ʻO ka maʻi phyllodes kahi maʻi ʻokoʻa o ka umauma, ʻike pinepine ʻia ma mua o ka maʻi maʻi umauma. He maʻi maʻamau ia, akā aia nā ʻano maʻi ʻino. ʻO ka lāʻau lapaʻau i makemake ʻia, ʻo ia ka hōʻoki ʻana, me ka prognosis maʻamau, ʻoiai inā ʻaʻole hiki ke hoʻokuʻu ʻia nā hoʻihoʻi kūloko.

Definition

ʻO ka maʻi ʻo Phyllodes kahi maʻi ʻokoʻa o ka umauma, e hoʻomaka ana ma ka ʻiʻo pili. He maʻi maʻi i hui ʻia, i kapa ʻia ʻo fibroepithelial, i hōʻike ʻia e ka hoʻonui ʻana o nā pūnaewele epithelial a me nā ʻiʻo pili pili, ʻoiai ka hapa nui o nā maʻi maʻi umauma e pili ana i nā cell glandular. 

Hāʻule nā ​​maʻi maʻi Phyllodes i ʻekolu pūʻulu:

• ʻO ka hapa nui (ma waena o 50% a me 75% e like me ka mea kākau) he mau maʻi maʻi benign (papa 1)
• ʻO 15-20% he mau maʻi maʻi palena, a i ʻole borderline (papa 2)
• ʻO 10 a 30% he mau maʻi maʻi ʻino, ʻo ia hoʻi ke kanesa (papa 3), i kapa ʻia i kekahi manawa he phyllodes sarcomas.

ʻOi aku ka lohi ʻana o nā maʻi ʻaʻai phyllodes papa 1 a liʻiliʻi pinepine (ma ke ʻano o ke kenimika), e ulu wikiwiki ana a ʻoi aku ka maʻi maʻi maʻi phyllodes nui (a hiki i 15 knm).

ʻO nā maʻi phyllodes malignant wale nō paha ke kumu o ka metastases.

Nā kumu

ʻAʻole maopopo i ke kumu o ka hoʻokumu ʻana o kēia mau ʻōpū.

PalekanaEND_LINK

ʻIke pinepine ʻia ka ʻōpū, kahi i hoʻohālikelike maikaʻi ʻia i ka wā o ka nānā ʻana iā ʻoe iho a i ʻole ka hoʻokolohua lapaʻau ma kahi kūkākūkā gynecological.

ʻO ka ulu wikiwiki ʻana o kahi nui i ʻike mua ʻia e hōʻike paha i ka ʻike, alakaʻi pū ʻia e ka makahiki o ka mea maʻi.

NA POSA

ʻO nā hoʻokolohua kiʻi i makemake ʻia he mammography a me ultrasound, akā hiki i ka MRI ke hāʻawi i ka ʻike i nā hihia kikoʻī. Eia naʻe, ʻaʻole hiki i kēia mau hoʻokolohua ke nānā i ka pae o ka maʻi phyllodes, a ʻaʻole hoʻi e hoʻokaʻawale iā ia mai ka fibradenoma, kahi maʻi umauma maʻi like ʻole.

nā lāʻau kanu

Hana ʻia ka biopsy percutaneous (lawe ʻana i nā ʻāpana ʻiʻo me ka nila i hoʻokomo ʻia ma ka ʻili) ma lalo o ke alakaʻi ʻana i ka ultrasound. Hāʻawi ia i ka hōʻoia histological: ʻike ʻia nā ʻiʻo i lawe ʻia ma lalo o kahi microscope e hoʻoholo ai i ke ʻano o ka ʻōpū.

Pili ka poʻe

Hiki ke loa'a ka ma'i ma'i Phyllodes i nā makahiki a pau akā pili nui i nā wāhine ma waena o 35 a 55 mau makahiki, me ka pi'i nui ma waena o 40 a me 45 mau makahiki. No laila, ʻike ʻia lākou ma hope o ka fibradenoma, ka mea e pili ana i nā wahine ʻōpio, akā ma mua o ka maʻi maʻi umauma.

