Carcinoma Hepatocellular kwesibindi: Ihlahlubo, Izimpawu kanye Ukwelashwa

zomdlavuza Primary izifo isibindi awavamile. Ngokuvamile umdlavuza wendlala yabesilisa yesibili, okungukuthi metastatic. Okuxhunyanwa izimila isibindi uyalandisa holangio- futhi hepatocellular carcinoma. Lezi zomdlavuza kungakheka kunoma abesilisa phakathi kwabesifazane (akuvamile). Ezinganeni, lezi izimila Cishe ziphinde zenzeke. Ngo seziguli ezisencane zingase ukuthuthukisa nomdlavuza wesibindi, ethathwe izicubu embryonic - hepatoblastoma. Lokhu zokugula akuvamile. Cishe zonke eyinhloko izimila isibindi abhekwa nolaka. Akulesi endaweni 5th phambili yokufa umdlavuza pathologies isakhiwo. Okwamanje thina athungatha izindlela ezintsha ukuze silwe nomdlavuza wesibindi. kwentuthuko Omkhulu kufezwa ngokusebenzisa ukutholakala kanye okubhekiswe yokwelapha mzimba.

Incazelo carcinoma hepatocellular

carcinoma Hepatocellular - umdlavuza kwamaseli isibindi yavezwa atypia. Uma kuqhathaniswa namanye pathologies eyinhloko oncological yomzimba, ke luvame kakhulu. Lokhu kuwuphawu lwesimila ubizwa nangokuthi hepatic cell carcinoma. Ngo ukuvama carcinoma hepatocellular phakathi kwabantu iyona enkulu kunazo zonke 5th emhlabeni. Lokhu kuwuphawu lwesimila landile amazwe athuthukile. Libhekisela umdlavuza ngokushesha okuqhubekayo ezinzima futhi luvame ukubulala. Akukona nje uphethwe sekwedlule isifo, kodwa futhi ulaka yayo kanye nekhono iyakhula kwezinye izitho. Lokhu kungenxa isibindi perfusion.

Zonke izinhlobo umdlavuza ezisohlwini International Ukwahlukanisa Diseases (ICD). Njengezinye zokugula umdlavuza, it has ikhodi yayo ekhethekile, futhi carcinoma hepatocellular. ICD-10 isetshenziswa kuwo wonke amazwe emhlabeni. Esikhathini ngezigaba zesifo has a S22.0 ikhodi, okusho "isibindi cell carcinoma." Ngokuvamile, lokhu zokugula kwenzeka ngokumelene isizinda kwezimo ezimbi kakhulu ezingalapheki, ngaphansi kwethonya izici ezingezinhle.

Izimbangela isibindi carcinoma

Njengoba yaziwa, etiology izimila abulalayo ingakamiswa wafunda. Nokho, ososayensi baye eside wathola okuyinto izici ezenza abantu ukuthuthukiswa kuwuphawu lwesimila. Ayikho ngaphandle futhi hepatic cell carcinoma. Ukuletha kwakhe miphumela elandelayo:

1. Yesikhathi eside abathwali amagciwane athile. Kucatshangwa ukuthi pathologies ezifana kwesibindi kohlobo B no-C, kwandisa ingozi yokuba carcinoma hepatic by izikhathi ezingaphezu kuka-100. Ngaphezu kwalokho, lezi zifo ezimbi zivame asymptomatic. Ngakho-ke, ukunciphisa ingozi yomdlavuza kufanele njalo unikele ngegazi ngokusha kwesibindi amagciwane.
2. Isibindi isifo sokusha iyiphi omsakazo. Ukubuyiselwa hepatocytes ku ezicutshini ngokuvamile kwenzeka ngenxa ezingamahlalakhona igciwane lohlobo, edonsa utshwala nezidakamizwa.
3. Ukudla ukudla okune-aflatoxin.
4. yofuzo yilesi sifo.
5. Ukwamukelwa izidakamizwa hepatotoxic.

Uma Sizibeka eceleni ohlwini izici ayeke ukunisa, ingozi yokuba hepatocellular carcinoma incane. Noma kunjalo, sonke sibhekana kusukela kule lwesimila. Njengezinye zokugula umdlavuza, kunalokho kungase kubangelwe ukuchayeka ionizing emisebeni, ukubhema, ukudla okungenamsoco, ukucindezeleka, nokunye. D.

I pathogenesis ka carcinoma hepatocellular

Ngenxa yalokho, amangqamuzana ukuvuvukala ezingamahlalakhona ezivamile isibindi uqale aguqule ibe izakhi lwesimila. Yini kahle hle kuholela yokulibiza ayaziwa. Ngenxa isenzo igciwane ijwabu isibindi abavusa, umzimba iba edematous, futhi kabuhlungu. semithambo permeability inyuka, ziba-ngesihluku egcwele. Ngenxa yalokho, umsebenzi isibindi kuphazamisekile. Ngaphandle kweqiniso lokuthi umzimba ukubhubhisa izinhlayiya viral, isithinta nezinye izinto eziyingozi ivela ukudla. Konke lokhu kuholela cell ukuguqulwa. Ikhenela ikhula ubukhulu, cytoplasm nezinye organelles udlulele ukuba azungeze. Ngemva kwalokho, ingqamuzana iqala ukwehlukana unmotivated. It uthola sebuningini nuclei, hepatocyte umzimba i-. Kuseli, isimila siqala synthesize amaprotheni ukuthi zanda ngokushesha ngemithambo yegazi. oxhumene Ngakho-Hepatitis C no Hepatocellular carcinoma.

