ʻElua pūʻulu nui o ka maʻi maʻi ʻāʻī: "ka maʻi maʻi ʻaʻai liʻiliʻi liʻiliʻi" pili kokoke i ka ʻai ʻana i ka paka a me "ka maʻi maʻi maʻi ʻaʻa ʻole liʻiliʻi liʻiliʻi", ʻo ia hoʻi ka adenocarcinomas (i loaʻa mai nā ʻili glandular o ka bronchi).

ʻO Adenocarcinoma ke ʻano maʻamau o ka 'non-small cell lung cancer' (NSCLC). Hoʻoulu ia ma nā ʻāpana ʻaoʻao o ka māmā, ʻoi loa ma nā lobes luna a kokoke i ka pleura. Ua hoʻonui ʻia kona maʻi ma kahi o 10 mau makahiki. 

Nā ʻano like ʻole o ka adenocarcinoma

Hiki i nā Adenocarcinomas ke ʻokoʻa i ka nui a me ka wikiwiki o ka ulu ʻana. ʻElua mau ʻano ʻano histologically:

• acinar adenocarcinoma ke lawe ʻia ke ʻano o kahi ʻeke liʻiliʻi;
• papillary adenocarcinoma, i ka wā e hōʻike ai nā pūnaewele i nā protrusions i ke ʻano o ka manamana lima.

Adenocarcinoma pulmonary

ʻO ka maʻi adenocarcinoma ka mea nui i ka poʻe puhi paka. Akā ʻo ia ke ʻano maʻamau o ka maʻi kanesa maʻi i nā wahine a me nā mea puhi ʻole.

ʻO ia ke kumu nui o ka make (nā kumu āpau) i nā kāne ma waena o 45 a me 64 mau makahiki ma Farani, e like me ka Haute Autorité de Santé (HAS).

ʻO ka ʻai ʻana i ka paka ka helu ʻekahi kumu pilikia no kēia ʻano maʻi kanesa. Akā ʻaʻole wale. "E pili ana paha nā hōʻike ʻoihana," wehewehe ʻo Dr Nicola Santelmo, Thoracic Surgeon ma Clinique Rhéna ma Strasbourg. ʻO nā pūhui kemika (e like me ka asbestos, arsenic, nickel, tar, etc.) i ʻike pinepine ʻia ma nā pae haʻahaʻa ma ka wahi hana i ʻike ʻia e ka International Agency for Research against Cancer ma ke ʻano he pulmonary carcinogens no ke kāne.

ʻIke ʻia hoʻi ʻo nā kumu ʻē aʻe o ka hoʻohaumia ʻana i ke kaiapuni, i ka liʻiliʻi liʻiliʻi, nā kumu pilikia no ka maʻi maʻi ʻāʻī, e like me ka pollution ea a me ka radon).

Ua lohi pinepine nā hōʻailona o ka pulmonary adenocarcinoma no ka mea ʻaʻole ia e hōʻeha i kekahi ʻeha. Ke ulu ka maʻi koko, hiki iā ia ke hana i nā hōʻailona e like me:

• ʻo ka ʻū a i ʻole ka pilikia o ka hanu ʻana inā e kaomi ma luna o ka bronchi;
• kahe koko (sputum);
• lilo kaumaha maopopo ʻole.

"I kēia lā, akā naʻe, mahalo i ka hoʻohana nui ʻana o ka scanner no ka nānā ʻana i nā mea maʻi puhi paka, hiki iā mākou ke hana i ka maʻi maʻi maʻi ma mua o nā pae mua, me kahi prognosis maikaʻi ʻole", hōʻoiaʻiʻo i ke kauka.

Pono kekahi mau ho'āʻo no ka hōʻoia ʻana i ka maʻi maʻi ʻaʻai māmā.

Ke kiʻi

Pono ke kiʻi kiʻi e loiloi i ka nui o ka maʻi:

• ʻO ka CT scan "hoʻopiha" (ke poʻo, ka ʻāʻī, ka ʻōpū a me ke pelvis) me ka ʻokoʻa ʻokoʻa inā ʻaʻole contraindicated, hāʻawi i ka ʻike e pili ana i ke ʻano a me ka nui o kekahi maʻi kanesa.

