Ciwon Daji Na Baka

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Ciwon Daji Na Baka
ZungenCa2a.jpg
Description (en) Fassara
Iri gastrointestinal system cancer (en) Fassara, mouth disease (en) Fassara, oral cavity neoplasm (en) Fassara, head and neck cancer (en) Fassara
disease (individual) (en) Fassara
Specialty (en) Fassara oncology (en) Fassara
oral and maxillofacial surgery (en) Fassara
Identifier (en) Fassara
ICD-10-CM C04, C04.0, C04.1 da C04.9
ICD-9-CM 144.9, 144.1, 144 da 144.0
DiseasesDB 9288
MedlinePlus 001035
eMedicine 001035
Disease Ontology ID DOID:8618

Ciwon daji na baka, wanda kuma aka sani da kansar bakin, shi ne ciwon daji na rufin lebe, baki, ko babba makogwaro. [1] A cikin baki, yawanci yana farawa azaman facin fari mara radadi, wanda yayi kauri, yana tasowa jajayen faci, ulcer, kuma yana ci gaba da girma. Lokacin da yake kan lebe, yawanci yakan yi kama da ƙwanƙwasa miki wanda baya warkewa, kuma a hankali yana girma.[2] Sauran alamomin na iya haɗawa da hadiya mai wahala ko mai raɗaɗi, sabbin kullutu ko kumbura a wuya, kumburi a baki, ko jin kumbura a baki ko lebe. [3]

Abubuwan haɗari sun haɗa da shan taba da barasa .[4][5] Wadanda ke amfani da barasa da taba suna da haɗarin kansar baki sau 15 fiye da waɗanda ba sa amfani da su.[6] Sauran abubuwan haɗari sun haɗa da kamuwa da cutar HPV, [7] taunar tauna, [8] da bayyanar rana a ƙasan leɓe.[9] Ciwon daji na baka rukuni ne na kansa da wuyansa . [1] Ana yin ganewar asali ta hanyar biopsy na yankin da ya shafi, sannan bincike tare da CT scan, MRI, PET scan, da jarrabawa don sanin ko ya yadu zuwa sassa masu nisa na jiki.

Ana iya kare kansa ta baka ta hanyar guje wa kayan sigari, iyakance amfani da barasa, kariya daga rana akan lebe na ƙasa, allurar HPV, da nisantar ɓacin rai. Magungunan da ake amfani da su don ciwon daji na baka na iya haɗawa da haɗin tiyata (don cire ciwace-ciwacen ƙwayar cuta da ƙwayar lymph nodes ), maganin radiation, chemotherapy, ko kuma maganin da aka yi niyya . Nau'o'in jiyya za su dogara da girman, wurare, da yaduwar cutar kansa da aka yi la'akari da lafiyar mutum gaba ɗaya.[1]

A cikin 2018, ciwon daji na baki ya faru a duniya a cikin kusan mutane 355,000, kuma ya yi sanadiyar mutuwar 177,000.[10] Tsakanin 1999 da 2015 a Amurka, yawan ciwon daji na baka ya karu da kashi 6% (daga 10.9 zuwa 11.6 cikin 100,000). Mutuwar cutar kansar baki a wannan lokacin ta ragu da kashi 7% (daga 2.7 zuwa 2.5 a cikin 100,000).[11] Ciwon daji na baka yana da jimlar adadin rayuwa na shekara 5 na 65% a cikin Amurka kamar na 2015. [12] Wannan ya bambanta daga 84% idan an gano shi lokacin da aka gano shi, idan aka kwatanta da kashi 66% idan ya yadu zuwa ƙwayoyin lymph a wuya, da 39% idan ya yada zuwa sassan jiki masu nisa.[12] Yawan tsira kuma ya dogara ne da wurin da cutar ke cikin baki. [13]

Alamomi da alamomi[gyara sashe | Gyara masomin]

Kumburi na wuyan dama daga yaduwar ciwon daji na baki.
Ulceration akan leben ƙasa na hagu wanda ciwon daji ke haifarwa

