Mesothelium ndi nembanemba yomwe imalumikiza ziwalo zambiri zamkati kuti zitseke ndi kuziteteza. Amapangidwa ndi zigawo ziwiri za cell flattened, imodzi yomwe, mkati mwake, imaphimba ziwalo zosiyanasiyana monga mapapo, mtima ndi m'mimba, ndipo chachiwiri, chakunja, chimapanga mtundu wa thumba lozungulira mkati. . Madzi amadzimadzi amapezeka pakati pa zigawo ziwiri za maselo, zomwe zimathandizira kuyenda kwa ziwalo.

Ma mesothelium nthawi zina amatha kukhudzidwa ndi zotupa zoyipa, ndipo nthawi zambiri, khansa yotchedwa mesotheliomas. Ndiye mu pleura kuti imakhala kawirikawiri, ndiko kunena kuti mesothelium yomwe imaphimba mapapo; Nthawi zambiri, zimachitika chifukwa cha kukhudzana ndi asibesitosi. Koma vutoli likadali losowa kwambiri, pali, malinga ndi ziwerengero za High Authority for Health, 600 mpaka 900 milandu yatsopano yomwe imadziwika chaka chilichonse ku France.

Mesothelium imapangidwa ndi zigawo ziwiri za cell flattened zomwe zimatchedwa mesothelial cell. Pakati pa zigawo ziwirizi pali madzi. Mesothelium imayika mkati mwa minyewa yosalala ya thupi la munthu (yotchedwa serous nembanemba). Chifukwa chake, zigawo ziwiri zama cell izi zimateteza thorax, pamimba kapena mtima.

Mesothelium ili ndi mayina osiyanasiyana kutengera komwe ili m'thupi: ponena za mapapu ndi pleura, nembanemba yomwe imaphimba pamimba, pelvis kapena viscera imatchedwa peritoneum, ndipo pamapeto pake mesothelium yomwe imateteza mtima imatchedwa pericardium (pericardium imaphimbanso chiyambi cha ziwiya zazikulu).

Madzi omwe amapezeka pakati pa zigawo ziwiri za mesothelium amathandiza kuti ziwalo ziyende bwino. M’kati mwake, mkati mwake mumakuta ziwalozo, pamene kunja kwake kumapanga thumba lozungulira mkati mwake.

Ntchito yayikulu ya epithelium ndikuteteza ziwalo zamkati zomwe zimaphimba:

• mesothelium yomwe imazungulira mapapo imatchedwa pleura: motero imasonyeza makhalidwe a epithelial lining cells. Koma imakhalanso ndi mphamvu yotulutsa maselo: imatulutsa, makamaka, ma cytokines komanso zinthu zomwe zimakula. Kuphatikiza apo, kufalikira kwa mitsempha yamagazi komanso kusuntha kwamadzimadzi kumalumikizidwa kuzinthu zina za pleura. Izi zimaphatikizapo, makamaka, pores pamlingo wa parietal pleura, zomwe zimalola kuti mitsempha ya mitsempha igwirizane ndi malo ozungulira;
• peritoneum ndi mesothelium yeniyeni ya pamimba. Peritoneum iyi iyenera, kwenikweni, kuwonedwa ngati chiwalo. Kapangidwe kake kamafotokoza makamaka kayendedwe ka peritoneal fluid, injini yake yayikulu yomwe ndi diaphragm yoyenera. Kuphatikiza apo, nembanemba ya peritoneal imakhalanso malo ofunikira osinthira. Pomaliza, zikuwonekeranso kuti nembanemba iyi ilinso ndi machitidwe ambiri ammunological;
• Pericardium, yomwe ndi mesothelium yozungulira mtima, imakhala ndi ntchito yosamalira myocardium, komanso kulola kuti igwedezeke panthawi ya kugunda kwake.