Hōʻike lākou ma lalo o 0,5% o nā maʻi umauma āpau.

Nā mea pilikino

Manaʻo nā mea noiʻi i ke komo ʻana o nā kumu predisposing genetic like ʻole i ka ʻike a me ka ulu ʻana o kēia mau maʻi koko.

ʻAʻole ʻeha ka hapa nui o nā ʻōpū phyllodes a ʻaʻole pili me ke axillary lymphadenopathy (ʻaʻohe mea kānalua, paʻakikī a i ʻole nā ​​​​lymp nodes inflamed ma ka ʻāʻī).

Ma ka palpation, paʻa ka nodule, paʻa i ka wā liʻiliʻi, pili i nā ʻiʻo ke ulu.

Hiki ke hui pū ʻia nā ʻōpū nui me nā maʻi ʻili. Kakaʻikahi, loaʻa ka nipple discharge or nipple retraction.

ʻoki kino

Hoʻokumu ʻia ka lāʻau lapaʻau ma ka excision surgical o nā maʻi maʻi non-metastatic, inā he benign a malignant paha, ʻoiai e mālama ana i kahi palena palekana o 1 knm. ʻOi aku ka maikaʻi o ka ʻoki kino conservative ma mua o ka mastectomy. Pono paha kēia i ka wā o ka hoʻi hou ʻana.

ʻAʻole kōkua ka wehe ʻana i ka node lymph axillary.

ʻO ke kelepona

Hiki i ka Radiotherapy ke hana i kahi lapaʻau kōkua o nā maʻi maʻi phyllodes malignant, ʻoi aku ka nui o ka hoʻi hou ʻana.

Chemotherapy

ʻO ka pono o ka chemotherapy ma ke ʻano he hoʻoponopono kōkua o nā maʻi maʻi phyllodes malignant e kūkākūkā ʻia ma ke ʻano hihia. Ua like nā protocols i hoʻohana ʻia me nā mea i hoʻohana ʻia i ka mālama ʻana i nā sarcomas ʻili palupalu.

Maikaʻi ka wānana no nā maʻi ʻōpū phyllodes, me ka loaʻa ʻole o ka hoʻi hou ʻana i 10 mau makahiki i 8 o 10 wahine, me ka nānā ʻole i ka pae o ka maʻi ʻaʻai. 

ʻO ka hoʻi hou ʻana o ka ʻāina, e mau nō naʻe. Loaʻa lākou i loko o ʻelua mau makahiki o ka ʻoki ʻana, akā hiki ke ʻike ʻia ma hope aku, kahi e pono ai ka nānā mau. Hoʻomaka hou ka maʻi maʻi maʻi ma mua.

ʻOi aku ka ʻoi aku o ka ʻinoʻino o ka maʻi phyllodes e hoʻi hou ana ma mua o ke kino kumu. ʻOi aku ka kakaikahi, ma kahi ʻē, e loaʻa iā ia kahi ʻano benign. No laila hiki ke hoʻi hou kekahi mau maʻi maʻi maʻi ma ke ʻano o nā maʻi maʻi kanesa, a i ʻole ka metastatic evolution. ʻOi aku ka nui o ka loaʻa ʻana o ka metastasizing i ka wā i ʻinoʻino ka maʻi phyllodes mua.

Inā hoʻi hou ka ʻāina, ʻo ka mastectomy i kapa ʻia ʻo "catch-up" mastectomy e hāʻawi i kahi lāʻau lapaʻau kiʻekiʻe akā hoʻomau mau i kahi ʻano hōʻemi, ʻike pinepine ʻia e nā wahine ʻōpio. Kūkākūkā ʻia ka pōmaikaʻi o ka radiotherapy a me / a i ʻole ka chemotherapy i kēlā me kēia hihia e ka hui mālama ola.

Noho maikaʻi ʻole ka prognosis ke alakaʻi ka hoʻi hou ʻana i ke ʻano o nā metastases. ʻAʻole lōʻihi ka pane i ka chemotherapy, me ka make i loko o 4 a 6 mau mahina. No laila he kuleana ko ka nānā ʻana.