Matakan Ciwon daji

Tsarin **[[Ciwon Daji|ciwon daji]]** shine tsari na tantance iyakar abin da ciwon daji ya tasowa ta hanyar girma da yaduwa. Ayyukan zamani shine sanya lamba daga I zuwa IV zuwa ciwon daji, tare da kasancewa ciwon daji da kuma IV kasancewa ciwon daji wanda ya yadu zuwa iyakar abin da matakan tantancewar. Matsayin gabaɗaya yana yin la'akari da girman ƙwayar cuta, ko ya mamaye gabobin da ke kusa, yawancin yanki na yanki (kusa da) ƙwayoyin lymph nawa ya bazu zuwa (idan akwai), kuma ko ya bayyana a wurare masu nisa ( metastasized ).

Ba a aiwatar da tsarin tsarawa ga astrocytoma, wanda a maimakon haka an bayyana shi azaman "I-IV". Grade IV astrocytoma, wanda aka fi sani da glioblastoma multiforme, shine ciwon daji na farko na kwakwalwa wanda aka fi gani a cikin shekaru 7th na rayuwa.

## Tsari na TNM

Za a iya raba matakin ciwon daji zuwa mataki na asibiti da kuma mataki na pathologic. A cikin tsarin TNM (Tumor, Node, Metastasis), mataki na asibiti da kuma pathologic ana nuna su ta hanyar ƙananan "c" ko "p" kafin mataki (misali, cT3N1M0 ko pT2N0). Ana amfani da wannan tsarin tsarawa don yawancin nau'ikan ciwon daji, ban da ciwace-ciwacen ƙwayar cuta da cututtukan jini .

* Matakin asibiti ya dogara ne akan duk bayanan da aka samu kafin tiyata don cire ƙari. Wannan mataki na iya haɗawa da bayani game da ciwon daji da aka samu ta hanyar nazarin jiki, gwajin jini, nazarin rediyo, biopsy, da endoscopy .
* Matakin cututtukan cututtuka yana ƙara ƙarin bayanan da aka samu ta hanyar bincikar ƙwayar cuta ta microscopically ta hanyar likitan dabbobi bayan an cire shi ta hanyar tiyata.
* Saboda suna amfani da ma'auni daban-daban, mataki na asibiti da kuma pathologic sau da yawa ya bambanta. Yawancin lokaci ana la'akari da tsarin ilimin cututtuka a matsayin mafi daidai saboda yana ba da damar yin nazari kai tsaye a kan ciwon gabaɗaya, akasin haka da tsarin asibiti wanda aka iyakance ta hanyar gaskiyar cewa ana samun bayanin ta hanyar duban wani ƙari wanda har yanzu yana cikin jiki. Duk da haka, matakan asibiti da tsarin cututtuka sukan haɗu da juna. Ba kowane ciwace-ciwace ake yi wa tiyata ba, don haka ba a ko da yaushe ana samun maganin cututtukan cututtuka. Har ila yau, wani lokacin tiyata yana gaba da wasu jiyya irin su chemotherapy da radiation far wanda ke rage ƙwayar cuta, don haka mataki na pathologic na iya raina matakin gaskiya.

## La'akari
Daidaitaccen tsari yana da mahimmanci saboda jiyya (musamman buƙatun maganin kafin a yi aiki da/ko don jiyya mai ƙarfi, girman tiyata) gabaɗaya ya dogara akan wannan siga. Don haka, matakin da ba daidai ba zai haifar da magani mara kyau.

Ga wasu cututtukan daji na yau da kullun ana tsara tsarin tsarawa. Misali, a lokuta na ciwon nono da ciwon prostate, likitoci akai-akai za su iya gane cewa ciwon daji ya fara da wuri kuma yana da ƙananan haɗarin metastasis. A irin waɗannan lokuta, ƙwararrun ƙwararrun ƙwararrun likitoci sun ba da shawarar yin amfani da PET scans, CT scans, ko sikanin kashi saboda bincike ya nuna cewa haɗarin samun irin waɗannan hanyoyin ya fi amfanin da za a iya samu. Wasu daga cikin matsalolin da ke da alaƙa da gwajin wuce gona da iri sun haɗa da marasa lafiya da ke karɓar hanyoyin cin zarafi, yin amfani da sabis na likitanci fiye da kima, samun bayyanar hasken da ba dole ba, da fuskantar rashin ganewa.