Alamu da alamun ciwon daji na baka sun dogara ne akan wurin da ƙari yake amma gabaɗaya suna sirara, marasa daidaituwa, fararen faci a baki. Hakanan zasu iya zama gaurayawan faci na ja da fari (haɗe-haɗen facin ja da fari sun fi kamuwa da cutar daji idan aka yi musu rai). Alamar faɗakarwa ta al'ada alama ce mai tsayi mai tsayi tare da ulceration, da tsayin iyaka wanda ke da ɗan raɗaɗi. A kan lebe, gyambon ya fi kumbura da bushewa, kuma a cikin pharynx ya fi yawa. Hakanan ana iya haɗa shi da farar faci, kwancen hakora, gumi na zubar jini, ciwon kunne mai dagewa, jin kumbura a cikin leɓe da gaɓoɓinsa, ko kumburi.[14]

Lokacin da ciwon daji ya miƙe zuwa makogwaro, ana iya samun wahalar haɗiye, haɗiye mai raɗaɗi, da kuma sauya murya. [15] Yawanci, raunuka suna da ƙananan zafi har sai sun girma sannan kuma suna hade da jin zafi. [16] Yayin da raunin ya yadu zuwa ƙwayoyin lymph na wuyansa, rashin jin zafi, taro mai wuya zai ci gaba. Idan ya yada wani wuri a cikin jiki, ciwon daji na gaba ɗaya zai iya tasowa, mafi sau da yawa saboda ƙasusuwan kashi .[17]

Dalilai[gyara sashe | Gyara masomin]

Cutar sankarau ta baka cuta ce ta abubuwan muhalli, mafi girma daga cikinsu ita ce taba. Kamar duk abubuwan muhalli, ƙimar da ciwon daji zai haɓaka ya dogara ne akan adadin, mita da kuma hanyar aikace-aikacen carcinogen (abun da ke haifar da ciwon daji). Baya ga shan taba sigari, sauran cututtukan daji na ciwon daji na baka sun haɗa da barasa, ƙwayoyin cuta (musamman HPV 16 da 18), radiation, da hasken UV.

Taba[gyara sashe | Gyara masomin]

Taba ita ce mafi girman sanadin ciwon daji na baka da na pharyngeal. Sanannen ciwon daji ne na gabobin jiki da yawa, wanda ke da hulɗar haɗin gwiwa tare da barasa don haifar da ciwon daji na baki da pharynx ta hanyar lalata DNA ta salula kai tsaye. An kiyasta cewa taba yana ƙara haɗarin kansar baki ta hanyar 3.4 -6.8 kuma yana da alhakin kusan kashi 40% na duk ciwon daji na baki.[18]

Barasa[gyara sashe | Gyara masomin]

Wasu bincike a Ostiraliya da Brazil da Jamus sun yi nuni da wankin baki mai dauke da barasa kamar yadda kuma ke iya zama sanadi. Da'awar ita ce bayyanar da kullun ga waɗannan kurrukan da ke ɗauke da barasa, ko da idan babu shan taba da sha, yana haifar da haɓakar haɓakar ciwon daji na baka. Duk da haka, binciken da aka gudanar a 1985,[19] 1995,[20] da 2003[21] ya taƙaita cewa wanke baki mai ɗauke da barasa ba ya da alaƙa da ciwon daji na baki. A cikin taƙaitaccen Maris na 2009, Ƙungiyar Haƙori ta Amurka ta ce "shaidar da ake da ita ba ta goyi bayan alaƙa tsakanin ciwon daji na baki da kuma shan barasa mai ɗauke da barasa".[22] Wani bincike na 2008 ya nuna cewa acetaldehyde (wani samfurin barasa) yana cikin ciwon daji na baki,[23][24] amma wannan binciken ya mayar da hankali ga masu cin zarafin barasa kuma bai yi magana game da wanke baki ba.

Human papillomavirus[gyara sashe | Gyara masomin]

