Kunamaqembu amabili amakhulu omdlavuza wamaphaphu: “umdlavuza wamaphaphu omncane” oxhumene kakhulu nokusetshenziswa kukagwayi kanye “nomdlavuza wamaphaphu wamangqamuzana ongewona omncane”, ohlanganisa ikakhulukazi i-adenocarcinomas (etholakala kumaseli ezindlala ze-bronchi).

I-Adenocarcinoma iwuhlobo oluvame kakhulu 'lomdlavuza wamaphaphu weseli ongewona omncane' (NSCLC). Ikhula ezindaweni eziseceleni kwephaphu, ikakhulukazi kuma-lobe angaphezulu naseduze ne-pleura. Izigameko zayo sezilokhu zanda cishe iminyaka eyi-10. 

Izinhlobo ezahlukene ze-adenocarcinoma

I-Adenocarcinomas ingahluka kokubili ngobukhulu nangendlela ekhula ngayo ngokushesha. Kunezinhlobo ezimbili eziyinhloko ze-histologically:

• i-acinar adenocarcinoma uma ithatha uhlobo lwesikhwama esincane;
• i-papillary adenocarcinoma, lapho amaseli ebonisa ama-protrusions ngesimo somunwe weglavu.

I-adenocarcinoma yamaphaphu

I-adenocarcinoma yamaphaphu ithinta ngokuyinhloko ababhemayo. Kodwa futhi wuhlobo oluvame kakhulu lomdlavuza wamaphaphu kwabesifazane nakubantu abangabhemi.

Kuyimbangela ehamba phambili yokufa (zonke izimbangela) emadodeni aphakathi kweminyaka engama-45 nengama-64 ubudala eFrance, ngokusho kweHaute Autorité de Santé (HAS).

Ukusetshenziswa kukagwayi kuyisici esiyingozi kakhulu salolu hlobo lomdlavuza. Kodwa hhayi kuphela. "Ukuchayeka emsebenzini kungase kuhileleke," kuchaza uDkt Nicola Santelmo, Udokotela Ohlinza Ithoracic eClinique Rhéna eStrasbourg. Izithako zamakhemikhali (njenge-asbestos, i-arsenic, i-nickel, itiyela, njll.) ezivame ukutholakala emazingeni aphansi emsebenzini ziye zaqashelwa yi-International Agency for Research against Cancer njengamagciwane omdlavuza wamaphaphu endodeni.

Futhi kubonakala sengathi eminye imithombo yokungcoliswa kwemvelo, ngokwezinga elincane, yizici eziyingozi zomdlavuza wamaphaphu, njengokungcoliswa komoya kanye ne-radon).

Izimpawu ze-pulmonary adenocarcinoma zivame ukufika sekwephuzile ngoba azibangeli buhlungu obuthile. Lapho isimila sikhula, singadala izimpawu ezifana nalezi:

• ukukhwehlela noma ukuphefumula kanzima uma icindezela i-bronchi;
• isikhwehlela esinegazi (isikhwehlela);
• ukuncipha kwesisindo okungachazeki.

"Namuhla, nokho, ngenxa yokwanda kokusetshenziswa kwesithwebuli ukuze kuhlolwe iziguli ezibhemayo, singakwazi ukuxilonga umdlavuza ezigabeni zangaphambili, nge-prognosis engcono ngokungenakuphikwa", kuqinisekisa udokotela ohlinzayo.

Kudingeka izivivinyo eziningana ukuze kuqinisekiswe ukutholakala komdlavuza wamaphaphu.

Isithombe

Ukuthwebula kubalulekile ukuhlola izinga lesifo:

• I-CT scan "ephelele" (ugebhezi, ithorax, isisu kanye ne-pelvis) enomjovo wokuqhathanisa uma ingaphikiswanga, inikeza ulwazi ngesimo nobukhulu banoma yimuphi umdlavuza.

