ʻO kahi neuroendocrine tumor o ka pancreas a me ka gastrointestinal tract kahi kahi adenoma a i ʻole neoplasm, kahiʻano i nānā ʻia e ka hana nui o ka hana a nā poʻe kino e hoʻomaʻamaʻa i nā kino o nā kino, e alakaʻi ana i ka hoʻokūkū o ka metabolism interstitial.
ʻO ke kumu o nā neoplasms he mea hana ia o ka ʻōnaehana neuroendocrine, ka mea e pili ana i nā pūlehu synthesizing o ka peptide hormones a me nā biogen amines, hoʻohui ʻia ma lalo o ka huaʻōlelo "APUD-system."
Ua kapa ʻia nā selela o kēia ʻōnaehana nā apudocytes, he ikaika ia no ka hormonally, hiki ke hopu i ka poʻe amine precursors, decarboxylate a synthesize amines, pono no ka hana a me ka hoʻoponopono o nā peptides hormonal.
ʻIke ka ʻike ʻepekema hou aku ma mua o 20 mau ʻano o nā apudocytes i loaʻa i ke kikowaena o ke kino (hypothalamus a me pituitary gland), i ka ʻaoʻao o ka pūnaehana nūnū, ma ka ʻōpū, duodenum, pancreas a me nā ʻāpana gastrointestinal.
He aha ka maʻi nuro neuroendocrine?
ʻO ka pancreatic NEO ua kapa ʻia ʻo ia he ʻāpana puʻupuʻu islet i ka hana lapaʻau. Kūpili ʻia nā ʻano neoplasms manuahi, no laila, i ka endocrinology e noʻonoʻo i kahi kūʻokoʻa.
I loko o ka pancreas, ʻelua mau hanana o nā cell - endocrine a exocrine. Hoʻokū ka hui mua o nā pū i ka hana ʻana o kekahi mau ʻano o nā mea hormonal - hāʻawi lākou i ka mana o kekahi mau cell a i ʻole nā ʻōnaehana i ke kino o ke kanaka. No ka hoʻohālikelike, mālama ka hāmeʻe o ka hāmeʻe i ka ʻike glucose.
Hoʻākoakoa ʻia kēia mau ʻāpana ma nā mokupuni liʻiliʻi a puni ka pancreas. Ua kapa ʻia lākou he mau seler a he islet cells. ʻO ka neoplasm e pili ana i kēia mau wahi i kapa ʻia ke ʻano o nā aʻa o nā islet. Nā inoa ʻē aʻe - endocrine neoplasm a i ʻole NEO.
Hoʻokomo nā pūnaehana i ka māhele exocrine o ke kino i nā enzyme i hoʻokuʻu i ka pā liʻiliʻi. Hoʻonohonoho lākou i ka hoʻomālamalama ʻana i ke kaʻina o ka kāpili ʻana o ka meaʻai. ʻO ka hapa nui o nā pancreas me nā ʻāpana liʻiliʻi me nā puʻupuʻu liʻiliʻi kahi i waiho ʻia kēia mau sela.
ʻO nā ʻōpū neuroendocrine paha i benign ma ke ʻano (ʻaʻole ke kanesa) a he hōʻeha paha i ke ʻano (ʻeha). Inā hōʻike ʻoe i ka hōʻike maʻi neoplasm malignant, a laila kamaʻilio lākou e pili ana i ka oncology endocrine o ka pancreas a insuloma paha.
Hoʻokahi pinepine ʻia kahi maʻi neuroendocrine pancreatic ma mua o kahi tumela sela exocrine, me ka hoʻomaikaʻi ʻana aku i ka maikaʻi o ka hoʻomanawanui.
Ka papa ʻaina o NEO pancreas
Ma ka hoʻomaʻamaʻa lāʻau lapaʻau, ʻokoʻa ka NEO ma muli o ke wahi. Inā hele mai ka ʻōpala i loko o ka digestive tract, a laila aneane hiki ʻole ke hoʻowalewale i ka ʻatikala i nā hoʻomaka mua a hiki i ka neoplasm e hāʻawi i nā metastases i nā ʻokoʻa ʻē aʻe.