Kamuwa da cutar papillomavirus (HPV), musamman nau'in 16 (akwai nau'ikan nau'ikan sama da 180), sanannen haɗarin haɗari ne kuma sanadin cutar kansa mai zaman kanta ga kansar baka. [25] Wani yanki mai girma cikin sauri na waɗanda aka gano baya gabatar da ƙwararrun alƙaluma na tarihi. A tarihi wanda ya kasance mutane sama da 50, baƙar fata fiye da farare 2 zuwa 1, maza akan mata 3 zuwa 1, da 75% na lokutan mutanen da suka yi amfani da kayan sigari ko masu yawan shan barasa. Wannan sabuwar ƙabila mai girma da sauri tsakanin shekaru 30 zuwa 50,[26] galibi marasa shan taba ne, farare, kuma maza sun fi mata yawa. Bincike na baya-bayan nan daga labaran mujallolin da aka bita da yawa ya nuna cewa HPV16 shine babban abin haɗari a cikin wannan sabon yawan mutanen da ke fama da cutar kansa ta baki. HPV16 (tare da HPV18) kwayar cuta iri ɗaya ce da ke da alhakin mafi yawan duk cututtukan daji na mahaifa kuma ita ce mafi yawan kamuwa da kamuwa da jima'i a Amurka. Ciwon daji na baka a cikin wannan rukuni yana kula da tonsil da ginshiƙan tonsillar, tushe na harshe, da kuma oropharynx . Bayanai na baya-bayan nan sun nuna cewa mutanen da suka kamu da cutar daga wannan dalili na musamman suna da fa'ida mai mahimmanci na rayuwa, [27] yayin da cutar ta fi dacewa da jiyya na radiation fiye da yadda taba ke haifar da cuta.

Kwayar goro[gyara sashe | Gyara masomin]

Rukunin sayar da betel quid

Cin dusar ƙanƙara, paan da Areca an san su zama haɗari mai ƙarfi don haɓaka ciwon daji na baki koda kuwa babu taba. Yana ƙara yawan ciwon daji na baka sau 2.1, ta hanyar nau'ikan kwayoyin halitta da abubuwan da ke da alaƙa ta hanyar hangula na gida na ƙwayoyin mucous membrane, musamman daga ƙwaya da lemun tsami. A Indiya inda irin waɗannan ayyuka suka zama ruwan dare, ciwon daji na baka yana wakiltar kusan kashi 40% na duk cututtukan daji, idan aka kwatanta da kawai 4% a Burtaniya .

Dashen kwayar halitta[gyara sashe | Gyara masomin]

Mutane bayan dashen kwayar cutar hematopoietic (HSCT) suna cikin haɗari mafi girma ga carcinoma na bakin squamous cell. Bayan-HSCT ciwon daji na baka na iya samun ƙarin hali mai muni tare da rashin fahimta, idan aka kwatanta da ciwon daji na baki a cikin mutanen da ba a bi da su tare da HSCT ba. Ya kamata wannan tasirin ya kasance ne saboda ci gaba da danne garkuwar jiki na tsawon rayuwa da kuma na yau da kullun na baka -da-masu cuta .[28]

Launuka masu tasowa[gyara sashe | Gyara masomin]

Leukoplakia na baka (fararen faci) akan harshen hagu. An tabbatar da kasancewar dysplasia mai tsanani akan biopsy

An bayyana raunin da ba a taɓa gani ba (ko wanda ya rigaya ya rigaya) a matsayin "nama mara kyau, mai canza yanayin halitta wanda ke da haɗari fiye da al'ada na canji mara kyau." Akwai nau'o'in nau'ikan raunuka daban-daban waɗanda ke faruwa a cikin baki. Wasu cututtukan daji na baka suna farawa azaman facin fari ( leukoplakia ), jajayen faci ( erythroplakia ) ko gauraye ja da fari faci (erythroleukoplakia ko “speckled leukoplakia”). Sauran cututtuka na yau da kullun sun haɗa da fibrosis submucous na baka da actinic cheilitis .[29] A cikin nahiyoyin Indiya, fibrosis na baka na baka ya zama ruwan dare saboda cin goro . Wannan yanayin yana da alaƙa da iyakancewar buɗe baki da zafi mai zafi akan cin abinci mai yaji. Wannan ciwo ne mai ci gaba wanda buɗe baki ya zama mai iyakancewa, kuma daga baya ko da cin abinci na yau da kullum yana da wahala.

Pathophysiology[gyara sashe | Gyara masomin]

Kwayar Cuta mara tsari. Tantanin halitta guda ɗaya yana canzawa zuwa clone wanda ya ƙunshi sel ƴan mata da yawa tare da tarin sauye-sauyen ƙwayoyin halittar da ake kira oncogenes . Abin da ke nuna mummunan ƙwayar cuta a kan mara lafiya shine ikonsa na metastasize. Wannan ikon ya kasance mai zaman kansa daga girman ko darajar ƙwayar cuta (sau da yawa kamar jinkirin girma ciwon daji kamar adenoid cystic carcinoma na iya metastasis a ko'ina). Ba wai kawai saurin girma ne ke nuna ciwon daji ba, amma ikon su na ɓoye enzymes, abubuwan angiogeneic, abubuwan mamayewa, abubuwan haɓaka da sauran abubuwan da ke ba da damar yaduwa.