Kufanele kukhunjulwe ukuthi iyisifo viral cishe njalo kungaholela isifo sokusha kwesibindi noma umdlavuza. Ezimweni eziningi, isivele kutholakala ukuthi uphethwe yini lapho kuphakama izinkinga ezingase zivele. Enye igama hepatitis C - "umbulali ithenda". Lokhu kungenxa ukungabi okuphelele ukubonakaliswa emitholampilo ye isifo iminyaka eminingi, futhi ukufa okuseduze ngenxa ukuqedwa ukusebenza isibindi.

Ukwahlukanisa carcinoma hepatocellular

Hepatocellular carcinoma isibindi ihlukaniswe izinhlobo emitholampilo morphological eziningana. Ngaphezu kwalokho, isimila libhekwa ngokuvumelana komqondo nezinga lokukhula kwengane kanye degree of kobukhulu. Kuye macroscopic isithombe engeyokuqala isehlane, omkhulu kanye namafomu ehlasela umzimba ka nomdlavuza wesibindi. Kubhekwe kohlobo ahlukene hepatocellular fibrolamellar carcinoma. Ngokwalesi sithombe emitholampilo kukhona 6 izinhlobo isibindi cell carcinoma. Phakathi kwabo:

1. inketho Gepatomegalichesky.
2. ifomu Icteric.
3. samuntu Febrile of nomdlavuza wesibindi.
4. ifomu ascites.
5. inketho olunamandla besisu.
6. Metastatic nomdlavuza wesibindi.

Ngokuvamile kukhona inhlanganisela ezahlukeneyo emitholampilo eziningana. Isiteji umdlavuza Isibindi-cell incike ubukhulu yesimila nekwenteka yayo eseduze lymph node kanye nezinye izitho.

carcinoma Hepatocellular: izimpawu

Izimpawu zincike ifomu basemtholampilo carcinoma. Ezimweni eziningi, lapho kusaqalwa umdlavuza asinazo izimpawu. Ngaphezu kwalokho, ukuxilongwa kunzima ngenxa yokuthi ukuthi izimpawu isimila zifane isithombe basemtholampilo nezinye isifo sesibindi (ukusha kwesibindi kohlobo okungamahlalakhona, isifo sokusha). Ngu umdlavuza ngasekupheleni ukubonakaliswa zihlanganisa ongaphakeme-ebangeni imfiva, ukungakuthandi ukudla, ubuthakathaka, lymphadenopathy, kwesisindo. Lapho gepatomegalicheskoy uhlobo carcinoma banda olukhulu endleleni kwesibindi, ubuhlungu hypochondrium kwesokudla. Okukodwa iziguli jaundice ezahlukeneyo zokugula. It has a Izibikezelo abampofu. Jaundice kwenzeka esigabeni sokuqala noma sesibili ka lwesimila.

Ngaphezu kwalokho, iziguli esekhala ubuhlungu kanye ukulunywa. Lapho ifomu febrile ezinophawu ukwanda izinga lokushisa emzimbeni njalo, ezingemnandi ngiyaqaqanjelwa emizweni esiswini engenhla. Ascites ivela izigaba eziseqophelweni umdlavuza, isimila kuhambisana izimpawu ezivamile zokudakwa. Ngaphansi ezivamile acute ukuma besisu. It libhekene sebuhlungwini obunzima, imisipha ukungezwani abdominals. Inketho for metastatic carcinoma hepatocellular ubuswa izimpawu nezinye izitho. Phakathi kwabo - amathambo, emaphashini, amathumbu.

amafomu morphological isibindi carcinoma

ifomu morphology izimila secrete ezilandelayo:

1. Massive carcinoma hepatocellular. Kuthatha lonke ingxenye noma Lobe kwesibindi. Lapho Imi has imingcele ecacile. Futhi foci ezincane (iziphuphutheki) kungaba samanje ngaphakathi isayithi lwesimila. Omunye izinhlobonhlobo omkhulu nomdlavuza wesibindi ubhekwa uhlobo besisu. Ngezinye Sectional Kutholwe isimila site, ngaphakathi okuyinto kukhona uketshezi onsundu. Cavity odongeni obukhulu futhi abushelelezi.
2. Nodular carcinoma hepatocellular. Elinesimo sebuningini isimila foci asezindaweni ezikahle kulo lonke ebusweni parenchyma umzimba.
3. Ehlasela umzimba Isibindi carcinoma. Ngokuvamile eba ku ngemuva ngokoma kwesibindi. Zonke parenchyma siqukethe le izakhi zezicubu zezinzwa futhi amaseli angavamile.

carcinoma Fibrolamellar siqukethe eyodwa noma amasayithi amakhulu ambalwa. Ezimweni eziningi itholakala namanoni aphezu kwesokunxele isibindi. Umbala isimila - ophuzi noma oluhlaza. Olunye uhlobo ahlukene kubhekwa encapsulated (ezincane), hepatic cell carcinoma. It libhekene a Izibikezelo evumayo nangenkathi ukukhula kancane, usayizi Ithumba esingaphansi 5 cm ububanzi.