Maselo a mesothelium nthawi zina amatha kusintha momwe amakulira kapena kuchita molakwika:

• izi nthawi zina zimayambitsa mapangidwe otchedwa sanali khansa zotupa, choncho amayamba: mwachitsanzo, fibrous chotupa cha pleura, kapena chimene chimatchedwa multcystic mesothelioma;
• palinso khansa ya mesothelium, koma ndi khansa yosowa kwambiri: milandu 600 mpaka 900 yokha imawerengedwa chaka chilichonse ku France. Ndi mkati mwa pleura yomwe imapezeka kawirikawiri, popeza 90% ya masothelioma yowopsya imakhudza pleura iyi, kutenga dzina la pleural mesothelioma. Izi zowopsa za mesothelioma, nthawi zambiri, zimayamba chifukwa cha kukhudzana ndi asibesitosi. Pafupifupi 70% ya milandu ya pleural mesothelioma imapezeka mwa anthu. M'malo mwake, gawo lodziwika bwino la mesothelioma chifukwa chokhudzidwa ndi asibesitosi likuyerekezeredwa kukhala 83% mwa amuna ndi 38% mwa akazi, malinga ndi ziwerengero za Haute Autorité de Santé (HAS). Kuonjezera apo, mgwirizano wa zotsatira za mlingo wasonyezedwa;
• Nthawi zambiri, pafupifupi 10%, khansa iyi imathanso kukhudza peritoneum, ndipo imatchedwa peritoneal mesothelioma;
• Pomaliza, milandu yapadera kwambiri imakhudza pericardium, khansa iyi yotchedwa pericardial mesothelioma, ndipo makamaka, imatha kukhudza nyini ya testicular.

Kasamalidwe kachirengedwe, pakachitika masothelioma, khansa yosowa kwambiri iyi, imakhala yapadera kwambiri: iyenera kukambidwa pamsonkhano wokambirana wamagulu osiyanasiyana. Pali malo akatswiri odzipereka ku khansa iyi ku France, omwe ndi gawo la netiweki yotchedwa MESOCLIN. Chithandizo chokhacho chimayendetsedwa ndi gulu lapafupi. Chemotherapy yokhala ndi mchere wa pemetrexed ndi platinamu ndiye chithandizo chokhazikika.

Opaleshoni yochizira imakhala ndi pleuropneumonectomy yokulitsidwa koma imakhalabe yachilendo kwambiri: imangokhudza magawo oyambirira komanso osinthika a mesothelioma. Pakali pano ikuchitika m'mayesero achipatala.

Malo ofunikira ayenera kuperekedwa ku chisamaliro chothandizira komanso chithandizo chamankhwala, kuti apitirizebe kusunga moyo wabwino kwa wodwalayo. Thandizo ndi otsogolera ndizofunikira, komanso kumvetsera, kutsagana, kupezeka. Koma tiyeneradi kukumbukira kuti mtundu zilonda chotupa ndi osowa kwambiri ndipo amakhalabe yekha. Ponena za njira zamakono zofufuzira, akulonjeza komanso ali ndi chiyembekezo:

• motero, pali maphunziro angapo omwe amayang'ana ma interferon, ndi cholinga chotsekereza msewu wopita kukukula kwa khansa iyi mwa kulimbikitsa njira za chitetezo chachibadwa;
• Komanso, akadali pa kafukufuku pakali pano, njira yogwiritsira ntchito antitumor virotherapy imakhala ndi kupatsira maselo a khansa ndi kachilombo ka HIV ndi cholinga chowathetsa. Komabe, zikuwoneka kuti maselo a mesothelioma amakhudzidwa kwambiri ndi mankhwalawa. Gulu la Nantes lotsogozedwa ndi Jean-François Fonteneau langopeza kumene chifukwa chake ma cell a khansa ya mesothelial amakhudzidwa kwambiri ndi chithandizochi ndi virotherapy: izi zimalumikizidwa ndikuti, mwa ambiri aiwo, adawona kutha kwa ma jini omwe amasunga mtundu. 1 interferon, mamolekyu omwe ali ndi antiviral properties. Kupeza kumeneku kumatsegula njira yoyezetsa zolosera, makamaka, zomwe zingapangitse kuti zitheke kufotokozera yankho la chithandizo ndi virotherapy, ndi njira zowonjezera mphamvu zake.

Kuzindikira kwa mesothelioma m'mapapo kumakhala kovuta kuzindikira koyambirira, ndipo kumaphatikizapo magawo angapo otsatizana.

Kufufuza mwakuthupi

Zizindikiro zoyamba nthawi zambiri zimakhala zosatchulika:

• zizindikiro za kukhudzidwa kwa pleural: kupweteka pachifuwa, chifuwa chowuma, dyspnea (kuvuta kupuma kumawonjezeka ndi kuyesetsa);
• kuwonongeka kwa chikhalidwe, ndi kuwonda;
• zizindikiro zakuukira kwanuko: kupweteka pachifuwa kapena paphewa.