Bincike[gyara sashe | Gyara masomin]

Babban ciwon daji na harshe kamar yadda aka gani akan hoton CT
Siffar histopathologic na nau'in ƙwayar ƙwayar ƙwayar ƙwayar cuta mara kyau. Hematoxylin-eosin tabo. p16 tabbatacce, EBV mara kyau

An kammala gano ciwon daji na baka don (1) ganewar asali, (2) tsarawa, da (3) shirin magani. Cikakken tarihin tarihi, kuma an fara kammala gwajin asibiti, sannan an yanke wani yanki na nama daga raunin da ake tuhuma don ganewar asali . Ana iya yin wannan tare da biopsy na fatar jiki, biopsy na punch, lafiya ko ainihin ƙwayar allura . A cikin wannan hanya, likitan fiɗa ya yanke duka, ko guntun nama, don a duba shi a ƙarƙashin na'urar gani da ido ta wurin likitan ilimin cututtuka .[30] Ba a yi la'akarin ɓangarorin goge goge daidai don gano ciwon daji na baki.[31]

Tare da biopsy na farko, likitan ilimin cututtuka zai samar da ganewar ƙwayar cuta (misali squamous cell carcinoma ), kuma ya rarraba tsarin tantanin halitta. Za su iya ƙara ƙarin bayani waɗanda za a iya amfani da su a cikin tsarawa, da tsarin kulawa, irin su mitotic rate, zurfin mamayewa, da kuma matsayin HPV na nama.

Bayan an tabbatar da nama yana da kansa, za a kammala wasu gwaje-gwaje zuwa:

  • mafi kyawun tantance girman raunin ( CT scan, MRI ko PET scan tare da 18F-fluorodeoxyglucose (FDG)),  : 143 
  • nemo wasu cututtuka na ciwon daji a cikin sashin jiki na sama (wanda zai iya haɗawa da endoscopy na kogon hanci / pharynx, larynx, bronchus, da esophagus da ake kira panendoscopy ko quadoscopy ),
  • yaduwa zuwa nodes na lymph ( CT scan ) ko
  • yaduwa zuwa wasu sassan jiki ( X-ray na kirji, maganin nukiliya ).

Sauran, ƙarin gwaje-gwaje masu cin zarafi, ana iya kuma iya kammala su kamar kyakkyawan fata na allura, biopsy na nodes na lymph, da biopsy node na sentinel . Lokacin da ciwon daji ya yada zuwa ƙananan ƙwayoyin lymph, ainihin wurin su, girman su, da yadawa fiye da capsule (na lymph nodes) yana buƙatar ƙayyade, saboda kowannensu na iya yin tasiri mai mahimmanci akan jiyya da tsinkaye. Ƙananan bambance-bambance a cikin nau'in ƙwayar ƙwayar ƙwayar ƙwayar cuta, na iya samun tasiri mai mahimmanci akan jiyya da tsinkaye. Ana iya ba da shawarar Panendoscopy, saboda kyallen takarda na gabaɗayan sashin iska na sama gaba ɗaya suna shafar carcinogens iri ɗaya, don haka sauran cututtukan daji na farko sun zama ruwan dare gama gari.[32][33]

Daga waɗannan binciken gama-gari, waɗanda aka yi la’akari da lafiya da sha’awar mutum, ƙungiyar ciwon daji ta haɓaka shirin jiyya. Tunda yawancin ciwon daji na baka suna buƙatar cirewar tiyata, za a kammala saiti na biyu na gwaje-gwaje na histopathologic akan duk wani ƙari da aka cire don tantance hasashen, buƙatar ƙarin tiyata, chemotherapy, radiation, immunotherapy, ko wasu tsoma baki.

Rabewa[gyara sashe | Gyara masomin]

Ciwon daji na baka rukuni ne na kansa da wuyansa wanda ya hada da na oropharynx, larynx, kogon hanci da sinuses na paranasal, glandan salivary, da glandar thyroid . Melanoma na baka, yayin da ake la'akari da wani ɓangare na kansa da wuyansa daban. Sauran cututtukan daji na iya faruwa a cikin baki (kamar ciwon daji na kashi, lymphoma, ko ciwon daji na metastatic daga wurare masu nisa) amma kuma ana la'akari da su daban da ciwon daji na baka.

