu. Ukongeza, uxilongo kunzima ngenxa yokuba iimpawu thumba bafana umfanekiso lwezonyango zezinye izifo zesibindi (kohlobo, ukuqina). Ngu obubonakala umhlaza emva kwexesha ziquka fever ephantsi-grade, ukungabi namdla, ubuthathaka, lymphadenopathy, ukwehla kobunzima bomzimba. Xa gepatomegalicheskoy uhlobo carcinoma ziphawule ukwanda okuphawulekayo esibindini, intlungu hypochondrium ekunene. Isinye esithathwini izigulane Ukrainian lunee ntlobo senyongo leengxaki. It has a abane olihlwempu. Senyongo kwenzeka yokuqala okanye yesibini ibakala ithumba.

Ukongeza, izigulane ezikhala intlungu ukurhawuzelela. Xa ifomu febrile ezinophawu ukwanda kweqondo lobushushu emzimbeni ukusoloko, mizwa ndiyaqaqanjelwa ekhathazayo esiswini eliphezulu. Ascites livela sesihambe somhlaza, ithumba sikhatshwa iimpawu eziqhelekileyo ukunxila. imilo azixhaphakanga esiswini bukhali. Lubonakala yintlungu enkulu, izihlunu nengxabano abdominals. Option for carcinoma kuwenza hepatocellular kugcwele iimpawu namanye amalungu. Phakathi kwabo - amathambo, imiphunga, amathumbu.

iintlobo Morphological kwesibindi carcinoma

ifomu morphology yamathumba cell zilandelayo:

1. Okukhulu hepatocellular carcinoma. Kuthatha icandelo yonke okanye nomhlehlo wesibindi. Xa Imi na imida ecacileyo. Kwakhona ngaphakathi site ithumba ekhona nakujoliso olutsha ezincinane (satellites). Enye iintlobo zomhlaza isibindi esikhulu kuthathwa ukuba uhlobo esiswini. Ekwisiza ithumba somhlathi elibhaqiweyo, ngaphakathi apho kukho ulwelo omdaka. Uvuleke udonga obukhulu egudileyo.
2. carcinoma Nodular hepatocellular. Lubonakala ngokuba ezininzi nakujoliso olutsha ithumba eliqhele kulo lonke kumphezulu umzimba parenchyma.
3. Ehlasela kwesibindi carcinoma. Amaninzi ukuvela kwisiqalo ngokoma. Yonke parenchyma iqulathe iimpawu zomzimba nokuqina kunye iiseli ezingaqhelekanga.

carcinoma Fibrolamellar ibandakanya iziza omnye okanye ezimbalwa enkulu. Kwiimeko ezininzi yenzelwe nomhlehlo lasekhohlo esibindini. Umbala Ithumba - mthubi okanye oluhlaza. Enye eyahlukileyo ifomu kucingelwa ukuba zicaciswa kakuhle (amancinci), hepatic cell carcinoma. Le lubonakala ngokuba ALS elilungileyo kwaye ukukhula kade, ubungakanani Ithumba ngaphantsi kwe-5 cm ubukhulu.

Uxilongo kwesibindi hepatocellular carcinoma

Kuyimfuneko ukwenza iintlobo iimviwo phambi ukuqaphela izifo ezifana hepatocellular carcinoma. Pathology Uxilongo iqulathe izigaba ezininzi. Okokuqala, ugqirha uphulaphula zonke izikhalazo nomonde uhlola. ingqalelo ekhethekileyo ihlawulwa kwesikhumba (umbala, ubukho raschosov, legazi), iindawo nkovu, Ngokucofa kwesibindi. Xa umhlaza umzimba kwindawo benqumla, texture ashinyeneyo, zimakishwe nesisa. Emva koko, uphando. Phakathi kwabo:

1. Kla, chemistry igazi.
2. Ukulinganisa izinga amakishayo ezikhethekileyo - alpha-fetoprotein.
3. Ultrasonography ye esiswini.
4. Itomography ngekhompyutha.
5. Studies imikhumbi hepatic. Ezi ziquka angio kunye portogepatografiyu.

Uxilongo isekelwe kwiziphumo cytological kunye histological. Ukuqhuba ezi zifundo, wenza ilungu biopsy.

carcinoma Hepatocellular kwesibindi: unyango lwezifo

Selection unyango qhinga ixhomekeke morphological uhlobo kunye nobungakanani nethumba, kwaye isigaba umhlaza yenkqubo. Kumanqanaba okuqala utyando umhlaza olwenziwa, ngeminqweno emihle maqhuqhuva lengqula, ichemotherapy. Xa yamathumba kwentamo eyenziwa embolization ngayo umthambo hepatic. Oku kunceda olucothayo nokukhula yamathumba kunciphise le nqubo. carcinoma Hepatocellular kwesibindi ayikho sensitive zonyango radiotherapy. Ngaphezu koko, akukho kunqabile efanele ichemotherapy, 15-20 kuphela% ezigulane kuba nemiphumo emihle yexeshana. Enye indlela kukuthi kwesibindi abohlukeneyo. Kumazwe aphuhlileyo, le ndlela isagquba. Abohlukeneyo of a ngezitho zomzimba lwenziwa kuphela xa nisaqala zomhlaza. Phambi metastases ezikude kuthathwa kuphela indlela yokunyanga unyango nomqondiso. Oku kuquka inkathalo lokudambisa (unonophelo isigulane, nonyango lwengqondo) kunye zomzimba.

unyango zoqhaqho umhlaza wesibindi

ungenelelo kuhlinzwa kuyinto phantse zonke izigulane uxilongwe "carcinoma hepatocellular" yenziwe. Unyango lubandakanya resection kwesibindi ngaphakathi kummandla yokwakheka (ingxenye share isiqingatha body). Ukuba unit amancinci ubungakanani eyenziwa enucleation aspirator yalo ekhethekileyo. Enye indlela i utyando - a embolization percutaneous ngayo umthambo hepatic.

Eyona ndlela isebenzayo kukuba ukufakela ilungu okanye inxenye yayo. Isibindi inyama unalo ubuchule ukuntshula. Oku kunokukhokelela recovery ngokupheleleyo yesigulana.

Drug therapy nxamnye carcinoma hepatocellular

Ukongeza leziyobisi chemotherapeutic, ngokubonakalayo kusetyenziswa iqela elitsha amayeza lwamachiza - inhibitors ze kinases protein. isiphumo yabo ukunciphisa kunyebeleziso iiseli ithumba. Nangona iziphumo ebezingalindelekanga ezininzi, la machiza zisebenza kakhulu. Umzekelo iziyobisi kweli qela lo ichiza "Nexavar".

I abane of hepatocellular carcinoma

Enye nangezilonda banqande amabi iphecana zesisu igqalwa carcinoma hepatocellular kwesibindi. I abane yale ithumba kwinkoliso kwiimeko ezingaginyisi mathe. nyaka-5 High rate kusinda waphawula kuphela ukubunjwa ubungakanani ezincinane emva utyando okanye isibindi abohlukeneyo. Kudla kukho ukwenzeka nethumba kunye Ukudlulela ngokukhawuleza. Ukupheliswa inxitywe emzimbeni lelibulalayo.

Prevention of carcinoma hepatocellular

Sizikhusele kuquka yonyaka uphando kwi-hepatitis iintsholongwane, ukwalela iziyobisi kunye notywala. Kuhle ukukhumbula ukuba ukudumba kwesibindi zingafumaneka ngenxa zazo ezifana unyango lwamazinyo nobuhle, ukutofelwa igazi.