Pancreatic islet cell tumor

Sefuba sa sehlekehleke sa pancreatic ke hlahala e sa tloaelehang ea manyeme e qalang ho tsoa mofuteng oa sele o bitsoang islet cell.

Ka manyeme a phetseng hantle, lisele tse bitsoang li-islet lisele li hlahisa lihormone tse laolang ts'ebetso ea 'mele. Tsena li kenyelletsa boemo ba tsoekere maling le tlhahiso ea asiti ea ka mpeng.

Lihlahala tse hlahang liseleng tse nyenyane tsa manyeme le tsona li ka hlahisa lihormone tse fapaneng, tse ka lebisang matšoao a itseng.

Li-tumor tsa sehlekehlekeng saancancic ha li na mofets'e (benign) kapa mofetše (tse kotsi).

Lihlahala tsa Islet cell li kenyelletsa:

• Gastrinoma (lefu la Zollinger-Ellison)
• Glucagonoma
• Insulinoma
• Somatostatinoma
  
• VIPoma (lefu la Verner-Morrison)

Nalane ea lelapa ea li-neoplasia tse ngata tsa endocrine, mofuta oa I (MEN I) ke sesosa sa kotsi bakeng sa nts'etsopele ea lihlahala tsa islet cell.

Matšoao a ipapisitse le hore na ke hormone efe e entsoeng ke hlahala.

Ka mohlala, insulinoma e hlahisa insulin, e theolelang tsoekere maling. Matšoao a ka kenyelletsa:

• Ho ikutloa u khathetse kapa u fokola
• Ho tsitsinyeha kapa ho fufuleloa
• Ho opeloa ke hlooho
• Tlala
• Ho tšoha, ho tšoenyeha kapa ho ikutloa u teneha kapele
• Ho nahana ho sa hlaka kapa ho ikutloa o sa phutholoha
• Pono e habeli kapa e lerootho
• Ho otla ha pelo kapele kapa ka potlako

Haeba tsoekere e maling a hao e theoha haholo, u ka 'na ua akheha, ua akheha kapa ua ba le mailiili.

Gastrinomas e etsa hormone gastrin, e bolellang 'mele ho etsa asiti ea ka mpeng. Matšoao a ka kenyelletsa:

• Bohloko ba mpeng
• Letšollo
• Liso tsa ka mpeng le mala a manyane
• Ho hlatsa mali (ka linako tse ling)

Li-glucagonomas li etsa hormone glucagon, e thusang 'mele ho phahamisa tsoekere maling. Matšoao a ka kenyelletsa:

• Lefu la tsoekere
• Bofubelu bo bofubelu bo bofubelu ka har'a mokokotlo kapa likoti
• Ho fokotsa boima ba 'mele
• Ho rota khafetsa le lenyora

Somatostatinomas e etsa hormone somatostatin. Matšoao a ka kenyelletsa:

• Tsoekere e phahameng maling
• Majoe a majoe
• Ponahalo e mosehla letlalong, le mahlo
• Ho fokotsa boima ba 'mele
• Letšollo le nang le litulo tse nkhang hampe

VIPomas e etsa li-hormone vasoactive intestinal peptide (VIP) e amehang ho boloka litekanyo tsa letsoai, sodium, potasiamo le liminerale tse ling tse pampitšaneng ea GI. VIPomas e ka baka:

• Letšollo le matla le ka lebisang ho felloa ke metsi 'meleng
• Potasiamo e tlase ea mali, le maemo a phahameng a calcium
• Mahlaba a ka mpeng
• Ho fokotsa boima ba 'mele

Mofani oa hao oa tlhokomelo ea bophelo o tla nka nalane ea hau ea bongaka mme a etse tlhahlobo ea 'mele.

Liteko tsa mali li ka fapana, ho latela matšoao, empa li ka kenyelletsa:

• Ho itima lijo tsoekere boemo
• Boemo ba Gastrin
• Teko ea mamello ea tsoekere
• Teko ea ts'usumetso ea sephiri bakeng sa manyeme
• Boemo ba glucagon ea mali
• Insulin ea mali C-peptide
• Tekanyo ea insulin ea mali
• Ho itima lijo serum somatostatin level
• Boemo ba serum vasoactive intestinal peptide (VIP)

Ho etsa liteko ho ka etsoa:

• Tlhaloso ea mpa ea mpa
• Mpa ea ka mpeng
• Endoscopic ultrasound
• MRI ea mpa

Sampole ea mali le eona e ka nkuoa mothapong oa manyeme bakeng sa tlhahlobo.

