Neuroblastoma ndi imodzi mwazotupa zolimba zomwe zimapezeka mwa ana. Timalankhula za chotupa chowopsa cha muubongo chifukwa chimayambira mu ubongo koma sichipezeka muubongo. Njira zingapo zochizira zitha kuganiziridwa malinga ndi vuto.

Tanthauzo la neuroblastoma

Neuroblastoma ndi mtundu wa khansa. Izi zilonda chotupa ali specificity wa kukhala pa mlingo wa neuroblasts, amene ali mwana mitsempha maselo achifundo mantha dongosolo. Chotsatirachi ndi chimodzi mwa zipilala zitatu za dongosolo lamanjenje la autonomic lomwe limayang'anira ntchito zosadziwika za chamoyo monga kupuma ndi kugaya chakudya.

neuroblastoma imatha kuchitika m'malo osiyanasiyana amthupi. Komabe, khansa yamtunduwu nthawi zambiri imawonekera pamimba pamlingo wa adrenal glands (ili pamwamba pa impso), komanso msana. Nthawi zambiri, imatha kuchitika m'khosi, pachifuwa kapena m'chiuno (chiuno chaching'ono).

Imakula, neuroblastoma imatha kuyambitsa metastasis. Awa ndi makhansa achiwiri: ma cell a chotupa choyambirira amathawa ndikumanga minofu ina ndi / kapena ziwalo.

Gulu la neuroblastomas

Khansara imatha kugawidwa molingana ndi magawo ambiri. Mwachitsanzo, masitepe amathandizira kudziwa kukula kwa khansa. Pankhani ya neuroblastoma, mitundu iwiri ya staging imagwiritsidwa ntchito.

Gawo loyamba ndilomwe limagwiritsidwa ntchito kwambiri. Imayika ma neuroblastomas kuchokera ku magawo 1 mpaka 4 komanso imaphatikizanso gawo linalake la 4. Uwu ndi m'gulu la kuuma, kuchokera pazovuta kwambiri mpaka zovuta kwambiri:

• magawo 1 mpaka 3 amagwirizana ndi mafomu omwe akukhalako;
• Gawo 4 limatchula mitundu ya metastatic (kusamuka kwa ma cell a khansa ndikukhazikika kwazinthu zina m'thupi);
• Gawo 4s ndi mawonekedwe enieni omwe amadziwika ndi metastases mu chiwindi, khungu ndi mafupa.

Gawo lachiwiri lilinso ndi magawo anayi: L4, L1, M, MS. Sizimangopangitsa kuti zitheke kusiyanitsa mitundu (L) kuchokera ku mafomu a metastatic (M), komanso kuganizira zifukwa zina zowopsa za opaleshoni.

Zimayambitsa neuroblastome

Monga mitundu ina yambiri ya khansa, ma neuroblastomas ali ndi chiyambi chomwe sichinakhazikitsidwebe.

Mpaka pano, zawonedwa kuti kukula kwa neuroblastoma kumatha chifukwa kapena kuyanjidwa ndi matenda osiyanasiyana osowa:

• lembani 1 neurofibromatosis, kapena matenda a Recklinghausen, omwe ndi achilendo pakukula kwa minofu ya minyewa;
• Matenda a Hirschsprung, omwe amayamba chifukwa cha kusakhalapo kwa minyewa yamtsempha pakhoma la matumbo;
• Ondine syndrome, kapena kobadwa nako chapakati alveolar hypoventilation syndrome, amene amakhala ndi kusowa kobadwa nako chapakati kulamulira kupuma ndi diffuse kuwonongeka kwa autonomic mantha dongosolo.

Nthawi zina, neuroblastoma imawonedwanso mwa anthu omwe ali ndi:

• Matenda a Beckwith-Wiedemann omwe amadziwika ndi kukula kwakukulu ndi zilema zobadwa;
• Di-George syndrome, vuto lobadwa mu ma chromosome lomwe nthawi zambiri limabweretsa zilema zamtima, kusokonekera kwa nkhope, kuchedwa kwakukula komanso kuchepa kwa chitetezo chathupi.

Kuzindikira kwa neuroblastome

Mtundu wa khansara ukhoza kuganiziridwa chifukwa cha zizindikiro zina zachipatala. Kuzindikira kwa neuroblastoma kumatha kutsimikiziridwa ndikuzama ndi:

• mayeso a mkodzo omwe amayesa kuchuluka kwa metabolites ena omwe kutuluka kwawo kumawonjezeka panthawi ya neuroblastoma (monga homovanilic acid (HVA), vanillylmandelic acid (VMA), dopamine);
• kujambula kwa chotupa chachikulu ndi ultrasound, CT scan kapena MRI (magnetic resonance imaging);
• MIBG (metaiodobenzylguanidine) scintigraphy, yomwe imafanana ndi kuyesa kujambula mu mankhwala a nyukiliya;
• biopsy yomwe imakhala ndi kutenga chidutswa cha minofu kuti aunike, makamaka ngati akukayikira khansa.

Mayeserowa angagwiritsidwe ntchito kutsimikizira matenda a neuroblastoma, kuyeza kukula kwake ndikuwona kukhalapo kapena kusapezeka kwa metastases.

Neuroblastoma nthawi zambiri imapezeka mwa makanda ndi ana aang'ono. Amayimira 10% ya khansa yaubwana ndi 15% ya zotupa zowopsa mwa ana osakwana zaka zisanu. Chaka chilichonse, pafupifupi milandu 5 yatsopano imadziwika ku France.

• Asymptomatic: neuroblastoma imatha kukhala yosazindikirika, makamaka ikangoyamba kumene. Zizindikiro zoyamba za neuroblastoma zimawonekera nthawi zambiri chotupacho chikafalikira.
• Kupweteka komweko: Kukula kwa neuroblastoma nthawi zambiri kumatsagana ndi ululu m'dera lomwe lakhudzidwa.
• Kutupa komweko: Chotupa, chotupa, kapena chotupa chingawonekere pamalo okhudzidwawo.
• Kusintha kwa chikhalidwe chambiri: neuroblastoma imasokoneza kugwira ntchito bwino kwa dongosolo lamanjenje, zomwe zingayambitse kutaya chilakolako, kuchepa thupi, kukula pang'onopang'ono.

Mpaka pano, chithandizo chachikulu chikhoza kukhazikitsidwa:

• opaleshoni kuchotsa chotupa;
• chithandizo cha radiation, chomwe chimagwiritsa ntchito ma radiation kuwononga maselo a khansa;
• chemotherapy, yomwe imagwiritsa ntchito mankhwala kuti achepetse kukula kwa maselo a khansa.

Pambuyo pamankhwala omwe tawatchulawa, chotengera cha stem cell chikhoza kukhazikitsidwa kuti chibwezeretse kugwira ntchito bwino kwa thupi.

Immunotherapy ndi njira yatsopano yochizira khansa. Zitha kukhala zowonjezera kapena njira zina zochiritsira zomwe tazitchula pamwambapa. Kafukufuku wambiri akuchitika. Cholinga cha immunotherapy ndikulimbikitsa chitetezo chamthupi cholimbana ndi kukula kwa maselo a khansa.

Magwero a neuroblastomas sakudziwikabe mpaka pano. Palibe njira yodzitetezera yomwe idadziwika.

Kupewa zovuta kumadalira kuzindikira msanga. Nthawi zina zimakhala zotheka kuzindikira neuroblastoma panthawi ya ultrasound. Kupanda kutero, kusamala ndikofunikira pambuyo pa kubadwa. Kuwunika kwachipatala kwa mwanayo nthawi zonse ndikofunikira.