He aha te mea tukanga neoplastic?

He tokomaha e wehi o te whiwhi mate pukupuku, a tika na. He mōrearea, me te hunga nanakia tenei mate. putanga Matenui tika ki te mate pukupuku kei roto i te wahi tuarua, i muri i te tuatahi anake o te mate i te mate ngakau. I te tahi taime pāngia tākuta rite "tukanga neoplastic." He aha te tikanga o tenei, o te akoranga e kore te mea hoki tūroro katoa. Etahi ara whakaaro e he tahi mea pai ranei i te iti rawa e kore e kino tenei. I roto i te meka, he tātaritanga taua ko te tukanga neoplastic taua e puta i roto i te mate pukupuku. pā ratou iwi o reanga katoa, tae atu ki ngā tamariki, kia whakawhanake i roto i tetahi okana me tetahi kikokiko o te tinana mo te roa te wa kihai i whai he pānga atu te uaua rawa ki te hamani me te pōhara kē te waitohunga. E aparau teie nei tuhinga nga take o te mate pukupuku, rawa o tona whanaketanga me ngā tikanga o te maimoatanga.

Ko te etiology o te pukupuku

huaina tukanga Neoplastic i roto i te ara rerekē te neoplasia, i whakamaoritia tikanga "tupu hou". Ētahi atu wā maori i roto i tenei āhuatanga - puku, e te tikanga rerekē, nui, tupu whakakeke o ngā pūtau rerekē e taea pā i tetahi kikokiko tinana. kia timata tukanga Neoplastic ki te irakētanga i roto i te pūtau kotahi, engari kei te rerekëtanga i rite ki te pūnaha ao whakaaetia anake ka ngaro 1/3 o ngā pūtau katoa o tetahi okana ona āhuatanga tawhito, me te neke ki te āhua hou. Ko te kupu, ko te timatanga o te hanganga o ngā pūtau mate pukupuku ko te tikanga matua mo te whanaketanga o te mate, engari e kore e te tenei ano whakaaro. I roto i te nuinga o te wā, ka tīmata te tukanga neoplastic i roto i te wahi kotahi. huaina whakawhanake reira ko te puku tuatahi. I roto i te heke mai, te huringa pathological e pa ana i te mahi o nga whekau katoa tangata, a ka riro pūnahanaha mate. A feruri i te āhuatanga o ngā pūtau mate pukupuku.

wehenga

hanga to tatou tinana te ake o miriona o ngā pūtau. E ratou rerekētanga āhuatanga i roto i te hanganga, i runga i te okana kikokiko ranei mahi, e he rānei. Ko e ngohengohe ki te ture noa katoa o ratou - ki te whakarite i te noho tuwhera tonu o te pūnaha rite te katoa. Neke atu i te te ora o ia pūtau, i reira te mea he huringa pūtau raupapa e kore e i pā ana ki te tukanga neoplastic me ko te whakautu ki te whakahau, i homai tona tinana. Hei tauira, whakareatanga (wehenga) o ngā pūtau noa tīmata anake ka e tango reira te tohu e tika ana i te waho. Im Ko te aroaro i roto i te reo te ahurea , me te 20% serum me te tupu āhuatanga. Ēnei āhuatanga, mā te whakamahi i receptors motuhake e tuku ki te "tikanga" tukuruatanga pūtau (rāpoi ariā tamahine) o te DNA, e ko, ki te wehe. e kore e pūtau Cancer rapua e whakahau. faaite ia pehea pai ia, unpredictably me uncontrollably.

ture pumau Tuarua mō ngā pūtau noa ko e taea timata te reira ki te faaite anake i roto i te take o te āpiti i te reira ki te tetahi kopu wahopūtau, pērā i fibronectin mō fibroblasts he. Ki te kahore he āpitihanga, ara, ki te reira e whakahau i waho e kore e te wehenga puta. e kore e te pūtau pukupuku i roto i te kopu e hiahia ana. Ka i roto i tona huringa, mahia te reira ona ake "kapa" ki te tihi o te wehenga, e tohe pono.