Ka linako tse ling, ho hlokahala ho buuoa ho fumana le ho phekola boemo bona. Nakong ea ts'ebetso ena, ngaka e buoang e hlahloba manyeme ka letsoho le ka ultrasound.

Kalafo e ipapisitse le mofuta oa hlahala le haeba e le mofetše.

Lihlahala tse nang le mofetše li ka hola kapele mme tsa namela lithong tse ling. Li kanna tsa se phekolehe. Hangata lihlahala li tlosoa ka opereishene, ha ho khonahala.

Haeba lisele tsa mofetše li namela sebeteng, karolo e 'ngoe ea sebete le eona e ka tlosoa, haeba ho khonahala. Haeba mofetše o atile, chemotherapy e ka sebelisoa ho leka ho fokotsa lihlahala.

Haeba tlhahiso e sa tloaelehang ea lihormone e baka matšoao, o ka fumana meriana ho loants'a litlamorao tsa ona. Mohlala, ka gastrinomas, tlhahiso e fetelletseng ea gastrin e lebisa ho asiti e ngata haholo ka mpeng. Meriana e thibelang ho tsoa ha asiti ka mpeng e ka fokotsa matšoao.

U ka fokotsa khatello ea maikutlo ea bokuli ka ho kenela sehlopha sa ts'ehetso ea mofets'e. Ho arolelana le ba bang ba nang le liphihlelo tse tšoanang le mathata ho ka u thusa hore u se ke ua ikutloa u le mong.

U ka fola haeba lihlahala li etsoa opereishene pele li hasana ho litho tse ling. Haeba lihlahala li na le mofetše, chemotherapy e ka sebelisoa, empa hangata e ke ke ea phekola batho.

Mathata a sokelang bophelo (joalo ka tsoekere e tlase haholo maling) a ka hlaha ka lebaka la tlhahiso e fetelletseng ea lihormone, kapa haeba mofetše o ata hohle 'meleng.

Mathata a lihlahala tsena a kenyelletsa:

• Lefu la tsoekere
• Mathata a hormone (haeba hlahala e ntša mefuta e itseng ea lihormone)
• Tsoekere e tlase ea mali (ho tloha insulinomas)
• Liso tse matla ka mpeng le mala a manyane (ho tsoa ho gastrinomas)
• Ho hasana ha hlahala ho ea sebeteng

Bitsa mofani oa hau haeba u ba le matšoao a lihlahala tsena, haholoholo haeba u na le nalane ea lelapa ea MEN I.

Ha ho na thibelo e tsebahalang bakeng sa lihlahala tsena.

Kankere - manyeme; Kankere - pancreatic; Kankere ea pancreatic; Lihlahala tsa Islet; Islet ea hlahala ea Langerhans; Lihlahala tsa neuroendocrine; Seso sa lefu la pepere - sehlahala sa lisele tsa sehlekehleke; Hypoglycemia - sehlahala sa sele; Lefu la Zollinger-Ellison; Lefu la Verner-Morrison; Gastrinoma; Insulinoma; VIPoma; Somatostatinoma; Glucagonoma

• Litšoelesa tsa endocrine
• Mekhanya

Foster DS, Norton JA. Tsamaiso ea lihlahala tsa lisele tsa pancreatic islet ntle le gastrinoma. Ka: Cameron AM, Cameron JL, bahlophisi. Phekolo ea Hajoale ea Ts'ebetso. 13th ed. Philadelphia, PA: Elsevier; 2020: 581-584.

Webosaete ea National Cancer Institute. Kalafo ea mofets'e ea Pancreatic (PDQ) - mofuta oa litsebi tsa bophelo bo botle. www.cancer.gov/types/pancreatic/hp/pnet-tlhare-pdq. E ntlafalitsoe ka la 2 Pherekhong 2020. E fihlile ka la 25 Hlakola 2020.

Webosaete ea National Comprehensive Cancer Network. Litaelo tsa NCCN tsa litloaelo tsa bongaka ho oncology (litataiso tsa NCCN). Neuroendocrine le lihlahala tsa adrenal. Mofuta oa 1.2019. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. E ntlafalitsoe ka la 5 Hlakubele 2019. E fihlile ka la 25 Hlakola 2020.

Webosaete ea National Comprehensive Cancer Network. Litataiso tsa NCCN bakeng sa bakuli. Lihlahala tsa Neuroendocrine. 2018. www.nccn.org/patients/guidelines/content/PDF/neuroendocrine-patient.pdf.