Ọkpụkpụ akpụ

. Ọrịa cancer nke ọkpụkpụ na-esikarị na ọrịa kansa n'akụkụ ọzọ nke ahụ dịka site na akpa ume, ara, thyroid, akụrụ na prostate. Enwere ike inwe ihe ịrịba ama, ihe mgbu, ma ọ bụ ihe ịrịbaanya nke akwara site na nrụgide. Ọkpụkpụ akpụ nwere ike ịpụta na ọkpụkpụ gbajiri agbaji. Mgbaàmà ndị ọzọ nwere ike ịgụnye ike ọgwụgwụ, ahụ ọkụ, ibu ibu, ụkọ ọbara na agbọ onunu. Mgbe ụfọdụ, ọ dịghị ihe mgbaàmà na a na-ahụ etuto ahụ mgbe ị na-enyocha nsogbu ọzọ.
A na-ahụkarị nchọpụta site na X-ray na nyocha radiological ndị ọzọ dị ka CT scan, MRI, PET scan na scintigraphy ọkpụkpụ. Nnyocha ọbara nwere ike ịgụnye ọnụ ọgụgụ ọbara zuru ezu, akara mgbu, serum electrophoresis, PSA, ọrụ akụrụ na ọrụ imeju. Enwere ike ịnwale mamịrị maka protein Bence Jones. Maka nkwenye nke nchọpụta, enwere ike ịchọ biopsy maka nyocha histological.
Ọkpụkpụ akpụ a na-ahụkarị bụ fibroma na-abụghị ọkpụkpụ. Nkezi afọ ise nke ndụ na United States mgbe a chọpụtara na ọ na-arịa ọrịa kansa ọkpụkpụ na nkwonkwo bụ 67%. Ọkpụkpụ akpụ mbụ a maara bụ osteosarcoma na ọkpụkpụ ụkwụ a chọpụtara na South Africa, n'etiti 1.6 na 1.8 nde afọ gara aga.
A na-ekewa akpụ ọkpụkpụ dị ka ndị na-enweghị ọrịa kansa (na-adịghị njọ) ma ọ bụ ndị nwere ọrịa kansa (malignant). Ọtụtụ ihe ndị dị na akpụ ọkpụkpụ na akpụ anụ ahụ dị nro na-agbakọta. Òtù Ahụ Ike Ụwa (WHO) dezigharịrị nhazi ha na 2020. Nkewa ọhụrụ a na-ekewa akpụ ọkpụkpụ n'ime akpụ cartilage, akpụ osteogenic, akpụ fibrogenic, akpụ vascular nke ọkpụkpụ, akpụ buru ibu nke osteoclastic, akpụ notochordal, akpụ mesenchymal ndị ọzọ nke ọkpụpụ, na hematopoietic neoplasms nke ọkpụ.
Enwere ike ịkewa etuto ọkpụkpụ dị ka " etuto isi", nke sitere na ọkpụkpụ ma ọ bụ site na mkpụrụ ndụ na anụ ahụ sitere n'ọkpụkpụ, yana " etuto nke abụọ" nke sitere na saịtị ndị ọzọ wee gbasaa (metastasize) na ọkpụkpụ. Carcinomas nke prostate, ara, ngụgụ, thyroid, na akụrụ bụ carcinomas nke na-ebutekarị ọkpụkpụ. A na-eche na etuto ọkpụkpụ dị njọ nke abụọ ga-abụ ugboro 50 ruo 100 dịka ọrịa kansa ọkpụkpụ nke mbụ.
Enwere ike kewaa akpụ isi nke ọkpụkpụ n'ime akpụ na ọrịa kansa. Ọkpụkpụ akpụ ndị a na-ahụkarị nwere ike ịbụ neoplastic, developmental, traumatic, infectious, ma ọ bụ inflammatory na etiology. Ụfọdụ akpụ ndị na-adịghị njọ abụghị ezigbo neoplasms, kama, na-anọchite anya hamartomas, ya bụ osteochondroma. Ebe ndị a na-ahụkarị maka ọtụtụ akpụ isi, ma ndị na-adịghị njọ ma ndị na'ụzọ ọjọọ gụnyere femur distal na proximal tibia (n'akụkụ nkwonkwo ikpere). atụ nke akpụ ọkpụkpụ na-adịghị njọ gụnyere osteoma, osteoid osteoma, osteochondroma, osteoblastoma, enchondroma، nnukwu akpụ nke ọkpụkpụkpụ na aneurysmal bone cyst.
