Iyini iMerkel Cell Carcinoma?
IMerkel cell carcinoma (MCC) iyifomu engavamile futhi ehlaselayo ye-skin cancer evela kumaseli eMerkel, amaseli e-neuroendocrine akhethekile atholakala ebhakedeni le-epidermis. Lezi zicubu zisebenza ekuzwisiseni ukuthinta okukhanyayo futhi zitholakala zixhumene eduze nezinsika zenuzi emzimbeni. IMCC ihlukaniswa njenge-neuroendocrine carcinoma, ibeka le ndawo esigabeni esibanzi esifanayo nezinye i-cancers ze-lung ne-gastrointestinal ezivela kumaseli akhiqiza amahormone. Naphezu kokungavamile kwayo, lapho cishe iziguli eziyizinkulungwane ezi-3 zixilongwa minyaka yonke e-United States, i-MCC ithole ukunakwa okwandayo ngenxa yokuziphatha kwayo okuhlaselayo nokutholakala kwayo kokuxhumana ne-virus ethile.
Ukungavamile Nokuhlasela
IMerkel cell carcinoma ingama-30 kuya kuma-40 izikhathi ezingavamile kune-melanoma, nokho iphethe izinga eliphezulu lokufa. I-tumor inethuba eliqinile lokuphinda ibonakale endaweni emva kokususa, ukusabalala kumaseli e-lymph, nokumemetheka ezithweni ezikude kuhlanganise ne-liver, amaphaphu, ubuchopho, nezinsimbi. Cishe u-1/3 weziguli ziveza ukuhlanganiswa kwamagciwane ngesikhathi sokuxilongwa kokuqala, futhi izinga lokuphila eminyakeni emihlanu liphakathi kuka-60 percent kuzo zonke izigaba.!! Ukuhlasela kwe-MCC kuncike ngokwengxenye ekukhuleni kwayo okusheshayo kanye namandla ayo okwandisa ngohlelo lwe-lymphatic nolwe- blood vessel.
Kubukeka Njani?
I-Merkel cell carcinoma ivame ukuvela njenge-nodule engalaleli, eqinile, enobubanzi obuphakeme esikhumbeni esikhula ngokushesha ezinsukwini ezithile kuya ezinyangeni. Umbala uvame ukuba mnyama, pinki, i-violet, noma i-bluish-red, nakuba kungase kube nesikhumba esinombala. Umphetho uvame ukuba bushelelezi futhi bukhazimula, futhi isikhumba esiphezulu singase sibe nekhwalithi yokukhanya.
Abahlola kwesinye isikhathi basebenzisa i-acronym ye-AEIOU ukuchaza izici ezijwayelekile: Asymptomatic, Expanding rapidly, Immune suppression, Older than 50, kanye ne-UV-exposed site. Izingxenye eziningi zikhona ekhanda, emzimbeni, noma ezandleni, okuyizindawo ezine-sun exposure enkulu.
Izici Ezithinta Ingozi
Izici ezithile ezaziwayo zikhona ezithinta ukuthuthukiswa kweMerkel cell carcinoma. Ukuchayeka okuqhubekayo nokuhlanganisiwe kwe-ultraviolet radiation kuyinto ebalulekile, okuchaza ukuthi kungani i-MCC ivame ukwenzeka esikhumbeni esichayekile elangeni. Ukuguga okuthuthukile kuyinto enkulu, lapho inqwaba yeziguli zenzeka kubantu abangaphezu kweminyaka engu-65.
Ukuncipha kwemvelo kwandisa kakhulu ingozi, lapho abamukeli bezitho zomzimba bebhekene nethuba elingu-10 kuya kwelingu-15 eliphezulu lokuthola i-MCC. I-Merkel cell polyomavirus (MCPyV) itholakala ihlanganiswe kumaseli e-tumor cishe kuma-80 percent wezimo ze-MCC.
