Yintoni iMerkel Cell Carcinoma?
I-Merkel cell carcinoma (MCC) yindlela engavamile kwaye enobungozi ye-haukt cancer ephuma kwi-Merkel cells, iiseli ezikhethekileyo ze-neuroendocrine ezikwi-basal layer ye-epidermis. Ezi sCell zixhaphakile kwi-sensation yokuthinta okukhanyayo kwaye zifumaneka ngokusondeleyo kwiindawo zempembelelo zemithambo emzimbeni. I-MCC ibonwa njengokungumhlathi we-neuroendocrine, ibeka kwi-categories ezibanzi ezifanayo nezinye i-cancers ze-lung kunye ne-gastrointestinal ezivela kwiiseli ezikhiqiza i-hormone. Nangona ibonakala ingavakali, ngama-3,000 amacala amatsha afumaneka ngonyaka e-United States, i-MCC ifumene ingqalelo eyandisiweyo ngenxa yokuziphatha kwayo okungxamisekileyo kunye nokufumanisa ubudlelwane bayo ne-virus ethile.
Ukungavakali kunye Nobungozi
I-Merkel cell carcinoma ingama-30 ukuya kuma-40 amaxesha angavakali kune-melanoma, nangona ibamba umphumo ophakamileyo wokufa. I-tumor ine-tendency eqinileyo yokuphinda ibonakale ngendawo emva kokuhlanjwa, ukusasazeka kwiindawo ze-lymph nodes, kunye nokuhamba kwiindawo ezikude kuquka i-liver, i-lungs, i-brain, kunye neebhontsi. Cinga ukuba malunga ne-onyaka wesithathu wabaguli baveza ukungenelela kwe-lymph node ngexesha lokuqala lokufumanisa, kwaye umphumo ophakathi kweminyaka emihlanu ulinganiselwa kwi-60 percent kumjikelo wonke.!! Ubugwenxa be-MCC buncinci ngenxa yokukhula kwayo ngokukhawuleza kunye nokukwazi kwayo ukusasaza kwiindlela ze-lymphatic kunye neendawo ze-ngxowa.
Ibukeka Njani?
I-Merkel cell carcinoma ivame ukuvela njenge-nodule engabuhlungu, eqinileyo, enobukhulu obuphezulu emzimbeni ekhula ngokukhawuleza kwiiveki ukuya kumaxesha. Umbala uvame ukuba mnyama, pink, violet, okanye obomvu-oluhlaza, nangona ngamanye amaxesha ungavela njengombala wesikhumba. Umphezulu uvame ukuba mhlophe kwaye ubonakale, kwaye isikhumba esiphezulu sinokubangela umphumo opholileyo.
Abaguli bahlala besebenzisa i-acronym AEIOU ukuchaza iimpawu ezijolise kumgangatho: Asymptomatic, Ukukhula ngokukhawuleza, Ukunciphisa umphunga, Ukudala ngaphezu kwe-50, kunye ne-site ye-UV-exposed. Iitumu ezininzi zivele kwi-head, neck, okanye i-extrimities, ezona ndawo zine-sun exposure enkulu.
Iingxaki Zokhuseleko
Iingxaki ezininzi ezivela kwiingxaki ezaziwayo zikhokelela ekuphuhliseni i-Merkel cell carcinoma. Ukuphazamiseka kwe-ultraviolet radiation okuphakathi kunye nokukhula kukhulu, oku kuchaza ukuba kutheni i-MCC ivame ukuvela kwi-skin exhaswe yi-sun. Ubudala obuphakathi buye bube nomphumo ophakamileyo, kunye neengxaki ezininzi zenzeka kubantu abangaphezulu kwe-65.
Ukunciphisa umphunga kukhokelela kakhulu kumngcipheko, kunye nabamkeli be-organ transplant bejolise kwi-10 ukuya kwi-15 amaxesha umngcipheko wokuphuhlisa i-MCC. I-Merkel cell polyomavirus (MCPyV) ifumaneka ibhityile kwiiseli ze-tumor kwi-80 percent ye-MCC cases.