Ọrịa akpụ ọkpụkpụ kachasị njọ gụnyere osteosarcoma, chondrosarcoma, Ewing's sarcoma, fibrosarcoma na ụdị ndị ọzọ. Ọ bụ ezie na malignant fibrous histiocytoma (MFH) - nke a na-akpọzi "pleomorphic undifferentiated sarcoma" - a maara na ọ bụ isi n'ọkpụkpụ na-eme mgbe ụfọdụ, usoro ndị dị ugbu a na-ewere MFH dị ka nchọpụta mkpofu, na ihe na-eme ugbu a bụ iji ọmụmụ pụrụ iche (ya bụ nyocha mkpụrụ ndụ ihe nketa na immunohistochemical) iji kewaa akpụ ndị a na-enweghị ọdịiche n'ime klas akpụ ndị ọzọ. Multiple myeloma bụ ọrịa kansa ọbara, nke na-esite na ụmị ọkpụkpụ, nke na'enwekarị otu ma ọ bụ karịa mmerụ ọkpụkpụ.
Ọrịa cancer nke mkpụrụ ndụ germ, gụnyere teratoma, na-adịkarị ma malite n'etiti etiti nke sacrum, coccyx, ma ọ bụ ha abụọ. Teratomas sacrococcygeal ndị a na-enwekarị ọgwụgwọ.
Ọkpụkpụ nke abụọ bụ mmerụ ahụ metastatic nke gbasara site na akụkụ ndị ọzọ, ọkachasị carcinomas nke ara, akpa ume, na prostate. N'ụzọ na-adịghị ahụkebe, malignancies nke ọkpụkpụ dị ka osteosarcoma nwekwara ike ịgbasa na ọkpụkpụ ndị ọzọ. Ndekọ ọnụ ọgụgụ a pụrụ ịdabere na ya na ihe na-eme, mgbasa, na ọnwụ nke akpụ ọkpụkpụ na-emebi emebi siri ike ịchọta, ọkachasị na ndị okenye (ndị karịrị afọ 75) - n'ihi na carcinomas nke na-agbasa n'ọtụtụ ebe na ọkpụkpụ anaghị agwọta. Biopsies iji chọpụta mmalite nke akpụ n'ọnọdụ ndị dị ka nke a anaghị eme ya. [citation needed]
Ihe ndị na-ahụ maka ahụike nke akpụ ọkpụkpụ na-adabere na ụdị akpụ na akụkụ nke ọkpụkpụ ọ na-emetụta. Mgbaàmà na ihe ịrịba ama na-esikarị na mmetụta nrụgide nke akpụ ahụ.
Enwere ike inwe ụyọkọ, na-enwe ma ọ bụ na-enweghị ihe mgbu. Ihe mgbu nwere ike ịbawanye ka ọ na-etolite ma nwee ike ịka njọ n'abalị na n'oge ezumike. Ọkpụkpụ akpụ nwere ike ịnwe ọkpụkpụ gbajiri agbaji a na-akọwaghị akọwa; na obere ma ọ bụ enweghị mmerụ ahụ. Mgbaàmà ndị ọzọ nwere ike ịgụnye ike ọgwụgwụ, ahụ ọkụ, ibu ibu, ụkọ ọbara na agbọ onunu. Ọ bụrụ na akpụ ahụ na-agbanye akwara, ihe ịrịba ama akwara nwere ike ịdị. Mgbe ụfọdụ, ọ dịghị mgbaàmà ọ bụla, a na-ahụkwa akpụ ahụ mgbe a na-enyocha nsogbu ọzọ.