Tsayawa[gyara sashe | Gyara masomin]

Matsayin ciwon daji na baka shine kimanta girman yaduwar cutar kansa daga asalinsa.[34] Yana daya daga cikin abubuwan da suka shafi duka tsinkaye da yuwuwar maganin ciwon daji na baka.

Ƙimar ciwon daji na squamous cell carcinoma na baki da pharynx staging yana amfani da tsarin TNM (tumor, node, metastasis). Wannan ya dogara ne akan girman ƙwayar ƙwayar cuta ta farko, shigar kumburin lymph, da metastasis mai nisa.[35]

T: Ciwon farko
TX Ba za a iya tantance ƙwayar cuta ta farko ba
Tis Carcinoma a wurin
T1 Tumor ≤ 2 cm tare da zurfin mamayewa (DOI*) ≤5mm
T2 Tumor ≤ 2 cm tare da DOI*>5mm ko ƙari>2 cm da ≤ 4 cm tare da DOI * ≥10mm
T3 Tumor> 2 cm da ≤4 cm tare da DOI*> 10mm ko ƙari> 4 cm tare da DOI* ≤ 10mm
T4 Cututtukan gida masu matsakaicin ci gaba ko ci gaba sosai
T4a Ciwon gida mai matsakaicin ci gaba, kumburi>4 cm tare da DOI *> 10mm ko ƙari yana mamaye tsarin da ke kusa da shi kawai (kashin cortical na mandible ko maxilla (ban da yashewar haƙori kawai a cikin ciwan gingival) ko ya haɗa da maxillary sinus ko fatar fuska)
T4b Ciwon gida mai ci gaba sosai. Tumor ya mamaye sararin masticator, faranti na pterygoid, ko gindin kwanyar da/ko ya ƙunshi jijiya carotid na ciki.
*DOI zurfin mamayewa ne ba kauri ba.
N: Nodes na Lymph na asibiti (rarrabuwa daban don rarrabuwar cututtuka)
NX Ba za a iya tantance nodes na yanki ba
N0 Babu metastasis na yankin lymph nodes
N1 Metastasis a cikin kumburin lymph na ipsilateral guda ɗaya, <3 cm da ENE (-)
N2 Metastasis a cikin kumburin lymph na ipsilateral guda ɗaya, ≤3 cm ko karami da ENE(+) ko> 3 cm da ≤6 cm da ENE (-); ko metastases a cikin nodes na ƙwayar cuta na ispsilateral, babu> 6 cm da ENE (-); ko a cikin nodes (s) na lymph na gefe ko na gaba, ba> 6 cm ENE (-)
N2a Metastasis a cikin kumburin ipsilateral guda ɗaya <3 cm da ENE (+); ko guda ipsitereral node ≥3 cm da <6 cm da ENE (-)
N2b Metastases a cikin nodes na ipsilateral da yawa, <6 cm da ENE (-)
N2c Metastases a cikin nodes na lymph na biyu ko na gaba; <6 cm da ENE (-)
N3 Metastasis a cikin kumburin lymph ≥6 cm da ENE (-); ko metastasis a cikin kowane nbodes (s) da na asibiti overt ENE (+)
N3a Metastasis a cikin kumburin lymph ≥6 cm da ENE (-)
N3b Metastasis a cikin kowane nodes (s) da ENE (+) na asibiti.
Lura: Za a iya amfani da alamar "U" ko "L" don kowane nau'in N don nuna metastasis a sama (U) ko ƙasa (L) ƙananan iyakar cricoid. ENE (+/-) yana nuna kasancewar ko rashi na cutar extranodal
M: Metastasis
cM0 Babu metastasis mai nisa
cM1 Metastasis mai nisa
pM1 Metastasis mai nisa, an tabbatar da ɗan ƙaramin abu

Ƙimar TMN yana ba da damar a rarraba mutumin zuwa ƙungiyar tsinkaya;

Spread of cancer beyond the capsule of a lymph node (ENE+).

TMN evaluation allows the person to be classified into a prognostic staging group;[36]

AJCC Prognostic Stage Groups[36]
When T is... And N is... And M is... Then the stage group is...
Tis N0 M0 0
T1 N0 M0 I
T2 N0 M0 II
T3 N0 M0 III
T1,T2,T3 N1 M0 III
T4a N0,N1 M0 IVA
T1,T2,T3,T4a N2 M0 IVA
Any T N3 M0 IVB
T4b Any N M0 IVB
Any T Any N M1 IVC
Yaduwar cutar kansa fiye da capsule na kumburin lymph (ENE+).

