Sekureva kweInternational Agency for Research on Cancer yeWorld Health Organization, muna 2020, China yaive nevanhu vanosvika mamiriyoni 4.57 vane kenza itsva, uye kenza yemapapu yaisvika vanhu vanosvika 820,000. Sekureva kweChinese National Cancer Center's "Guidelines for Lung Cancer Screening and Early Diagnosis and Treatment in China," kuwanda kwevanhu vanofa nekenza yemapapu muChina kwaisvika 37% uye 39.8% yehuwandu hwepasi rose, zvichiteerana. Nhamba idzi dzinopfuura zvakanyanya huwandu hwevanhu vemuChina, inova inenge 18% yevanhu pasi rose.
Tsanangudzo uyeMhando dzemhando dikiyeKenza yeMapapu
Tsanangudzo:Kenza yemapapu inonzi primary bronchogenic, inozivikanwawo sekenza yemapapu, ndiyo bundu rinonyanya kukonzera kenza rinobva mu trachea, bronchial mucosa, small bronchial, kana glands mumapapu.
Zvichibva pahunhu hwe histopathologicalkenza yemapapu inogona kuiswa muzvikamu zviviri: kenza yemapapu isiri diki (80%-85%) uye kenza yemapapu iri diki (15%-20%), iyo ine huwandu hwakanyanya hwekenza. Kenza yemapapu isiri diki inosanganisira adenocarcinoma, squamous cell carcinoma, uye large cell carcinoma.
Zvichibva panzvimbo yakaitikakenza yemapapu inogona kuiswa muzvikamu zviviri: kenza yemapapu yepakati nekenza yemapapu yeperipheral.
Kuongororwa kweKenza yeMapapu
Kenza yeMapapu yeCentral:Inoreva kenza yemapapu inobva mubronchi iri pamusoro pechikamu, kunyanya inosanganisirasquamous cell carcinoma uye kenza yemapapu yemasero madiki. Kuongororwa kwechirwere kunogona kuwanikwa kuburikidza ne fiber bronchoscopyKuvhiyiwa kwekenza yemapapu epakati kwakaoma, uye kazhinji kunogumira pakuvhiyiwa kwemapapu ese akabatwa. Varwere vanogona kunetseka kutsungirira kuvhiyiwa uku, uye nekuda kwedanho repamusoro, kupinda kwenzvimbo, mediastinal lymph node metastasis, nezvimwe zvinhu, mhedzisiro yekuvhiyiwa inogona kunge isiri yakanaka, nenjodzi yakakura yekupararira kwemapfupa.
Kenza yeMapapu yePeripheral:Zvinoreva kenza yemapapu iri kuitika pasi pebronchi yechikamu,kunyanya kusanganisira adenocarcinoma. Kuongororwa kwechirwere kunowanzo kuwanikwa kuburikidza ne percutaneous transthoracic needle biopsy inotungamirirwa neCT.Mukurapa, kenza yemapapu inowanzova isina zviratidzo pakutanga uye inowanzoonekwa netsaona panguva yekuongororwa kwemuviri. Kana ikaonekwa nekukurumidza, kuvhiyiwa ndiyo nzira huru yekurapa, ichiteverwa ne adjuvant chemotherapy kana kurapwa kwakanangana.
Kune varwere vane kenza yemapapu vasingakodzeri kuvhiyiwa, vane chirwere chakasimbiswa chinoda kurapwa kunotevera, kana vanoda kuteverwa nguva nenguva kana kurapwa mushure mekuvhiyiwa,kurapwa kwakakodzera uye kwakakodzera kwakakosha zvikuruTinoda kukuzivisai nezveDr. An Tongtong, nyanzvi ine mukurumbira mukurapa kenza yechipfuva ine ruzivo rwemakore anopfuura makumi maviri mukurapa kenza paDhipatimendi reTsamba, Beijing University Cancer Hospital.
Nyanzvi Inozivikanwa: Dr. An Tongtong
Chiremba Mukuru, Chiremba weMishonga. Ane ruzivo rwekutsvagisa paMD Anderson Cancer Center muUnited States, uye nhengo yekomiti yevechidiki yeChinese Anti-Cancer Association Lung Cancer Professional Committee.