Enwere ike ịnụ akpụ ọkpụkpụ mgbe a na-enyocha ya, mgbe nke ahụ gasịrị, a na-emekarị X-ray nkịtị. Nnyocha ọbara nwere ike ịgụnye ọnụ ọgụgụ ọbara zuru ezu, akara mgbu, serum electrophoresis, PSA, ọrụ akụrụ na ọrụ imeju. Enwere ike izipu mamịrị maka protein Bence Jones. Nnyocha ndị ọzọ enwere ike ịrịọ gụnyere CT scan, MRI, PET scan na scintigraphy ọkpụkpụ. Maka nkwenye nke nchọpụta, enwere ike ịchọ biopsy maka nyocha histological, site na iji agịga ma ọ bụ site na ịwa (open biopsy).
Ọgwụgwọ nke akpụ ọkpụkpụ dabere na ụdị akpụ. N'ebe enwere, a na-agwọ ndị nwere akpụ ọkpụkpụ n'ụlọ ọrụ ọkachamara nke nwere ndị dọkịta na-awa ahụ, ndị radiologist, ndị na-ahụ maka ọrịa, ndị na'ahụ maka ọrịa na ndị ọrụ nkwado ndị ọzọ. N'ozuzu, enwere ike ịhụ akpụ ọkpụkpụ na-abụghị cancer maka mgbanwe na ịwa ahụ a na-enye ma ọ bụrụ na enwere ihe mgbu ma ọ bụ nrụgide na akụkụ ahụ ndị agbata obi. Enwere ike ịtụle resection ịwa ahụ na ma ọ bụ na-enweghị ọgwụ cytotoxic.
Chemotherapy na radiotherapy dị irè na ụfọdụ akpụ (dị ka Ewing's sarcoma) mana ọ dị obere na ndị ọzọ (dị ka chondrosarcoma). E nwere usoro ọgwụgwọ ọgwụgwọ dịgasị iche iche maka akpụ ọkpụkpụ. Usoro nke nwere akụkọ kachasị mma na ụmụaka na ndị okenye bụ usoro intra-arterial ebe a na-agbaso mmeghachi omume tumor site na usoro arteriogram. Mgbe mmeghachi omume nke akpụ ruru >90% necrosis ịwa ahụ a na-eme atụmatụ.
Otu n'ime nchegbu ndị bụ isi bụ ọkpụkpụ na ọkpụkpụ. Non-hormonal bisphosphonates na-eme ka ọkpụkpụ sie ike ma dị ka ọgwụ ọgwụ na-edepụta otu ugboro n'izu. Metastron nke a makwaara dị ka strontium-89 chloride bụ ọgwụ intravenous e nyere iji nyere aka na ihe mgbu ma enwere ike inye ya n'ime ọnwa atọ. Generic Strontium Chloride Sr-89 Injection UPS, nke Bio-Nucleonics Inc. rụrụ, ọ bụ ụdị Metastron.
Ọgwụgwọ maka ọrịa kansa ọkpụkpụ ụfọdụ nwere ike ịgụnye ịwa ahụ, dị ka igbupụ aka, ma ọ bụ ịwa ahụ na-echekwa aka (nke a na-ejikọta ya na ọgwụgwọ ọgwụ na radiation). Ịwa ahụ na-eme ka ọ ghara ịdị n'otu, ma ọ bụ ịwa ahụ na na-eme ihe na-eme, pụtara na a na-echebe aka na aka na aka. Kama igbupụ ya, a na-ewepụ ọkpụkpụ ahụ metụtara ma dochie ya n'otu n'ime ụzọ abụọ: (a) ọkpụkpụ, nke a na-ewere ọkpụkpụ site n'ebe ọzọ n'ahụ ma ọ bụ (b) ọkpụ aka. Na ịwa ahụ n'elu ụkwụ, a na-enweta ndị e ji eme ka ọ dị mma. [citation needed]
Enwere nhọrọ ndị ọzọ na-echekwa njikọ ahụ, nke gụnyere allograft, tumor-devitalized autograft, vascularized fibula graft, distraction osteogenesis, na omenala omenala. Nnyocha nke nnukwu nkwonkwo ikpere mgbe resection nke akpụ ọkpụkpụ mbụ gosipụtara na ndị ọrịa enwetaghị akara dị elu na Musculoskeletal Tumour Society Score na Knee Society Score dị ka ndị ọrịa na-agafe intra-articular resection.