Ukuxilongwa isibindi hepatocellular carcinoma

Kuyadingeka ukwenza ezihlukahlukene izivivinyo ngaphambi ukuhlonza izifo ezifana hepatocellular carcinoma. Pathology Sifo unezigaba eziningana. Okokuqala, udokotela uyilalela yonke izikhalazo nesineke futhi uhlola. Ngokukhethekile ikhokhelwa kuze esikhunjeni (umbala, khona raschosov, ukopha), izindlala zamanzi, palpation kwesibindi. Ngo umdlavuza yomzimba has a ebusweni esingemnandi, ukuthungwa obukhulu, imakwe ngesisa. Ngemva kwalokho, eziningi survey. Phakathi kwabo:

1. Kla, igazi kwamakhemikhali.
2. Icacisa ezingeni izimpawu ezikhethekile --alpha-fetoprotein.
3. Ultrasonography esiswini.
4. computed tomography.
5. Izifundo izitsha hepatic. Lezi zihlanganisa angio futhi portogepatografiyu.

Sifo kusekelwe okutholakele cytological futhi histological. Ukuze siqhube lezi zifundo, wenziwa isitho biopsy.

carcinoma Hepatocellular kwesibindi: ekwelapheni izifo

Isu ukwelashwa Ukukhethwa incike ifomu morphological kanye nosayizi yesimila, futhi isigaba ohlelweni umdlavuza. Ezigabeni kokuqala ezohlinzwa ngenxa yokuthi wayenomdlavuza kwenziwa, isifiso yendlala Izigaxana, ngelashwa nangemithi. Ngo izimila ehlasela umzimba kwenziwa embolization ka Umthambo hepatic. Lokhu kusiza ukuthi lihambe kancane ukukhula izimila kanye nomkhawulo inqubo. carcinoma Hepatocellular kwesibindi ingazikhathaleli radiotherapy ukwelashwa. Ngaphezu kwalokho, kuyaqabukela amenable ukuba chemotherapy% 15-20 kuphela eziguli nethonya elihle yesikhashana. Enye indlela esiyishisekela ngayo isibindi ukufakelwa. Emazweni athuthukile le ndlela kuyinto ejwayelekile. Ukufakelwa of isitho donor uqhutshwa kuphela kusaqalwa umdlavuza. Ephambi kwezinduna metastases ezikude kubhekwa indlela kuphela ukwelapha yokwelapha lingaze. Kubandakanya ukunakekelwa okuthuthukisa (ukunakekelwa isiguli, ukwelashwa kwengqondo) futhi izinzwa.

ukwelashwa Steel of nomdlavuza wesibindi

kokungenela Steel Kwenziwa cishe zonke iziguli ukuthi nginesifo "carcinoma hepatocellular". Le nqubo yokwelapha ihlanganisa isibindi resection ngaphakathi esifundeni yokwakheka (ingxenye Nenxenye umzimba). Uma iyunithi wosayizi omncane kwenziwa enucleation yayo aspirator ekhethekile. Enye indlela ukuhlinzwa - a embolization percutaneous ka Umthambo hepatic.

Indlela ephumelela kunazo iwukuba kabusha isitho noma ingxenye yayo. Izicubu isibindi unekhono sikhiqize. Lokhu kungaphumela ekululameni kwesiguli egcwele.

ukwelashwa ngokumelene carcinoma hepatocellular

Ngaphezu izidakamizwa chemotherapeutic, ngenkuthalo esetshenziswa iqembu elisha kwemithi izidakamizwa - inhibitor wamaprotheni kinases. umphumela wabo ukunciphisa ekwandeni isimila cells. Naphezu eminingi engemihle, le mithi ziyasebenza ngempela. Isibonelo izidakamizwa kuleli qembu Isidakamizwa "Nexavar".

Onalesi sifo ka carcinoma hepatocellular

Omunye enolaka izimila abulalayo pheshana emathunjini kubhekwa carcinoma hepatocellular kwesibindi. Onalesi sifo salokhu isimila ezimweni eziningi ezingezinhle. High engu-5 izinga lokusinda siyenzeka kuphela osayizi ezincane kumiswa emva kokuhlinzwa noma isibindi ukufakelwa. Ngokuvamile kukhona yokuphindela isimila nendlala okuthiwa i Ukudlulela okusheshayo. ukusebenza Ukunqanyulwa umzimba liyabulala.

Ukuvimbela carcinoma hepatocellular

Izinyathelo ufaka inhlolovo yonyaka ngokusha kwesibindi amagciwane, uyaphika izidakamizwa notshwala. Kubalulekile nokukhumbula ukuthi ukuvuvukala isibindi angatholakala ngenxa manipulations ezifana zamazinyo beauty zokwelapha, ukumpontshelwa igazi.