Carcinoid maʻi maʻi

ʻO Carcinoid Syndrome kahi hui o nā ʻōuli e pili ana i nā tumors carcinoid. ʻO kēia nā tumors o ka ʻōpū liʻiliʻi, kolona, ​​pākuʻi, a me nā paipu bronchial i nā akemāmā.

ʻO Carcinoid Syndrome ke kumu o nā ʻōuli i ʻike ʻia i kekahi manawa i ka poʻe me nā tumo carcinoid. He kakaikahi kēia mau tumors, a lohi ka ulu ʻana. ʻO ka hapa nui o nā tumors carcinoid i loaʻa i ka gastrointestinal tract a me nā akemāmā.

Aia ʻo Carcinoid Syndrome i kekahi mau poʻe me nā tumo carcinoid, ma hope o ka palahalaha ʻana o ka tumo i ke akepaʻa a i ʻole ka lung.

Hoʻokuʻu nui kēia mau tumors i ka serotonin hormone, a ʻo kekahi mau kemika ʻē aʻe. Hoʻokumu nā hormones i nā kīʻaha koko e wehe (dilate). ʻO kēia ke kumu o ka maʻi carcinoid.

Hana ʻia ka carcinoid Syndrome o nā ʻōuli nui ʻehā e like me:

• Flushing (ke alo, ka ʻāʻī, a i ʻole ka umauma luna), e like me nā kīʻaha koko ākea i ʻike ʻia ma ka ʻili (telangiectasias)
• Ka hanu paʻakikī ʻana, e like me ka hū ʻana
• Pohā
• Nā pilikia o ka puʻuwai, e like me ka hoʻokahe ʻana o nā puʻuwai puʻuwai, kuʻi puʻuwai, haʻahaʻa a kiʻekiʻe paha ke koko

Lawe ʻia nā ʻōuli e ka hoʻoikaika kino, a i ʻole ka ʻai ʻana a inu paha i nā mea e like me ka tī uliuli, kokoleka, a i ʻole ka waina ʻulaʻula.

Loaʻa ka hapa nui o kēia mau tumors ke hana ʻia nā hoʻokolohua a i ʻole nā ​​kaʻina hana no nā kumu ʻē aʻe, e like me ka wā o ka ʻoki ʻana o ka ʻōpū.

Inā hana ʻia kahi hoʻokolohua kino, loaʻa i ka mea mālama ola nā hōʻailona o:

• Nā pilikia o ka puʻuwai puʻuwai, e like me ka namunamu
• ʻO ka maʻi deficit Niacin (pellagra)

ʻO nā hoʻāʻo e hana ʻia ana paha:

• 5-HIAA pae i ka mimi
• Nā ho'āʻo koko (me serotonin a me chromogranin koko hōʻike)
• CT a me MRI scan o ka umauma a i ʻole ka ʻōpū
• ʻEchocardiogram
• ʻO ka scanner radiolabeled ʻo Octreotide

ʻO keʻoki e wehe i ka tumo ka maʻamau maʻamau. Hiki iā ia ke hoʻōla mau i ke ʻano inā hemo loa ka tumo.

Inā ua pālahalaha ka tumo i ke akepaʻa, pili kekahi i kekahi o kēia mau mea:

• Ke lawe nei i nā wahi o ke akepaʻa i loaʻa nā hunaola tumola
• Ke hoʻouna nei (infusing) i ka lāʻau i loko o ke ake e luku i nā tumors

Ke hiki ʻole ke hemo i ka tumo holoʻokoʻa, hiki i ka hemo ʻana i nā ʻāpana nui o ka tum tum ("debulking") ke kōkua i ke kōkua ʻana i nā ʻōuli.

Hāʻawi ʻia nā kīkī ʻo Octreotide (Sandostatin) a i ʻole lanreotide (Somatuline) i ka poʻe me nā tumo carcinoid holomua i hiki ʻole ke hemo me ke ʻoki.

Pono ka poʻe me ka maʻi carcinoid e hōʻalo i ka wai ʻona, nā pāʻina nui, a me nā meaʻai i kiʻekiʻe i ka tyramine (nā ʻūlū ʻelemakule, a me nā avocado, nā meaʻai he nui i hana ʻia),

ʻO kekahi mau lāʻau maʻamau, e like me nā serotonin reuptake inhibitors (SSRIs), e like me paroxetine (Paxil) a me fluoxetine (Prozac), e hōʻino paha i nā ʻōuli ma ka hoʻonui ʻana i ka pae o ka serotonin. Eia naʻe, mai hōʻoki i ka lawe ʻana i kēia mau lāʻau inā ʻaʻole haʻi ʻia kāu mea lawelawe.

E aʻo hou aʻe e pili ana i ka maʻi carcinoid a loaʻa ke kākoʻo mai:

• ʻO ka Carcinoid Cancer Foundation - www.carcinoid.org/resource/support-groups/directory/
• ʻO ka Neuroendocrine Tumor Research Foundation - netrf.org/for-patients/

ʻO ke kuanaʻike i loko o ka poʻe me ka maʻi carcinoid ʻokoʻa i kekahi manawa ʻokoʻa i ka kuanaʻike i ka poʻe i loaʻa i nā tumo carcinoid me ka ʻole o ka syndrome.

Pili pū ka Prognosis ma ke kahua o ka tumo. I ka poʻe me ka maʻi pīpī, ua pālahalaha pinepine ka tumo i ke ake. Hoʻoiho kēia i ka helu ola. ʻO ka poʻe me ka maʻi carcinoid e loaʻa pū kekahi ka maʻi ʻaʻai ʻokoʻa (ka maʻi ʻelua mua) i ka manawa like. Ma ke ʻano holoʻokoʻa, maikaʻi loa ka wānana.

Komo pū kekahi nā pilikia o ka maʻi carcinoid:

• Hoʻonui i ka makaʻu o ka hāʻule a me ka hōʻeha (mai ke kaomi haʻahaʻa)
• Hoʻopili i ka ʻōpū (mai ka tumo)
• Kahe ʻana o ka gastrointestinal
• Holo ka puʻuwai puʻuwai

ʻO kahi ʻano make o ka carcinoid syndrome, carcinoid crisis, hiki ke hana ʻia ma ke ʻano he ʻaoʻao o ke ʻoki, anesthesia a chemotherapy paha.

Kāhea aku i kāu mea hoʻolako no kahi kau inā loaʻa nā ʻōuli o ka maʻi carcinoid.

ʻO ka mālama ʻana i ka tumo e hoʻemi ana i ka makaʻu o ka maʻi carcinoid.

Flush maʻi pale; ʻO ka maʻi maʻi Argentaffinoma

• Lawe ʻia ʻo Serotonin

Pūnaewele ʻo National Cancer Institute. ʻO ka mālama ʻana i nā tumors Carcointestinal carcinoid tumors (makua) (PDQ) - mana ʻoihana olakino. www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq. Hoʻohou ʻia Kepakemapa 16, 2020. Loaʻa iā ʻOkakopa 14, 2020.

ʻO nā tumors Öberg K. Neuroendocrine a me nā maʻi e pili pū ana. I: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 45.

ʻO Wolin EM, ʻo Jensen RT. Nā Tumora Neuroendocrine. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 219.