Hepatocellular carcinoma chiropa: nechirwere, Zviratidzo neMarapirwo

Primary nekenza zvirwere chiropa hadziwanzowaniki. Kazhinji prostate kenza hakukoshi, kureva metastatic. The chikuru chiropa mapundu anorondedzera holangio- uye hepatocellular carcinoma. nekenza izvi zvinogona kuva varume pakati pevakadzi (kazhinji). In vana, mapundu aya anenge kumbobvira kuitika. Muvarwere vaduku vanogona kuva kenza chiropa, zvinobva embryo zvinyama - hepatoblastoma. zvokurwara Izvi kushoma. Anenge zvose chikuru mapundu chiropa vanoonekwa kuti hasha. Ivo rwugare 5th nzvimbo hwenyama mune kenza pathologies mamiriro. Pari tiri kutsvaka nzira itsva kurwisa kenza chiropa. Great mberi runowanikwa kuwanikwa uye Vanosarudzwa masoja kurapa.

Tsanangudzo hepatocellular carcinoma

Hepatocellular carcinoma - nekenza chiropa masero vakafumura atypia. Tichienzanisa nedzimwe chepuraimari oncological pathologies muviri, chitsvene-zvakapararira. bundu ichi chinonziwo hepatic muchitokisi carcinoma. Mune kakawanda hepatocellular carcinoma pakati pevanhu chechi5 pakukura munyika. bundu Izvi zvinozivikanwa munyika dzakabudirira. Rinoreva chakakomba uye nokukurumidza mberi kenza uye kazhinji zvinouraya. Haisi chete kunonoka chirwere chirwere, asi ayo sehasha uye kukwanisa metastasize kune dzimwe nhengo. Izvi nokuda chiropa perfusion.

mhando dzose kenza akanyorwa muna International kupatsanura kwezvirwere (ICD). Kufanana nevamwe kenza zvokurwara, ine bumbiro yayo inokosha, uye hepatocellular carcinoma. ICD-10 rinoshandiswa munyika dzese munyika. Mune kupatsanura pakati chirwere ane bumbiro S22.0, zvinoreva "chiropa masero carcinoma." Kakawanda, zvokurwara ichi chinoitika pamusoro mamiriro echirwere ezvinhu, achifuridzirwa rwakashata zvinhu.

Zvinokonzera chiropa carcinoma

Sezvo chikazozikamwa, ari etiology pamusoro nyanyisa anomera asati kudzidza. Zvisinei, masayendisiti refu vakawana izvo zvinoita kutsamwisa kukura bundu. No kunze uye hepatic muchitokisi carcinoma. Amuise zvinotevera migumisiro:

1. Long-rokuti vatakuri zvimwe wanda. Zvinofungidzirwa kuti pathologies dzakadai chisingaperi kuzvimba chiropa hepatitis B uye C, kuwedzera pangozi yokuita hepatic carcinoma neinopfuura ka100. Uyezve, zvirwere izvi kakawanda asymptomatic. Naizvozvo, kuti yekuzvidzivirira kenza inofanira nguva kupa ropa pamusoro nehepatitis wanda.
2. Chiropa cirrhosis chero etiology. Yaitsiva hepatocytes ari connective zvinyama rinowanzoberekera somugumisiro chirwere chaikonzerwa noutachiona, yaunodya doro uye zvinodhaka.
3. Kudya zvokudya akapfuma aflatoxin.
4. Genetic kubatwa kuti chirwere.
5. Rubvumo hepatotoxic zvinodhaka.

Kana isu haabatanidzi vakanyorwa precipitating zvikonzero, ngozi kusimukira hepatocellular carcinoma riri shoma. Kunyange zvakadaro, hapana munhu kusiya bundu iri. Kufanana nevamwe kenza zvokurwara, kungaguma nezvemidzimu ionizing nemwaranzi, kusvuta, murombo muviri, kushushikana, uye zvichingodaro. D.

The pathogenesis pamusoro hepatocellular carcinoma

Somugumisiro, chirwere kuzvimba zvakajairika chiropa masero vanotanga kuchinja kupinda bundu zvinhu. Chii chaizvo chinoita kuti izvozvo harizivikanwi. Nokuda zviito utachiona chiropa rinenge riri uchazvimba, muviri inova edematous, uye kurwadza. vascular permeability kunowedzera, vanova yakazara ropa rechiJudha chairo. Somugumisiro, chiropa basa ravapo havachanyatsogoni. Kunze chokwadi chokuti muviri kuparadza nemavhairasi nezvimedu, chokuita nezvimwe zvinhu zvinokuvadza achibva zvokudya. izvi zvose zvinotungamirira masero kuchinja. The tsanga rinokura kukura, asi cytoplasm nemamwe organelles vari zvava arikunze. Pashure paizvozvo, sero anotanga kugovera unmotivated. It anopiwa muzvizhinji pamusoro nuclei, hepatocyte muviri mu chibharo. Muchitokisi, bundu anotanga synthesize mapuroteni kuti akakurumidza kupararira kuburikidza muropa. Saka interconnected Hepatitis C uye Hepatocellular Carcinoma.

