Carcinoid syndrome: zizindikiro, matenda ndi mankhwala

ziwerengero Medical bwanji kuti chiwerengero cha khansa wakhala likunena likutuluka. zakambidwa Dzitetezeni ku kunadetsa analembedwa chaka chilichonse. Zimenezi ndi onse kwambiri vuto ndi amachititsa madokotala kuchita ntchito njira pakati anthu kuti azisunga pang'ono aukali kukula mopanda.

Carcinoid syndrome: ndichiyani?

Carcinoid - ichi ndi chotupa ambiri maselo a dongosolo neuroendocrine. Maselo amenewa akhoza kukhala chiwalo chilichonse ndipo zimakhala. Ntchito yawo yaikulu - kukhala mapuloteni kwambiri yogwira. Za makumi asanu ndi atatu pa zana a carcinoids zonse zili thirakiti m'mimba, mu malo chachiwiri ndi mapapo. Zambiri kawirikawiri peresenti asanu okha milandu, zotupa zimapezeka ziwalo zina ndi zimakhala.

Carcinoid syndrome ndi carcinoid chotupa sangakhoze anapatukana, monga matenda - akonzedwa zizindikiro amene amapezeka maziko a kukula ndi ntchito ya chotupa chija. Ndipotu, thupi sagwirizana kulowa mahomoni magazi tochoka ndi chotupa cha. matumbo carcinoids angakhale "wosalankhula" mwachitsanzo, si kuonekera mpaka nthawi imeneyi mpaka pali metastases ndi matenda sizimapita mu gawo osachiritsika.

zifukwa

Akufufuza osati mfundo zokwanira kumvetsa chifukwa chake kukhala carcinoid syndrome ndi carcinoid chotupa. Asayansi angathe kumanga malingaliro za etiology matenda, koma zonse zimagwirizana pa mfundo yakuti chitetezo cha m'thupi panthawi ina ikutha kuzindikira mutated maselo APUD system (ndi acronym makalata woyamba mawu "Amen," "kuloŵedwa", "kuloŵerera", "decarboxylation" ).

A khansa Gawo limodzi kuti mwa Kutacha wathunthu kukula latsopano kuti udzabala mahomoni ndi kusintha kuti zigwirizane ndi zosowa zanu njira zonse amuzolengedwa mu thupi la munthu.

pathogenesis

Kodi angathe syndrome carcinoid? Kodi izo ndi momwe mungapewere izo? Popeza kuti neuroendocrine maselo ili thupi lonse, ndi mawonetseredwe matenda a chotupa pafupifupi sasiya ndondomeko, madokotala sangathe.

Panthawi ina selo ndi "Kulephera" DNA amene anachira kapena molakwa lidakali ndi mpukutu kuonongeka. Zimenezi zimabweretsa kusokoneza selo ntchito ndi kugawikana ake kusalankhula. Ngati thupi wathanzi, chitetezo cha m'thupi angachite kuti kusintha ndi kuchotsa chinthu zolakwika. Ngati izi sizichitika, ndiye khungu ndidzachulukitsa, adzalenga Mabaibulo ndi kuyamba inafikira poizoni thupi ndi mahomoni.

Madokotala amakonda kulephera kuzindikira malo chotupa, ngakhale syndrome symptomatic carcinoid.

Carcinoma ya phapo

Only chakhumi milandu mu dongosolo kupuma angathe kutupa ndipo, chotero, carcinoid syndrome. Zizindikiro mu phapo adzakhala si yeniyeni, ndi zina ayi konse. Ichi ndi chifukwa kukula ochepa a zotupa ndi pakalibe metastasis. Odwala kupempha thandizo kuchokera matenda patsogolo ndi, monga ulamuliro, osati oncologist, ndi oyamba madokotala a. Iye akanakhoza anali anavutika kuchitira bronchiolitis, mphumu kapena kulephera kupuma, kufikira kukhalapo amaganiziridwa ndondomeko khansa.

Zizindikiro mu nkhani iyi ndi atypical:

• palpitations, palpitations;
• dyspepsia;
• kumamverera kutentha ndi liwiro la magazi kwa theka chapamwamba wa thupi;
• kutsokomola, kufupika kwa mpweya;
• bronchospasm.

Ndi ya matenda Sitinganene kuti amaganiziridwa carcinoid. No wakuta, kwambiri kuwonda, kuchepetsa chitetezo chokwanira, kutopa ndi zizindikiro zina khalidwe la ndondomeko khansa.

ang'ono matumbo chotupa

Mu intestine yaing'ono pang'ono kambirimbiri kuposa mu phapo, chotupa cha inalembedwa ndi m'munsili carcinoid matenda ake. Zizindikiro za izo zikusoŵa kwambiri. Nthawi zambiri pali kokha si yeniyeni ululu m'mimba. Ichi ndi chifukwa kukula ka chotupa cha. Nthawi zina sikutheka kupeza ngakhale pa ntchito. Education zimachitika mwangozi pa Kupenda radiological.