### Cutar cututtuka
Pathologic Staging, inda masanin ilimin cututtuka yayi nazarin sassan nama, na iya zama matsala musamman don dalilai guda biyu: hankali na gani da kuma samfurin bazuwar nama. "Hanyar gani" na nufin samun damar gano ƙwayoyin kansa masu cutar kansa guda ɗaya waɗanda aka haɗa su da sel lafiyayyu akan faifai. Sa ido kan tantanin halitta ɗaya na iya haifar da kuskure kuma yana haifar da mummunar yaɗuwar cutar kansa da ba zato ba tsammani. "Samfurin bazuwar" yana nufin gaskiyar cewa ƙwayoyin lymph ana ɗaukar ceri daga marasa lafiya kuma ana bincika samfuran bazuwar. Idan sel masu ciwon daji da ke cikin kumburin lymph ba su kasance a cikin yanki na nama da aka gani ba, matakin da ba daidai ba da kuma rashin dacewa zai iya haifar da.

### Bincike na yanzu
Sabbin hanyoyi masu mahimmanci na tsarawa suna cikin haɓakawa. Alal misali, mRNA don GCC ( guanylyl cyclase c ), wanda ke samuwa ne kawai a cikin yanayin haske na epithelium na hanji, ana iya gano shi ta hanyar amfani da kwayar cutar ta kwayar halitta ( RT-PCR ) tare da matsayi mai mahimmanci da ƙwarewa. Kasancewar GCC a cikin kowane nau'in nama na jiki yana wakiltar metaplasia mai launi. Saboda yawan hazakar sa, duban RT-PCR don GCC yana rage girman rashin kima na matakin cuta. Masu bincike suna fatan cewa yin aiki tare da wannan matakin daidai zai haifar da mafi dacewa da magani da kuma kyakkyawan hangen nesa . Bugu da ƙari, masu bincike suna fatan cewa wannan dabarar za a iya amfani da ita ga wasu takamaiman sunadaran nama.

### Tsarukan aiki
Tsarin tsari sun keɓance ga kowane nau'in ciwon daji (misali, kansar nono da kansar huhu ), amma wasu kansar ba su da tsarin tsarawa. Ko da yake har yanzu tsarin fafatawa a gasa na wanzuwa ga wasu nau'ikan ciwon daji, tsarin da aka yarda da shi a duk duniya shine na UICC, wanda ke da ma'anoni iri ɗaya na nau'ikan mutum ɗaya kamar AJCC .

Tsarin tsari na iya bambanta tsakanin cututtuka ko takamaiman bayyanar cututtuka.

### Jini

* Lymphoma : yawancin amfani da Ann Arbor staging
* Hodgkin lymphoma : yana bin ma'auni daga I zuwa IV kuma ana iya nuna shi gaba ta hanyar A ko B, dangane da ko mara lafiya ba shi da alamar cututtuka ko yana da alamun cututtuka irin su zazzaɓi. An san shi da "Cotswold System" ko "Ann Arbor Staging System wanda aka gyara".

### Solid
Don ciwace-ciwacen ciwace-ciwace, TNM shine tsarin da aka fi amfani dashi, amma an daidaita shi don wasu yanayi.

