Muaj ob pawg tseem ceeb ntawm kev mob ntsws ntsws: "mob qog nqaij hlav qog noj ntshav" txuas nrog rau kev haus luam yeeb thiab "tsis yog mob qog noj ntshav ntawm lub ntsws", feem ntau suav nrog adenocarcinomas (los ntawm cov qog qog nqaij hlav ntawm lub ntsws).

Adenocarcinoma yog hom mob qog noj ntshav uas tsis yog me me (NSCLC). Nws tshwm sim nyob rau hauv peripheral cheeb tsam ntawm lub ntsws, tshwj xeeb tshaj yog nyob rau hauv lub Upper lobes thiab nyob ze ntawm lub pleura. Nws qhov xwm txheej tau nce mus rau yuav luag 10 xyoo. 

Variants ntawm adenocarcinoma

Adenocarcinomas tuaj yeem sib txawv ntawm qhov loj thiab lawv loj hlob sai npaum li cas. Feem ntau muaj ob qhov txawv ntawm histologically:

• acinar adenocarcinoma thaum nws siv lub hnab me me;
• papillary adenocarcinoma, thaum lub hlwb qhia protrusions nyob rau hauv cov duab ntawm lub hnab looj tes ntiv tes.

Pulmonary adenocarcinoma

Mob ntsws adenocarcinoma feem ntau cuam tshuam rau cov neeg haus luam yeeb. Tab sis nws kuj yog hom mob ntsws cancer tshaj plaws hauv cov poj niam thiab cov neeg tsis haus luam yeeb.

Nws yog qhov ua rau tuag (txhua yam ua rau) hauv cov txiv neej ntawm 45 thiab 64 xyoo nyob rau Fabkis, raws li Haute Autorité de Santé (HAS).

Kev haus luam yeeb yog nyob deb ntawm tus naj npawb ib qho kev pheej hmoo rau hom mob qog noj ntshav no. Tab sis tsis yog xwb. Dr Nicola Santelmo, kws phais neeg thoracic ntawm Clinique Rhéna hauv Strasbourg hais tias "Kev ua haujlwm raug cuam tshuam tuaj yeem koom nrog," Cov tshuaj lom neeg (xws li asbestos, arsenic, npib tsib xee, tar, thiab lwm yam) feem ntau pom nyob rau theem qis hauv chaw ua haujlwm tau lees paub los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Mob ntsws rau tus txiv neej.

Nws kuj pom tias lwm qhov chaw ntawm ib puag ncig muaj kuab paug yog, tsawg dua, muaj feem cuam tshuam rau mob qog noj ntshav, xws li huab cua paug thiab radon).

Cov tsos mob ntawm pulmonary adenocarcinoma feem ntau lig vim nws tsis ua rau mob tshwj xeeb. Thaum cov qog loj hlob tuaj, nws tuaj yeem ua rau cov tsos mob xws li:

• hnoos lossis ua pa nyuaj yog tias nws nias rau ntawm lub bronchi;
• ntshav sputum (sputum);
• piav tsis hnyav poob.

"Hnub no, txawm li cas los xij, ua tsaug rau kev siv dav dav ntawm lub tshuab luam ntawv rau kev tshuaj ntsuam xyuas hauv cov neeg mob haus luam yeeb, peb tuaj yeem ua rau kev kuaj mob qog noj ntshav hauv ntau theem ua ntej, nrog rau qhov kev kuaj pom zoo dua tsis txaus ntseeg," tus kws phais mob rov hais dua.

Yuav tsum muaj ntau qhov kev ntsuam xyuas kom paub meej tias qhov kev kuaj mob ntsws cancer.

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Kev yees duab yog qhov tseem ceeb los ntsuas qhov ntev ntawm tus kab mob:

• Ib qho "ua tiav" CT scan (pob txha taub hau, thorax, plab thiab plab pelvis) nrog kev txhaj tshuaj zoo sib xws yog tias tsis muaj contraindicated, muab cov ntaub ntawv ntawm cov duab thiab qhov loj ntawm cov qog noj ntshav.