ʻO ka pancreas kanaka ka hapa o nā ʻāpana - ke poʻo, ka ʻili a me ke kino. Me nā pīpī i loko o kēia mau wahi, ua uluwehi i ka ʻeʻe ʻana o ka hormon, a ulu ka hopena maikaʻi ʻole. Inā objectively, me ka hoʻomohala ʻana o ka ʻepekema, paʻakikī paʻakikī loa ka hōʻoia ʻana i ia maʻi.
Ma muli o ke wahi, ua loaʻa ka maʻi o ka maʻi. Heʻokoʻa nui ko lākou. Wahi a ia, ua hoʻoholo ʻia ka papa lāʻau hou e nā ʻano he nui - kahi o ka nui, ka nui o ka hoʻonaʻauao, etc.
ʻO nā ʻōpū pancreatic hana Neuroendocrine, ka mea i loaʻa i nā mea i loaʻa i kēia:
- ʻO Gastrinoma kahi neoplasm i wahi i loko o nā hale i kāpili i ka hormone gastrin. Hoʻokomo kēia mau mea i ka hoʻokuʻu i ka wai o gastric, kōkua i ka hoʻokaʻawale ʻana o nā meaʻai. Me kahi kakaho, ka ʻike o ka wai o ka gastric a me ka ʻike ʻana o ka hormone hoʻonui. ʻO Gastrinoma i ka hapa nui o nā kiʻi paʻi ʻia i ke poʻo o ke kino o loko. I kekahi mau kiʻi, ke hōʻike nei ma loko o kahi ʻāpana liʻiliʻi. ʻO ka pinepine, hoʻokumu ʻia ke ʻano kino o ka neoplasm.
- ʻO ka Insulinoma kahi mea i loaʻa i loko o nā pūpuna e hana ai i ka insulin hormone. Na ka māhele ke kuleana no ka ʻike i ka glucose i loko o ke kino. Kūleʻa ikaika kēia neoplasm, ʻaʻole anuʻu i hāʻawi i nā metastases. Loaʻa ʻia ma ke poʻo, ka ʻili a i ʻole ke kino o ka nui. ʻO ia ka benign ma ke ʻano.
- Glukagonoma. Ke kūloko ʻia ka maʻi i loko o nā pehu e pili ana i ka hana ʻana o ka glucagon i loko o ke kino. Hoʻonui kēia mea hoʻohui i ka hoʻonaʻu gula ma o ka wāwahi o ka glycogen i loko o ka ate. I ka ʻike kiʻekiʻe o ka momona o ka glucagon, ʻike ʻia kahi kūlana hyperglycemic. ʻO ka tumōkahi neuroendocrine ka pāpale o ka pancreatic i ka manawa pinepine e hōʻeha.
I ka lāʻau lapaʻau, hoʻokaʻawale nā ʻano o nā neoplasms ʻaʻa, ʻoi ka mea maʻamau. Hoʻohana pū lākou i ka hana o nā hormones, kahi komo i nā hoʻoponopono i nā glucose, nā ʻike o nā paʻakai a me nā wai pā.
Vipoma (pancreatic cholera) - he neoplasm, i hoʻopaʻa ʻia i loko o nā mea i hana i ka peptide ʻaki; ʻO ka somatostatinoma kahiʻano maʻi o nā pūpū e hana ai i ka hormone somatostatin.
ʻO ka Somatostatinoma ka ʻike maikaʻi a ka makaʻi radionuclide.
Nā hōʻike maʻi lapaʻau e pili ana i ke ʻano o ke ʻano o ke ʻano
Hoʻomaʻamaʻa ʻia nā hōʻailona o kahi neoplasm pathological ma muli o ka ulu ʻana o ke aʻa a me / a ma muli o ka hana ʻana o ka hormone impaired. ʻAʻole hōʻike kekahi mau ʻano o ka huki i kā lākou hoʻomohala e kekahi mau hōʻailona, no laila, ʻike ʻia lākou i nā hana hope loa, kahi e alakaʻi ai i kahi prognosis maikaʻi ʻole.
