Cudurka 'Adrenocortical Carcinoma'

Kansarka adrenocortical, oo sidoo kale loo yaqaan ACC, waa nooc naadir ah oo dagaal badan oo kansar ah oo saameeya qanjidhada adrenal. Qanjidhadan waxay ku yaalliin korka sare ee kelyaha waxayna mas'uul ka yihiin soo saarista hormoonno nidaamiya shaqooyinka kala duwan ee jirka. Kansarka adrenocortical wuxuu dhacaa marka unugyo aan caadi ahayn ay ka soo baxaan lakabka sare ee qanjidhada adrenal, oo loo yaqaan kortex adrenal. Kansarka noocaan ah wuxuu noqon karaa mid adag in la ogaado maadaama astaamihiisa ay noqon karaan kuwo aan caddayn oo aan gaar ahayn.

Haddii aad ka shakisan tahay adiga ama qof kale inuu ku dhacay kansarka Adrenocortical, waa muhiim inaad raadsato daryeel caafimaad oo degdeg ah adigoo wacaya adeegyada degdegga ah ama la tashanaya Dhakhaatiirta Oncology ee ugu Fiican Hyderabad. 

Sababaha Kansarka Adrenocortical

• Arrimaha Hidde-sidaha :

  • Xanuunada la iska dhaxloQaar ka mid ah cilladaha hiddaha waxay la xiriiraan khatarta sare ee ACC. Kuwaas waxaa ka mid ah:
    • Li-Fraumeni SyndromeXaalad dhaxal ah oo kordhisa khatarta ah in ay ku dhacaan dhowr cudur noocyada kansarka, oo ay ku jirto ACC.
    • Beckwith-Wiedemann SyndromeCillad koritaaneed oo u horseedi karta khatarta sii kordheysa ee burooyinka kala duwan, oo ay ku jiraan ACC.
    • Familial Adenomatous Polyposis (FAP): Xaalad la iska dhaxlo oo u horseedaysa shakhsiyaadka inuu ku dhaco kansarka mindhicirka waxayna sidoo kale kordhin kartaa halista ACC.
    • Nooca 1aad ee Endocrine Neoplasia (MEN1)Xanuunka hidde-sideyaasha oo keeni kara burooyin ku dhaca qanjidhada endocrine, oo ay ku jiraan qanjidhada adrenal.

• Dheelitir la'aanta Hormoonka :

  • Soo saarista xad dhaafka ah ee hormoonnada adrenal, sida cortisol, aldosterone, iyo hormoonnada jinsiga, waxay mararka qaarkood u horseedi karaan ACC. Isku dheelitir la'aanta hoormoonka waxay ka dhalan kartaa shaqada aan caadiga ahayn ee qanjidhada adrenal, taas oo keeni karta horumarinta kansarka.

• Taariikhdii Hore ee Burooyinka Adrenal :

  • Dadka qaba burooyinka qanjidhada adrenal ee aan fiicneyn ama noocyada kale ee xanuunka adrenal ayaa laga yaabaa inay halis yar ugu jiraan inay yeeshaan ACC.

• Da'da iyo Jinsiga :

  • ACC waxay ku dhici kartaa da' kasta, laakiin waxay ku badan tahay dadka qaangaarka ah ee da'doodu u dhaxayso 40 iyo 50. Sido kale wax yar ayay ku badan tahay dumarka marka loo eego ragga.

• Arrimaha Deegaanka :

  • Iyadoo sababaha tooska ah ee deegaanka ee ACC aysan caddayn, soo-gaadhista qaar ka mid ah kansarka ama kiimikooyinka ayaa kordhin kara khatarta ah inay yeeshaan noocyo kala duwan oo kansar ah, oo ay ku jiraan kuwa qanjidhada adrenal.

• Taariikhda Qoyska :

  • Taariikhda qoyska ee ACC ama noocyo kale oo kansar ah ayaa sidoo kale kordhin kara halista, taasoo soo jeedinaysa u janjeersiga hidde-sidaha ee horumarinta cudurka.

Arrimaha Khatarta ah ee Kansarka Adrenocortical

• Isbeddellada hidde-sideyaasha (tusaale, Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome)
• Da'da (sida caadiga ah 40-60 sano)
• Jinsiga (wax yar ayaa ku badan dumarka)
• Isku dheelitir la'aanta hormoonnada (tusaale, Cushing's syndrome, hyperaldosteronism)
• Taariikhda qoyska ee kansarka
• cayilka
• Daawayntii hore ee kansarka (tusaale, shucaaca caloosha ama miskaha)

Calaamadaha Kansarka Adrenocortical

Xanuun caloosha ah ama cufnaan : Kuus ama raaxo darro caloosha ah oo ka dhalata burooyinka sii kordhaya.

