Akawanda endocrine neoplasia (MEN) II

Akawanda endocrine neoplasia, mhando II (MEN II) chirwere chinopfuura nemumhuri umo imwe kana dzinopfuura dzematope endocrine dzakanyanyisa kushanda kana kuumba bundu. Endocrine glands anowanzo kuverengerwa anosanganisira:

• Adrenal gland (inenge hafu yenguva)
• Parathyroid gland (20% yenguva)
• Utachiona gland (dzinenge nguva dzese)

Multiple endocrine neoplasia (MEN I) mamiriro akafanana.

Iko kunokonzeresa kweVARUME II kuremara mune geni inonzi RET. Kuremara uku kunokonzeresa kuti mamota mazhinji aoneke mumunhu mumwe chete, asi kwete hazvo panguva imwe chete.

Kubatanidzwa kweadrenal gland kazhinji kazhinji ine bundu rinonzi pheochromocytoma.

Kubatanidzwa kweiyo yegland gland kazhinji kazhinji ine bundu rinonzi medullary carcinoma yeiyo thyroid.

Tumota muhutachiona, adrenal, kana parathyroid gland inogona kuitika makore akaparadzana.

Dambudziko racho rinogona kuitika chero zera, uye rinobata varume nevakadzi zvakaenzana. Iyo yakanyanya njodzi njodzi ndeye nhoroondo yemhuri yeVANHU II.

Kune maviri madiki madiki eMEN II. Ivo VANHU IIa uye IIb. VANHU IIb haina kujairika.

Zviratidzo zvinogona kusiyana. Nekudaro, iwo akafanana neaya e:

• Medullary carcinoma yehutachiona
• Pheochromocytoma
• Parathyroid adenoma
• Parathyroid hyperplasia

Kuti uongorore mamiriro aya, mupi wezvehutano anotarisa shanduko muRET geni. Izvi zvinogona kuitwa nekuongororwa kweropa. Kuwedzera bvunzo kunoitwa kuona kuti ndeapi mahormone ari kuwedzererwa.

Kuongorora kwepanyama kunogona kuratidza:

• Yakawedzera lymph node mumutsipa
• Kupindwa nechando
• Kuwedzera kweropa
• Kukurumidza kurova kwemoyo
• Makunduru ehutachiona

Kufungidzira bvunzo dzinoshandiswa kuzivisa mamota dzinogona kusanganisira:

• Abdominal CT scan
• Kufananidza kweitsvo kana ureters
• MIBG scintiscan
• MRI yemudumbu
• Utachiona hwehutachiona
• Ultrasound yehutachiona

Kuongororwa kweropa kunoshandiswa kuona kuti mamwe magland mumuviri ari kushanda zvakadii. Zvinogona kusanganisira:

• Chikamu cheCalcitonin
• Ropa alkaline phosphatase
• Ropa calcium
• Ropa parathyroid hormone nhanho
• Ropa phosphorus
• Weti catecholamines
• Weti metanephrine

Mimwe bvunzo kana maitiro anogona kuitwa anosanganisira:

• Adrenal biopsy
• Electrocardiogram (ECG)
• Utachiona bhiopsy

Kuvhiya kunodiwa kubvisa pheochromocytoma, iyo inogona kutyisidzira hupenyu nekuda kwemahormone ainoita.

Kune medullary carcinoma yehutachiona, iyo yegland gland uye yakakomberedza lymph node inofanira kubviswa zvachose. Thyroid hormone kutsiva kurapa kunopihwa mushure mekuvhiyiwa.

Kana mwana achizivikanwa kuti anotakura RET gene mutation, kuvhiyiwa kubvisa iyo thyroid isati yaita cancer inofungidzirwa. Izvi zvinofanirwa kukurukurwa nachiremba anoziva nezvechiitiko ichi. Izvo zvaizoitwa pazera diki (pamberi pemakore mashanu) muvanhu vane inozivikanwa MEN IIa, uye pamberi pemakore matanhatu mwedzi muvanhu vane MEN IIb.

Pheochromocytoma kazhinji haisi cancer (benign). Medullary carcinoma yehutachiona igenza ine hukasha uye inogona kuuraya, asi kuongororwa kwekutanga uye kuvhiyiwa zvinowanzo kutungamira kurapa. Kuvhiya hakurape pasi peVANHU II.

Kupararira kwemasero ane gomarara ingangoita kusangana.

Fonera waunopa kana iwe ukaona zviratidzo zveVANHU II kana kana mumwe munhu mumhuri yako akawana chirwere chakadai.

Kuongorora vepedyo vehukama hwevanhu vane MEN II kunogona kutungamira mukutanga kuona chirwere uye nekenza dzakabatana. Izvi zvinogona kubvumira matanho ekudzivirira matambudziko.

Sipple chirwere; VANHU II; Pheochromocytoma - VANHU II; Chirwere chekenza - pheochromocytoma; Kenza yeparathyroid - pheochromocytoma

• Endocrine masero

National Yakakwana Cancer Network webhusaiti. Clinical tsika nhungamiro mune oncology (NCCN nongedzo): neuroendocrine mamota. Shanduro 1.2019. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Yakagadziridzwa Kurume 5, 2019. Yakasvika muna Kurume 8, 2020.

Newey PJ, Thakker RV. Akawanda endocrine neoplasia. Mune: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Chinyorwa cheEndocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: chitsuwa 42.

Nieman LK, Spiegel AM. Polyglandular kusagadzikana. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 218.

Tacon LJ, Learoyd DL, Robinson BG. Multiple endocrine neoplasia mhando 2 uye medullary thyroid carcinoma. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chitsiko 149.