Sekureva kweInternational Agency for Research on Cancer yeWorld Health Organisation, muna 2020, China yakave nekenza nyowani 4.57 miriyoni, nekenza yemapapu inoverengera mazana masere nemakumi maviri ezviuru.Sekureva kweChinese National Cancer Center's "Nhungamiro yeKuvhenekwa Kwegomarara reLung uye Kuongororwa Kwekutanga uye Kurapwa muChina," huwandu uye huwandu hwekufa kwegomarara remapapu muChina hunoita 37% uye 39.8% yehuwandu hwepasi rose, zvichiteerana.Huwandu uhu hunodarika huwandu hwehuwandu hweChina, hunove hunosvika 18% yehuwandu hwepasi rose.
Definition uyeSub-mhandoyeLung Cancer
Tsanangudzo:Chekutanga bronchogenic cancer yemapapu, inowanzozivikanwa sekenza yemapapu, ndiyo inonyanya kuzivikanwa bundu rinouraya rinobva mutrachea, bronchial mucosa, diki bronchi, kana glands mumapapu.
Kubva pane histopathological maitiro, kenza yemapapu inogona kuiswa mugomarara remapapu risiri diki (80% -85%) uye kenza diki yemapapu (15% -20%), iyo ine dhigirii repamusoro rehuipi.Gomarara remapapu risiri diki rinosanganisira adenocarcinoma, squamous cell carcinoma, uye hombe cell carcinoma.
Kubva panzvimbo yechiitiko, kenza yemapapu inogona kuverengerwa zvakare sekenza yemapapu yepakati uye kenza yemapapu.
Pathological Diagnosis yeLung Cancer
Central Lung Cancer:Zvinoreva kenza yemapapu inobva kubronchi pamusoro pechikamu chechikamu, kunyanya chinosanganisirasquamous cell carcinoma uye kenza yemapapu diki. Pathological chirwere chinogona kuwanikwa kuburikidza nefiber bronchoscopy.Kuvhiya kubviswa kenza yepakati kwekenza kunonetsa, uye kazhinji kunogumira pakupedza resection yemapapu ese akabatwa.Varwere vangave vakaoma kushivirira nzira, uye nekuda kwechinhanho chepamusoro, kupinda munharaunda, mediastinal lymph node metastasis, uye zvimwe zvikonzero, migumisiro yekuvhiya inogona kunge isina kunaka, ine ngozi yakawanda yefupa metastasis.
Peripheral Lung Cancer:Inoreva cancer yemapapu inoitika pazasi segmental bronchi,kunyanya kusanganisira adenocarcinoma. Pathological diagnosis inowanzowanikwa kuburikidza nepercutaneous transthoracic tsono biopsy inotungamirirwa neCT.Muchiito chekiriniki, gomarara remapapu repamhepo rinowanzova asymptomatic mumatanho ekutanga uye rinowanzo onekwa sezvinei panguva yekuongororwa kwemuviri.Kana ikaonekwa nekukurumidza, kuvhiyiwa ndiyo yekutanga kurapwa sarudzo, inoteverwa neadjuvant chemotherapy kana kurapa kwakanangwa.
Kune varwere vekenza yemapapu vasingakodzeri kuvhiyiwa, vane chirwere chakasimbiswa chechirwere chinoda kurapwa kunotevera, kana kuti zvinoda kugara uchitevera kana kurapwa mushure mekuvhiyiwa,kurapa kwakaenzana uye kwakakodzera kunonyanya kukosha.Tinoda kukuzivisaiDr. An Tongtong, nyanzvi ine mukurumbira mune thoracic oncology ane makore anopfuura makumi maviri eruzivo mukurapa oncology kuDhipatimendi reThoracic Oncology, Beijing University Cancer Hospital.
Nyanzvi ine mukurumbira: Dr. An Tongtong
Chiremba Mukuru, Chiremba weMishonga.Aine ruzivo rwekutsvagisa kuMD Anderson Cancer Center muUnited States, uye nhengo yekomiti yevechidiki yeChinese Anti-Cancer Association Lung Cancer Professional Committee.