Ukuhlola iMerkel Cell Carcinoma
Ukuhlola kuyisinyathelo esibalulekile ekunqumeni ububanzi besifo nasekukhombiseni izinqumo zokwelashwa zeMerkel cell carcinoma. Uhlelo lokuhlola lubheka usayizi we-tumor eyinhloko, ukubandakanywa kwezinqe ze-lymph zendawo, kanye nokuba khona noma ukungabi khona kwe-metastases ezikude. Isigaba I ne-II sikhawulelwe esikhumbeni, kanti ukuhlukaniswa kwesigaba kusekelwe osayizi be-tumor.
Isigaba III sikhombisa ukusabalala kwezinqe ze-lymph zendawo. Isigaba IV simela isifo se-metastatic esikude. Ukuhlolwa kwe-sentinel lymph node kuyas rekomendwa kubaguli abaningi be-MCC ngoba noma ama-tumor amancane anengozi enkulu yokubandakanywa kwe-lymph node ngokomfanekiso.
Izindlela Zokwelapha
Ukwelashwa kweMerkel cell carcinoma ngokuvamile kuhlanganisa indlela ebanzi yokwelapha ehlanganisa ukuhlinzwa kanye ne-radiation therapy. Ukuhlinzwa okuvulekile okunezikhala ezingu-1 kuya kwezi-2 centimeters kuyindlela ejwayelekile yokwelashwa kwe-tumor eyinhloko, futhi ukuhlolwa kwe-sentinel lymph node kuvame ukuwenziwa ngesikhathi esifanayo. I-radiation therapy ye-adjuvant endaweni ye-tumor eyinhloko kanye nezinqe ze-lymph zendawo ivame rekomendwa ngoba i-MCC iyaphendula kakhulu ku-radiation. Kubantu abane-sifo esithuthukile noma esine-metastatic, i-immunotherapy enezithiyo ze-checkpoint ezifana ne-avelumab noma i-pembrolizumab ibuyisele iziphumo eminyakeni edlule, ifinyelela eziphumeleni eziqhubekayo engxenyeni enkulu yabaguli.
Ukwelashwa Nokuphila
Ukwelashwa kweMerkel cell carcinoma kuhluka kakhulu ngokuya ngesigaba sokuxilongwa. Abaguli abane-sifo esikhethiwe esikhumbeni abathola ukwelashwa okufanele banamazinga okuphila eminyakeni emihlanu aphakathi kuka-50 kuya ku-75 percent. Lapho izinqe ze-lymph zendawo zibandakanyeka, izinga lokuphila eminyakeni emihlanu lehla lize libe cishe ku-35 kuya ku-50 percent.
Ukwethulwa kwe-immunotherapy kuthuthukise kakhulu imiphumela yabaguli abane-sifo esithuthukile. Izici ezihlobene nokuphila okungcono zifaka usayizi omncane we-tumor, ukungabikho kokubandakanywa kwe-lymph node, uhlelo lwezokwelapha oluqinile, kanye nokuba khona kwe-Merkel cell polyomavirus ku-tumor.
Ukuqapha Nokutholwa Kwesikhathi Esifushane
Ngoba iMerkel cell carcinoma iyinto engavamile futhi ingafana nokubukeka kwezimo ezivamile ezingenasifo, ukuqwashisa kuyisinyathelo sokuqala sokutholwa kwangaphambili. Noma iyiphi i-nodule eqinile, engabuhlungu, ekhula ngokushesha esikhumbeni esithintwe ilanga, ikakhulukazi kumuntu oneminyaka engaphezu kwengu-50 noma onokuncipha kwemvelo, kufanele kube nomthelela ophuthumayo wezokwelapha.!! Ngemuva kokwelashwa kwe-MCC, ukulandela ngokuqinile ngokuhlolwa okujwayelekile kanye nezithombe kuyindlela ejwayelekile. I-Skinscanner ingaba umngane osebenzayo wokuhlola isikhumba, ikuvumela ukuthi ubhale futhi ulandele noma yiziphi izinguquko ezisha noma ezishintshayo ezikhumbeni, futhi ikhuthaze ukuvakashela ngokushesha kumdokotela wakho wesikhumba.