Miisaan lumis aan la garanayn : Miisaan lumis oo muhiim ah oo aan la garanayn.

Koritaanka timaha oo xad dhaaf ah (hirsutism) : Koritaanka timaha oo kordha, gaar ahaan dumarka, taasoo ay ugu wacan tahay wax soo saarka xad dhaafka ah ee androgens.

Isbeddellada wareegga caadada : Caado aan joogto ahayn ama maqan oo ku dhaca haweenka, taasoo ka dhalata dheelitir la'aanta hoormoonka.

Dhiigkar sare (dhiigkar) : Waxaa sababa soo saarista xad dhaafka ah ee aldosterone ama cortisol.

Haraad xad dhaaf ah iyo kaadida : Sababtoo ah heerarka sare ee aldosterone.

Daal : Daal joogto ah ama daciifnimo, oo caadi u ah nooc kasta oo kansar ah.

Calaamadaha cudurka Cushing's syndrome :

• Waji wareegsan, casaan (wejiga dayaxa)
• Maqaar dhuuban oo si fudud u nabarro
• Calaamadaha fidsan ee maqaarka (striae)
• Murqaha daciifka

Firfircoonida dumarka : Codka oo sii xoogeysta, murqaha oo kordha, iyo bidaarta qaabka ragga oo ay ugu wacan tahay soo saarista xad-dhaafka ah ee androgen-ka.

Hyperglycemia : Heerarka sonkorta dhiigga oo sarreeya iyadoo ay ugu wacan tahay soo saarista xad-dhaafka ah ee cortisol.

Xanuun laabta ah ama neef qabasho : Haddii kansarku ku faafay sambabada ama xubnaha kale.

Cunista cuntada oo yaraata : Waxay horseeddaa miisaan lumis aan la filayn.

Ogaanshaha cudurka Kansarka Adrenocortical

• Taariikhda Caafimaadka iyo Baaritaanka Jirka :

  • Bixiyaha daryeelka caafimaadka ayaa qiimeyn doona calaamadaha, taariikhda qoyska, oo sameyn doona baaritaan jireed, oo ay ku jiraan hubinta calaamadaha dheelitir la'aanta hoormoonka.

• Baaritaannada Dhiigga :

  • Tijaabada Hormoonka: Si loo cabbiro heerarka hoormoonka adrenal (cortisol, aldosterone, androgens) si loo ogaado wax-soo-saarka hoormoonka.
  • Corticosteroid iyo heerarka ACTHHeerarka cortisol ee sarreeya iyo ACTH oo la xakameeyey ayaa laga yaabaa inay muujiyaan xanuunka Cushing ee la xidhiidha ACC.

• Daraasadaha Sawirka :

  • Sawirka 'CT Scan': Baadhitaanka CT-ga ee caloosha ee isbar-bar-dhigga ayaa caadi ahaan loo isticmaalaa si loo aqoonsado loona qiimeeyo cabbirka, qaabka, iyo fiditaanka burada qanjidhada adrenal.
  • MRI (Sawirka Resonance Imaging)Inta badan waxaa loo isticmaalaa in lagu sii qiimeeyo burada adrenal iyo xiriirka ay la leedahay dhismayaasha ku xeeran, gaar ahaan haddii natiijada baaritaanka CT aysan caddayn.
  • Sawirka 'PET Scan' (Positron Emission Tomography): Waxay kaa caawin kartaa in la qiimeeyo in kansarku uu ku faafay (metastasized) qaybaha kale ee jidhka.

• Ultrasound-ka :

  • Loo isticmaalo xaaladaha qaarkood si loo ogaado joogitaanka cufka adrenal, inkastoo ay ka faahfaahsan tahay CT ama MRI.

• Baayobsi :

  • Ka-qaadista Irbada: Muunad yar oo burada ah ayaa laga qaadayaa si loogu baaro mikroskoob si loo xaqiijiyo unugyada kansarka.
  • Biopsy caadi ahaan waa la iska ilaaliyaa haddii buradu weyn tahay ama ay jirto walaac ku saabsan fidinta unugyada kansarka, iyo natiijooyinka sawirku waa ku filan yihiin ogaanshaha.