N'ime afọ iri abụọ gara aga, CT na-eduzi radiofrequency ablation apụtawo dị ka ihe ọzọ na-adịchaghị njọ na resection ịwa ahụ na nlekọta nke akpụ ọkpụkpụ, ọkachasị osteoid osteomas. Na usoro a, nke enwere ike ime n'okpuru sedation maara ihe, a na-ewebata nyocha RF n'ime nidus tumor site na agịga cannulated n'okpuru nduzi CT ma tinye okpomọkụ n'ógbè iji bibie mkpụrụ ndụ tumor. Ebe ọ bụ na e bu ụzọ webata usoro ahụ maka ọgwụgwọ nke osteoid osteomas na mbido afọ 1990, egosila na ọtụtụ ọmụmụ na ọ dị obere ma dị oke ọnụ, iji mee ka mbibi ọkpụkpụ dị ala ma nwee nchekwa na ịdị irè na usoro ịwa ahụ, na 66 ruo 96% nke ndị ọrịa na-akọ nnwere onwe pụọ na mgbaàmà. Ọ bụ ezie na ọnụọgụ ihe ịga nke ọma mbụ na RFA dị elu, a kọọrọ na mgbaàmà na-abịaghachi mgbe ọgwụgwọ RFA gasịrị, na nyocha ụfọdụ na-egosi ọnụọgụ na-abata nke yiri nke ọgwụgwọ ịwa ahụ.
Thermal ablation techniques are also increasingly being used in the palliative treatment of painful metastatic bone disease. Currently, external beam radiation therapy is the standard of care for patients with localized bone pain due to metastatic disease. Although the majority of patients experience complete or partial relief of pain following radiation therapy, the effect is not immediate and has been shown in some studies to be transient in more than half of patients. For patients who are not eligible or do not respond to traditional therapies ( i.e. radiation therapy, chemotherapy, palliative surgery, bisphosphonates or analgesic medications), thermal ablation techniques have been explored as alternatives for pain reduction. Several multi-center clinical trials studying the efficacy of RFA in the treatment of moderate to severe pain in patients with metastatic bone disease have shown significant decreases in patient reported pain after treatment. These studies are limited however to patients with one or two metastatic sites; pain from multiple tumors can be difficult to localize for directed therapy. More recently, cryoablation has also been explored as a potentially effective alternative as the area of destruction created by this technique can be monitored more effectively by CT than RFA, a potential advantage when treating tumors adjacent to critical structures.
Ọdịdị ahụ dabere na ụdị akpụ. A na-atụ anya na nsonaazụ ga-adị mma maka ndị nwere akpụ na-abụghị nke kansa (na-adịghị njọ), ọ bụ ezie na ụdị ụfọdụ nke akpụ na-adịghị njọ nwere ike ịghọ nke kansa (malignant). Site na akpụ ọkpụkpụ na-egbu egbu nke na-agbasaghị, ọtụtụ ndị ọrịa na-enweta ọgwụgwọ, mana ọnụego ọgwụgwọ na-adabere na ụdị ọrịa kansa, ebe, nha, na ndị ọzọ. [citation needed]
Ọkpụkpụ akpụ nke sitere na ọkpụkpụ dị ụkọ ma bụrụ ihe dị ka 0.2% nke akpụ niile. Nkezi afọ ise nke ndụ na United States mgbe a chọpụtara na ọ na-arịa ọrịa kansa ọkpụkpụ na nkwonkwo bụ 67%.
Ọkpụkpụ akpụ mbụ a maara bụ osteosarcoma na ọkpụkpụ ụkwụ nke onye nwụrụ na Swartkrans Cave, South Africa, n'etiti 1.6 na 1.8 nde afọ gara aga.
Ọkpụkpụ bụ ebe a na-ahụkarị maka akpụ na nwamba na nkịta.