Uhlalutyo lwe-Merkel Cell Carcinoma
Uhlalutyo luyinyathelo elibalulekileyo ekuchazeni ubungakanani besifo kunye nokukhokela izigqibo zokwelashwa ze-Merkel cell carcinoma. Uhlalutyo luthathela ingqalelo ubungakanani be-tumor eyintloko, ukungenelela kwe-lymph nodes, kunye nokuba khona okanye ukungabikho kwe-metastases ezikude. Isigaba I kunye ne-II sikhawulelwe kwi-skin, kunye nezigaba ezahlukeneyo zesisigaba zihlala zixhomekeke kubungakanani be-tumor.
Isigaba III sikhombisa ukusasazeka kwi-lymph nodes. Isigaba IV simele isifo se-metastatic esikude. I-sentinel lymph node biopsy iyacetyiswa kubaninzi abaguli be-MCC kuba nokuba i-tumors encinci zine-mngcipheko ophakamileyo wokungenelela kwe-lymph node.
Iindlela Zokwelapha
Ukwelashwa kweMerkel cell carcinoma ngokubanzi kubandakanya indlela ye-multimodal ehlanganisa ukuhlinzwa kunye ne-radiation therapy. Ukususa okukhulu endaweni enomda we-1 ukuya kwi-2 centimeters yindlela yokuhlinzwa eqhelekileyo ye-tumor ephambili, kwaye i-sentinel lymph node biopsy ivamise ukwenza ngaxeshanye. I-radiation therapy ye-adjuvant kwi-site ye-tumor ephambili kunye neendawo ze-lymph ezisemgangathweni ivame ukunconywa kuba i-MCC iyaphendula kakhulu kwi-radiation. Kwiimeko eziphucukileyo okanye ezithathelwanayo, i-immunotherapy kunye ne-checkpoint inhibitors ezifana ne-avelumab okanye i-pembrolizumab itshintshile iziphumo kwiinyanga ezidlulileyo, ifezekisa iimpendulo ezihlala ixesha elide kwiindawo ezithile zabaguli.
Uphando kunye nokuPhila
Uphando lweMerkel cell carcinoma luhluka kakhulu ngokuxhomekeka kumjikelo wokuxilongwa. Abaguli abanezigulo ezikwi-skin kuphela abaphumelele ukwelashwa okufanelekileyo banemilinganiselo yokuphila eminyakeni emihlanu ephakathi kwe-50 ukuya kwi-75 percent. Xa iindawo ze-lymph ezisemgangathweni zixhaphakile, imilinganiselo yokuphila eminyakeni emihlanu iyah下降 ukuya kwi-35 ukuya kwi-50 percent.
Ukungena kwe-immunotherapy kuphucule kakhulu iziphumo zabaguli abanezigulo eziphucukileyo. Iimpawu ezinxulumene nokuphila okungcono ziquka ubungakanani obuncinci be-tumor, ukungabikho kokuhlangana kwe-lymph node, inkqubo ye-immune eqinile, kunye nokuba khona kweMerkel cell polyomavirus kwi-tumor.
Ukwahlula kunye nokuFumaneka kwangaphambili
Ngenxa yokuba iMerkel cell carcinoma iyahlukeneyo kwaye ingafana nokubukeka kwezinye iimeko ezivamile ezingenabungozi, ukuqonda kukhulu kakhulu kumjikelo wokuqala. Nanyani, i-nodule eqinileyo, engabuhlungu, ekhula ngokukhawuleza kwi-skin evulileyo elangeni, ngakumbi kumntu oneminyaka engama-50 okanye onokuphuculwa kwe-immune, kufuneka ibangele uvavanyo lwezempilo oluphuthumayo.!! Emva kokwelashwa kwe-MCC, ukulandela ngokuqinileyo kunye neengxelo ezihlala zikhona kunye ne-imaging kuyindlela eqhelekileyo. I-Skinscanner ingaba ngumhlobo oncedisayo wokuhlola i-skin ngokuqhelekileyo, ikuvumela ukuba ubhale kwaye ulandele nayiphi na i-lesions ezintsha okanye ezitshintshayo kwi-skin kwaye ikhuthaze ukuxhumana kwangexesha nomphakathi wakho wezempilo.