Nunawa[gyara sashe | Gyara masomin]

Miyagun Ayyukan Tsoratarwar Amurka (Uspstf) a cikin 2013 da aka bayyana hujjoji ba su da isasshen inganci da cutar kansa ba tare da alamomi ta hanyar ba da kulawa. [37] Cibiyar Nazarin Likitocin Iyali ta Amurka ta zo ga irin wannan matsaya yayin da Ƙungiyar Ciwon daji ta Amurka ta ba da shawarar cewa manya sama da shekaru 20 waɗanda ke yin gwajin lafiya na lokaci-lokaci yakamata a bincika kogon baki don ciwon daji. Ƙungiyar Haƙori ta Amurka ta ba da shawarar cewa masu ba da sabis su kasance a faɗake don alamun ciwon daji yayin gwaje-gwaje na yau da kullun.

Akwai nau'ikan na'urorin dubawa iri-iri irin su toluidine blue, brush biopsy, ko hoto mai haske, duk da haka, babu wata shaida cewa yin amfani da waɗannan na'urori na yau da kullun a aikin haƙori na gaba ɗaya yana taimakawa. [38] Haɗarin da za a yi amfani da su na yin amfani da na'urorin tantancewa sun haɗa da abubuwan da ba su dace ba, gwajin ƙwayoyin cuta marasa amfani, da nauyin kuɗi. Ƙididdigar ƙananan ƙwayoyin cuta na iya taimakawa a farkon ganewar cututtuka na pre-malignant da m raunuka, don haka inganta rayuwa da kuma rage cututtuka da ke hade da magani.

Haka kuma an yi bincike da ke nuna yuwuwar yin amfani da ilimin sinadarai na baka a matsayin gwajin cutar kansar baki maimakon dabarun biopsy na gargajiya. A cikin cytology na baka, ana amfani da goga don ɗaukar wasu sel daga raunin da ake zargi kuma ana aika su zuwa dakin gwaje-gwaje don dubawa. [39] Wannan na iya zama ƙasa da ɓarna da zafi fiye da ƙwayar ƙwayar cuta ga mai haƙuri, duk da haka, akwai buƙatar ƙarin bincike kafin a iya ɗaukar cytology na baka azaman kayan aikin tantancewa na yau da kullun idan aka kwatanta da biopsies.

Gudanarwa[gyara sashe | Gyara masomin]

Hoton bayan aikin bayan an cire ciwon daji na baka tare da wani yanki na mandible ( bubin ciyarwa a hanci)

Ciwon daji na baka (squamous cell carcinoma) yawanci ana yi masa tiyata ne kawai, ko kuma a hade tare da jiyya, gami da radiation, tare da ko ba tare da chemotherapy ba. (pp602)Tare da ƙananan raunuka (T1), tiyata ko radiation suna da nau'o'in kulawa iri ɗaya, don haka yanke shawara game da abin da za a yi amfani da shi ya dogara ne akan sakamakon aiki, da kuma rikitarwa.

Tiyata[gyara sashe | Gyara masomin]

A mafi yawan cibiyoyi, kawar da ciwon daji na squamous cell daga kogon baka da wuya ana samun su da farko ta hanyar tiyata. Wannan kuma yana ba da damar cikakken nazarin nama don halaye na tarihi, kamar zurfin, da kuma yada zuwa nodes na lymph waɗanda zasu buƙaci radiation ko chemotherapy. Don ƙananan raunuka (T1-2), samun dama ga kogon baka yana ta bakin. Lokacin da raunin ya fi girma, ya haɗa da kashi na maxilla ko mandible, ko samun damar shiga ya iyakance saboda buɗe baki, babba ko ƙananan lebe ya rabu, kuma kunci ya ja baya don ba da damar shiga bakin. Lokacin da ƙari ya ƙunshi kashin muƙamuƙi, ko lokacin tiyata ko radiation zai haifar da iyakacin buɗe baki, ana kuma cire ɓangaren kashi tare da ƙari.

