Kaposi Sarcoma: Ukuqonda Le Ntliziyo YeVascular Engaqhelekanga

IKaposi sarcoma (KS) yirhwebo elivela kwiikhowudi ezijolise kwiivenkile zegazi kunye neezithuthi ze-lymphatic, okuholela kwiindawo ezahlukeneyo kwiimpawu zomzimba kwaye ngamanye amaxesha kwiingxaki zangaphakathi. Kubangelwa kukhuseleko lwe-humane herpesvirus 8 (HHV-8), eyaziwa ngokuba yiKaposi sarcoma-associated herpesvirus. Ngokungafaniyo nezinye iirhwebo, i-KS ikhethekile kuba uphuhliso lwayo luhambelana kakhulu nesimo somzimba. Le mngeni yafumana ingqalelo enkulu kwiminyaka ye-1980 njengomnye wemifanekiso yokuqala eyaziwayo ye-AIDS, kodwa ikhona kwiifom ezininzi ezichaphazela abantu abaninzi.

IKaposi sarcoma yeClassical ibonakala ikakhulu kumadoda amadala avela kwiindawo zeMediterranean, eMpuma Yurophu, okanye eMntla Mpuma, kwaye ihlala iphucuka kancinci ngendawo eziphakathi kweenyawo. IKaposi sarcoma yeEndemic okanye yeAfrika ibonakala kwiindawo zeSub-Saharan Africa ngaphandle kokuxhomekeka kwi-HIV kwaye ingachaphazela abantu abancinci, ngamanye amaxesha ibandakanya ukungenelela kwee-lymph nodes. IKaposi sarcoma yeIatrogenic okanye ye-transplant-associated ibonakala kubantu abathatha iimveliso zokunciphisa umphunga, ngakumbi kubamkeli be-organ transplant, kwaye ingaphucuka ukuba ukunciphisa umphunga kungavunyelwa. IKaposi sarcoma ebandakanyekayo kwi-AIDS, eyayiyifom eyaziwayo kakhulu kwaye eyenzakalayo, ibonakala kubantu abane-HIV abanesimo somzimba esiphantsi kakhulu, nangona umphumo wayo wehla kakhulu ngokufika kwemithi ye-antiretroviral efanelekileyo.

Iindawo zeKaposi sarcoma zihlala zibonakala njengezindawo eziphakanyisiweyo okanye ezincinci, iiplakethi, okanye ii-nodules kwiimpawu zomzimba ezibomvu, eziphuzi, okanye ezimnyama. Iindawo zihlala zingabuhlungu kwaye zingavela kwiinyawo, ubuso, iindawo zokuzala, okanye ngaphakathi emlonyeni. Kwiimpawu zomzimba ezimnyama, iindawo zingavela zibe mnyama okanye zibe mnyama kunokuba zibe ne-purplish hue eyaziwayo. Xa i-KS ibandakanya iingxaki zangaphakathi ezifana neempumlo, umphunga, okanye umgudu wokugaya, ingabangela iimpawu ezifana nezinkathazo zokuphefumla, ukopha, okanye ukungonwabi emathunjini, oku kungaba yingozi empilweni.!!

Uphando lweKaposi sarcoma luqala ngovavanyo olucokisekileyo lomzimba kunye nokuhlola imbali yezempilo yomgibeli, kubandakanywa nesimo se-HIV kunye nayiphi na imithi yokunciphisa umphunga. I-biopsy yesikhumba ye-lesion enokuthi ibonakale iyimfuneko ukuze kufumaneke ukungqinelana, njengoko iikhowudi ezine-spindle-shaped kunye nokwakhiwa kwee-venules ezingalunganga kuqinisekisa le mngeni phantsi kokuhlolwa kwe-microscopic. Ukuvavanywa kwe-HHV-8 kungasekela uphando, kwaye uvavanyo lwe-HIV lukhuthazwa kubantu abaninzi abavela ne-KS. Ukuba ukungenelela kwangaphakathi kuyasokola, uphando lwezithombe ezifana ne-CT scans kunye ne-endoscopy lungasebenza ukuze kuhlolwe ubungakanani besifo.