Tau o wehenga

pūtau Normal ora, mea, i roto i te hapori hoa o ratou ake ahua. tikanga o tēnei e kore e te wehenga, te tipu me te whanaketanga o tetahi o ratou takahi ki runga ki te oraraa o te tahi atu. Taunekeneke ki ia atu, me te kaupapa ki te "Order" cytokines (rāpoi mōhiohio), mutu ratou ki proliferate, ina riro hiahia mo te rauropi tenei. Hei tauira, wehe te taua fibroblasts noa te hanga i tētahi monolayer mātotoru me te whakatū i ngā hoapā pūtau. tukanga neoplastic motuhake āhuatanga e te meka e te pūtau rerekē, ara ki te kē ratou ko rawa nui, haere tonu ki te tini, ngokingoki i runga i tahi i te tahi, pēpēhinga te pūtau tata, whakangaro ratou me te patu. e kore e pūtau Cancer huru ki "whakahau" inhibitors tupu cytokine ki te mutu wehewehe, a haunga, kahore ratou e aukati i te tārua puta i ratou mahi tikanga kino, pērā i hypoxia, te kore o nucleotides. I tua atu, whakahihi ratou rawa fefeka - timata ki te pokanoa ki te kōtuitui o ngā pūtau noa hauora, akina ratou ki te whakaputa i matū kore e tika mo a ratou me te tika mo ratou, ko te kupu ia mutu te pākia. I tua atu, e taea ki te tomo ki roto ki te toto, me te neke ki a ia o nāianei i roto i te tinana, me te noho i roto i te tahi atu te kopa atu i te puku tuatahi, arā, metastasize pūtau mate pukupuku.

tahuti ore

I roto i te ao i reira he mea tonu. whai hoki ngā pūtau hauora he whanganga ora i roto i nei ratou kawe i to ratou maha wahi o wehenga, āta tupu koroheke, me te mate. huaina ana tēnei āhuatanga te apoptosis. Ki reira, tautoko te tinana te matau ia maha o ia momo pūtau. Kei te āhuatanga e te meka e te pūtau mutated "wareware" te maha o wehenga, kua whakaritea nei i te reira na roto i te natura, na pa tonu te tau whakamutunga ki te tini atu tukanga Neoplastic. E ko, whiwhi ratou te kaha ki te tupu koroheke, me te mate. I te wa ano te taonga ahurei o ngā pūtau mate pukupuku whiwhi tetahi - he takahi o te pārōnaki, e ko, e kore e taea te pukupuku hanga pūtau motuhake e synthesize nga pūmua e tika ana, a ka timata ratou ki te tini i mua i te taenga paari.

neoangiogenesis

He āhuatanga ahurei o te mate pukupuku, ko to ratou kaha angiogenesis ki kaha rawa, i.e., te hanganga o oko toto hou. I roto i te tinana hauora, puta angiogenesis i roto i te nui iti, hei tauira, i roto i te hanganga o tohu i roto i te whakaora mumura ranei aronga. tukanga Neoplastic whakanui i tamau te mahi o te tinana, te mea ki te kore e puta pukupuku i roto i te tinana whakawhānui oko toto, e whiwhi kore katoa pūtau mate pukupuku te matūkai e hiahiatia hoki ratou. I tua atu, kei te whakamahia te oko toto ki te kōkiri atu haere te tinana (ki te hanga i metastases).

tapepe ira

A, no te tuwhatuwhaia te pūtau noa, whiwhi i te āpiti i te kape tangohia o reira. I raro i etahi āhuatanga i roto i ona rahunga DNA puta, a ki reira he wehenga "tamahine" - he mutant, matou i tetahi mau huru hou. I reira tahuri ia ki te faaite, i reira e noa pūtau atu ke. tukanga Neoplastic puta i āta piki enei irakētanga. Ko te tahuti ore o enei pūtau me ratou withdrawal i te rauropi whakahau subordination arata'i ki rerekē atu mārere me haereraa tuutuu o tupu puku.

take

tīmata te pūtau ki te tikanga hē e tika ana ki ngā rerekētanga i roto i ona DNA. He aha puta ratou, i kore whakahoki tangohia, i reira te mea anake he ariā, rite ki nei kia tīmata te tukanga neoplastic ki te tetahi tohu o te tūponotanga.