Qhov biopsy

Yog tias kev kuaj hluav taws xob qhia pom tias mob qog noj ntshav, nws yog ib qho tseem ceeb uas yuav tau coj cov qauv ntawm qhov txhab, los ntawm biopsy, kom tau txais cov pov thawj histological lossis cytological. Cov qauv ntaub so ntswg no feem ntau yog ua los ntawm endoscopy lossis los ntawm kev sib tsoo hauv qab scanner. Qee lub sij hawm, kev phais yuav tsum tau ua kom coj tus qauv no: biopsy ntawm lymph node lossis loj hauv lub ntsws.

Bronchial fibroscopy

"Kev kuaj mob bronchial kuj tseem yuav tsim nyog, tshwj xeeb tshaj yog tias cov qog los ntawm lub bronchus. Nws kuj tseem yuav tsim nyog kom tau txais cov qauv ntawm cov qog lossis cov qog ntshav kom ua tiav qhov kev ntsuas ”.

Kev ntsuam xyuas ua rau nws muaj peev xwm txiav txim siab txog theem ntawm tus kab mob, suav nrog qhov loj thiab qhov chaw ntawm cov qog ("T"), qhov muaj thiab qhov chaw ntawm cov qog nqaij hlav ("N") thiab qhov muaj nyob los yog tsis yog "metastases" uas. yog qhov kev ncua deb ntawm lub ntsws qog ("M"). Ob feem peb ntawm me me cell bronchial carcinomas raug kuaj pom nyob rau theem metastatic.

Kev soj ntsuam ntawm kev ua pa thiab lub plawv ua haujlwm

Thaum kawg, kev ntsuam xyuas ntawm kev ua pa thiab lub plawv ua haujlwm yog qhov tseem ceeb txhawm rau txiav txim siab seb kev phais lossis kev kho mob puas ua tau nrog kev pheej hmoo ntawm cov teeb meem.

"Qhov kev cia siab yog nyob ntawm theem ntawm kev mob qog noj ntshav thiab kev kho mob uas tuaj yeem txiav txim siab," tus kws tshaj lij hais. Nws txawv ntawm tsawg dua 10% ntawm 5 xyoo nyob rau theem siab dua thiab 92% ntawm 5 xyoo nyob rau theem pib. Qhov tseem ceeb ntawm kev kuaj mob ntxov yog li ntawd loj heev! Tsis tas li ntawd, ntawm tag nrho cov neeg mob tau ua los ntawm kev phais (txhua theem ua ke) 1 ntawm 2 tus neeg mob muaj sia nyob 5 xyoos tom qab ”.

Kev kho mob yog nyob ntawm seb hom mob qog noj ntshav, nws theem (uas yog hais txog nws qhov kev txuas ntxiv), lub xeev ntawm kev noj qab haus huv ntawm tus neeg mob, thiab kev txiav txim siab coj los ntawm ntau pawg kws kho mob coj ua ke pulmonologist, kws phais neeg, kws kho mob hlwb. , radiologist, kws kho mob nuclear thiab pathologist.

Lub hom phiaj ntawm kev ua haujlwm

Lub hom phiaj ntawm kev kho mob yog:

• tshem tawm cov qog los yog metastases;
• tswj kev sib kis ntawm pulmonary adenocarcinoma;
• tiv thaiv kev rov tshwm sim;
• kho cov tsos mob.

Cov kev kho mob sib txawv

Muaj ntau ntau hom kev kho mob pulmonary adenocarcinoma:

• resection phais, tshem tawm tag nrho cov qog, ua ke nrog kev kho mob, ua ntej lossis tom qab ua haujlwm
• radiotherapy ib leeg,
• chemotherapy ib leeg,
• chemotherapy ua ke nrog radiotherapy,
• radiofrequency los yog stereotaxic radiotherapy uas sib haum rau irradiation heev tsom rau ntawm lub ntsws qog,
• lwm txoj kev kho mob (immunotherapy thiab / lossis kev kho mob).

"Kev cuam tshuam kev phais niaj hnub no tau nce ntxiv thiab npaj los ntawm kev kuaj xyuas ua ntej thiab tej zaum yuav muaj segmentectomy lossis pulmonary lobectomies (suav nrog ntau dua lossis tsawg dua qhov tseem ceeb ntawm lub ntsws)", xaus lus Dr Santelmo.