Hiki ke ulu i nā puka i ka pancreas o kahi ʻano hana ʻole ʻole no ka manawa lōʻihi, me nā hōʻailona ʻole i haʻi ʻia. Hiki iā lākou ke pālahalaha i nā kino pilikino ʻē aʻe. ʻO nā ʻōmaʻomaʻi koʻikoʻi ka komo ʻana i ka hana o ka digestive tract, ʻaʻai, ʻeha ma ka ʻōpū a i ʻole hoʻi hope, ʻili o ka ʻili a me ka sclera o nā kino o ka ʻike.
ʻO ka hōʻailonaatology o ka hana o ka maʻi pancreatic ma muli o ke ʻano o ka hormonal mea, ke kū nei ka neʻe e hoʻonui i ka ulu ʻana ma muli o ka ulu ʻana o ka pīpī. Me kahi kiʻekiʻe o gastrin, ʻike ʻia nā hōʻailona like ʻole:
- ʻAkia hoʻi ka ʻoki o ka ʻōpū.
- ʻO ka ʻeha ma ka ʻōpū, e pā mai ana i hope. Hoʻomaʻamaʻa pinepine ʻia ka ʻeha a hele pinepine ʻia paha.
- Hoʻokiʻoki i ka maʻi lōʻihi.
- Hoʻopili i ka Gastroesophageal.
E kūʻē i ke kua ʻana o ke kaila o ka insulin, kahi ulu hypoglycemic ulu (kūmole haʻahaʻa i loko o ke kino). Ma ka huli ʻana, alakaʻi ka hypoglycemia i nā hōʻeha, ka ʻeha, ka nāwaliwali, nā ke kaniʻuhū, me ka nui o ka luhiluhi. Eia kekahi, ʻo nā mea maʻi e hoʻopiʻi i ka puʻuwai wikiwiki a me ka pulse.
Me ka piʻi wikiwiki o ka glucagon, ua hōʻike ʻia nā hōʻike pilikino:
- ʻO nā ʻeha ma ka maka, ʻōpū a me nā haʻahaʻa haʻahaʻa.
- Ka hoʻonui ʻia ʻana o ka glucose i ke kino, kahi e alakaʻi ai i ka hōʻeha, ka piʻi ʻana o ka gravity kūikawā o ka urine i kēlā me kēia lā, maloʻo o ka ʻōpūʻā a me ka ʻili, ka pōloli, ka makewai, a me ka nāwaliwali mau.
- Nā ʻano kahaka koko. Inā hoʻokomo ʻia nā ʻōmaka koko i loko o ka māmā, a laila ke alakaʻi i ka pōkole o ka hanu, ka u, ka ʻeha ma ka umauma. Me nā wahi o nā kahakaha koko ma nāʻaoʻao kiʻekiʻe a i lalo paha, aia ka ʻeha, ka ʻana o nā lima a i ʻole nā wāwae, ka maʻi maʻi o ka ʻili.
- ʻO ka hoʻopauʻana o ka kāwili.
- Hoʻemi i ka momona.
- ʻEha ma loko o ka waha, ʻeha i nā kihi o ka waha.
Me ka hoʻonui ʻana o ka peptide ʻōpū, ʻike mau ʻia ka maʻi maʻamau, kahi e alakaʻi ai i ka dehydration me nā hōʻailona concomitant - ke makemake mau ʻana e inu, ka hoʻemi ʻana o ka urine, ka ʻili maloʻo a me ka mucous waha i loko o ka waha, ka ʻeha pinepine a me ka dizziness, a me ka malish maʻamau.
Hōʻike nā hoʻokolohua laboratory i ka emi o ke kaohi o ka pāhana i loko o ke koko, ka mea e hoʻonāukiuki i ka nāwaliwali o ka naʻau, nā ʻeha, nā hoʻokolohua, hōʻeha a me ka ʻike ʻana i nā mea pili, nā manawa pinepine, ka puʻuwai koke, ʻeha o ka ʻōpū a me ka kaumaha o ka ʻike ʻole i ka etiology.
Me ka hoʻonui nui o nā pae somatostatin, nā hōʻailona koʻikoʻi ka hyperglycemia, ke nānā ʻana, ka hōʻea i ka momona i nā feces, gallstones, yellowness o ka ʻili a me ka protein o ka maka, ka hoʻolilo ʻana.
