La wendlala iyindlala yeuhlelo lokuzala wesilisa. Itholakala ngezansi nje kwesinye futhi, njengendandatho, izungeza i-urethra, umgudu okuphuma ngawo umchamo nesidoda emzimbeni. Iqhaza le-prostate ukukhiqiza uketshezi lwe-prostatic, enye yezingxenye zesidoda kanye noketshezi lwesidoda kanye nesidoda, ukugcina isidoda okwesikhashana ngaphambi kokuphuma, bese sifinyela ngesikhathi sokuqhafaza, ngaleyo ndlela iqhaza ohlelweni lokuphuma. ukuxoshwa kwesidoda.

Le umdlavuza wendlala wuhlobo oluvame kakhulu lomdlavuza emadodeni: kulinganiselwa ukuthi indoda eyodwa kwabayi-1 izotholakala inawo, imvamisa eminyakeni yawo-7. Nakuba kungekho sizathu esiqondile esitholakele, kukhona a ukuthambekela kofuzo.

Iningi lomdlavuza wendlala yesinye liyathuthuka kancane kakhulu. Ngaphezu kwalokho, iningi lamadoda okutholwa kuwo lo mdlavuza lizofa ngenye imbangela. Ngokuvamile kakhulu isisu uhlala endaweni wendlala futhi inemiphumela yezempilo elinganiselwe, ngezinye izikhathi ebangela ukuphazamiseka komchamo noma kwe-erectile. Nokho, eminye imidlavuza ingakhula futhi isabalale ngokushesha.

E-France, umdlavuza wendlala yesinye umdlavuza wesilisa ovame kakhulu (amacala amasha angama-71 alinganiselwa ku-200) kanye nembangela yesithathu ehamba phambili yokufa komdlavuza emadodeni (ukufa kuka-2011 ngonyaka). Isikhathi esimaphakathi sokuxilongwa yiminyaka emi-3, kanti ama-8% omdlavuza wendlala yesinye atholakala ngemuva kweminyaka engama-700. Isilinganiso seminyaka yobudala yokufa ngenxa yomdlavuza wendlala yesinye sineminyaka engama-74, cishe okuyisilinganiso seminyaka yokuphila kwabesilisa eFrance. Umdlavuza wendlala yesinye umdlavuza onesimo esihle sokubikezela: Ukusinda kwesihlobo seminyaka engu-44 kuye kwaba ngcono kakhulu, kusuka ku-75% ezimweni ezitholakala ku-78 kuya ku-5% kwabangu-70.

Umdlavuza we-Prostate 2^e imbangela yokufa komdlavuza wesilisa eNyakatho Melika, ngemuva komdlavuza wamaphaphu.

izinhlobo

THEi-adenocarcinoma uhlobo oluvame kakhulu lomdlavuza wendlala yesinye. Imelela cishe amacala angama-95%.

Ubukhulu bomdlavuza buncike ekutheni ungakanani isisu (indawo, enama-metastases aseduze noma akude) kanye nohlobo lwe amangqamuzana omdlavuzaKukhona amaphuzu okulinganisa ukubikezelwa komdlavuza wendlala yesinye, okusho ukuthi ubungozi obukhona kumuntu othintekile. Lona umphumela we-Gleason.

Leli phuzu linikeza izinombolo ezimbili ukusuka ku-3 kuya ku-5 lapho uhlola izicubu ze-prostate ngaphansi kwesibonakhulu, izinombolo ezihambisana namabanga 3, 4 noma 5. Inombolo 3 ihambisana nezicubu ze-prostatic ezinobungozi kanye nenombolo 5 kuya kwenamandla kakhulu.

Ngalezi zibalo, ukuze sithole amaphuzu angasukela koku-2 kuye kwayi-10, sihlanganisa amamaki angu-2, lawo ezibalo ezivame kakhulu zamaseli ku-prostate kanye nenani eliphakeme kakhulu elibonwayo. Ngakho-ke, amaphuzu angu-6 (1-1) ahambisana nomdlavuza ongenalo ulaka, u-7 kancane, futhi inani eliphakeme, ulaka lwesimila luyanda. Le nombolo ibalulekile ekunqumeni ukukhethwa kokwelashwa okungcono kakhulu kwendoda ngayinye.

