I-neuroblastoma ingesinye sezimila eziqinile ezivame kakhulu ezinganeni. Sikhuluma ngesimila esiyingozi esingaphezu kobuchopho ngoba siqala ohlelweni lwezinzwa kodwa asitholakali endaweni ebuchosheni. Izinketho zokwelashwa eziningana zingacatshangelwa kuye ngokuthi icala.

Incazelo ye-neuroblastoma

I-neuroblastoma wuhlobo lomdlavuza. Lesi simila esiyingozi sinobuchwepheshe bokukhula ezingeni lama-neuroblasts, okungamaseli ezinzwa angavuthiwe wesimiso sezinzwa esinozwela. Lesi sakamuva sakha enye yezinsika ezintathu zesimiso sezinzwa esizihambelayo esiqondisa imisebenzi ezenzakalelayo yento ephilayo njengokuphefumula nokugaya ukudla.

I-neuroblastoma ingakhula ezindaweni ezihlukene kakhulu zomzimba. Kodwa-ke, lolu hlobo lomdlavuza luvame ukuvela esiswini ezingeni lezindlala ze-adrenal (ezitholakala ngaphezu kwezinso), kanye nomgogodla. Okungavamile, kungenzeka entanyeni, esifubeni noma okhalweni (i-pelvis encane).

Njengoba ikhula, i-neuroblastoma ingabangela i-metastasis. Lawa umdlavuza wesibili: amaseli wesimila esiyinhloko ayabaleka futhi aqoqe ezinye izicubu kanye/noma izitho.

Izigaba ze-neuroblastomes

Umdlavuza ungahlukaniswa ngokwemingcele eminingi. Isibonelo, ukwenza isiteji kusiza ukuhlola izinga lomdlavuza. Endabeni ye-neuroblastoma, izinhlobo ezimbili zesiteji ziyasetshenziswa.

Isigaba sokuqala yisona esisetshenziswa kakhulu. Ihlukanisa i-neuroblastomas kusukela kusigaba 1 kuya ku-4 futhi ihlanganisa isigaba 4 esithile. Lokhu ukuhlukaniswa ngokuqina, kusukela kokuncane kakhulu kuya kwesinzima kakhulu:

• izigaba 1 kuya kwezi-3 zihambisana namafomu asendaweni;
• isigaba sesi-4 sibonisa amafomu e-metastatic (ukufuduka kwamangqamuzana omdlavuza kanye nekoloni kwezinye izakhiwo emzimbeni);
• Isigaba sesi-4 siyifomu elithile elibonakala ngama-metastases esibindini, esikhunjeni nasemongweni wamathambo.

Isigaba sesibili sinezigaba ezi-4: L1, L2, M, MS. Ayenzi nje kuphela ukuthi kwenzeke ukuhlukanisa amafomu wendawo (L) kumafomu e-metastatic (M), kodwa futhi ukucabangela izici ezithile eziyingozi zokuhlinzwa.

Ibangela i-neuroblastome

Njengezinye izinhlobo eziningi zomdlavuza, ama-neuroblastoma anemvelaphi engakaqinisekiswa ngokugcwele.

Kuze kube manje, kuye kwaphawulwa ukuthi ukuthuthukiswa kwe-neuroblastoma kungase kube ngenxa noma kuthandwe yizifo ezihlukahlukene ezingavamile:

• thayipha i-neurofibromatosis 1, noma isifo sika-Recklinghausen, okungavamile ekuthuthukiseni izicubu ze-neural;
• Isifo sikaHirschsprung esiwumphumela wokungabikho kwe-nerve ganglia odongeni lwamathumbu;
• I-Ondine syndrome, noma i-congenital central alveolar hypoventilation syndrome, ebonakala ngokungabikho kokuzalwa kokulawula okuphakathi kokuphefumula kanye nokusabalalisa umonakalo ohlelweni lwezinzwa oluzimele.

Ezimweni ezingavamile, i-neuroblastoma nayo ibonakale kubantu abane:

• I-Beckwith-Wiedemann syndrome ebonakala ngokukhula ngokweqile kanye nokukhubazeka kokuzalwa;
• I-Di-George syndrome, ukukhubazeka kokuzalwa kuma-chromosome okuvame ukuholela ekukhubazekeni kwenhliziyo, ukukhubazeka kobuso, ukubambezeleka kwentuthuko kanye nokuntuleka kokuzivikela komzimba.