Hoʻomaka maʻi maʻi pancreatic
I ka loaʻa ʻana o kahi maʻi pancreatic neuroendocrine, pono ke koi ʻana i ka hōʻulu ʻana. Ua kapa ʻia ka hana ʻo ka gastrectomy. Eia naʻe, loaʻa nā pilikia hana i ka pilikia, ʻo ia ka mea i loaʻa i nā neoplasms lehulehu, i pili ana a i loko o ke ʻano.
I kekahi mau kiʻi lāʻau lapaʻau, paʻakikī ka nui o ka hana e wānana ʻia, no laila ua hoʻoholo ʻia ka papa o ke kaʻina lapaʻau e ka mea ʻoiaʻiʻo - ma hope o ka hoʻomaka ʻana o ka mea maʻi.
Hoʻomaopopo ka wā hōʻike i nā hōʻike kulana o kahi maʻi pancreatic, kēlā, e hoʻomaka i kahi lāʻau kūpono, hiki i ke kauka keʻike hiki. Akā ʻaʻole iki nā neoplasms, no laila ʻaʻole hiki ke mālama mau ʻia i ka maʻi i kahi wā mua.
Inā ulu ka ulu i ka wikiwiki, aʻo ka liʻiliʻi o ke kūʻokoʻa e ʻike ʻia ana, a laila ua kuhikuhi ka mea maʻi i ka chemotherapy. Hoʻohana ʻia kēia mau lāʻau lapaʻau i ka wā o ka hoʻomālamalama ʻana o nā maʻi:
- Chlorozotocin.
- Doxorubicin.
- Epirubicin.
ʻO kekahi manawa ke koi ʻia ka hoʻomaka ʻana o ka hormone syntat somatostatin, ʻo ia hoʻi, ʻo ka hoʻokō ʻana i ka lāʻau hormone. ʻO ke kumuhana o ka maʻi maʻi, ke ʻano o nā lāʻau lapaʻau, ka manawa o ko lākou luna - i kūʻokoʻa pū kekahi. Hāʻawi ʻia kahi hana ikaika ma hope o ka hoʻohemo ʻana i kahi maʻi hohonu, ma ka helu he nui.
He liʻiliʻi ka hopena o ka chemotherapy. Kūpono nā hōʻike i loaʻa kahi hopena maikaʻi i ka 15-20% o nā hihia. Inā hāʻawi ka chemotherapy i ka hopena maikaʻi ma hope o kekahi mau papa, a laila e hiki i ka mea maʻi ke ola mai 2 a 9 mau makahiki.
Hoʻopili i nā chemotherapy, ua hoʻoholo ʻia nā lāʻau lapaʻau e kuhikuhi ana e hōʻemi i nā hōʻailona hopohopo. Koho ʻia ka koho o ka lāʻau lapaʻau ma nā hōʻike hōʻike kino. Hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau.
- ʻOihope.
- Omez.
- Ranitidine.
- Omeprazole
Inā ʻaʻohe hopena kūpono ma muli o chemotherapy, e kū mai ka nīnau e pili ana i ka hōʻoki ʻana. I ka lāʻau lapaʻau hou, hoʻāʻo lākou e hoʻohana i nā ʻano ʻoi loa ka maikaʻi. ʻO kekahi o ia ka lāʻau radionuclide.
ʻO ka loaʻa o ke ola holoʻokoʻa (prognosis) hilinaʻi i nā ʻano he nui: nā ʻano o nā mea maʻi o ke kanesa, ke kahi o ka ʻōpū, ka hele ʻana / ʻaʻole i loaʻa i nā metastases, nā maʻi concomitant, ka makahiki o ka mea maʻi. ʻO ka mea kūpono maikaʻi loa no nā tumi hou ʻana i ʻoi aku ma mua o ʻelua mau kenimika, ʻaʻole ia i metastasize i loko o ka lymph a me ka ate.
ʻO ka tumors pancreatic i wehewehe ʻia i ke wikiō ma kēia ʻatikala.