1. tuku predisposition ira. Tāuta 200 momo o te mate pukupuku meinga e pīari ira e whai ake ira:

'Ka mea hoki i te ora o ngā pae DNA tūkinotia;

-regulates taunekeneke i waenganui i ngā pūtau;

'Ka mea hoki pehi whanaketanga puku.

2. Chemical matū (carcinogens). E ai ki ngā tatauranga i te WHO, he ratou kawenga mō te 75% o ngā take o te mate pukupuku. carcinogens mohio he paowa hikareti, nitrosamines, epoxides, waiwaro kakara - neke atu i te 800 ngā huānga me ratou pūhui.

3. āpiha-tinana. Ko ētahi o ēnei radiation, radiation, te rongo ki pāmahana teitei i roto i te whara.

4. carcinogens Endogenous. Tenei taonga i hanga i roto i te rauropi i roto i raruraru hormonal, rahunga i roto i ngā tukanga pūkoro tinana.

5. Oncoviruses. Kei te whakapono te reira e te vai nei te momo motuhake o te huaketo e taea rere tukanga neoplastic. Ko ētahi o ēnei herpes huaketo, papillomavirus, retrovirus, me ētahi atu.

taiao rawakore, kai kounga rawakore, arata'i ahotea hinengaro tiketike ki te meka e putanga tonu nga pūtau mutant i roto i te tangata, engari kitea ratou tiaki ārai, me te faaore wā. Ki te ngoikore te pūnaha ārai mate te, tonu nga pūtau rerekē ki te ora, me te pae hopea riro matepukupuku.

momo o te pukupuku

maha ui iwi, tukanga neoplastic, he reira mate pukupuku e kore ranei? Ko te whakahoki ta'e ki ia kahore e. Kua wehea te pukupuku katoa ki e rua ngā kāwai:

-dobrokachestvennye;

-zlokachestvennye.

whakaaro mārire te hunga i roto i nei e taea te rerekëtanga ngā pūtau, a e kore e hoatu e metastases.

I roto i te pūtau puku mārere e maha tino ngaro to ratou ahua ki te kikokiko tipu i ai e ratou. Ēnei ngā hanganga i te tupu tere, kaha ki te kookuhutanga (, kătahi ki te kopa pātata me okana), whai metastasis me te pānga pathological i runga i te rauropi katoa.

maha pukupuku mārire kahore maimoatanga tika whakawhanake ki mārere. Wehewehe taua ratou momo:

-epitelialnye (kore e whai i te wāhi motuhake);

-epitelialnye pukupuku o te repe endocrine me pukupuku;

-mezenhimalnye (te kopa ngohengohe);

te kopa -Muscular;

anga o te roro;

-organov pūnaha io;

-krovi (haemoblast);

-teratomy.

atamira whanaketanga

Te whakautu ki te pātai, tukanga neoplastic, he reira mate pukupuku ranei e kore, me e mea ai e te kāwanatanga pērā i precancer kitea i roto i te pathogenesis o te pukupuku. E rua ngā momo o reira:

-obligatny (tahuri tata tonu ki te mate pukupuku);

-fakultativny (kore he tahuri ki te mate pukupuku tonu). precancer Kōwhiringa kia whakahuatia kaipaipa Bronchitis gastritis ma'i ranei.