• Baaritaanka Hidda-sidaha :

  • Si loo aqoonsado aasaaska hoose xanuunka hidde-sideyaasha (tusaale ahaan, cudurka Li-Fraumeni, cudurka Beckwith-Wiedemann syndrome) oo laga yaabo inuu u horseedo shakhsiyaadka inay qaadaan ACC.

• Baaritaanka Histopathology-ga :

  • Muunad ka-soo-baxa ama muunadda qalliinka ayaa lagu baadhaa mikroskoob si loo xaqiijiyo ACC, oo inta badan muujisa qaabab gaar ah oo unugyo ah oo la xidhiidha kansarka adrenocortical.

• Shaybaarka Xididdada Adrenal :

  • Xaaladaha qaarkood, baaritaankan waxaa loo isticmaalaa in lagu kala saaro cudurka asaasiga ah ee adrenal iyo xaaladaha kale haddii uu jiro shaki ku saabsan cudurka metastatic ee kansarrada kale.

Daawaynta Kansarka Adrenocortical

• Qalliinka :

  • Adrenalectomy: Daawaynta aasaasiga ah ee ACC gudaha ah waa ka saarista qaliinka qanjidhada adrenal ee saameeya (ama labadaba, haddii loo baahdo). Xaaladaha qaarkood, qanjidhada noo dhow ama unugyada ayaa sidoo kale laga yaabaa in laga saaro.
  • Laparoscopic Adrenalectomy: Qalliinka ugu yar waxaa loo isticmaali karaa xaaladaha qaarkood marka burooyinka ay yar yihiin ama ay xaddidan yihiin.

• Daaweynta Shucaaca :

  • Waxaa loo isticmaalaa in lagu yareeyo burada qaliinka ka hor ama lagu daaweeyo meelaha uu kansarku ku faafay (metastases). Waxa loo isticmaali karaa sidii daryeelka palliative ee bukaanka qaba burooyinka aan shaqaynayn ama ACC soo noqnoqda.

• Daaweynta Kiimikada :

  • MitotaneDaawada si gaar ah u bartilmaameedsata unugyada kansarka qanjidhada adrenal oo inta badan lagu daro wakiilada kale ee kemotherabi si loogu daweeyo ACC. Waa daawaynta ugu weyn ee kiimoterabiga.
  • Dawooyinka kale ee ChemotherapyDaawooyinka sida etoposide, doxorubicin, ama cisplatin waa la isticmaali karaa, gaar ahaan haddii kansarku ku faafo qaybaha kale ee jidhka.

• Daaweynta Hormoonka :

  • Daaweynta Bedelka IsteeroodhkaBukaanka lagu sameeyo qaliinka si looga saaro qanjidhada adrenal waxa laga yaabaa inay u baahdaan dawooyin steroids si ay u bedelaan hormoonada sida caadiga ah ay soo saaraan qanjidhada adrenal, sida cortisol.
  • Kahortagayaasha Soosaarka HormoonkaHaddii ACC ay soo saarto hormoono xad-dhaaf ah (sida cortisol ama aldosterone), daawooyinka sida mifepristone (si loo xakameeyo cortisol) ama spironolactone (si loo xakameeyo aldosterone) ayaa laga yaabaa in loo isticmaalo si loo xakameeyo calaamadaha.

• Daaweynta Bartilmaameedka ah :

  • Kahortagga IsbaaradaDaawaynta Immunotherapy oo ujeedadeedu tahay in kor loo qaado difaaca jidhka ee unugyada kansarka.
  • TKI (Tyrosine Kinase Inhibitors)Daawooyinka sida sunitinib waxaa laga yaabaa in lagu tixgaliyo tijaabooyinka kiliinikada ee ACC sare si loo beegsado korriinka kansarka ee heerka molecular.

• Daryeelka Nabar-jabka :

  • Bukaannada qaba ACC sare ama metastasis, daawaynta palliative ayaa la siin karaa si loo maareeyo calaamadaha, loo hagaajiyo tayada nolosha, loona yareeyo xanuunka.
  • Tan waxa ku jiri kara maaraynta xanuunka, daawaynta shucaaca ee metastasis-ka, iyo taageerada shucuureed.