Zvinofanira kurangarirwa kuti chinhu nemavhairasi chirwere anenge nguva dzose kuita kuti cirrhosis chiropa kana kenza. Kazhinji, atova nechirwere kana matambudziko angamuka. Rimwe zita hepatitis C - "nyoro muurayi". Izvi imhaka asipo kunotoda kurapwa zvinoratidza chirwere kwemakore akawanda, uye kwava kuda kufa pamusana kugumiswa kushanda chiropa zvakakwana.

Kupatsanura pakati hepatocellular carcinomas

Hepatocellular carcinoma chiropa rakakamurwa dzakawanda kurapwa uye morphological siyana. Mukuwedzera, bundu iri Classified maererano padariro kukura nekuomarara. Zvichienderana macroscopic mufananidzo dzoga raiva pedyo nebundu, hombe uye diffuse siyana kenza chiropa. Vaitirei vakaparadzana rudzi fibrolamellar hepatocellular carcinoma. Maererano kunotoda remifananidzo 6 siyana chiropa muchitokisi carcinoma. Pakati pavo:

1. Gepatomegalichesky kuita.
2. Icteric chimiro.
3. Febrile pachake kenza chiropa.
4. Ascites fomu.
5. Chenjera abdominal kuita.
6. Metastatic chiropa kenza.

Kakawanda pane mubatanidzwa kunotoda kurapwa dzakasiyana siyana. Stage kenza Fígado-sero kunoenderana ukuru bundu wayo hwakapararira ari pedyo node nodes uye dzimwe nhengo.

Hepatocellular carcinoma: zviratidzo

Zviratidzo kuvimba kunotoda muchimiro carcinoma. Kazhinji, nzendo kenza mangwanani haina zviratidzo. Mukuwedzera, chirwere kwakaoma nokuti kuti bundu zviratidzo kufanana kunotoda mufananidzo dzimwe chiropa chirwere (chirwere chiropa, cirrhosis). By mukupera kenza kuratidzwa zvinosanganisira nefivha yakaderera-sosaiti, kurasikirwa kudya, simba, lymphadenopathy, uremu. Kana gepatomegalicheskoy muchimiro carcinoma aona anyatsoona yakawedzera chiropa, marwadzo zvakarurama hypochondrium. Mumwe pavatatu varwere vane jaundice dzakasiyana pamusoro zvokurwara. It ane murombo fungidziro. Jaundice rinowanikwa pakutanga kana chechipiri padanho bundu.

Uyezve, varwere vakanyunyutira kurwadziwa uye kuvaviwa. Kana febrile chimiro akacherekedza kuwedzera muviri tembiricha kugara, kusingafadzi achirwadza nezvekufadza iri repamusoro mudumbu. Ascites anooneka yepamusoro nzendo kenza, bundu achabatsirwa zvakafanana zviratidzo kudhaka. Ishoma chenjera abdominal chimiro. It kunoratidzwa irwadziwe, sunga pamusoro abdominal netsandanyama. Option nokuti metastatic hepatocellular carcinoma hunodzorwa zviratidzo nedzimwe nhengo. Pakati pavo - mapfupa, mapapu, ura.

Morphological siyana chiropa carcinoma

Morphology fomu mapundu secrete zvinotevera:

1. Wandisa hepatocellular carcinoma. Zvinotora chidimbu rose kana akafukidza chiropa. Kana vendu ane miganhu zvakajeka. Uyewo foci diki (satellites) anogona kuvapo mukati bundu nzvimbo. Mumwe akasiyana hombe kenza chiropa anoonekwa kuva muchimiro abdominal. At sectional dzakaonekwa bundu nzvimbo, mukati umo pane mashava zvokunwa. Mhango rusvingo gobvu kumeso.
2. Nodular hepatocellular carcinoma. Dzinoratidzwa muzvizhinji kuti nebundu foci iri yose parenchyma muviri pamusoro.
3. Diffuse Fígado carcinoma. Kakawanda anovandudza pamusoro pakanyorwa cirrhosis. parenchyma All inoumbwa chinobatanidza connective zvinyama uye masero mwero.