Tetahi tukanga neoplastic kore e whakawhanake tonu, engari āta, maha tīmata ki huringa mohiotia katoa i roto i te whare herehere taua. huaina ana tēnei wā ko te tomokanga. Ko te kupu i roto i te pūtau puta oncogenes (tetahi ira e taea tahuri ki te pūtau mārere). Ko te p53 oncogene pai-mohiotia, i te tikanga ko te anti-oncogene, kei te aro e ki te whanaketanga o te pukupuku, a ka karanga ia ratou, a ka irakētanga.

I roto i te wā i muri, ka karanga te whakatairanga o taua pūtau rerekē timata ki te wehe.

huaina te atamira tuatoru te predinvazivnym. I roto i tenei take, tupu te puku, engari i roto i mana tata kihai i ano ngoto.

te wha o nga atamira - urutomo.

rima o te atamira - metastasis.

Tohu o te tukanga neoplastic

I roto i timata te wāhanga tuatahi e kore e māuiuitanga faaite mai iho. Kimihia reira rawa uaua, ara ki te akoranga pērā i te ultrasound, X-hihi, ngā tätari. I muri, tohu motuhake o nga tūroro ', te āhua o e tei runga i te localization o te puku tuatahi. Na, tona whanaketanga i roto i te kiri ranei i roto i nga puku uma me te tohu kōpeketanga, te whanaketanga o roto i-taringa - rongo mate i roto i te tuaiwi - uaua i roto i te kaupapa, i roto i te roro - tohu neurological i roto i te pūkahukahu - mare i roto i te kōpū - toto tara. A, no te haamata i ngā pūtau matepukupuku ki te urutomo i te kopa tata, kei te whakangaro ratou a ratou i roto i te oko toto. Ko tenei he aha ai te ahua o te toto i roto i te secretions, e kore anake i te kikokiko. Ko te kupu, puta ai toto i roto i te mimi, ka whakawhanake i te neoplastic tākihi tukanga, tōngāmimi mimi ranei mate, kia tohu toto i roto i te kumete pukupuku wawe i roto i nga whekau, te toto i te kōmata - he puku i roto i te uma. Me meinga taua tohu whakaoho, me te faahepo wāhi tonu ki te tākuta.

Ko tētahi atu tohumate wawe ko te tohu iti syndrome pera-ka karanga. Ko tōna āhuatanga matua ko te whānui o ngā tohu momo. Ka taea te huaina General amuamu o ngoikore, rohirohi nga tūroro ', puta ohorere hūpeke i te pāmahana, ritenga haa, ranei, i runga i te anga ke, tau'a ki nga mea katoa, mate o te hiahia, ka i tenei emaciation kaupapa.

I ngā wāhanga o muri, tohu o te haurangi, me te discoloration o te kiri jaundiced ki te hue ha ma, heke turgor kiri, cachexia mate pukupuku.

A, no te he rawa iti, me te hoki take o pū o ia mahi rohe roro pukupuku i roto i te kiko roro tika ki te meka i iti te tinana e nga wheua o te angaanga, me te wāhi puku whakawhanake, te tohu ko nga āhuatanga e tukua ki te rerekëtanga localization. Ko te kupu, ko te tukanga neoplastic i roto i te hoki o te ahua kitea o kite, tae perception whakararuraru o te manawanui. A, no te kore e kitea te tukanga i roto i te rohe pae tino o nga kite, engari i reira he moemoea māna. Te puku i roto i te taupa frontal o te manawanui āhuatanga e disorders hinengaro, tona kupu, a i roto i te rohe kōpako i roto i te ofatiraa o te nekeneke mahi me te tūtohutanga. tohu Cerebellar - ruaki auau me pāhoahoa whakamataku, me pāpaka o te kakau roro - uaua horomia, disorders romahā, rahunga i te mahi o te maha whekau.