Gudanar da wuyansa[gyara sashe | Gyara masomin]

Layin tabo na gama gari bayan rarraba kumburin kumburin mahaifa

Yaduwar ciwon daji daga kogon baka zuwa ga nodes na lymph na wuyansa yana da tasiri mai mahimmanci akan rayuwa . Tsakanin 60-70% na mutanen da ke fama da ciwon daji na baki ba za su sami kumburin ƙwayar lymph na wuyansa a asibiti ba, amma 20-30% na mutanen (ko har zuwa 20% na duk wadanda abin ya shafa) za su sami ciwon daji wanda ba za a iya gano shi ba. ƙwayoyin lymph na wuyansa (wanda ake kira cutar occult).

Gudanar da wuyansa yana da mahimmanci, tun lokacin da aka yada shi yana rage yiwuwar rayuwa ta hanyar 50%.[39] Idan akwai shaidar shigar kumburin lymph na wuyansa, a lokacin lokacin ganewar asali, to, ana yin gyaran gyare-gyaren wuyan wuyansa gabaɗaya. Inda ƙwayoyin lymph na wuyansa ba su da shaidar shiga asibiti, amma raunin kogin baki yana da haɗari ga yaduwa (misali. T2 ko sama da raunuka), sa'an nan kuma za a iya kammala rarraba wuyan wuyansa na ƙwayoyin lymph sama da matakin tsokar omohyoid . Lokacin da cutar idan aka samu a cikin nodes bayan cirewa (amma ba a gani a asibiti ba) yawan maimaitawa shine 10-24%. Idan an ƙara radiation bayan tiyata, ƙimar gazawar ita ce 0-15%. Lokacin da aka gano ƙwayoyin lymph a asibiti a lokacin lokacin ganewar asali, kuma an ƙara radiation bayan tiyata, kula da cututtuka shine> 80%.[40]

Radiotherapy da chemotherapy[gyara sashe | Gyara masomin]

Maganin radiation

Chemotherapy da radiotherapy yawanci ana amfani da su, azaman haɗin kai ga tiyata, don sarrafa ciwon daji na baka wanda ya fi mataki na 1, ko kuma ya yadu zuwa ko dai ƙwayoyin lymph na yanki ko wasu sassan jiki. Radiotherapy kadai za a iya amfani da shi a maimakon tiyata, don ƙananan raunuka, amma ana amfani dashi a matsayin haɗin gwiwa lokacin da raunuka suka yi girma, ba za a iya cire su gaba daya ba, ko kuma sun yada zuwa ƙwayoyin lymph na wuyansa. Chemotherapy yana da amfani a cikin ciwon daji na baka idan aka yi amfani da shi tare da wasu hanyoyin magani kamar radiation far amma ba a yi amfani da shi kadai a matsayin monotherapy. Lokacin da magani ba shi da wuya, ana iya amfani da shi don tsawaita rayuwa kuma ana iya la'akari da shi azaman magani amma ba kula da warkewa ba. [41]

Monoclonal antibody far (tare da jamiái irin su cetuximab ) an nuna cewa yana da tasiri a cikin maganin ciwon daji na squamous cell da wuyansa, kuma yana iya samun tasiri mai yawa a cikin kula da wannan yanayin a nan gaba idan aka yi amfani da shi tare da sauran maganin da aka kafa. modalities, ko da yake ba maye gurbin chemotherapy a kai da kuma wuyansa cancers. [42] Hakazalika, hanyoyin da aka yi niyya ta ƙwayoyin cuta da magungunan rigakafi na iya zama tasiri don maganin ciwon daji na baka da na oropharyngeal. Ƙara abubuwan haɓakar haɓakar epidermal receptor monoclonal antibody (EGFR mAb) zuwa daidaitaccen magani na iya haɓaka rayuwa, kiyaye ciwon daji iyakance ga wannan yanki na jiki kuma yana iya rage bayyanar cutar kansa.

Gyaran jiki[gyara sashe | Gyara masomin]

Bayan jiyya, gyara na iya zama dole don inganta motsi, taunawa, hadiye, da magana. Masana magana da harshe na iya shiga cikin wannan matakin. Maganin ciwon daji na baki yawanci zai kasance ta ƙungiyar ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararru, tare da ƙwararrun jiyya daga yanayin radiation, tiyata, chemotherapy, abinci mai gina jiki, likitan haƙori, har ma da ilimin halin ɗan adam duk mai yuwuwar haɗawa da ganewar asali, jiyya, gyarawa, da kulawa. Saboda wurin ciwon daji na baka, ana iya samun lokacin da mutum ya buƙaci tracheotomy da bututun ciyarwa .

Manazarta[gyara sashe | Gyara masomin]

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