ʻO ka biopsy

Inā hōʻike ʻia nā hoʻokolohua radiological i ka maʻi kanesa, pono e lawe i kahi laʻana o ka lesion, ma ka biopsy, e loaʻa ai ka hōʻike histological a cytological paha. Hana ʻia kēia laʻana kikoo ma ka endoscopy a i ʻole ma ke kī ʻana ma lalo o ka scanner. I kekahi manawa, pono e hana ʻia ke ʻoki ʻana no ka lawe ʻana i kēia laʻana: biopsy o kahi puʻupuʻu lymph a i ʻole he nui i loko o ka māmā.

Bronchial fibroscopi

"Pono paha ka endoscopy bronchial, ʻoiai inā loaʻa ka maʻi maʻi i loko o kahi bronchus. Pono paha e kiʻi i kahi laʻana o ka ʻōpū a i ʻole kahi lymph node e hoʻopau ai i ka loiloi ".

ʻO ka loiloi e hiki ai ke hoʻoholo i kahi pae o ka maʻi, e noʻonoʻo ana i ka nui a me kahi o ka ʻōpū ("T"), ke ola a me kahi o nā lymph nodes ("N") a me ke ola a ʻaʻole ʻole "metastases" he mau hoʻolōʻihi lōʻihi o ka ʻōpū māmā (ka "M"). Ua ʻike ʻia ʻelua hapakolu o nā maʻi maʻi maʻi bronchial cell liʻiliʻi ma ka pae metastatic.

ʻO ka loiloi o ka hana hanu a me ka naʻau

ʻO ka mea hope loa, he mea nui ka loiloi ʻana i ka hana hanu a me ka puʻuwai i mea e hoʻoholo ai inā hiki ke hoʻomaʻamaʻa ʻia a i ʻole ka chemotherapy me ka haʻahaʻa o nā pilikia.

"ʻO ka prognosis e pili ana i ka pae o ka maʻi kanesa a me ka mālama ʻana i hiki ke noʻonoʻo ʻia," wahi a ka loea. Hoʻololi ia ma waena o ka liʻiliʻi ma lalo o 10% ma 5 mau makahiki i nā pae kiʻekiʻe a me 92% ma 5 mau makahiki i ka pae mua. No laila, nui ke koʻikoʻi o ka ʻike mua! Eia kekahi, ma waena o nā poʻe maʻi āpau i hana ʻia e ka ʻokiʻoki (nā pae āpau i hui pū ʻia) 1 i 2 mau mea maʻi ke ola 5 mau makahiki ma hope ".

ʻO ka lāʻau i hoʻokō ʻia ma muli o ke ʻano histological o ka maʻi kanesa, kona pae (ʻo ia hoʻi ke ʻano o ka hoʻonui ʻana), ke kūlana olakino o ka mea maʻi, a me ka hoʻoholo i lawe ʻia e kahi hui lapaʻau multidisciplinary e hui pū ana i ka pulmonologist, surgeon, radiotherapist. , radiologist, kauka nukelea a me ka mea kālaihonua.

Ke kumu o ka hana ʻana

ʻO ka pahuhopu o ka lāʻau lapaʻau e:

• wehe i ke koko a i ʻole metastases;
• mālama i ka laha o ka pulmonary adenocarcinoma;
• pale i ka hana hou;
• mālama i nā hōʻailona.

ʻO nā lāʻau lapaʻau like ʻole

Nui nā ʻano lapaʻau no ka pulmonary adenocarcinoma:

• ka ʻoki ʻoki ʻana, ka wehe ʻana i ke koko holoʻokoʻa, i hui pū ʻia me ka chemotherapy, ma mua a ma hope paha o ka hana
• radiotherapy wale nō,
• ka chemotherapy wale nō,
• hui pū ʻia ka chemotherapy me ka radiotherapy,
• ka radiofrequency a i ʻole ka radiotherapy stereotaxic e pili ana i ka irradiation i kālele nui ʻia i ka ʻōpū o ka māmā,
• ʻO kekahi lapaʻau ʻōnaehana (immunotherapy a / a i ʻole nā ​​​​lāʻau lapaʻau i kuhikuhi ʻia).

"Ke hoʻonui nui ʻia nei nā hana ʻokiʻoki i kēia lā a hoʻolālā ʻia ma ke kumu o nā hoʻokolohua preoperative a hiki ke komo i ka segmentectomy a i ʻole pulmonary lobectomies (e pili ana i nā ʻāpana koʻikoʻi a ʻoi aʻe paha o ka māmā)", hoʻopau ʻo Dr Santelmo.