Ukuxilongwa nokuhlolwa

·         Ukuhlolwa kwegazi: ukulinganisa izinga le-prostate antigen (I-APS ou PSA). Umdlavuza wendlala yesinye ungabonwa ngokubona ukwanda kweprotheyini egazini: i-prostate specific antigen noma PSA. I-PSA iyinto ekhiqizwa i-prostate. Nokho, umphumela ophezulu kulokhu kuhlolwa awusho ngempela ukuthi kukhona a umdlavuza. Ngempela, inani elingaphezu kwe-4 nanograms / ml yale phrotheni egazini lihlotshaniswa nomdlavuza we-prostate cishe ku-25% wamacala, futhi ngesinye isifo se-prostate ku-75% yamacala. Uma kwenzeka ungewona umdlavuza, i-PSA ephakeme ingase ihambisane ne-benign prostatic hyperplasia, ukuvuvukala noma ukutheleleka kwe-prostate. wendlala.

Ngakolunye uhlangothi, ukuhlolwa kwe-PSA akuziboni zonke izimo zomdlavuza. Ocwaningweni oluhlola ukusebenza kokuhlolwa kwe-PSA, u-15% wamadoda ahlolwe ukuthi akanalo lokhu kuhlolwa (kusuka eqenjini lamadoda amabili aneminyaka engama-2 kuya kwengama-950) anomdlavuza wendlala yesinye62. Ake sikhulume ukuthi I-PSA umthamo ibuye isetshenziselwe ukuqapha inkambo yomdlavuza wendlala yesinye.

I-biopsy ayitholakaliokuqhamuka uma udla imishanguzo. Okuvame kakhulu kukhona khona isikhathi esifushane kakhulu igazi emchameni, esithweni noma esidodeni, imfiva kanye nokutheleleka kwe-prostate.

Ngokwenzayo:

– Uma i-prostate ingajwayelekile ekuhlolweni kwe-digital rectal futhi ukushaya izandla kwayo kuphakamisa umdlavuza, i-biopsy iyenziwa, ngisho noma i-PSA ivamile.

- Uma i-prostate ijwayelekile ekushayeni futhi i-PSA ingaphezu kuka-4 ng / ml, i-biopsy izokwenziwa uma i-PSA ikhula ngokuhamba kwesikhathi.

• Ukuthinta i-rectal. Inhloso yayo ukushaya indlala ye-prostate. Ukuze enze lokhu, udokotela ufaka umunwe ombozwe iglavu ku-rectum futhi ngaleyo ndlela angakwazi ukulinganisa ivolumu nokuvumelana kwe-prostate. Lokhu kuthinta kuvumela kuphela ukwazisa okuyingxenye. Kodwa kwesinye isikhathi iyakwazi ukubona umdlavuza kubantu abanezinga lawoi-antigen i-prostatic ethize (= APS noma i-PSA ye-“Prostatic Specific Antigen”) evamile.
  • I-Transrectal ultrasound. Yenziwa kuphela ukwenza i-prostate biopsy futhi ayinantshisekelo ngokwayo.
  • Biopsy ngesikhathi transrectal ultrasound. Ngesikhathi se-ultrasound, udokotela angase aqondise inaliti ukuze azilolonge we ama-prostate biopsies, okungukuthi, ukuthatha izicubu ze-prostate ukuze zihlolwe ngaphansi kwesibonakhulu. Lokhu kuvumela isikolo se-Gleason ukuthi silinganiswe. I-biopsy kuphela engaxilonga umdlavuza wendlala yesinye ngokuqiniseka. I-biopsy ngokuvamile yenziwa kusetshenziswa inaliti efakwe ku-prostate. Amasampula amathishu ayi-10 kuye kwayi-12 athathwa ngesikhathi esifanayo, ezindaweni ezihlukene ze-prostate

    Le nqubo isetshenziselwa izinhloso zokuxilonga, hhayi ukuhlola. Lokhu kusho ukuthi kwenziwa lapho owesilisa ene-PSA ephezulu noma lapho ukuhlolwa kwe-digital rectal kuthola i-prostate engavamile.