Nzvimbo dzeUnyanzvi:Kurapa nemakemikari uye kurapwa kwakanangana nemasero ekenza yemapapu, thymoma, mesothelioma, uye nzira dzekuongorora nekurapa dzakadai sebronchoscopy uye kuvhiyiwa kwechipfuva nemavhidhiyo mukurapa kwemukati memuviri.
Dr. An vakaita tsvakiridzo yakadzama pamusoro pekugadzirisa kenza yemapapu uye kurapwa kwakazara kwekenza yemapapu yemhando yepamusoro,kunyanya panyaya yekurapa kwakazara kwekenza yemapapu isiri yemasero madiki. Dr. An vane hunyanzvi mumirayiridzo mitsva yepasi rose yekuongorora nekurapa mabundu echipfuva.Munguva yekubvunzana, Dr. An anonyatsonzwisisa nhoroondo yekurapa kwemurwere uye anonyatsotarisa shanduko dzechirwere nekufamba kwenguva. Anobvunzawo nokungwarira nezvezvirongwa zvekare zvekuongorora nekurapa kuti ave nechokwadi chekuti chirongwa chekurapa chakanyatsogadziriswa chemurwere. Kune varwere vachangoonekwa vaine chirwere ichi, mishumo neongororo dzakabatana hazviwanzo kukwana. Mushure mekunzwisisa nhoroondo yekurapa, Dr. An achatsanangura zvakajeka nzira yekurapa mamiriro aripo iye zvino kumurwere nemhuri yake. Achapawo gwara rekuti ndeapi mamwe mabvunzo anodiwa kuti abatsire kusimbisa chirwere ichi, achivimbisa kuti nhengo dzemhuri dzanzwisisa zvizere vasati vavabvumira ivo nemurwere kubuda muimba yekubvunzana vaine rugare rwepfungwa.
Nyaya Dzazvino
VaWang, murwere ane makore makumi mashanu nemapfumbamwe ekuberekwa ane chirwere chemapapu chinonzi lung adenocarcinoma ane multiple systemic metastases, vakatsvaga rubatsiro kuBeijing panguva yedenda iri pakupera kwa2022. Nekuda kwezvirambidzo zvekufamba panguva iyoyo, vaifanira kupihwa kekutanga keke yechemotherapy kuchipatara chiri pedyo mushure mekunge chirwere ichi chasimbiswa. Zvisinei, VaWang vakasangana nechirwere che chemotherapy uye mamiriro emuviri asina kunaka nekuda kwekushaya maalbuminemia.
Pavakasvika padanho rechipiri rekurapa chemotherapy, mhuri yake, ichinetseka nezvechirwere chake, yakabvunza nezvehunyanzvi hwaDr. An uye pakupedzisira vakabudirira kuronga musangano kuVIP Outpatient service yeChipatara chedu. Mushure mekuongorora nhoroondo yezvekurapa zvakadzama, Dr. An akapa mazano ekurapwa. Zvichienderana nemazinga akaderera ealbumin aVaWang uye maitiro echemotherapy, Dr. An akagadzirisa nzira yekurapa chemotherapy nekutsiva paclitaxel nepemetrexed ukuwo vachiisa bisphosphonates kudzivirira kuparadzwa kwemapfupa.
Mushure mekugamuchira mhedzisiro yekuongororwa kwemajini, Dr. An vakabatanidza VaWang nekurapa kwakakodzera, Osimertinib. Mwedzi miviri gare gare, panguva yekushanya kwekutevera, mhuri yaVaWang vakataura kuti mamiriro avo ezvinhu akanga ava nani, nezviratidzo zvishoma uye kugona kuita zvinhu zvakaita sekufamba, kudiridza zvirimwa, uye kutsvaira pasi kumba. Zvichibva pamhedzisiro yekuongororwa kwekutevera, Dr. An vakakurudzira VaWang kuti varambe vachirapwa uye vachiongororwa nguva dzose.
Nguva yekutumira: Nyamavhuvhu-31-2023