Utyando lweKaposi sarcoma luncike kwiintlobo, ubungakanani besifo, kunye nesimo somzimba somgibeli. Ku-KS ebandakanyekayo kwi-AIDS, ukuqala okanye ukulungisa umphunga we-antiretroviral yinyathelo lokuqala elibalulekileyo, njengoko ukuphinda kuphucula umphunga kungaholela ekuphucukeni okukhulu okanye nokuphuma ngokupheleleyo. Iindawo zesikhumba ezikwiindawo ezithile zinganyango ngonyango lwe-radiation, i-cryotherapy, i-topical retinoids, okanye ukususa ngesikhumba. Ku-sifo esibanzi okanye esibandakanya i-organ, i-chemotherapy ye-systemic ngama-agent afana ne-liposomal doxorubicin okanye i-paclitaxel isetyenziswa ngokubanzi, kwaye iindlela ezintsha ze-immunotherapy zihlolwe.

Iprognosis yeKaposi sarcoma ihluka kakhulu ngokuxhomekeka kuhlobo kunye nempilo ye-immune yomgibeli. I-KS ye-classic ikhuluma ngexesha elide elingenamsebenzi kangangeminyaka emininzi kwaye ngokungaqhelekanga ibanga ubungozi empilweni. I-KS ebandakanyekayo ne-AIDS, eyayiyimbangela ephambili yokufa kubantu abane-HIV, ngoku inephephe elingcono kakhulu ngenxa yokwelashwa okusebenzayo kwe-antiretroviral, kunye nabaninzi abagibeli befikelela kwi-remission epheleleyo.

I-KS ebandakanyekayo ne-transplant ingaphela ukuba ukwelashwa kokunciphisa i-immune kungancitshiswa okanye kwaguqulwa ngokukhuselekileyo. Ukufumaneka kwangaphambili kunye nolawulo olufanelekileyo lwesimo se-immune kuhlala kuyimiba ebalulekileyo ethintela iziphumo.

Uphuhliso kunye nokuqhubeka kweKaposi sarcoma kuxhomekeke kakhulu empilweni yesistim ye-immune. Ngelixa ukutheleleka kwe-HHV-8 kubalulekile ukuze i-KS iphuhlise, isistim ye-immune esebenzayo ikhulisa umkhawulo wevirus kwaye ivimbele ukwakheka komhlaza. Ukwanda kwe-immune, kungakhathaliseki ukuba kusemva kwe-HIV, imithi, okanye ukuguga, kuvumela i-HHV-8 ukuba iqhube ukwakheka kwee-lesions ze-KS.!! Le nto yenza ukuba ukuphinda kubuyiswe ukusebenza kwe-immune nge-antiretroviral therapy okanye ukunciphisa imithi yokunciphisa i-immune kube yindlela yokwelapha ephumelelayo.

Kubantu abaninzi abaninzi beKaposi sarcoma, ukulawula rhoqo i-skin kubalulekile ukuze kufumaneke kwangaphambili kunye nokungenelela kwangexesha. I-lesions ezintsha zesikhumba ezihlala zimpurple, zimbala, okanye zimbala kwaye ezingapheli kufuneka zihlolwe ngochwepheshe bezempilo. I-Skinscanner ingakunceda ukuba ulandele utshintsho lwe-skin ngexesha, okwenza kube lula ukuqaphela i-lesions ezintsha okanye eziguqukayo ezifunekayo ukuba zifumane uncedo lwezempilo. Ngelixa akukho thuluzi lodijithali lungatshintsha ukuxilongwa kochwepheshe, ukulawula okuqhubekayo kusebenza njengomgca wokuqala obalulekileyo wokwazi oza kuholela ekwelapheni kwangaphambili kunye neziphumo ezingcono.