* Ciwon daji na nono : A cikin rarrabuwar kansar nono, ana yin gyare-gyare akai-akai akan TNM, amma ana iya amfani da shi a cikin I-IV kuma.
* Ciwon daji na mahaifa da ovarian : an karɓi tsarin " FIGO " a cikin tsarin TNM. Don sauye-sauye na dysplastic premalignant, ana amfani da tsarin grading CIN ( cervical intraepithelial neoplasia ). 
* Ciwon daji : asalinsa ya ƙunshi matakai huɗu: A, B, C, da D ( tsarin tsagaitawar Dukes ). Kwanan nan, ana nuna alamun cutar kansar hanji ko dai ta ainihin matakan AD ko ta TNM.
* Ciwon daji na koda : yana amfani da TNM. 
* Ciwon daji na makogwaro : Yana amfani da TNM.
* Ciwon daji na hanta: yana amfani da TNM.
* Ciwon daji na huhu : yana amfani da TNM.
* Melanoma : ana amfani da TNM. Har ila yau, mahimmanci shine "Level Clark" da "Breslow zurfin" wanda ke nufin ƙananan ƙananan ƙwayar ƙwayar cuta ("Microstaging").
* Prostate cancer : TNM kusan ana amfani dashi a duk duniya.
* Ciwon daji na Testicular : yana amfani da TNM tare da ma'aunin alamun jini (TNMS).
* Ciwon daji na fata wanda ba melanoma ba : yana amfani da TNM.
* Ciwon daji na mafitsara : yana amfani da TNM.

## Gabaɗaya rukunin mataki

Gabaɗaya Rukunin Mataki kuma ana kiransa da Matsayin Lissafi na Roman . Wannan tsarin yana amfani da lambobi I, II, III, da IV (tare da 0) don bayyana ci gaban ciwon daji.

* **Mataki na 0** : carcinoma *in situ*, ƙananan ƙwayoyin da ke girma a cikin al'ada ("in situ" daga Latin don "a wurinsa").
* **Mataki na 1** : ana ware cutar daji zuwa wani sashe na jiki. Za a iya cire ciwon daji na Stage I ta hanyar tiyata idan ƙananan isa.
* **Mataki na II** : Ciwon daji sun ci gaba a cikin gida. Za a iya magance ciwon daji na Stage II ta hanyar chemotherapy, radiation, ko tiyata.
* **Mataki na III** : ciwon daji kuma suna ci gaba a cikin gida. Ko an sanya ciwon daji a matsayin Stage II ko Stage III na iya dogara da takamaiman nau'in ciwon daji; alal misali, a cikin Ciwon Hodgkin, mataki na II yana nuna alamun ƙwayar lymph da aka shafa a gefe ɗaya kawai na diaphragm, yayin da mataki na III ya nuna alamun lymph da aka shafa a sama da ƙasa da diaphragm. Musamman ma'auni na Mataki na II da na III don haka sun bambanta bisa ga ganewar asali. Za a iya bi da mataki na III ta hanyar chemotherapy, radiation, ko tiyata.
* **Mataki na IV** : Ciwon daji sun sau da yawa metastasized, ko yada zuwa wasu gabobin ko cikin jiki. Za a iya bi da ciwon daji na Stage IV ta hanyar chemotherapy, radiation, ko tiyata. Duk da jiyya, yawan mace-macen majiyyaci na iya zama mafi girma tare da ciwon daji na Stage IV, misali, ciwon daji na iya ci gaba zuwa zama mai ƙarewa .
* A cikin tsarin TNM, ana iya sanya ciwon daji a matsayin maimaituwa, ma'ana cewa ya sake bayyana bayan an cire shi ko kuma bayan an kawar da duk wani ciwuka da ake gani. Maimaituwa na iya zama na gida, ma'ana ya bayyana a wuri ɗaya da na asali, ko kuma mai nisa, ma'ana yana bayyana a wani sashe na jiki daban.

## Hijiran mataki
Hijira mataki shine canji a cikin rarraba matakai a cikin takamaiman adadin cutar kansa, wanda ya haifar da ko dai canji a cikin tsarin tsarin kanta ko kuma canjin fasaha wanda ke ba da damar gano ƙwayar ƙwayar cuta mai zurfi don haka ƙarin hankali wajen gano yaduwar cuta ( misali, yin amfani da MRI scans). Hijira mataki na iya haifar da ban sha'awa al'amuran ƙididdiga (misali, abin mamaki na Will Rogers ).

## Manazarta