Mofuta ona oa kankere ea mala o thata ho o khetholla, kahoo e-ba hlokolosi nakong ea endoscopy!

Har'a tsebo e tsebahalang ka mofetše oa pele oa mala, ho na le lintlha tse ling tse sa tloaelehang tsa tsebo ea mafu tse hlokang tlhokomelo e khethehileng le thuto. E 'ngoe ea tsona ke mofetše oa HP-negative gastric. Khopolo ea "lihlahala tse sa tšoaetsanoang tsa epithelial" e se e tumme haholo. Ho tla ba le maikutlo a fapaneng mabapi le taba ea lebitso. Khopolo ena ea litaba e thehiloe haholo-holo ho litaba tse amanang le makasine "Mpa le Mala", 'me lebitso le boetse le sebelisa "HP-negative gastric cancer".

Mofuta ona oa liso o na le litšobotsi tse fokolang, bothata ba ho khetholla, tsebo e rarahaneng ea theory, le mokhoa o bonolo oa MESDA-G ha o sebetse. Ho ithuta tsebo ena ho hloka ho tobana le mathata.

1. Tsebo ea motheo ea mofetše oa HP-negative gastric

Histori

Nakong e fetileng, ho ne ho lumeloa hore molato o le mong ketsahalong le nts'etsopele ea kankere ea ka mpeng e ne e le tšoaetso ea HP, kahoo mohlala oa khale oa kankere ke HP - atrophy - metaplasia ea mala - hlahala e tlaase - hlahala e phahameng - kankere. Mohlala oa khale o 'nile oa tsejoa ka ho pharaletseng, o amoheloa le ho lumeloa ka tieo. Lihlahala li hlaha hammoho motheong oa atrophy le tlas'a ketso ea HP, kahoo kankere hangata e hōla ka har'a lipampitšana tsa mala a atrophic le tse sa tloaelehang tse sa tloaelehang tse se nang atrophic gastric mucosa.

Hamorao, lingaka tse ling li ile tsa fumana hore mofetše oa mala o ka hlaha leha ho se na tšoaetso ea HP. Le hoja sekhahla sa ts'oaetso se le tlase haholo, se ka khoneha. Mofuta ona oa mofetše oa ka mpeng o bitsoa mofetše oa HP-negative.

Ka kutloisiso ea butle-butle ea mofuta ona oa lefu lena, litebello tse tebileng tse hlophisitsoeng le kakaretso li qalile, 'me mabitso a lula a fetoha. Ho bile le sengoloa ka 2012 se bitsoang "Gastric Cancer After Sterilization", sengoloa ka 2014 se bitsoang "HP-negative Gastric Cancer", le sengoloa ka 2020 se bitsoang "Epithelial Tumors Not Infected with Hp". Phetoho ea lebitso e bonts'a kutloisiso e tebileng le e felletseng.

Mefuta ea Litšoelesa le Mekhoa ea Khōlo

Ho na le mefuta e 'meli e meholo ea litšoelesa tsa fundic le litšoelesa tsa pyloric ka mpeng:

Litšoelesa tsa Fundic (litšoelesa tsa oxyntic) li ajoa ka har'a fundus, 'mele, likhutlong, joalo-joalo tsa mpa. Ke litšoelesa tse nang le mela e le 'ngoe ea tubular. Li entsoe ka lisele tsa mucous, lisele tse ka sehloohong, lisele tsa parietal le lisele tsa endocrine, e 'ngoe le e' ngoe e etsa mesebetsi ea eona. Har'a bona, lisele tse ka sehloohong The pente PGI le MUC6 staining e ne e le ntle, 'me lisele parietal secreted hydrochloric acid le intrinsic factor;

Litšoelesa tsa pyloric li sebakeng sa gastric antrum 'me li entsoe ka lisele tsa mucus le lisele tsa endocrine. Lisele tsa mucus li na le li-MUC6 tse ntle, 'me lisele tsa endocrine li kenyelletsa lisele tsa G, D le lisele tsa enterochromaffin. Lisele tsa G li hlahisa gastrin, lisele tsa D li hlahisa somatostatin, 'me lisele tsa enterochromaffin li hlahisa 5-HT.

Lisele tse tloaelehileng tsa mucosal le lisele tsa hlahala li hlahisa mefuta e sa tšoaneng ea liprotheine tsa mucus, tse arotsoeng ka "gastric", "intestinal" le "motsoako" oa liprotheine tsa mucus. Polelo ea li-mucins tsa gastric le intestinal li bitsoa phenotype eseng sebaka se itseng sa sebōpeho sa mpa le mala.

Ho na le li-phenotypes tse 'nè tsa lisele tsa gastric: gastric ka ho feletseng, e kopantsoeng ka mpeng, e kopantsoeng le mala a mangata, le mala ka ho feletseng. Lihlahala tse hlahang motheong oa metaplasia ea mala hangata ke lihlahala tse tsoakiloeng tsa phenotype tsa mala. Lik'hemik'hale tse fapaneng li bonts'a haholo mofuta oa mala (MUC2+), 'me mefuta ea mofetše haholo-holo e bontša mofuta oa gastric (MUC5AC+, MUC6+).

Ho fumana hore Hp ha e mpe ho hloka motsoako o khethehileng oa mekhoa e mengata ea ho lemoha bakeng sa boikemisetso bo felletseng. Kankere ea mala ea HP-negative le mofets'e oa ka mor'a ho tsoakoa ke maikutlo a mabeli a fapaneng. Bakeng sa tlhahisoleseling mabapi le lipontšo tsa X-ray tsa mofetše oa HP-negative gastric, ka kopo sheba karolo e amehang ea makasine ea "Mpa le Mala".

2. Lipontšo tsa Endoscopic tsa HP-negative kankere ea mala

Tlhahlobo ea Endoscopic ke sepheo sa mofetše oa mala oa HP-negative. Haholo-holo e akarelletsa fundic tšoelesa mofuta gastric kankere, fundic tšoelesa mucosal mofuta gastric kankere, gastric adenoma, raspberry foveolar epithelial hlahala, signet ring cell carcinoma, joalo-joalo.

1) Mofuta oa lefu la tsoekere la mofuta oa lefu la tsoekere

-Mala a masoeu a phahamisitsoeng