Nzvimbo dzeUnyanzvi:Chemotherapy uye molecular yakanangwa kurapwa kwekenza yemapapu, thymoma, mesothelioma, uye yekuongorora uye yekurapa maitiro akadai sebronchoscopy uye vhidhiyo-inobatsira thoracic kuvhiyiwa mumushonga wemukati.
Dr. An vakaita tsvakiridzo yakadzama pamusoro pekumisikidzwa uye kurapa kwakasiyana-siyana kwechirwere chegomarara remapapu,kunyanya mumamiriro ezvinhu ega ega ega ega kurapa kwekenza yemapapu isiri diki.Dr. An ane hunyanzvi mune ichangoburwa yepasirese yekuongorora uye yekurapa nhungamiro yemamota emuchipfuva.Panguva yekukurukurirana, Dr. An anonzwisisa zvizere nhoroondo yehutano hwemurwere uye anonyatsocherechedza kuchinja kwechirwere nekufamba kwenguva.Anonyatso kubvunza nezve chirongwa chekare chekuongororwa uye chekurapa kuti ave nechokwadi chekugadziriswa kweiyo yakanyanya optimized yega yega chirongwa chekurapa murwere.Kune vachangobva kuongororwa, mishumo ine chekuita uye ongororo kazhinji haina kukwana.Mushure mekuwana kunzwisisa kwakajeka kwenhoroondo yezvokurapa, Dr. An achatsanangura zvakajeka nzira yekurapa yemamiriro ezvinhu aripo kune murwere nemhuri dzavo.Iye achapawo nhungamiro pamusoro peidzi nzvero dzokuwedzera dzinodiwa kubetsera kusimbisa utachiona, kuva nechokwadi chokuti mitezo yemhuri inonzwisisa zvizere isati yavabvumira uye murwere kubuda mukamuri rokubvunzurudza norugare rwendangariro.
Recent Cases
VaWang, ane makore makumi mashanu nemapfumbamwe ekuberekwa adenocarcinoma murwere ane akawanda systemic metastases, akatsvaga kurapwa muBeijing panguva yedenda mukupera kwa 2022. Nekuda kwezvirambidzo zvekufamba panguva iyoyo, aifanira kugashira rake rekutanga rechemotherapy panzvimbo yaive pedyo. chipatara mushure mekuongororwa kwepathological kwakasimbiswa.Zvisinei, VaWang vakawana zvakakosha chemotherapy toxicity uye mamiriro asina kunaka emuviri nekuda kwekubatana kwe hypoalbuminemia.
Achisvika pachikamu chake chechipiri chechemotherapy, mhuri yake, ichinetsekana nezvechirwere chake, yakabvunza nezvehunyanzvi hwaDr. An uye pakupedzisira vakabudirira kuita nguva yekuonana kuVIP Outpatient service yeChipatara chedu.Mushure mekunyatsoongorora nhoroondo yezvehutano, Dr. An akapa mazano ekurapa.Mukuona kwaVaWang's low albumin levels uye chemotherapy reactions, Dr. An akagadzirisa chemotherapy regimen nekutsiva paclitaxel ne pemetrexed asi achibatanidza bisphosphonates kuti inhibit kuparadzwa kwemapfupa.
Pakugamuchira mhedzisiro yekuongorora genetic, Dr. An zvakare akafananidza Mr. Wang nekwakakodzera kwakanangwa kurapwa, Osimertinib.Mwedzi miviri gare gare, panguva yekushanya kwekutevera, mhuri yaVaWang yakashuma kuti mamiriro ake akanga avandudzwa, ane zviratidzo zvakaderera uye kukwanisa kuita zvinhu zvakadai sekufamba, kudiridza miti, uye kutsvaira pasi pamba.Kubva pamigumisiro yekuongororwa kwekutevera, Dr. An akarayira Mr. Wang kuti vaenderere mberi nehurongwa hwemazuva ano hwekurapa uye kuongorora nguva dzose.
Nguva yekutumira: Aug-31-2023