I-biopsy

Uma ukuhlolwa kwe-radiological kuphakamisa umdlavuza wamaphaphu, kubalulekile ukuthatha isampula lesilonda, nge-biopsy, ukuthola ubufakazi be-histological noma cytological. Lesi sampula sethishu ngokuvamile senziwe nge-endoscopy noma ngokubhoboza ngaphansi kwesikena. Kwesinye isikhathi, kuyodingeka ukuthi kwenziwe ukuhlinzwa ukuze kuthathwe lesi sampula: i-biopsy ye-lymph node noma inqwaba emaphashini.

I-bronchial fibroscopic

"I-endoscopy ye-bronchial nayo ingadingeka, ikakhulukazi uma isimila sisuka ku-bronchus. Kungase futhi kudingeke ukuthi kutholwe isampula yesimila noma ye-lymph node ukuze kuqedelwe ukuhlolwa ”.

Ukuhlola kwenza kube nokwenzeka ukunquma isigaba sesifo, kucatshangelwa ubukhulu kanye nendawo yesimila (“T”), ubukhona kanye nendawo yama-lymph nodes (“N”) kanye nokuba khona noma cha “ama-metastases” okuthi yizandiso ezikude zesimila samaphaphu (“M”). Izingxenye ezimbili kwezintathu ze-cell bronchial carcinomas zitholwa esigabeni se-metastatic.

Ukuhlolwa kokusebenza kokuphefumula kanye nenhliziyo

Okokugcina, ukuhlolwa komsebenzi wokuphefumula nowokushaya kwenhliziyo kubalulekile ukuze kunqunywe ukuthi ukuhlinzwa noma ukwelashwa ngamakhemikhali kungenzeka yini ngengozi ephansi yezinkinga.

“Isibikezelo sincike esigabeni somdlavuza kanye nokwelashwa okungacatshangelwa,” kusho uchwepheshe. Ihluka phakathi kwangaphansi kuka-10% eminyakeni emi-5 ezigabeni ezithuthuke kakhulu kanye nama-92% eminyakeni emi-5 ezigabeni zokuqala. Ngakho-ke ukubaluleka kokuxilongwa kusenesikhathi kukhulu kakhulu! Ngaphezu kwalokho, phakathi kwazo zonke iziguli ezihlinzwe ngokuhlinzwa (zonke izigaba zihlangene) isiguli esisodwa kwezi-1 siphila eminyakeni emi-2 kamuva ”.

Ukwelashwa okwenziwayo kuncike ohlotsheni lomdlavuza we-histological, isigaba sawo (okungukuthi izinga lawo lokunwetshwa), isimo sempilo jikelele yesiguli, kanye nesinqumo esithathwe ngokubambisana yithimba lezokwelapha lezinhlaka eziningi elihlanganisa i-pulmonologist, udokotela ohlinzayo, i-radiotherapist. , i-radiologist, udokotela wenuzi kanye nesazi sezifo.

Inhloso yokucubungula

Inhloso yokwelashwa ukuthi:

• ukususa isimila noma metastases;
• lawula ukusabalala kwe-adenocarcinoma yamaphaphu;
• vimbela ukuphindeka;
• phatha izimpawu.

Izindlela zokwelapha ezehlukene

Kunezinhlobo eziningana zokwelapha i-adenocarcinoma yamaphaphu:

• ukuhlinzwa kokuhlinza, ukususwa kwaso sonke isimila, kuhlanganiswe nokwelashwa ngamakhemikhali, ngaphambi noma ngemva kokuhlinzwa
• i-radiotherapy kuphela,
• i-chemotherapy kuphela,
• i-chemotherapy ehlanganiswe ne-radiotherapy,
• i-radiofrequency noma i-stereotaxic radiotherapy ehambisana nokukhipha imisebe egxile kakhulu esimila samaphaphu,
• okunye ukwelashwa kwe-systemic (i-immunotherapy kanye / noma izindlela zokwelapha ezihlosiwe).

"Ukungenelela kokuhlinzwa namuhla kuya ngokuya kuhloswe futhi kuhlelwa ngesisekelo sokuhlolwa kwangaphambi kokuhlinzwa futhi kungase kuhlanganise i-segmentectomy noma i-lobectomies yamaphaphu (okuhilela izingxenye eziningi zamaphaphu ezingabalulekile)", kuphetha uDkt Santelmo.