Iimpawu zokungcola eziqhelekileyo zenkqubo yokuphefumula zizona zixhaphake kakhulu kwi-pathologies. Indawo yokuqala phakathi kwabo ngumhlaza wemiphunga, ngonyaka kukho ngaphezu kwezigidi ezili-1 ezi zifo. Ngenxa yokuqhubela phambili ngokukhawuleza kunye nobunzima bonyango, i-tumor iyona yeqela lezona zifo eziyingozi kakhulu.
Izizathu zomhlaza wemiphunga
Olu luhlu luvela kwiinguqulelo zenkqubela kwi-DNA ye-epithelium ye-bronchial. Izicubu ezininzi ziwonakaliswe, iphakamileyo yengozi yokubunjwa kwesisu. Iimbangela eziphambili zomdlavuza wamaphaphu zi-carcinogens, ingakumbi ukuba zingena emzimbeni rhoqo. Iidayibini zitshintsha ngokuthe ngcembe isakhiwo somzimba se-epithelium esine-bronchi. Ezinye izinto ezibangela ukuba le sifo zibandakanye izifo zentsholongwane kunye ne-radioactive (ionizing) imitha.
Isizathu esibalulekileyo somdlavuza wamaphaphu
Phantse i-90% yazo zonke izifo zesifo esicatshulwayo kunye neempawu zayo kuqala ngenxa yokutshaya . Lo mkhuba omubi ukwandisa umngcipheko wokukhula okubi ngento engama-20. Hayi kuphela i-nicotine, ukukhusela umkhuhlane, kuphazamisa umdlavuza wamaphaphu - izimbangela ze-tumor zifihliwe kwizenzo zee-carcinogens, kubandakanywa i-isotopes e-radioactive ye-radon ekhoyo kwingqumbo yomsiya. Ukongezelela kwii-toxins eziyaziwayo, iqulethe ngaphezu kwe-4000 i-chemical compounds.
Izizathu zomdlavuza wamaphaphu kwabangabhemi
Iimpawu kunye neempawu zesifo esichazwayo zifumaneka kubantu abangenazo izilwanyana, kodwa ngokungafanekiyo (10-15% amacala). Nangona kungekho bungqina obuqinileyo bokuthi ukutshaya umsila kungenxa yomdlavuza wamaphaphu, kukho phakathi kweemeko eziye zenziwa izidumbu kwisimo sokuphefumula. Izinto ezincinci eziqhelekileyo ezibangela ukukhubazeka ngokubuza:
- uthuli;
- i-asbestos;
- radon;
- ezinye iintlobo zegciwane;
- arsenic;
- nickel;
- chrome;
- cadmium;
- i-radiation irradiation;
- isifo sobhubhane esingapheliyo.
Umdlavuza womlenze yimbangela yengqondo
Uninzi lweengcali zithandekile ukuba zikholelwe ukuba izifo zesifo se-oncological ziyi-multipletifactorial, kwaye kubangelwa ukuhlanganiswa kwemiphumo emibi emzimbeni. Abanye abaphengululi bachaza ezinye izinto ezibangela umdlavuza wamaphaphu:
- ukungakwazi ukudala intsapho eqinile;
- ukudana ebomini;
- ubudlelwane obubi nabazali;
- ukungabi nabangane abasondeleyo okanye ukuxhamla ngokomzwelo;
- akunakwenzeka ukukwazi ukukwazi ukuzibona.
Iingxaki ezidwelisweyo kuphela zibonisa ukuba zibonakalise iimpawu kunye neempawu ezihamba kunye neeplasms eziyingozi kwiinkqubo zokuphefumula. Akukho zifundo zoogqirha ezisemthethweni eziqinisekisa ukuba indima yezinto ezinjalo kwiimeko okanye ukuqhubela phambili komhlaza. Ngokuphathelele ukungabikho kobu bungqina bolu mbono, i-oncologists ayinakuqaphela ingqalelo kwiingxaki zengqondo zengqondo.
Iindidi zomhlaza wemiphunga
Kukho iintlobo ezahlukeneyo zokuhlelwa kwezifo ezichazwe kwisifo. Kwizonyango zasekhaya, kuyisiko ukuhlukanisa ngokwemiqathango emi-2 - iimpawu ze-hertological zeesilini ze-tumor kunye nobunzima beempawu kunye neempawu ngokuhambelana nesigaba sophuhliso. Kubalulekile ukucacisa uhlobo lwesifo ngokukhawuleza, iintlobo ezahlukeneyo ze-neoplasms ezingumzimba zinezinga lazo lokuqhubeka kwaye zifuna unyango olulodwa.
Iindidi zomdlavuza wamaphaphu nge-histology:
- encinci;
- iseli esincinci.
Iintlobo zeemathumba ngobunzima nangobunzima beempawu:
- Isigaba 1 - sinobubele, ekuqaleni;
- 2 isigaba - esilinganiselweyo, esiphakathi;
- Isigaba sesi-3 - esinzima;
- Isigaba sesi-4 - esinzima kakhulu, esingasebenzi.