Pafupi khumi okha peresenti ya zotupa zonse za m'mimba wamng'ono wa etiology ya chifukwa cha matenda carcinoid. Kwa dotolo, izi zikutanthauza kuti ndondomeko wakhala zilonda ndi kufalitsa chiwindi. zotupa izi zingathe kudzetsa obturation wa lumen wa intestine ndi zotsatira zake, matumbo kutsekeka. Wodwala akubwera ku chipatala ndi zowawa za pobereka ngati, nseru, kusanza ndi matenda a mpando. Ndi operewera adzadziwa okha pa tebulo ya opareshoni.

Kutsekeka choncho chifukwa mwachindunji chotupa kukula ndi torsion intestine chifukwa zochitika za fibrosis ndi kutupa nembanemba mucous. Nthawi zina mabala kusokoneza otaya magazi kwa matumbo dera, imbaenda necrosis ndi peritonitis. Aliyense wa zinthu izi ndi moyo pachiswe alandire imfa ya wodwala.

A chotupa cha kumapeto

Zotupa za kumapeto - zosayembekezereka osowa yokha. Pakati pawo carcinoids zatenga yolemekezeka choyamba, koma nkomwe chifukwa syndrome carcinoid. Zizindikiro zawo patalipatali kwambiri. Monga ulamuliro, ndi zomwe anapeza pathologists pambuyo appendectomy. Kutupa kukula ndi centimeter osachepera limodzi ndi khalidwe kwambiri "chete". N'zotheka kuti pambuyo kuchotsa chotupa cha kumapeto limapezeka m'malo ena, wooneka.

Koma ngati chotupa anali wapezeka mu masentimita awiri kukula, ndi zina zambiri, muyenera kukhala osamala wa metastasis mu mfundo m'dera lymph ndi kufalitsa maselo chotupa mu ziwalo zina. Wamba appendectomy mu Zikatero sangathe kulimbana ndi screenings onse ndipo adzakhala ndi kukopa oncologists kuchititsa mankhwala mabuku.

Thumbo zotupa carcinoid

kutanthauzira wina, imene pafupifupi osati anasonyeza matenda carcinoid. Palibe zizindikiro za chotupa ndipo mwangozi anapeza njira yodziwira ngati colonoscopy kapena sigmoidoscopy.

Mwina chotupa chija (chotupa chija), ndi maonekedwe a metastases lakutali zimadalira kukula chotupa cha. Ngati ndi wamkulu kuposa awiri a masentimita awiri, chiopsezo cha matenda oyamba ndi za makumi asanu ndi atatu peresenti. Ngati chotupa sationanso mpaka centimeter wina awiri, mukhoza onetsetsani kuti nainte-eyiti, palibe metastasis.

Choncho, kufupi ndi mankhwala mu milandu awiri osiyana. A chotupa zochepa kuchotsedwa zambiri ndalama resection ya m'matumbo, ndipo ngati pali zizindikiro za chotupa chija, izo inafunika kuchotsedwa kwa m'matumbo lonse, komanso mankhwala amphamvu.

muzituluka carcinoid

Pali mitundu itatu carcinoid zotupa m'mimba, kuchititsa matenda carcinoid. The mbali yoyamba ya zotupa:

• miyeso ang'onoang'ono (mpaka 1 cm);
• chosaopsa Inde.

Zotheka kufala kwa chotupa kovuta pamene ndondomeko likuthandiza m'mimba lonse. Iwo ali oyanjana ndi magazi m'thupi pertsinoznoy kapena gastritis aakulu wodwalayo. Mankhwala a zotupa amenewa ndi kulandira somatostatin chopinga wa yopanga gastrin kapena gastrectomy.

Mtundu wachiwiri chotupa limakula pang'onopang'ono, kawirikawiri kukhala khansa. Iwo zofala odwala matenda ndi chibadwa monga neoplasia angapo endocrine. Usadabwe osati m'mimba, koma England pineal, chithokomiro England, kapamba.

Mtundu wachitatu chotupa - ndi zotupa zazikulu kukula m'mimba wathanzi. Iwo zilonda, mkatikati zakuya kukhoma thupi ndi kupereka metastases angapo. Zikhoza perforation ndi magazi.

Zotupa ya m'matumbo

M'mimba - ndi malo amene anthu amakonda matenda carcinoid syndrome ndi carcinoid chotupa. Photo mucosa pa mosamala matumbo gawo limasonyeza pamaso pa lalikulu (masentimita asanu kapena kuposa) zotupa. Iwo metastasize kuti mfundo dera lymph ndi nthawi yoopsa.

Oncologists mu Zikatero akulangizidwa opaleshoni kwakukulu ndi adjuvant ndi neoadjuvant Morning kukwaniritsa zotsatira bwino. Koma kupulumuka madokotala ananena zawo odwala awa akadali zovuta.