Ukuxilongwa kwe-neuroblastome

Lolu hlobo lomdlavuza lungasolwa ngenxa yezimpawu ezithile zomtholampilo. Ukuxilongwa kwe-neuroblastoma kungaqinisekiswa futhi kujulwe yilokhu:

• ukuhlolwa komchamo okuhlola amazinga ama-metabolite athile okuphuma kwawo kukhuphuka ngesikhathi se-neuroblastoma (isb i-homovanilic acid (HVA), i-vanillylmandelic acid (VMA), i-dopamine);
• izithombe zesimila esiyinhloko nge-ultrasound, i-CT scan noma i-MRI (imaging resonance magnetic);
• I-MIBG (metaiodobenzylguanidine) i-scintigraphy, ehambisana nokuhlolwa kwe-imaging emithini yenuzi;
• i-biopsy ehlanganisa ukuthatha ucezu lwethishu ukuze luhlaziywe, ikakhulukazi uma kusolwa umdlavuza.

Lezi zivivinyo zingasetshenziswa ukuze kuqinisekiswe ukutholakala kwe-neuroblastoma, ukukala izinga layo kanye nokuhlola ubukhona noma ukungabikho kwama-metastase.

I-Neuroblastomas ivame ukuvela ezinsaneni nasezinganeni ezincane. Bamele i-10% yezigameko zomdlavuza wezingane kanye ne-15% yezimila eziyingozi ezinganeni ezingaphansi kweminyaka engu-5 ubudala. Unyaka ngamunye, kutholakala amacala amasha ayi-180 eFrance.

• I-Asymptomatic: I-neuroblastoma ingase ingabonakali, ikakhulukazi phakathi nezigaba zayo zakuqala. Izimpawu zokuqala ze-neuroblastoma zivame ukubonakala lapho isimila sisabalala.
• Ubuhlungu bendawo: Ukuthuthukiswa kwe-neuroblastoma kuvame ukuhambisana nobuhlungu endaweni ethintekile.
• Ukuvuvukala kwendawo: Isigaxa, isigaxa, noma ukuvuvukala kungase kuvele endaweni ethintekile.
• Ukuguqulwa kwesimo esijwayelekile: I-neuroblastoma iphazamisa ukusebenza kahle kwesimiso sezinzwa, okungabangela ukulahlekelwa ukudla, ukulahlekelwa isisindo, ukukhula kancane.

Kuze kube manje, izindlela zokwelapha ezintathu eziyinhloko zingasetshenziswa:

• ukuhlinzwa ukususa isimila;
• ukwelapha ngemisebe, esebenzisa imisebe ukucekela phansi amangqamuzana omdlavuza;
• i-chemotherapy, esebenzisa amakhemikhali ukunciphisa ukukhula kwamangqamuzana omdlavuza.

Ngemuva kokwelashwa okukhulunywe ngenhla, ukufakelwa kwe-stem cell kungafakwa ukuze kubuyiselwe ukusebenza kahle komzimba.

I-Immunotherapy iyindlela entsha yokwelapha umdlavuza. Kungaba umphelelisi noma enye indlela yokwelapha eshiwo ngenhla. Luningi ucwaningo olwenziwayo. Umgomo we-immunotherapy ukukhuthaza izivikeli mzimba zokulwa nokuthuthukiswa kwamangqamuzana omdlavuza.

Imvelaphi ye-neuroblastomas isalokhu iqondwa kabi kuze kube namuhla. Azikho izindlela zokuvimbela ezingakhonjwa.

Ukuvimbela izinkinga kuncike ekuxilongweni kusenesikhathi. Ngezinye izikhathi kuyenzeka ukuhlonza i-neuroblastoma ngesikhathi sokuhlolwa kwe-ultrasound ngaphambi kokubeletha. Uma kungenjalo, ukuqapha kubalulekile ngemva kokuzalwa. Ukuqapha ingane ngokwezempilo njalo kubalulekile.