Fibrolamellar carcinoma ine rimwe kana hombe nzvimbo shoma. Kazhinji zviri vemunyika mu rworuboshwe akafukidza chiropa. Color bundu - yero kana girini. Chimwe yoga chimiro anoonekwa kuti encapsulated (diki), hepatic sero carcinoma. It kunoratidzwa yakanaka fungidziro uye kunonoka kukura, bundu saizi idukusa 5 masendimita ari dhayamita.

Chirwere kuti chiropa hepatocellular carcinoma

Zvinokosha kuita zvakasiyana siyana bvunzo asati kuona zvakadai zvirwere sezvo hepatocellular carcinoma. Zvokurwara chirwere ine mumatanho anoverengeka. Chokutanga, chiremba anoteerera murefu kunyunyuta zvose uye anoongorora. Pfungwa iri rwakabhadharwa kuna ganda (ruvara, kuvapo raschosov, ropa), node nodes, palpation chiropa. In kenza muviri ane nematambudziko pamusoro, gobvu magadzirirwo, kwakaratidzwa unyoro. Zvadaro, vakawanda kuongorora. Pakati pavo:

1. KLA, ropa kemisitiri.
2. Pakusarudza pachiyero dzinokosha zvezvinangwa - Alpha-fetoprotein.
3. Ultrasonography pakati mudumbu.
4. Computed tomography.
5. Studies hepatic midziyo. Izvi zvinosanganisira angio uye portogepatografiyu.

Chirwere pazvikanganiso cytological uye histological zvakawanikwa. Kuitisa zvidzidzo izvi, akaita biopsy muviri.

Hepatocellular carcinoma chiropa: pakurapa zvirwere

Selection kurapwa zano zvinoenderana morphological chimiro uye kukura bundu, uye pavaipfuura kenza kwacho. In kwokutanga nzendo kenza kuvhiyiwa rinoitwa chido pamusoro thyroid nodules, mishonga. In diffuse mapundu anoitwa embolization pamusoro hepatic tsinga. Izvi zvinobatsira kuderedza kukura anomera uye kukutadzisa muitiro. Hepatocellular carcinoma chiropa hakusi nehanya radiotherapy kurapa. Uyezve, zviri kashoma amenable kuti mishonga, 15-20 chete% wevarwere vane pfupi zvakwakanakira. Imwe nzira iri chiropa transplantation. Munyika dzakabudirira, nzira iri kwakapararira. Transplantation ane anyatsoronga nhengo iri kuitwa chete tanga kenza. In pamberi metastases kure anonzi chete nzira yokurapa symptomatic kurapa. Rinosanganisira palliative hanya (vatarisire murwere, psychotherapy) uye yokutindivadza.

Kuvhiya mabatiro kenza chiropa

Kuvhiya kupindira rinoitwa anenge varwere vose chirwere "hepatocellular carcinoma". Marapirwo zvinosanganisira chiropa resection mukati anatomical nharaunda (chidimbu mugove hafu muviri). Kana diki kadikidiki chikwata rinoitwa ayo enucleation chaiyo aspirator. Chimwe nzira iri kuvhiyiwa - a percutaneous embolization pamusoro hepatic tsinga.

Nzira inonyatsobudirira yokuita kuti ndinobvisa nhengo kana mugove waro. Chiropa rinenge anokwanisa panoda. Izvi zvinogona kuguma murwere kunaya zvakakwana.

Drug jekiseni pamusoro hepatocellular carcinoma

Kuwedzera chemotherapeutic zvinodhaka, achishingaira kushandiswa pharmacological boka idzva zvinodhaka - FIs mapuroteni kinases. Zvazvinoita ndiko kuderedza kuwandisa bundu masero. Pasinei akawanda nemishonga, mishonga ava zvikuru inobudirira. Muenzaniso zvinodhaka muboka iri ndiro chinodhaka "Nexavar".

The fungidziro pamusoro hepatocellular carcinoma

Mumwe vanotyaira nyanyisa yamamota nemudumbu anonzi hepatocellular carcinoma chiropa. The fungidziro nokuti bundu iri kakawanda zvisingafadzi.. High-gore 5 wokurarama iri kuchengetwa chete panguva diki hukuru inotungamirwa pashure pokuvhiyiwa kana chiropa transplantation. Kazhinji pane dzokororo pakati bundu uye nokukurumidza metastasis. Kumisa kushanda muviri rakaipa.

Kudzivirira hepatocellular carcinoma

Matanho ichisanganisira wepagore Ongororo pamusoro chiropa nemavhairasi, nokumunyima zvinodhaka uye doro. Zvinokosha kuyeuka kuti kuzvimba chiropa anogona kuwanikwa somugumisiro manipulations zvakadai mazino uye runako mishonga, ropa.