Kuyeza kwachipatala kuyenera kuphatikizapo, mwadongosolo, mafunso omwe angayang'ane kuwonetseredwa kwa asibesito m'mbuyomo, kaya ndi malo ogwira ntchito kapena ayi, ndikuwunikanso kudalira kotheka kwa fodya. Kusiya kusuta kudzalimbikitsidwa.

ZITHUNZI

Kukonzekera kwadongosolo kumaphatikizapo:

• x-ray pachifuwa. Chithunzi chilichonse chokayikitsa chiyenera kutsogolera ku ntchito yofulumira kwambiri ya thoracic scanner;
• chojambulira pachifuwa, chokhala ndi jekeseni wazinthu zomwe zili ndi ayodini (popanda contraindication). Ngati kukayikira kuli kolimba, malangizowo amasonyeza nthawi yomweyo kuchita mabala a m'mimba chapamwamba.

Biology

Pakadali pano, palibe chomwe chikuwonetsa kuyesedwa kwa zolembera za serum chotupa pofuna kudziwa.

Anatomopathology

Pomaliza, matendawa adzatsimikiziridwa ndi zitsanzo za biopsy. Kuwerenga kawiri kwa dokotala wodziwa za mesothelioma ndikofunikira (madokotala omwe ali mu network ya MESOPATH).

Chiphunzitso cha ma cell ndi chimodzi mwa ziphunzitso zazikulu za biology yamakono. Mfundo zake zitatu zazikuluzikulu ndi izi: kumbali imodzi, zamoyo zonse zimapangidwa ndi maselo (selo limodzi la zamoyo za unicellular, maselo angapo a zamoyo zina zonse, kaya ndi nyama, zomera kapena bowa). Choncho, selo ndiye gawo lofunika kwambiri la kapangidwe ndi kachitidwe ka zinthu zamoyo. Pomaliza, maselo onse amachokera ku maselo omwe analipo kale.

Chiphunzitso cha cell ichi chimachokera ku XVI^e ku Netherlands, chifukwa cha kupanga maikulosikopu oyamba okhala ndi magalasi awiri, ndi Zacharais Janssen. Wasayansi wachidatchi, Antoine Van Leuwenhoek, nayenso apanga maikulosikopu yake yoyamba, chifukwa adzapeza mabakiteriya poyang'ana tizidutswa ta tartar totuluka m'mano ake. Maselo oyamba adzapezedwa ndi mnzake wa Leuwenhoek, wasayansi waku England Robert Hooke.

Malingaliro asayansi nthawi zonse amakhala zipatso za kutanthauzira kwanthawi yayitali, nthawi zambiri zophatikizika: inde, nthawi zambiri zimakhudza ntchito yomanga kuyambira pomwe anthu ena atulukira. Kuti tibwererenso mwachindunji ku maselo a mesothelial, ndi kwa wasayansi kuyambira koyambirira kwa zaka za zana la 1865 kuti tili ndi mwayi wopeza. Katswiri wa sayansi ya zamoyo zam'maselo woyamba dzina lake Edmund B. Wilson (1939-XNUMX) adawonadi ndikufotokozera momwe dzira la ubwamuna limagawika m'maselo mazana ambiri kuti apange mwana wosabadwayo, ndi ziwalo ziti zathupi zomwe zimachokera ku maselo. Kuphatikiza apo, pa mbiriyi, pambuyo pake wophunzira wake Walter Sutton yemwe adapeza gawo la ma chromosome ngati magawo a cholowa.

Pomaliza, zopezedwa motsatizanazi makamaka zidabweretsa chidziwitso chatsatanetsatane chokhudza ma cell a mesothelial: zikuwoneka kuti izi, kwenikweni, zimachokera ku mesoblast, gawo lapakati la cell la embryo (motero mluza uli ndi zigawo zitatu zomwe zili pa chiyambi. maselo onse a thupi: endoderm, mesoderm ndi ectoderm). Pamapeto pake, tisaiwale kuti maselo onse omwe amachokera ku mesoderm amapanga zonse kapena mbali ya ziwalo zosiyanasiyana zamkati, kupatulapo dongosolo lamanjenje lomwe limachokera ku ectoderm.