Umhlaza wesibindi - hepatocellular carcinoma

I-Hepatocellular carcinoma ngumhlaza oqala esibindini.

I-Hepatocellular carcinoma yenza ii-cancer ezininzi zesibindi. Olu hlobo lomhlaza lwenzeka rhoqo emadodeni kunabafazi. Ihlala ifunyaniswa kubantu abaneminyaka engama-50 okanye ngaphezulu.

I-Hepatocellular carcinoma ayifani nomhlaza wesibindi we-metastatic, oqala kwelinye ilungu (njengesifuba okanye ikholoni) kwaye usasazeka kwisibindi.

Kwiimeko ezininzi, unobangela wesifo somhlaza wesibindi kukulimala kwexesha elide kunye nokuqhaqha kwesibindi (i-cirrhosis). I-Cirrhosis inokubangelwa ngu:

• Ukusetyenziswa gwenxa kotywala
• Izifo ezizimeleyo zesibindi
• IHepatitis B okanye usulelo lwentsholongwane lwe-hepatitis C
• Ukudumba kwesibindi ixesha elide (okungapheliyo)
• Ukugcwala kwentsimbi emzimbeni (hemochromatosis)

Abantu abane-hepatitis B okanye i-C basemngciphekweni omkhulu womhlaza wesibindi, nokuba ngaba abakhulisi i-cirrhosis.

Iimpawu zomhlaza wesibindi zinokubandakanya oku kulandelayo:

• Intlungu yesisu okanye ukuthamba, ngakumbi kwicandelo eliphezulu lasekunene
• Ukutyumza ngokulula okanye ukopha
• Isisu esandisiweyo (ascites)
• Ikhumba eliphuzi okanye amehlo (i-jaundice)
• Ukuphulukana nobunzima obungachazwanga

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho. Uvavanyo lomzimba lunokubonisa ukwanda, isibindi sethenda okanye ezinye iimpawu zesifo sokuqina komzimba.

Ukuba umboneleli ukrokrela umhlaza wesibindi, iimvavanyo ezinoku-odolwa zibandakanya:

• Ukuskena kwe-CT esiswini
• Isiskena seMRI esiswini
• I-ultrasound yesisu
• Isibindi se-biopsy
• Uvavanyo lomsebenzi wesibindi
• Iserum alpha fetoprotein

Abanye abantu abanethuba eliphezulu lokuba nomhlaza wesibindi banokufumana uvavanyo lwegazi rhoqo kunye nee-ultrasound ukuze babone ukuba amathumba ayakhula na.

Ukuchonga ngokuchanekileyo i-hepatocellular carcinoma, kufuneka kwenziwe i-biopsy ye-tumor.

Unyango luxhomekeke ekubeni umhlaza uqhubele phambili kangakanani.

Utyando lunokwenziwa ukuba i-tumor ayisasazekanga. Ngaphambi kotyando, ithumba inokunyangwa ngekhemotherapy ukunciphisa ubungakanani bayo. Oku kwenziwa ngokunikezela iyeza ngqo esibindini ngombhobho (ityhubhu) okanye ngokulifaka ngaphakathi (nge-IV).

Ukunyanga ngemitha kwindawo yomhlaza nako kunokuba luncedo.

I-Ablation yenye indlela enokusetyenziswa. Ablate kuthetha ukutshabalalisa. Iindidi zokupheliswa kubandakanya ukusebenzisa:

• Amaza erediyo okanye ii-microwaves
• I-Ethanol (utywala) okanye i-acetic acid (iviniga)
• Ukubanda kakhulu (cryoablation)

Ukufakelwa kwesibindi kunokucetyiswa.

Ukuba umhlaza awunakususwa ngotyando okanye usasazeke ngaphandle kwesibindi, kuhlala kungekho thuba lonyango lwexesha elide. Unyango endaweni yoko lujolise ekuphuculeni nasekwandiseni ubomi bomntu. Unyango kule meko lunokusebenzisa unyango ekujoliswe kulo ngamachiza anokuthathwa njengeepilisi. Amachiza amatsha e-immunotherapy nawo anokusetyenziswa.

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lokuxhasa umhlaza. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Ukuba umhlaza awunakunyangwa ngokupheleleyo, esi sifo sihlala siyabulala. Kodwa ukusinda kuyahluka, kuxhomekeka ekubeni umhlaza uqhubele phambili kangakanani na xa kufunyaniswa isifo kwaye uphumelele kangakanani unyango.

Fowunela umboneleli wakho ukuba ukhula nentlungu esiswini, ngakumbi ukuba unembali yesifo sesibindi.

Amanyathelo othintelo abandakanya:

• Ukuthintela nokunyanga i-hepatitis yentsholongwane kunokunceda ukunciphisa umngcipheko. Ukugonywa kwabantwana ngokuchasene ne-hepatitis B kunokunciphisa umngcipheko womhlaza wesibindi kwixa elizayo.
• Musa ukusela kakhulu utywala.
• Abantu abaneentlobo ezithile ze-hemochromatosis (i-overload yentsimbi) banokufuna ukuhlolwa umhlaza wesibindi.
• Abantu abane-hepatitis B okanye i-C okanye i-cirrhosis banokucetyiswa ukuhlolwa komhlaza wesibindi.

Isibindi se-carcinoma yesibindi; Tumor - isibindi; Umhlaza - isibindi; IHepatoma

• Inkqubo yokwetyisa
• Isibindi se-biopsy
• Umhlaza we-hepatocellular-CT scan

UAbou-Alfa GK, uJarnagin W, uDika IE, et al. Umhlaza wesibindi kunye nenyongo. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahluko 77.

UDi Bisceglie AM, uBefeler AS. Iimvumba ze-hepatic kunye ne-cysts. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 96.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lokuqala lomhlaza wesibindi (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/liver/hp/dult-liver-kunyanga-pdq. Ukuhlaziywa ngo-Matshi 24, 2019. Ifikeleleke ngo-Agasti 27, 2019.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Isikhokelo sonyango se-NCCN kwi-oncology: i-hepatobiliary cancer Inguqulelo 3.2019. www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf. Ukuhlaziywa kuka-Agasti 1, 2019. Ifikeleleke ngo-Agasti 27, 2019.