Umhlaza wesifo somnxeba omncinane
Ngokuqhelekileyo (kubakho malunga nama-20% amatyala), kodwa uhlobo olushushu nolusasazekayo lwesifo, iimpawu zalo zifunyanwe ngokuyinhloko kubantu ababhema. Ukuqonda into encinci yomhlaza wesifo somnxeba, unceda ukufunda izicubu ezenza i-tumor. Yakhiwa ukusuka kwizakhiwo ezincinci ezingena ngokukhawuleza kwigazi kunye ne-lymphatic system ngenxa yemilinganiselo emancinci. Iiseli ezinokukhubazeka zakhiwa kalula kwizitho eziphilileyo, ezikhokelela ekubonakalayo nasekukhuleni kweemastastases.
Lo ngowona mngcipheko kakhulu kwaye unobungozi womhlaza wamaphaphu - iimpawu kunye nemiqondiso yesityalo esincinci sesifo asizange kubonwe ixesha elide. Umntu akazi malunga nobukho beengxaki ade aqale ukukhwehlela igazi kwaye abe nemiphumo yokukhula kwe-neoplasm. Ngenxa yokungabikho kwemiboniso yekliniki, olu hlobo lwesifo luvame ukufunyaniswa kwisithuba sexesha lokuphuhlisa.
Amacandelo amancinci amancinci amancinci:
- i-pleomorphic;
- i-oat cell;
- esitokisi.
Umhlaza wesifo somhlaza wesininzi
Ngokutsho kwegama, uhlobo lweeoplasms ezicetywayo lubandakanya izakhiwo ezinkulu ezikhoyo. Olu hlobo lwesifo luqhelekileyo, iimpawu zalo zifunyaniswa kwi-80% yamatyala (ncinane ngakumbi). Izidumbu ezikhoyo zikhula ngokuthe ngcembe kwaye zincinci zibangele ukubonakala kweemetastases, kodwa ingozi yabo kunye nemiphumo eyingozi kwimimandla yomzimba iyafana nohlobo lwangaphambili lwentsholongwane.
Amanqamzana amancinci amancinci amancinci angama-adenocarcinoma kunye ne-epidermoid (i-squamous, squamous-cell) ye-carcinoma. Eminye, ngaphantsi kwexesha eliqhelekileyo, ukuhlukahluka kweeoplasms:
- iseli elikhanyayo;
- iseli elikhulu.
Iimpawu zomhlaza wemiphunga
Umfanekiso wekliniki wesi sifo kuxhomekeke kwinqanaba lokuqhubela phambili kunye nobunzima, ubukho kunye nenani leemetastases. Kubaluleke kakhulu indawo apho umdlavuza wamaphaphu uqhubeka khona - iimpawu kunye neempawu zesifo esiyintloko (ukusuka kwi-membrane ye-mucous ye-bronchus enkulu) ibonakala ngakumbi kwaye ibonakaliswe ekuqaleni. Njengoko ikhula, inokuchaphazela ukuphela kwezigulane zeentlungu kunye nokucaphukisa izicubu ezizungezile, ngoko umntu uyazibona utshintsho ekusebenzeni komzimba.
Ekuqaleni, akukho mpawu zangaphandle zomhlaza wamaphaphu xa kukho i-neoplasm kwimimandla yendawo yokuphefumula. Kwiimfesi zamasebe e-bronchi azikho izilwanyana ezibuhlungu kunye nokuphela kwezibilini, ngoko ingqondo ingaphenduli ngokukhula kweso sakhiwo sangaphandle. Izimpawu ezibonakalayo zivele kuphela kwizigaba zokugqibela zesifo.
Umhlaza womlenze - isigaba 1
Indlela echazwe ngayo ye-pathology iyaqhubeka ngaphandle kwemiboniso yekliniki. I-Neoplasm isancinci kakhulu, akukho metastasis, ngoko iimpawu zokuqala zomhlaza wamaphaphu azikho. Ubungakanani be-tumor kufinyelela ku-3 cm ububanzi, bufumaneka kwicandelo elinye leplmonta. Ngamanye amaxesha ukuqokelelwa kweeseli eziguqulweyo kufakwe kwindawo yesebe encinci. Kuyinto engavumelekanga kakhulu ukuxilonga umhlaza wesifo samaphaphu: iimpawu kunye neempawu kumanqanaba okuqala ziphelile (okanye azikho) ukuba izigulane azifunanga uncedo. I-tumor ifunyanwe ngengozi ngophando oluqhelekileyo.
Umhlaza weLung - iSigaba 2
Kule nqanaba, ubukhulu be-neoplasm banda kwi-5-6 cm (ubukhulu becala). Akukazanga ukwandisa kakhulu, kodwa ivumela i-metastases enye, ngoko ke kunokubakho iimpawu zokuqala zomhlaza wamaphaphu ekuqaleni kwexesha:
- ukukhathala;
- ukungakhathaleli;
- amandla aphantsi okusebenza;
- ukulala, ukunyaniseka.
