Pali magulu awiri akuluakulu a khansa ya m'mapapo: "khansa yaying'ono ya m'mapapo" yolumikizidwa kwambiri ndi kusuta fodya komanso "khansa ya m'mapapo yosakhala yaying'ono", makamaka yomwe imakhala ndi adenocarcinomas (yochokera ku maselo a glandular a bronchi).

Adenocarcinoma ndi mtundu wodziwika kwambiri wa 'non-small cell lung cancer' (NSCLC). Imakula m'madera ozungulira m'mapapo, makamaka kumtunda kwa lobes ndi pafupi ndi pleura. Zochitika zake zakhala zikuwonjezeka kwa zaka pafupifupi 10. 

Mitundu yosiyanasiyana ya adenocarcinoma

Adenocarcinomas imatha kusiyanasiyana kukula komanso momwe imakulirakulira. Pali mitundu iwiri ya histologically:

• acinar adenocarcinoma ikatenga mawonekedwe a thumba laling'ono;
• papillary adenocarcinoma, pamene maselo amasonyeza protrusions mu mawonekedwe a chala magolovesi.

Pulmonary adenocarcinoma

Mapapo adenocarcinoma amakhudza makamaka osuta. Koma ndiyonso khansa ya m’mapapo yofala kwambiri mwa amayi komanso mwa osasuta.

Ndiye chifukwa chachikulu cha imfa (zoyambitsa zonse) mwa amuna azaka zapakati pa 45 ndi 64 ku France, malinga ndi Haute Autorité de Santé (HAS).

Kusuta fodya ndizomwe zimayambitsa khansa yamtundu wotere. Koma osati kokha. Dr Nicola Santelmo, Dokotala wa Opaleshoni ya Thoracic ku Clinique Rhéna ku Strasbourg akufotokoza motero Dr. Mankhwala opangidwa ndi mankhwala (monga asbestos, arsenic, nickel, tar, etc.) nthawi zambiri omwe amapezeka pamagulu otsika kuntchito azindikiridwa ndi International Agency for Research against Cancer monga pulmonary carcinogens kwa mwamuna.

Zikuonekanso kuti magwero ena a kuipitsidwa kwa chilengedwe, pamlingo wocheperapo, ali pachiwopsezo cha khansa ya m'mapapo, monga kuipitsa mpweya ndi radon).

Zizindikiro za pulmonary adenocarcinoma nthawi zambiri zimakhala mochedwa chifukwa sizimayambitsa kupweteka kwenikweni. Chotupacho chikakula, chingayambitse zizindikiro monga:

• chifuwa kapena kupuma movutikira ngati kukakamiza pa bronchi;
• sputum wamagazi (sputum);
• kuonda kosadziwika.

"Lero, komabe, chifukwa cha kuchulukirachulukira kwa makina ojambulira powunika odwala omwe amasuta, titha kudziwa kuti ali ndi khansa m'magawo oyambilira, ndikuwonetsa bwino kwambiri", akutsimikizira dokotalayo.

Pakufunika mayeso angapo kuti atsimikizire kuti ali ndi khansa ya m'mapapo.

Zithunzi

Kujambula ndikofunikira kuti muwone kukula kwa matendawa:

• CT scan "yathunthu" (chigaza, thorax, mimba ndi chiuno) ndi jekeseni wosiyana ngati sichitsutsana, imapereka chidziwitso cha mawonekedwe ndi kukula kwa khansa iliyonse.

The biopsy

Ngati mayeso a radiological akuwonetsa khansa ya m'mapapo, ndikofunikira kutenga chitsanzo cha chotupacho, pogwiritsa ntchito biopsy, kuti mupeze umboni wa histological kapena cytological. Zitsanzo za minofu imeneyi nthawi zambiri zimachitika ndi endoscopy kapena ndi puncture pansi pa scanner. Nthawi zina, opaleshoni iyenera kuchitidwa kuti atenge chitsanzo ichi: biopsy ya lymph node kapena misa m'mapapo.

Bronchial fibroscope

"Endoscopy ya bronchial ingakhalenso yofunikira, makamaka ngati chotupacho chimachokera ku bronchus. Zitha kufunikiranso kupeza chitsanzo cha chotupacho kapena cha lymph node kuti mumalize kuwunika ".

Kuwunika kumapangitsa kuti athe kudziwa gawo la matendawa, poganizira kukula ndi malo a chotupacho ("T"), kukhalapo ndi malo a lymph nodes ("N") ndi kukhalapo kapena ayi "metastases" ndi zotupa zakutali za m'mapapo ("M"). Awiri mwa atatu aliwonse ang'onoang'ono a cell bronchial carcinomas amapezeka pamlingo wa metastatic.

Kuwunika kwa kupuma ndi ntchito ya mtima

Potsirizira pake, kuunika kwa kupuma ndi ntchito ya mtima ndikofunikira kuti mudziwe ngati chithandizo cha opaleshoni kapena chemotherapy ndi chotheka ndi chiopsezo chochepa cha zovuta.

“Kudziŵika kwake kumadalira pa siteji ya khansayo ndi chithandizo chimene chingaganizidwe,” anatero katswiriyo. Zimasiyana pakati pa zosakwana 10% pazaka 5 m'magawo apamwamba kwambiri ndi 92% pazaka 5 m'magawo oyambirira. Choncho, kufunikira kozindikira matenda msanga ndi kwakukulu! Kuphatikiza apo, mwa odwala onse omwe amachitidwa opaleshoni (magawo onse ophatikizidwa) wodwala 1 mwa 2 ali ndi moyo patatha zaka zisanu ”.

The mankhwala akhazikitsidwa zimadalira histological mtundu wa khansa, siteji yake (ndiko kunena mlingo wake wowonjezera), mkhalidwe wonse wa thanzi la wodwalayo, ndi chigamulo chotengedwa collegially ndi multidisciplinary gulu lachipatala kubweretsa pamodzi pulmonologist, opaleshoni, radiotherapist. , radiologist, dokotala wa nyukiliya ndi katswiri wa matenda.

Cholinga cha kukonza

Cholinga cha chithandizo ndi:

• kuchotsa chotupa kapena metastases;
• kuwongolera kufalikira kwa pulmonary adenocarcinoma;
• kupewa kubwereza;
• samalirani zizindikiro.

Mankhwala osiyanasiyana

Pali mitundu ingapo ya chithandizo cha pulmonary adenocarcinoma:

• opaleshoni ya resection, kuchotsa chotupa chonsecho, kuphatikiza ndi chemotherapy, opaleshoni isanayambe kapena itatha
• radiotherapy yokha,
• chemotherapy yokha,
• chemotherapy ndi radiotherapy,
• radiofrequency kapena stereotaxic radiotherapy yomwe imafanana ndi kuwala koyang'ana kwambiri chotupa cha m'mapapo,
• mankhwala ena amthupi (immunotherapy ndi / kapena njira zochizira).

"Njira zochitira opaleshoni masiku ano zikuchulukirachulukira ndikulinganizidwa potengera mayeso asanachitike opaleshoni ndipo zitha kukhala ndi segmentectomy kapena pulmonary lobectomies (kuphatikizapo mbali zofunika kwambiri za mapapo)", akumaliza Dr Santelmo.