• Beerka lagu tallaalo :

  • Xaalado naadir ah oo ay buradu ku faafto beerka balse ay ku sii jirto xubintaasi, beerka bedelka ayaa laga yaabaa in loo tixgeliyo qayb ka mid ah xeeladaha daawaynta.

Tallaabooyinka Ka Hortagga ah ee Kansarka Adrenocortical

• La-talinta iyo Baaritaanka Hidde-sidaha :

  • Shakhsiyaadka leh taariikhda qoyska ee cilladaha hidde-sideyaasha (tusaale, Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, ama Familial Adenomatous Polyposis), la-talinta hidde-raaca iyo baaritaanka waxay gacan ka geysan kartaa in la aqoonsado khataraha la iska dhaxlo ee ACC oo haga daryeelka ka hortagga.

• Baaritaanka Joogtada ah ee Dadka Halista ku Jira :

  • Dadka qaba xaaladaha hiddaha la iska dhaxlo ee kordhiya khatarta ACC waxa laga yaabaa inay ka faa'iidaystaan ​​baadhista hore, oo ay ku jiraan baadhitaannada sawirka (CT scans or MRIs) iyo hubinta heerka hormoonnada, si loo ogaado burooyinka wakhti hore, oo la daweyn karo.

• Xeerarka Hoormoonka :

  • Korjoogteynta iyo maaraynta dheelitir la'aanta hoormoonka, sida kuwa la xiriira xaaladaha sida Cushing's syndrome ama hyperaldosteronism, ayaa laga yaabaa inay ka hortagto horumarinta burooyinka qanjidhada adrenal, inkastoo tani aysan ahayn dammaanad.

• Hab-nololeed Caafimaad leh :

  • Cunto dheeli tiran: A cunto caafimaad leh oo qani ah Miraha, khudaarta, iyo miraha oo dhan waxay gacan ka geysan karaan taageeridda caafimaadka guud iyo yareynta halista kansarrada qaarkood.
  • Dhaqdhaqaaqa Jirka ee Joogtada ah: Jir ahaan firfircoonidu waxay caawisaa joogteynta miisaanka caafimaadka leh, yaraynta bararka, iyo taageeridda habka difaaca jidhka, taasoo suurtogal ah inay hoos u dhigto khatarta kansarka.
  • Ka Fogaanshaha Soo-gaadhista Kansarka: Xakamaynta soo-gaadhista sunta deegaanka, kiimikooyinka, iyo kansarka laga yaabo inay waxyeeleeyaan qanjidhada adrenal ama kordhinta halista kansarka.

• Oggaanshaha Hore iyo Baaritaannada Caafimaadka ee Joogtada ah :

  • Baadhitaannada caafimaad ee joogtada ah, gaar ahaan kuwa leh taariikhda qoyska ee kansarka endocrine ama saadaalinta hidde-sideyaasha, waxay gacan ka geysan karaan qabashada calaamadaha hore ee arrimaha adrenal ama burooyinka.
  • La socodka calaamadaha aan caadiga ahayn sida miisaan lumis aan la macnayn, dheelitir la'aanta hoormoonka, ama xanuunka caloosha ayaa soo dajin kara qiimeyn hore iyo ogaanshaha.

• Ka fogaanshaha Isticmaalka Isteeroydhiska Xad-dhaafka ah :

  • Isticmaalka muddada dheer ee corticosteroids ama daawooyinka kale ee saameeya shaqada qanjidhada adrenal waa in si taxadar leh loola socdo, sababtoo ah daawooyinkani waxay yeelan karaan saameyno saameynaya caafimaadka adrenal. Had iyo jeer raac talada caafimaadka markaad isticmaalayso steroids.

Samee & Ha samayn

Marka ay timaado in wax laga qabto kansarka adrenocortical, waxaa jira qaar la sameeyo iyo ma samayn kuwaas oo ka caawin kara bukaanka iyo kuwa ay jecel yihiin inay maraan safarkan adag. Marka la raaco tilmaamahan, shakhsiyaadka waxay si wanaagsan u maareyn karaan xaaladooda waxayna wanaajin karaan fayoobidooda guud. 

Haddii aad ka shakisan tahay adiga ama qof kale inuu ku dhacay kansarka Adrenocortical, waa muhiim inaad raadsato daryeel caafimaad oo degdeg ah adigoo wacaya adeegyada degdegga ah ama la tashanaya Isbitaalka ugu Fiican ee Oncology/Kansarka ee Hyderabad, Hindiya.