Neuroblastoma ke e 'ngoe ea lihlahala tse tiileng tse atileng haholo ho bana. Re bua ka hlahala e kotsi ka ntle ho boko hobane e qala tsamaisong ea methapo empa ha e be sebakeng sa boko. Mekhoa e mengata ea phekolo e ka nkoa ho itšetlehile ka nyeoe.

Tlhaloso ea neuroblastoma

Neuroblastoma ke mofuta oa mofetše. Hlahala ena e kotsi e na le sebopeho sa ho nts'etsapele maemong a li-neuroblasts, e leng lisele tsa methapo ea kutlo e nang le kutloelo-bohloko. Ea ho qetela e etsa e 'ngoe ea litšiea tse tharo tsa tsamaiso ea methapo ea boithaopo e tsamaisang mesebetsi e ikemetseng ea ntho e phelang e kang ho hema le ho sila lijo.

Neuroblastoma e ka hlaha libakeng tse fapaneng haholo tsa 'mele. Leha ho le joalo, mofuta ona oa kankere hangata o hlaha ka mpeng boemong ba litšoelesa tsa adrenal (tse ka holimo ho liphio), hammoho le mokokotlo. Hangata, e ka etsahala molaleng, sefuba kapa pelvis (pelvis e nyane).

Ha e ntse e hola, neuroblastoma e ka baka metastasis. Tsena ke li-cancer tsa bobeli: lisele tsa hlahala ea mantlha lia baleha 'me li bokella lisele tse ling le / kapa litho tsa 'mele.

Classification des neuroblastoms

Kankere e ka aroloa ho ea ka mekhahlelo e mengata. Mohlala, sethala se thusa ho lekola boholo ba mofets'e. Tabeng ea neuroblastoma, mefuta e 'meli ea staging e sebelisoa.

Mokhahlelo oa pele ke oona o sebelisoang hangata. E arola li-neuroblastoma ho tloha methating ea 1 ho isa ho ea 4 hape e kenyelletsa mohato o itseng oa 4. Ena ke karohano ka ho teba, ho tloha ho tse matla ho isa ho tse matla ka ho fetisisa:

• mekhahlelo ea 1 ho ea ho ea 3 e lumellana le mefuta ea libaka;
• Mothati oa 4 o fana ka mefuta ea metastatic (ho falla ha lisele tsa mofetše le bokolone ba likarolo tse ling tsa 'mele);
• Stage 4s ke mofuta o ikhethileng o khetholloang ke metastase sebeteng, letlalong le mokong oa masapo.

Mokhahlelo oa bobeli o boetse o na le mekhahlelo e 4: L1, L2, M, MS. Ha e etse feela hore ho khonehe ho khetholla libaka (L) ho mefuta ea metastatic (M), empa hape ho ela hloko lintlha tse itseng tsa kotsi ea ho buuoa.

E bakoa ke neuroblastome

Joalo ka mefuta e meng e mengata ea mofets'e, li-neuroblastoma li na le tšimoloho e e-s'o thehoe ka botlalo.

Ho fihlela joale, ho hlokometsoe hore nts'etsopele ea neuroblastoma e ka bakoa kapa ea ratoa ke mafu a fapaneng a sa tloaelehang:

• mofuta oa 1 neurofibromatosis, kapa lefu la Recklinghausen, e leng ntho e sa tloaelehang ho nts'etsopele ea lisele tsa methapo ea kutlo;
• Lefu la Hirschsprung e leng phello ea ho ba sieo ha methapo ea kutlo leboteng la mala;
• Ondine syndrome, kapa congenital central alveolar hypoventilation syndrome, e khetholloang ke ho ba sieo ha congenital ea taolo e bohareng ea ho phefumoloha le ho senya tšenyo ea tsamaiso ea methapo ea boipheliso.

Maemong a sa tloaelehang, neuroblastoma e boetse e bonoa ho batho ba nang le:

• Beckwith-Wiedemann syndrome e khetholloang ke kholo e feteletseng le bokooa ba tsoalo;
• Di-George syndrome, bofokoli ba tsoalo ho li-chromosome boo hangata bo fellang ka bofokoli ba pelo, ho senyeha ha sefahleho, ho lieha ho hōla le ho itšireletsa mafung.