Ezi zimpawu azihambelani nobukho besifo esibi, zivela kwiintlobo ezahlukeneyo zezifo. Izimpawu zomdlavuza wamaphaphu kwabesetyhini kunye namadoda ziyafana, ukuxilongwa kufana. Kamva, kukho ezinye iimpawu zeklinikhi, ezingenakwenzeka:
- ukulahlekelwa kakubi komzimba ;
- ukwanda kweqondo lokushisa kuma-37 degrees;
- izifo zokulala.
Umhlaza weLung - Isigaba 3
Kwinqanaba elichazwe, i-neoplasm engalunganga inomlinganiselo omkhulu, ngaphezu ko-6 cm ububanzi. Kukho umfanekiso weklinikhi oqhelekileyo, ngoko isigulane siphendula ugqirha okanye i-x-ray - iimpawu zomhlaza wemiphunga sele sele zicacile:
- owomileyo, ngokuqhelekileyo ukukhwehlela;
- ukuphefumula okufutshane;
- ukukhutshwa kwe- pneumonia ngaphandle kwe-arhente esebenzayo;
- ukukhathazeka esifubeni;
- ukwanda kweqondo lomzimba;
- ubunzima obuphantsi.
Ngethuba loviwo, kukho i-metastases eqala umdlavuza wamaphaphu - iimpawu kunye nempawu zentsholongwane ziquka ukunqotshwa (ukukhulisa, ukuvuvukala) kwamaqela amancinci amaninzi:
- tracheobronchial;
- i-bifurcation;
- iipatracheal;
- bronchopulmonary.
Umhlaza weLung - iSigaba 4
Uhlobo oluthile lwezikolo zesifo luhambelana nokukhula ngokukhawuleza kwe-tumor, ngokuphindaphindiweyo lidlulela ngaphaya kweqendu lokuqala kwaye lingena kwizakhiwo ezinxulumeneyo. Kwiimeko ezinjalo, umdlavuza wamaphaphu uqinisekiswa ngokukhawuleza - iimpawu kunye neempawu zesigaba se-4 ziquka zonke izibonakaliso ezingentla ngasentla, kodwa zichazwe ngakumbi:
- ukuvakala kwezwi;
- i-sputum ekhuphayo, ekhutshwa ngexesha lokukhwehlela;
- ukungabi nesidlo;
- ukukhubazeka kwesithintelo;
- intlungu kwingingqi yentliziyo;
- ukukhukhuma kobuso;
- Ikhumba liluhlaza-violet kumbala (i-cyanotic);
- izivilini ezivuvukileyo entanyeni naseengalo;
- dermatitis;
- utshintshe umlo weminwe ("iidonga").
Ngexesha lokukhwehlela, i-sputum ebomvu ivame ukukhwehlela, okuyi-blood clot. Ngenxa yomonakalo kwinkqubo yokuphefumula, umntu unenkxalabo yokuhamba kunye nezifo:
- pericarditis ;
- ingxaki engapheliyo;
- pleurisy ;
- pneumonia.
Ngaphantsi kaninzi ngexesha lokuxilonga ngokungafani, umhlaza wamaphaphu ufunyanwa - iimpawu zexesha elide kunye neempawu zesisu ziquka izidumbu ezininzi zendawo kunye nezikude. Ahluma nje kuphela kwii-lymph nodes, kodwa nakwizitho zangaphakathi, ukuphazamisa ngokunyanisekileyo imisebenzi yabo. Iimetastase zithe tye:
- izintso;
- amathambo;
- izigulana
- ingqondo;
- isibindi;
- ntliziyo;
- isophagus;
- umkhondo;
- naziphi na iimbambo zeentambo;
- thymus.
Umhlaza womlenze - ukuhlaziya
Nangona kwakungeke kwenzeke ukuphuhlisa i-algorithm esebenzayo yonyango, evumela ukunyanga ukugula. Awukwazi ukuphelisa ngokupheleleyo umdlavuza wamaphaphu - iimpawu kunye nempawu zenkqubela phambili, i-tumor ikhula kwaye inika i-metastases. Ekuqaleni isifo sibonisiwe, iphakamileyo amathuba okuphucula imeko yesigulane. Ukuba ukuxilongwa kwenziwa kwinqanaba lokuqala, izinga lokusinda iminyaka emi-5 li malunga ne-60%, okwesibini - malunga ne-40%, okwesithathu ukuya kwi-15%. Isifo esiyingozi se-oncological siphelela ukufa phakathi kweenyanga ezili-12 ukuya kwezi-12. Umphumo ofanayo, ukuba awukhathathi umhlaza wamaphaphu - umgaqo-nkqubo wokuphila awugqithisi iminyaka engama-1-2.