I roto i te wāhanga whakamutunga o te tūroro mate pukupuku katoa wheako mauiui rahi, e taea anake hopu i te raau taero whakapōauau.

tātaringa

Hei whakapumautia he tātaritanga o "tukanga neoplastic," Nōna te tūroro i te raupapa o ngā whakamātautau me whakahau te rangahau whānui. I maoro maha mahi whakamātautau mō tohu puku. He matū e taea tohu i te aroaro o te kaiao i roto i te tukanga neoplastic, ara i roto i te tīmatanga o te wāhanga enei. I tua atu, he maha tohu puku motuhake, faarahi ratou rahinga anake ki te papatipu puku i roto i tetahi okana kotahi. Hei tauira, tohu te PSA puku pou e kua tīmata te kaupapa tukanga neoplastic prostate, ko CA-15-3V oncomarker tukanga neoplastic i roto i te repe mammary. Ko te tātaritanga paku mō tohu puku ko e kia whakapiki ake i ratou i roto i te toto me te i roto i te tahi atu mate i roto i ngā tukanga kore-neoplastic.

kawea hoki te tātaritanga o te manawanui kei roto i taua tätari:

-Analysis o toto, mimi;

-UZI;

-KT;

-MRT;

-angiografiyu;

-biopsiyu (Ko te tātari tino nui, i nei e kore kitea anake te aroaro o te mate pukupuku tenei, engari ano hoki tona atamira o te whanaketanga).

Ki te whakapae koe whakamana te he pukupuku whēkau:

- tātaritanga o feces mo te aroaro o te toto tipua;

-fibrosigmoskopiyu;

-rektomonoskopiyu.

Kei te pai tukanga roro Neoplastic kitea e MRI. Ki te contraindicated te manawanui kei roto i tenei momo o te tātaritanga, i mahi ia CT. mo te pukupuku o te roro hoki kawe i:

-pnevmoentsefalografiyu;

-elektroentsefalogrammu (Tirohia te);

matawai -radioizotopnoe;

poka -spinnomozgovuyu.

maimoatanga

Ki te patua e te ma'i nga tamariki, Kei ratou maimoatanga te nuinga i roto i te hahau, me te iraruke, te uaua mahi pokanga. Hoki te maimoatanga o ngā pakeke whakamahi tikanga e wātea ana katoa e tika ana i te wā ngā o te tukanga neoplastic me i te wahi o tona wāhi rānei:

-himioterapiyu (maimoatanga pūnahanaha pa ana te tinana katoa);

-luchevuyu me iraruke (kia pā pānga tika i runga i te puku wāhi hauora tata);

-gormonoterapiyu (hangaia ki te whakaputa i hormones e tautāwhi i te tupu ranei whakangaro te puku, pērā i te tukanga neoplastic repeure taea te tāmau whakaiti taumata testosterone);

-immunoterapiyu (pai pānga te tinana katoa);

he therapy poto (e ngana ana pūtaiao ki te whakakapi i te ira mutated i runga i te p53 noa);

mahi -hirurgicheskuyu (taea te kawea atu ki te tango i te puku ranei ki te whakaiti i te mamae o te manawanui mā te whakaiti i te kiko puku tata mahi tika whakawhānui).

outlook

tukanga Neoplastic - ehara i te mea he rerenga kōrero. I roto i te tamariki, e tika ana ki te meka e taea ki te ora hohoro, te matapae pai i roto i te 90% o te wā, ki te kitea te whanaketanga o te pukupuku i te tīmatanga o wāhanga ratou tinana taitamariki ko. Otiia ara i roto i nga wāhanga i muri mai o te tāutu i ngā tamariki e taea te tino whakaora i roto i te tiaki kaha.

I roto i te pakeke, he waitohunga pai mo te wāhanga tuatahi o te puku i 80%, me te runga ake. I roto i te toru o taahiraa kitea te putanga pai o te maimoatanga e i roto i te 30% -50% o te wā (i runga i te wāhi me te āhuatanga o ia hanganga o te tinana tangata rānei). I roto i te wha o nga taahiraa rite ki tatauranga i te 2% ki te 15% o tūroro i muri i therapy 5 tau ora atu ranei. whakawhirinaki hoki enei tau i runga i te wāhi o te puku. Ko te waitohunga pai iti rawa i roto i te matepukupuku repeure, me roro.