Carcinoid Syndrome: Zizindikiro, zithunzi

The kuwonekera kwa matenda carcinoid kumatengera zinthu ndi yotengedwa chotupa. Zimenezi zingakhale serotonin, bradykinin, histamine kapena chromogranin A. Zizindikiro kwambiri mmene matendawa ndi:

• Redness a nkhope ndi thupi chapamwamba. Zimachitika pafupifupi odwala onse. Limodzi ndi kuwonjezeka m'deralo kutentha. Kuukira zimachitika zokha, iwo akhoza zidzayambike ndi mowa, maganizo kapena thupi. Pankhaniyi, pali tachycardia, kuthamanga akutsikira.
• Kukhumudwa mpando. ¾ pano odwala. Childs, izi zimachitika chifukwa mkwiyo wa Kakhungu mucous wa kapepalako m'mimba, matenda a matumbo kutsekeka.
• Kusokonezeka kwa mtima ndi chibadidwe theka la odwala. syndrome Carcinoid amalimbikitsa mapangidwe mtima vavu stenosis ndipo amachititsa kulephera mtima.
• Wheezing mu mapapo ndi chifukwa kuphipha wa bronchi ndi.
• ululu m'mimba amagwirizana ndi zikamera wa metastases mu chiwindi, kutsekeka m'matumbo, kapena kuwukira chotupa mu ziwalo zina.

Carcinoid mavuto - chikhalidwe kuti amakhala ndi dontho lakuthwa mu kuthamanga pa opaleshoni. Choncho, odwala kutumikiridwa somatostatin kuti mwai ofanana.

diagnostics

Kodi n'zotheka kudziwa syndrome carcinoid? Zizindikiro, photos, anthuwo chithandizo zizindikiro sapereka bwino matenda chithunzi, palibe zotsatira kuwoneka. Nthawi zambiri chotupa - mwangozi kupeza dokotala kapena radiologist. Pofuna kutsimikizira pamaso pa zotupa, m'pofunika kuchita biopsy wa zinkakhala m'dera ndi kufufuza minofu.

Iwe ukhoza ntchito mayeso kudziwa milingo okwera mahomoni, koma deta zimenezi zingakhale zimasonyeza matenda ena, ndipo dokotala ayenera kulingalira zomwe iwo ali kuchita. Mayeso yodziwika bwino ndi chiwerengero cha asidi 5-hydroxyindoleacetic. Ngati mlingo wake ndi kuchuluka, Mwina carcinoid - pafupifupi 90%.

Morning

Chiyani tinganene kuchitira mankhwala amphamvu-carcinoid syndrome? Zizindikiro, chithunzi mucosa pa EGD biopsy dera lymph mfundo ndi kusintha m'thupi amapereka dokotala chithunzithunzi cha mavuto amene amayambitsidwa ndi mtima pamaso pa chotupa. Ngati Mapa ndi akumane wodwala ngakhale kuchotsa chotupa cha, akatswiri amalangiza amachita mankhwala amphamvu.

Nthawi zambiri, madokotala ntchito atumiki cytotoxic kuti ziletsa kukula ndi chitukuko cha zotupa. Koma chifukwa cha kuchuluka kwa mphamvu ya njira imeneyi tikulimbikitsidwa yekha vuto la mwadzidzidzi. Kuwonjezera nchito zake - 40%.

mankhwala symptomatic

Pali maganizo omangika amene asunga pa maziko a pathologies monga syndrome carcinoid, carcinoid chotupa. Zizindikiro amakhala umafananirako mtundu wa timadzi kuti akumasula chotupa. Ngati izi serotonin, wodwalayo akuchipatala antidepressants. Ngati chachikulu "akagwiriridwa" ndi histamine nkubwera patsogolo blockers histamine zolandilira mu mankhwala.

analogues kupanga a somatostatin apezeka, kuchepetsa zizindikiro ndi pafupifupi 90%. Iwo ziletsa ulimi wa mahomoni angapo kuti ali ndi udindo malo awo kotheratu zochizira matenda.

mankhwala ntchito

Sitepe lofunika mankhwala ndi kuchotsa chotupa m'thupi, ndi kufufuza metastases resected, mtsempha wamagazi chiwindi ligation.

Pa voliyumu ya opaleshoni zimakhudza malo ndi kukula kwa zotupa, ndi kukhalapo kapena kusapezeka kwa metastases. Nthawi zambiri, madokotala kuchotsa mbali matenda a thupi, ndi phukusi la mfundo dera lymph. Monga ulamuliro, ndi kokwanira kuti adzapulumutsa anthu carcinoid muyaya. Nthawi zamakono, pamene mankhwala umathandizanso sizingatheke mtima wa akuitanidwa amathera embolization a mtsempha wamagazi ndi kwa chiwindi kuchotsa zizindikiro za matenda.

kaonedwe

Kodi mungayembekezere odwala matenda ndi matenda carcinoid ndi carcinoid chotupa? Ankatenthetsa, palpitations ndi chifundo cha breathlessness, zikuoneka kuti akhale nawo mpaka mapeto a moyo, koma adzakhala zochepa kutchulidwa mankhwala.

Medicine, pali milandu kumene odwala anakhalako zaka zoposa khumi pambuyo opaleshoni, ndi mankhwala symptomatic. Koma moyo wawo pafupifupi wamasiku za 5-10 zaka. Kuti madokotala ananena zawo koipa ndi chotupa ili mu phapo, ndi bwino - kumapeto.