Tlhahlobo ea neuroblastome

Mofuta ona oa mofetše o ka belaelloa ka lebaka la matšoao a itseng a kliniki. Tlhahlobo ea neuroblastoma e ka netefatsoa le ho tebisoa ke:

• teko ea moroto e hlahlobang maemo a metabolite e itseng eo mantle a eona a eketsehang nakong ea neuroblastoma (mohlala, homovanilic acid (HVA), vanillylmandelic acid (VMA), dopamine);
• ho nahana ka hlahala e ka sehloohong ka ultrasound, CT scan kapa MRI (imaging magnetic resonance imaging);
• MIBG (metaiodobenzylguanidine) scintigraphy, e tsamaellanang le tlhahlobo ea litšoantšo ka meriana ea nyutlelie;
• biopsy e kenyelletsang ho nka karolo ea lisele bakeng sa tlhahlobo, haholo haeba ho belaelloa mofetše.

Liteko tsena li ka sebelisoa ho netefatsa ho fumanoa ha neuroblastoma, ho lekanya boholo ba eona le ho hlahloba boteng kapa ho se be teng ha metastase.

Hangata li-neuroblastomas li etsahala ho masea le bana ba banyenyane. Li emela 10% ea linyeoe tsa kankere ea bongoaneng le 15% ea lihlahala tse kotsi ho bana ba ka tlase ho lilemo tse 5. Selemo se seng le se seng, ho tšoauoa linyeoe tse ka bang 180 Fora.

• Asymptomatic: Neuroblastoma e ke ke ea hlokomeloa, haholo-holo nakong ea eona ea pele. Matšoao a pele a neuroblastoma hangata a bonoa ha hlahala e ntse e ata.
• Bohloko ba sebakeng sa heno: Tsoelo-pele ea neuroblastoma hangata e tsamaisana le bohloko sebakeng se amehileng.
• Ho ruruha ha sebaka: Leqeba, kotola, kapa ho ruruha ho ka hlaha sebakeng se amehileng.
• Phetoho ea boemo bo akaretsang: neuroblastoma e senya ts'ebetso e nepahetseng ea tsamaiso ea methapo, e ka fellang ka ho lahleheloa ke takatso ea lijo, ho theola boima ba 'mele, ho hōla butle.

Ho fihlela joale, liphekolo tse tharo tsa mantlha li ka sebelisoa:

• ho buuoa ho tlosa hlahala;
• phekolo ea mahlaseli, e sebelisang mahlaseli ho senya lisele tsa kankere;
• chemotherapy, e sebelisang lik'hemik'hale ho fokotsa kholo ea lisele tsa mofetše.

Ka mor'a liphekolo tse boletsoeng ka holimo, ho ka etsoa transplant ea stem cell ho tsosolosa tšebetso e nepahetseng ea 'mele.

Immunotherapy ke mokhoa o mocha oa ho phekola mofetše. E ka 'na ea e-ba tlatsetso kapa mokhoa o mong oa phekolo o boletsoeng ka holimo. Ho ntse ho etsoa lipatlisiso tse ngata. Sepheo sa immunotherapy ke ho matlafatsa tšireletso ea 'mele ea ho itšireletsa mafung ho loantša tsoelo-pele ea lisele tsa mofetše.

Tšimoloho ea li-neuroblastoma e ntse e sa utloisisoe hantle ho fihlela kajeno. Ha ho mokhoa oa thibelo o ka tsejoang.

Thibelo ea mathata e itšetlehile ka ho hlahlojoa kapele. Ka linako tse ling hoa khoneha ho khetholla neuroblastoma nakong ea ultrasound ea bokhachane. Ho seng joalo, ho falimeha ho bohlokoa ka mor'a tsoalo. Tlhokomelo ea kamehla ea bongaka ea ngoana ke ea bohlokoa.